87: Chapter 87 In a disaster of this magnitude—a mine accident—zero deaths are virtually impossible.
6:15 AM.
Lu Chen was woken up by his phone alarm.
The lights in the Duty Room were somewhat dim. He lay on the bed for a few seconds to compose himself, then sat up.
His physical state was good.
With the workload of three consecutive surgeries yesterday plus over twenty trauma cases, if it were an ordinary Resident Physician, they would likely wake up today with sore arms.
But he felt almost no fatigue.
The system's implicit enhancement of his physical stamina was very apparent.
After washing up and changing into a clean white coat, he walked out of the Duty Room.
There were already people busy in the Red Zone.
The night shift Nurse was doing the final round of inspections before the shift handover, and Meng Yan was standing in front of the Nurse Station organizing the handover notes.
"Dr. Lu, morning."
"Morning, Sister Meng."
"The Red Zone admitted two new patients last night. One was a car accident trauma case, handled by Wu Fan, and the other was acute pancreatitis, which was transferred to the Department of Gastroenterology."
"What about those severely injured patients from yesterday's mining accident?"
"They are still under monitoring, and their vital signs are currently stable."
Lu Chen nodded.
He walked to the monitoring area and checked the condition of each of the severely injured miners from yesterday one by one.
For the patient who had the fasciotomy, the drainage in his left thigh was clear, the swelling had subsided compared to yesterday, and although the kidney function indicators were on the high side, they were still within a controllable range.
As for the other two miners kept for observation in the Red Zone, one had multiple rib fractures complicated by pulmonary contusion, and the other was post-op for a pelvic fracture.
Their conditions were relatively stable.
At 7:00 sharp, the handover meeting began.
Zhao Yaqin was the day shift supervisor today; she stood in front of the whiteboard and quickly went over the situation from the night.
"Regarding the severely injured patients brought in from yesterday's mining accident, there are currently three still under monitoring in the Red Zone, three were transferred to the ICU, and the rest have been diverted to their respective specialist wards."
"Today's priority is to continue monitoring the patient who had the fasciotomy. His myoglobin and creatinine levels need to be rechecked every two hours to prevent acute renal failure."
"Additionally, there may be follow-up patients from the mining accident coming for check-ups or developing complications, so everyone stay vigilant."
After the handover meeting ended, Zhao Yaqin walked over to Lu Chen.
"Keep a close eye on that fasciotomy patient. You follow up on the subsequent wound care and kidney function monitoring."
"Okay."
"Also, have you written the operation reports for those three surgeries yesterday?"
"I've written two. The fasciotomy one still needs a little bit more."
"Finish it this morning. Director Li said he wants to see it before getting off work today."
"Understood."
...
The Red Zone was much quieter this morning than yesterday.
The peak of the mining accident had passed; those brought in today were basically just ordinary emergency cases.
While handling routine emergency patients, Lu Chen closely monitored the various indicators of the post-fasciotomy patient.
At 9:30, a call came into the Red Zone.
Meng Yan answered it.
"Red Zone, yes, okay, I understand."
She hung up the phone, her expression somewhat heavy.
"What's wrong?" Zhao Yaqin asked.
"It was from the ICU. One of the miners we transferred from here yesterday passed away at 3:00 AM this morning."
The Red Zone went quiet for a moment.
"Which one?"
"The one with multiple organ injuries. He was already in very serious condition when he was brought in yesterday, and we transferred him to the ICU after doing initial treatment."
Zhao Yaqin sighed.
"It was expected. When that patient was brought in yesterday, he had hemorrhaging in multiple organs throughout his body. Even if transferred to the ICU, it would be very difficult to pull through."
Lu Chen stood to the side, not speaking.
He remembered that patient.
He knew at the time that the patient's probability of survival was extremely low.
But he still did everything he could.
Stopping the bleeding, stabilizing vital signs, and buying time for transfer.
The final outcome was not within his control.
"Also," Meng Yan added, "News came from the Department of Neurosurgery. One of the miners with a craniocerebral injury who was transferred there yesterday didn't make it this morning either."
Another one.
Zhao Yaqin's expression became even more solemn.
"That's two."
"Yeah, and there's one in the General Surgery Department. His condition wasn't very optimistic after a second surgery last night. Word is he's still in the ICU, but all his indicators are trending downwards."
Lu Chen listened silently.
For a disaster of this scale, like a mining accident, zero deaths is almost impossible.
Their Emergency Department achieved zero deaths during the reception and treatment phase, but in the subsequent treatment process within various specialist departments, some patients with injuries that were simply too severe ultimately could not pull through.
This was not the fault of any single department or any single doctor.
It was determined by the nature of the injuries themselves.
"Sister Zhao," Lu Chen spoke up.
"Hmm?"
"What we can do is ensure everything that needs to be done is done during the emergency phase. As for what follows, we leave it to the subsequent departments."
Zhao Yaqin looked at him.
"You're right."
"But knowing it is one thing; it still feels bad."
"Yeah, it's normal to feel bad."
The two remained silent for a while.
Then Zhao Yaqin patted Lu Chen on the shoulder.
"Alright, let's get to work."
...
10:40 AM.
A new emergency patient was wheeled into the Red Zone.
A 43-year-old male, one of the mining accident casualties. He had received initial treatment in the Yellow Zone yesterday and was kept for observation. This morning, he suddenly developed aggravated abdominal pain and positive Rebound tenderness.
Lu Chen scanned him with the Eye of Truth.
[Eye of Truth scan complete]
[Patient Information: Male, 43 years old]
[Chief Complaint: Progressive aggravation of abdominal pain for 12 hours]
[Eye of Truth Diagnosis: Rupture of delayed subcapsular splenic hematoma, active intra-abdominal hemorrhage]
[Danger Level: A+ Grade]
[Current Symptoms: Decreased blood pressure, increased heart rate, positive peritoneal irritation signs]
[Recommendation: Immediate surgical exploration and hemostasis]
[Warning: If surgery is not performed in time, he is expected to enter hemorrhagic shock within 30 minutes]
Lu Chen's expression changed immediately.
"Sister Zhao!"
Zhao Yaqin was processing medical orders for another patient; hearing his voice, she immediately walked over.
"Bed 4, delayed splenic rupture, intra-abdominal hemorrhage, needs immediate surgery."
Zhao Yaqin quickly walked to the bedside and checked the patient's abdominal signs and monitoring data.
"Blood pressure is dropping, heart rate is 110, we must deal with this immediately."
"Send him to the Operating Room. I'll do it."
Zhao Yaqin did not hesitate.
"Okay, I'll notify the Department of Anesthesiology. You get ready."
Ten minutes later.
Lu Chen was standing in the Emergency Operating Room again.
When Zhao Ming was called over and saw that it was Lu Chen again, his expression was quite something.
"I knew it."
"Brother Zhao, I have to trouble you again."
"I don't care about the trouble anymore. I just want to ask one thing: this Operating Room opened yesterday, you did three surgeries on the first day, and here you are again on the second day. Are you planning to take on the entire KPI of the Emergency Department Operating Room by yourself?"
"You're joking."
"I'm not joking."
Zhao Ming began preparing for anesthesia.
Zhao Yaqin was serving as the First assistant this time.
"Delayed splenic rupture. During the initial diagnosis yesterday, it must have been a small subcapsular splenic hematoma that hadn't ruptured, but it ruptured suddenly today."
"Yeah, this kind of delayed hemorrhage situation is not rare among mining accident casualties, especially for those with a history of abdominal crush injuries."
Lu Chen scrubbed his hands, put on his surgical gown, and put on his gloves.
He stood in front of the operating table.
"Start."
He chose a paramedian incision in the left upper abdomen.
He incised the skin, subcutaneous tissue, and anterior sheath, separated the rectus abdominis muscle, and incised the posterior sheath and peritoneum.
The moment the abdominal cavity was opened, dark red blood pooled out.
"Suction."
Shen Xiaoning was assigned as the circulating Nurse today, and she quickly handed over the suction tube.