65: After Chapter 65, the intubation in the Red Zone is also yours.

Wu Fan was momentarily choked up by those words.

He wanted to refute them, but he couldn't find a reason to.

Because he had seen it with his own eyes.

The fluidity of the operation, the stability of the hands, and the precise control of the angles.

That wasn't something that could be learned just from reading books.

But if it wasn't learned from books, how was it learned?

Wu Fan couldn't figure it out.

"Fine, talent then."

Wu Fan shook his head and walked away.

After a few steps, he turned back and added one more thing.

"From now on, the Tracheal Intubations in the Red Zone are yours too."

Lu Chen didn't respond.

But in his heart, he was actually quite happy.

Every intubation procedure meant experience points.

The progress bar for Tracheal Intubation was currently at 0/100.

For a Master Level skill, every progress point required a large amount of practical operation to push forward.

The Red Zone was the place in the entire hospital with the highest frequency of intubations.

This was equivalent to opening an experience point highway for him.

...

The transport team arrived.

The ICU doctors and Nurses came over with a Transport Ventilator to take over.

The ICU doctor was a young attending in his early thirties; he glanced at the position of the Tracheal Tube and the ventilator parameters, then nodded.

"Who intubated?"

"I did," Lu Chen said.

The ICU doctor sized him up.

"The position is very straight, the depth is just right. How many times have you done this?"

"The first time."

The corner of the ICU doctor's mouth twitched.

"Is everyone in your Emergency Department this humorous when they speak?"

"It's not humor, it's the truth."

Meng Yan, who was nearby, added a comment.

"He's telling the truth, it really is his first time."

The ICU doctor looked at Meng Yan, then back at Lu Chen.

"Fine, first time, Grade III Exposure, successful on the first try. I'll just assume you guys in the Emergency Department are joking with me."

He shook his head and wheeled the patient away.

The Resuscitation Room grew quiet.

Lu Chen returned to his workstation and opened the system panel.

[Ding!]

[System detected host completed a Tracheal Intubation procedure (Difficult Airway, Grade III Exposure, successful on first try)]

[Operation Rating: S-Rank]

[Triggered Special Bonus: Achieved perfect operation on first use of a new skill, Debut Experience Reward ×3]

[Triggered Special Bonus: Difficult Airway Extra Experience Reward ×2]

[Skill Experience calculating...]

[Tracheal Intubation (Master Level): Progress 0/100 → 12/100]

It jumped by 12 points all at once.

With the debut bonus plus the Difficult Airway bonus, this increase was very substantial.

At this rate, as long as he maintained a high frequency of intubation procedures in the Red Zone, the progress of this skill would advance very quickly.

[Internal Medicine Diagnostics (Proficient Level): Progress 93/100 → 95/100]

It rose by 2 points.

The diagnosis and management of Status Asthmaticus also fell within the scope of Internal Medicine Diagnostics.

Combined with several other internal medicine cases handled during the day, it pushed a total of 2 points.

He was only 5 points away from Mastery Level.

[Current gratitude points total: 35 → 62 points]

gratitude points increased by 27.

This patient's condition was quite critical, so the gratitude point contribution after successful treatment was fairly good.

Lu Chen looked at the numbers on the panel and calculated in his mind.

The timing of acquiring the Tracheal Intubation skill was too perfect.

Without this skill, he wouldn't have been able to handle today's patient independently.

With a Grade III Exposure Difficult Airway, in his previous state without the system's empowerment, he wouldn't have been able to intubate at all.

What would have happened if he couldn't get it in?

Either wait for someone from the Department of Anesthesiology to come, but calling them would take at least three to five minutes.

Or perform a Cricothyroidotomy, but that was an invasive procedure with even greater risks.

In that emergency moment when blood oxygen dropped to 72%, a three to five-minute wait could mean a human life.

The system gave him this skill.

He used this skill to save a life.

That was enough.

...

Lu Chen closed the system panel.

Just then, Zhao Yaqin walked back in from outside.

"The ICU has received them, the patient's condition is stable."

"Mm."

"Lu Chen."

"Sister Zhao."

"That intubation you did today."

Zhao Yaqin sat down opposite him, her expression very serious.

"To be honest, I was uncertain at the time. With a Grade III Exposure Difficult Airway, I couldn't even guarantee success on the first try if I did it myself."

"But you let me do it."

"Because the look in your eyes didn't seem like you were bragging."

Lu Chen smiled.

"Sister Zhao, your basis for judgment is a bit metaphysical."

"Sometimes metaphysics is more useful than science. I watched your thirty-second operation from start to finish; there wasn't a single redundant movement."

Zhao Yaqin looked at him.

"That technique you used to rotate the tube as you inserted it, who taught you that?"

"I figured it out myself."

"You figured it out yourself?"

"Mm."

Zhao Yaqin was silent for a few seconds.

"Fine, whatever you say, I'll believe it. I'll believe it, okay?"

"Sister Zhao is wise."

"Stop sucking up. You still have a shift in the Red Zone today, don't slack off."

"Understood."

Zhao Yaqin stood up and left.

After a couple of steps, she turned back and said one more thing.

"By the way, next time you encounter a Difficult Airway, just tell me you can do it. You don't need to explain which time it is for you."

"Why?"

"Because as soon as you say it's your first time, the blood pressure of the people around you becomes higher than the patient's."

Lu Chen was stunned for a moment, then he laughed.

Zhao Yaqin waved her hand and walked away.

...

A little after four in the afternoon.

Another patient arrived in the Red Zone.

A sixty-two-year-old woman had accidentally swallowed a peanut, which got stuck in her trachea.

Tracheal Foreign Body.

When Lu Chen arrived on the scene, the old lady was coughing violently, her face flushed red from holding her breath.

The family members nearby were pacing around in a panic.

"She choked while eating a peanut, and then she kept coughing, but she can't get it out!"

Lu Chen quickly scanned with the Eye of Truth.

[Eye of Truth scan complete]

[Patient Information: Female, 62 years old]

[Chief Complaint: Persistent choking cough for 30 minutes after accidental inhalation of foreign body]

[Eye of Truth Diagnosis: Foreign body in the right main bronchus (peanut fragment), partially obstructing the airway]

[Risk Level: Medium-High]

[Current Symptoms: Persistent irritative cough, decreased breath sounds in the right lung, blood oxygen saturation 91%]

[Recommendation: Emergency bronchoscopic removal of the foreign body. If conditions do not permit, Tracheal intubation for assisted ventilation can be performed before transferring to a higher-level department for treatment]

[Warning: The foreign body may shift to the subglottic region, causing complete airway obstruction]

Lu Chen assessed the situation.

Currently, it was a partial obstruction, not a complete one.

The patient could still cough and breathe, though the breath sounds were weakened.

"Start oxygen, open an intravenous line, prepare emergency intubation equipment in case the foreign body shifts, and simultaneously contact the Department of Respiratory Medicine for an emergency bronchoscopy."

The treatment plan was clear and decisive.

Meng Yan followed the orders.

The Department of Respiratory Medicine answered the call and said they could arrange a bronchoscopy within ten minutes.

But while waiting, the old lady suddenly had a fit of violent coughing, her whole body arching up.

Then, the sound of coughing suddenly stopped.

It wasn't because it was coughed out.

The foreign body had shifted.

The blood oxygen saturation on the monitor began to drop rapidly.

96%.

92%.

88%.

"The foreign body has shifted!" Lu Chen stood up.

He activated the Eye of Truth again to confirm.

Sure enough, the peanut fragment had moved from the right main bronchus to the subglottic area, causing near-complete airway obstruction.

The old lady's face quickly turned purple; her hands gripped the bedsheets, and her mouth was open, but she couldn't make a sound.

A typical manifestation of complete airway obstruction.

Unable to vocalize, unable to cough, unable to breathe.

"Will the Heimlich Maneuver work?" Meng Yan asked.

"No, she's already lying down, and given her age, the Heimlich Maneuver's impact could cause rib fractures."

Lu Chen's brain was working at high speed.

The bronchoscopy would still take ten minutes.

Ten minutes was too long.

For a patient with complete airway obstruction, cardiac arrest would occur within three to five minutes due to hypoxia.

An effective airway must be established immediately.

But there was a foreign body in the trachea.

Would direct intubation work?

Lu Chen simulated it in his mind.

The Master Level Tracheal Intubation skill gave him the answer.

It would.

Intubation itself would not push the foreign body deeper because the diameter of the tube's tip was smaller than the width of the glottis; after the tube entered the trachea, there would still be a gap between the foreign body and the tube.

Furthermore, oxygen could be supplied through the tube after intubation, and a suction catheter could be used from inside the tube to try and touch or adjust the position of the foreign body.

Most importantly, with the Tracheal Tube as a channel, the subsequent bronchoscopy could enter the trachea directly through the tube to remove the foreign body.

This was the optimal plan.

"Prepare for intubation!"

"Intubating again?" Sun Ji blurted out from the side.

Lu Chen ignored him.

"Sister Meng, Laryngoscope, size 7 tube, stylet, quick!"

Meng Yan's efficiency was extremely high.

It had been less than twenty minutes since the last set of intubation equipment was put away, and now it was needed again.

She laid out the equipment with the utmost speed.

Lu Chen walked to the head of the bed.

This time was easier than the last.

The old lady's airway conditions were not that complex.

Mallampati Grade II, with relatively sufficient glottis exposure.

But Lu Chen still didn't dare to be careless.

Because the difficulty this time did not lie in the glottis exposure.

It lay in the fact that there was a foreign body in the trachea.

He had to avoid the tip of the tube pushing the foreign body into a deeper position while intubating.

Laryngoscope in.

Exposing the glottis.

Grade II exposure, most of the vocal cords could be seen.

Below the glottis, that peanut fragment could be vaguely seen stuck in the subglottic area.

Lu Chen's eyes rested on that fragment for less than a second.

Then he adjusted the angle of the tube, avoiding the position where the foreign body was stuck.

The tip of the tube slid into the trachea from the side of the foreign body.

It didn't touch the foreign body.

He bypassed it perfectly.

Tube in place.

Inflate the cuff, confirm by auscultation.

Breath sounds in both lungs restored.

Connect to the ventilator.

Blood oxygen began to rise.

The entire process, from picking up the Laryngoscope to completing the tube fixation, took twenty-two seconds.

Eight seconds faster than the last time.

"Notify the Department of Respiratory Medicine. Tell them the patient is intubated, the tube is in place, and have them bring the Bronchoscope directly here to remove the foreign body through the tube."

Lu Chen's instructions were clear and decisive.