The night in the emergency department never feels peaceful.
In this place, it’s best not to let your thoughts wander.
Take Chen Cang for example, just as he lay down less than 10 minutes ago and his snoring was gradually picking up, a sudden and intense barrage of knocking violently erupted!
From opening his eyes to rolling out of bed, to urgently opening the door, it took less than 5 seconds.
After the door opened, Xiao Lin stood outside.
Xiao Lin’s face was panicked as he said hastily, “Dr. Chen, it’s bad news. A man riding a motorbike hit the pipe next to the pipe bridge. We are the closest here and are preparing to send a vehicle. We need a doctor to accompany!”
Chen Cang’s expression changed as he walked outside, saying as he moved, “Call Wang Yong quickly, his second line, and tell him to come here at once, I’m going to take a look.”
Xiao Lin nodded briskly, “Alright!”
Chen Cang hurried onto the ambulance, where driver Old Liu had already prepared everything, ready to depart at any moment.
Once Chen Cang was seated, the vehicle immediately took off.The distance to the pipe bridge from the Second Provincial Hospital was the shortest, only about 2 kilometers, but the most critical issue wasn’t the distance.
It was that the pipe bridge was impassable for vehicles!
The pipe bridge, as the name suggests, is a small bridge built opportunistically for the pipes between two rivers, where people usually stroll.
At most, electric bikes and bicycles can cross, but definitely not cars.
The vehicle could only be parked by the side of the road, and the doctors themselves had to run up there. There’s a long flight of stairs from the road to the bridge, which, for rescues, was undoubtedly a serious obstacle!
In less than two minutes, the vehicle immediately arrived at the parking location, Chen Cang opened the door and ran down with the emergency kit, while driver Old Liu brought down the stretcher from the 120 emergency vehicle.
Just as they were about to go up, but realized it was all stairs, the stretcher clearly could not be wheeled up, he quickly cradled it in his arms and charged up.
It was already past one in the morning!
There wasn’t a single pedestrian on the road.
By the time Chen Cang and driver Old Liu reached the pipe bridge, they saw two young men standing to the side, holding cell phones and making calls.
A motorbike lay on its side, and a man was sprawled on the ground, his life hanging by a thread!
However, seeing the state of the railing, a weight sank in Chen Cang’s heart!
With such damage!
It was perilous for the man as well.
Chen Cang had no time to think further and hurriedly ran with the driver to the scene.
The two young men, upon seeing Chen Cang in white, running urgently, immediately brightened.
“Doctor! It’s right here!”
At that moment, the injured man was propped against the railing, half on the bridge, prone to falling off if carelessly moved!
The street lights here were not very bright, only allowing a vague glimpse of the scene!
There was no blood on the road.
He likely had no external injuries…
But looking at the man’s condition, Chen Cang’s biggest concern was whether he had any fractures in the head or neck area.
If there were, transferring him would prove quite cumbersome.
Yet, with the man in such a position, there was no way to administer aid, and they had to move him down.
Chen Cang gently patted the man’s shoulder, “Comrade! Wake up!”
“Can you hear me, comrade?”
…
Chen Cang called near his ear several times, but there was no response.
He alerted everyone, “Let’s lift him down, Old Liu, you hold his waist, I’ll handle his head, and you… young men, help out with the legs.”
Both of them were young, probably eighteen or nineteen or just over twenty, but what were they doing wandering on the bridge in the middle of the night instead of sleeping.
Chen Cang had no time for those thoughts—saving the patient was his only concern at the moment.
Transferring a patient is a delicate matter.
Such a vehicular accident injury could easily involve fractures in the body, particularly in areas like the head, neck, and cervical spine.
An improper transfer could easily lead to secondary injuries or even exacerbate the condition.
Therefore, with emergent patients, you must not hastily transfer them, or you might inadvertently do harm while trying to help.
And the actions of the two young people were spot on!
After transferring the patient onto the stretcher, Chen Cang opened the first aid kit and hurriedly checked the blood pressure, then took the time to patiently observe the breathing and pulse…
At this moment, the two young men noticed that the street lamp wasn’t very bright, so they simply turned on the flashlight on their phones to illuminate the patient.
Before long, the blood pressure results were in, and when Chen Cang saw the numbers, his face instantly changed!
“60/30mmHg!”
Was this blood pressure indicative of hypovolemic shock?
As the thought struck him, Chen Cang’s face changed instantly.
Hypotensive shock… trauma…
Was there bleeding?
But he couldn’t find any bleeding site!
What could it be?
Suddenly, Chen Cang saw something strange in the area illuminated by the flashlight.
Without delay, Chen Cang said, “Give me the flashlight!”
The young man next to him cooperated and handed over the flashlight.
Chen Cang quickly stooped down for a closer look!
Jugular vein distension?!
In an instant, a critical emergency medical case sprung to Chen Cang’s mind—this was something he had to verify right away!
Chen Cang handed the phone to the other person and took out his stethoscope in a hurry.
His hands were somewhat trembling.
After all, he had heard of this illness but had never encountered it, and if confirmed, he would need to organize a rescue on the spot immediately.
There was no time to delay!
With that thought, Chen Cang fitted the stethoscope and placed it on the victim’s chest over the heart…
Suddenly, a series of distant and faint heart sounds reached his ears, fast-paced, like drumming from ten miles away, ceaseless yet distant and faint!
Chen Cang’s expression became grave!
It should be… Beck’s triad of cardiac tamponade!
This was an emergency and severe cardiac condition: acute heart compression with the typical symptoms of Beck’s triad.
It was primarily characterized by elevated venous pressure leading to raised jugular venous pressure and jugular vein distension, which was the first feature.
Second, was the abrupt drop in blood pressure resulting in decreased systolic pressure, narrowed pulse pressure, shock, pulsus paradoxus, and other symptoms—the second sign.
The third was reduced cardiac output, distant and faint heart sounds, and tachycardia—the third sign.
All three signs seemed to lay the truth bare before Chen Cang!
At that moment, Chen Cang touched the victim’s skin, feeling the body temperature continuously dropping.
Chen Cang was now certain that the patient was suffering from acute cardiac tamponade caused by trauma and was in a state of shock, in a critical condition, and at risk of dying at any moment.
What is cardiac tamponade?
The heart is the organ that maintains the circulation of blood throughout the body, ensuring blood supply to all the organs and tissues.
The pericardium is like armor for the heart, protecting it from outside, a sac-like structure that envelopes the heart and the roots of the large blood vessels going in and out of it.
Between the heart and the pericardium lies a cavity, called the pericardial cavity, which is the space between the parietal pericardium and the visceral pericardium on the heart’s surface.
Normally, the pericardial cavity contains a small amount of pale yellow fluid that lubricates the heart’s surface, much like the lubricating oil in an engine. After all, the heart, like a piston, constantly beats, and if there is a pericardium outside, it needs friction, and this pale yellow fluid acts as a lubricant, reducing the friction between the heart and the pericardium.
However, when traumatic heart rupture or pericardial blood vessel injury occurs, it causes blood accumulation in the pericardial cavity, known as hemopericardium or cardiac tamponade, which is a rapid cause of death from heart trauma.
Since the elasticity of the pericardium is limited, an acute accumulation of blood in the pericardium of 150ml can restrict blood return to the heart and heartbeats, causing acute circulatory failure and ultimately leading to cardiac arrest.
Imagine, after all, blood accumulating within the pericardial cavity compressing the heart, preventing it from beating. The heart, in an attempt to continuously supply the body with blood, can only desperately contract and relax, contract and relax… leading to an increased heartbeat rate, but the amount of blood pumped out becomes less and less because the pressure from outside the heart creates increasing resistance!
Soon, the heart might abruptly stop beating, causing acute circulatory failure and even… instant death!
Therefore, the patient’s condition is critical, extremely dangerous, facing the threat of death at any moment.
And what needed to be done now was to relieve the pressure on the heart—it was the patient’s only chance of survival.
ps: There are four more chapters, five chapters tonight.
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