Chapter 601 - Diagnosis

Chapter 601: Diagnosis
Translator: 
EndlessFantasy Translation 
 Editor: 
EndlessFantasy Translation


Collect blood from the deep vein, send it to the Medical Laboratory Department, and check for amniotic fluid embolism.
When Fang Pingzhu saw the patient, she immediately asked the nurse to send for a request for an amniotic fluid embolism examination.
For the Gynaecology Department, the highest mortality rate came from amniotic fluid embolism.
Amniotic fluid embolism meant that during the labor process, the amniotic fluid had suddenly entered the mother’s bloodstream, subsequently causing a series of severe complications such as acute pulmonary embolism, anaphylaxis, kidney failure, and sudden death.
Due to the high amount of fetal hair, cuticular epithelium, vernix caseosa, and meconium in the amniotic fluid, once the amniotic fluid entered the bloodstream, it would immediately cause damage to the balance of the body.
While in the First Division of Yun Hua Hospital’s Gynecology and Obstetrics Department, Fang Pingzhu’s policy was to immediately collect blood in the vein and do a quick diagnosis when she saw symptoms like massive bleeding.


This policy naturally did not provide a very high rate in catching on whether it was truly amniotic fluid embolism when massive bleeding occurred, but, from Fang Pingzhu’s perspective, confirming the diagnosis of amniotic fluid embolism a few minutes earlier would greatly increase the patient’s survival rate.
However, this policy which was originally implemented in the Gynaecology Department was only effective in the Gynaecology Department right now.
The department directors of the Second Division of Gynecology and Obstetrics Department and the Third Division of Gynecology and Obstetrics Department had their respective focus, so they were not willing to spend high amounts of manpower, time, and money on the examination of amniotic fluid embolism. This was one of the reasons for the doctors to strive for the position of a department director who owned authority when they reached a higher standard, even though they might offend others to the point that both sides would end up losing a lot.
Only when they became major department directors who owned power could decide the direction of the department. In other words, he could make the people and money in the whole department focus on him and the field that he was interested in, good at or learned. In the Gynaecology Department, besides amniotic fluid embolism, there were also fields like high-risk pregnancy, prenatal diagnosis, and placental abruption which they could focus on.
Ling Ran did not have any experience in the Gynaecology Department, so he did not judge whether this might be a case of amniotic fluid embolism.
He followed the gurney for a while. He first let Fang Pingzhu give her instructions before he asked after entering the operating theater,
How much is the blood loss?


Vaginal bleeding for 1.3 ounces.
The nurse reported seriously.
After working in the hospital for a long time, the nurses were all familiar with the main diseases and the display of the patient’s symptoms in the department. When they saw the patient who had just laid down on the operating table, they did not really believe that she had a high chance of surviving. They were all women. When the nurse thought about the patient possibly passing away right after giving birth to a baby… Instead of showing a serious expression, she did not really know what else to show on her face.
Department Director Hong did not enter the operating theater, instead, he stood outside the operating theater to comfort his brother and sister-in-law, who had just come.
He was an internist, so he was unable to perform this surgery. Even if he could, he would most likely not perform it. If the department director of the Gynaecology Department and Ling Ran could not save the patient even if they worked together, the other surgeons might not be able to do anything about it as well.



Exploratory laparotomy?
Ling Ran’s tone made it sound as if he was asking Fang Pingzhu, but in truth, he was already very certain that he wanted to perform the exploratory laparotomy.
The anesthetist could not help but look toward Fang Pingzhu.
This was the operating theater of the Gynaecology Department, and Ling Ran did not bring anybody over. It all depended on Fang Pingzhu on whether they were to bring the knife on the patient.
Fang Pingzhu nodded slightly. From the moment she allowed Ling Ran to come over, she did not have any right to turn him down.
General anesthesia was ready. In a while, Ling Ran pressed on the patient’s skin and said,
Perform laparotomy for exploratory laparotomy.

When he finished speaking, he asked for a scalpel and made a long incision with the fiddle bow hold.
Fang Pingzhu and the other doctors from the Gynaecology Department took a deep breath when they saw it.
The surgery that the Gynaecology Department usually performed was the Caesarean section. When they made the horizontal cut, short cuts would not allow them to be successful, but if they made the cut too long, the patient would be unhappy. Some women would want to discuss the length of the incision when they chose the doctors for the Caesarean section.
However, even a careless obstetrician would not dare to make a long incision like Ling Ran. If this were not handled well, it would cause a doctor-patient dispute.

Doctor Ling, you’re quite brave in performing exploratory laparotomy, huh?
Fang Pingzhu said very
tactfully
.


The female doctor who was the third assistant thought that the department director wanted to give Ling Ran a reminder, so she immediately added,
Doctor Ling, such a long incision will make you get blocked and scolded by people in front of the office.

Ling Ran stared at the surgical area in front of him and said calmly,
If the patient can block and scold me at the office, this incision will not be a waste.

The female doctor who was the third assistant could not help but be stunned.

Pull the retractor.
Ling Ran reminded her.

Oh, oh… Okay.
The female doctor peeped at Ling Ran and could not help but think. ‘Those men whom I met during the matchmaking sessions were not as handsome as Doctor Ling, and their kindness is not even one-tenth of Ling Ran’s. No. One percent, no, it should be one in ten thousand…’
Fang Pingzhu also praised what Ling Ran had just said in a low voice,
We won’t mention the standards of the doctors Department Director Huo taught, but their medical ethics are good. Save the life first before treating the patient, right?

Huo Congjun had been in Yun Hua Hospital for many years, so his famous quotes were remembered by everyone.
Ling Ran smiled.
Fang Pingzhu continued to say,
The environment now is way different from the time Department Director Huo worked actively in the frontlines. During that time, when we met emergency cases, we would sometimes push them into the operating theaters and perform the surgery without waiting for the family members to sign the forms. There were countless women and children who had been saved. Now, who would dare to do so? Some doctors are worried when they see that there was only one signature, so they wanted both husband and wife to sign before the surgery. Say, how would you choose between treatment and saving a life?

Ling Ran only smiled as usual. He was not interested in discussing this kind of topic at all.


Ling Ran just wanted to perform the surgery seriously.

Speed up the aspiration.
While Ling Ran spoke, he pushed his hands into the patient’s abdomen.
The abdominal cavity was accumulated with blood. So, he could only use his hands to detect the bleeding point, as this was a strategy to fight for more time. A normal doctor would not be able to do so. When they saw the amount of blood flowing out, they knew that the patient’s abdominal cavity was a mess. It was quite amazing to even think about using their hands to figure out the condition of the tissues inside the abdominal cavity.
However, it was precisely because the condition in the abdomen was not known that they had to quickly explore the abdominal cavity once they performed laparotomy after they reduced their pressure.
This was just like the battle between two armies. The reconnaissance forces would definitely have to suffer losses, but if the recon squad was not sent out, they would suffer a greater loss.
Fang Pingzhu was anxious when she watched from the side. Now, she knew why Department Director Huo wanted to ask Ling Ran to help.
She had heard that Ling Ran was very skillful, but she only learned of his true strength when she witnessed it with her own eyes.
There might only be a few organs in the human body, but the doctors would not be able to recognize the tissues of the organs had changed, and it was incredibly difficult for them to search for the bleeding point in a pool of blood.
Fang Pingzhu could not help thinking. ‘If there is someone who can actually save this patient under this kind of condition, that person might just be Doctor Ling, who is a little too young.’
Ling Ran’s moving arms stopped for a while.


Fang Pingzhu could not help but show an expectant face.
Ling Ran slowly raised his head. He looked at Fang Pingzhu before he glanced at the others.
No bleeding point.

Fang Pingzhu was stunned, then she instantly felt resigned. ‘If there’s no bleeding point, why are you behaving so seriously?’
But Ling Ran still looked very serious.
This means that it’s not the exposed organs that are bleeding.


Maybe you just did not find it.
Fang Pingzhu refuted.

Impossible.
Ling Ran shook his head firmly. If he could not find the bleeding point with his Perfect Level Barehanded Bleeding Control, it was impossible for there to be such a huge amount of blood accumulated in the patient’s abdominal cavity.
From this point of view, his barehanded exploration already eliminated a lot of possibilities.

What do you think?
Fang Pingzhu did not feel unhappy because of Ling Ran’s attitude. In the hospital, the Gynaecology Department was always known for doing work crudely. Forget about comparing their work with the complicated procedures from the Department of Hepatobiliary and Pancreatic Surgery, even if the Gynaecology Department were to be compared with the General Surgery Department, the difficulty in the surgeries of the Gynaecology Department was still low. People always said that when a person was old, they could not compare their strength with others. Therefore, it was not wrong if the Gynaecology Department did not compare with others in terms of their skills.
Ling Ran was not concerned with the assistants’ mental processes. He just thought for a short while and said,
There’s no bleeding point on the surface of the organs. By considering the patient’s condition… There is bleeding in the uterus due to disseminated intravascular coagulation.


Then, the uterus must be removed.
Fang Pingzhu did not give any comment on Ling Ran’s diagnosis. A mere diagnosis was meaningless, the important thing was in how to verify the diagnosis and how to provide the correct treatment.
Ling Ran shook his head slightly. He had not removed a uterus before. So, unlike those obstetricians who would remove the uterus for practically all surgeries, Ling Ran extended his hand and said,
Absorbable suture.