White armor

Chapter 774 What are you consuming? A lighter?

Chapter 774 What are you consuming? A lighter?
Luo Hao is quite busy today.

After finishing the surgery in the morning, I ate a meal in the operating room and then rushed to the medical university for class.

After finishing all his work and sitting down, it was almost time to leave work. Luo Hao looked at the lush greenery outside the window, feeling somewhat dazed.

There's still so much work to do; I'll have to work overtime again tonight.

"Professor Luo, the emergency department admitted two energetic young men today," the head of the ward gossiped with Luo Hao.

Professor Luo is getting busier and busier, and it's even difficult for the head of the ward to have a word with him.

So he seized the opportunity to gossip, talking about topics that Luo Hao was interested in.

"Oh? What kind of patient?" Luo Hao asked casually as he searched for literature on his phone.

"He inhaled the gas from a lighter, then smoked a cigarette after inhaling it, and ended up setting himself on fire."

"!!!"

Luo Hao was taken aback by the hospital manager's words, but then shook his head.

The hospital's general manager clicked his tongue and continued vividly, "You didn't see the scene—one of the blond guys had a face as black as the bottom of a pot, and his hair was so burnt and curly that it looked like he was wearing a piece of burnt instant noodles."

The other one wasn't much better; a huge, shiny blister rolled up on its upper lip, looking exactly like two sausages stacked on top of each other.

He pulled out his phone and swiped it a couple of times: "Look, I also took a picture. Look at his right hand, all five fingers are like charcoal, the burn surgeon was cleaning the wound and the skin was peeling off."

Luo Hao frowned and glanced at the photo. The patient's arm in the photo still had several strange bluish-purple tattoos, like some kind of homemade branding.

“The most disheartening people are the families,” the head of the ward suddenly lowered his voice, “from admission until now, not a single person has come to visit. Instead, there are a few young women squatting outside the emergency room, as thin as sticks, with dark circles under their eyes, constantly shouting that they want to see their ‘big brother.’”

He shook his head, a half-open package of gauze peeking out of his white coat pocket: "The head nurse couldn't stand it, so she bought them a boxed lunch. Guess what? Those girls devoured it, licking the lunchbox clean, and then immediately went to the nurses' station to borrow a lighter."

Luo Hao remained silent after hearing the description of the "spiritual young woman".

The head of the ward was still rambling on: "I just contacted the doctors in the burn unit to ask how those two were doing. The head of the burn unit said that those two were secretly tampering with the IV lines in the ward, probably trying to use the rubber tubing as a suction device."

Luo Hao put down his phone, his brow furrowed. "Have you had a lung CT scan? Butane inhalation can easily cause chemical pneumonia."

"Yes, yes," the head of the ward nodded repeatedly. "The lungs are fine, but the face and hands have second-degree burns. Burn specialist Zhang said the dressings will need to be changed for at least two weeks." He suddenly lowered his voice, "These two idiots are really something. Even with all these burns, they were asking the nurses for a lighter in the ambulance, saying they hadn't finished inhaling the last puff."

Luo Hao sighed, his professional instincts kicking in as he began to explain, as if he were back in the classroom half an hour earlier.

"Volatile solvents like butane can rapidly cross the blood-brain barrier upon inhalation, producing a brief feeling of euphoria. However, they quickly lead to oxygen deficiency, and long-term use can dissolve brain white matter."

He paused abruptly, looking at the head of the ward's "here we go again" expression, and shook his head helplessly: "Forget it, tell the burn unit that they absolutely must do a toxicology screening. These kinds of patients are prone to withdrawal symptoms, and then they'll be demanding to be discharged again."

"Understood!" The head of the ward made an exaggerated gesture. "Professor Luo, what do you think these people are after?"

Luo Hao picked up his phone again and replied without looking up, "Just want to ascend to heaven in an instant, huh? Alright, get back to work, stop gossiping."

"However, we don't see any signs of chemical pneumonia now, but what about later? We've never seen patients with butane inhalation before, so we don't have much experience with that. The head of the burns department contacted me to find out what Xiao Meng thought."

"Oh, is that so?" Luo Hao glanced at "Xiao Meng". "We do have some medical records, but they are all from decades ago, when disposable lighters were being made in the southeastern coastal areas right after the reform and opening up."

"It took that long?!"

"We didn't have much experience back then, and some workers got chemical pneumonia. The treatments were limited, nothing special." Luo Hao suddenly remembered something, "By the way, did they use disposable lighters or gas canisters for refilling disposable lighters?"

Disposable lighters that need to be refilled?
The hospital director felt there was something wrong with what Luo Hao said, but he didn't tell Luo Hao.

After glancing at the hospital manager's expression, Luo Hao knew what he meant. "I also heard it from the boss. In the beginning, disposable lighters were not cheap. We Chinese value simplicity, so at that time there were butane canisters that could be filled with gas."

"If it's just a lighter, it wastes more butane. If we had a can, I think we could trace the source."

The hospital's general manager was taken aback.

I was just gossiping about a rare case, why is Professor Luo making such a big deal out of it? But what Professor Luo said doesn't seem to have any problems.

Nowadays, lighters are usually thrown away after use, or even mysteriously lost before they're fully used, and nobody cares.

In short video live-streaming e-commerce, exquisitely crafted items...

He thought for a moment and then took out his lighter.

I bought this lighter on a whim after seeing it being sold cheaply during a live-streaming sales event while browsing short videos. It's windproof and the workmanship is a bit more refined than ordinary lighters.

Turning the lighter over, the hospital director noticed a hole on the back, presumably for refilling.

This thing can be inflated?!

It really can.

He handed the lighter to Luo Hao.

Luo Hao glanced at it and laughed, "I was overthinking it. I never even noticed that lighters could be refilled. It's too much trouble. I reckon in a few years, lighters will be given away for free."

"Just for the sake of advertising?"

"Hey."

"Professor Luo, are they alright with burns of this severity?" the head of the ward asked.

"It should be fine," Luo Hao said. "I don't see it in hospitals often. Once, when I went to help out at Boss Xia's place, I saw Junma's belly was swollen and filled with air."

This is a type of abdominal pain in horses caused by excessive gas production or poor gas expulsion due to the consumption of large amounts of easily fermentable feed, leading to over-distension of the intestinal tract. Its clinical features include a rapid increase in abdominal girth, severe and persistent abdominal pain, and a short, rapid course of illness.

"There's such a disease?!"

"Yes, it is more common in summer and autumn. The main reasons are overfeeding or grazing on easily fermentable, tender and juicy pastures, especially legumes such as alfalfa, or horses suddenly changing from stall feeding to grazing, and their digestive system cannot adapt in time, thus causing the disease."

"What should I do?"

"It's done in two steps. The first step is to insert a tube into the horse's belly to draw out the fermenting gases. Once lit, the horse will burst into flames, just like... a demon ridden by a warlock in a game."

As Luo Hao spoke, he searched on short video websites and found relevant videos, which he then handed over to the hospital's general manager.

The hospital's general manager could hardly imagine such a scene.

However, short video websites are indeed great; scenes that are unimaginable before they have ever been seen suddenly become real.

"The clinical symptoms usually appear on horses 2-4 hours after they have eaten a large amount of easily fermentable feed. At the beginning of the disease, there is intermittent abdominal pain, which quickly turns into persistent and severe abdominal pain, sweating all over the body, sometimes getting up and sometimes lying down or rolling on the ground, and the abdomen enlarges rapidly, most obviously in the right flank."

The abdomen is tense and elastic upon palpation, and percussion produces a tympanic sound. Breathing is rapid and forceful, and the patient's overall condition is generally good.

Uh.

The hospital director watched as Luo Hao explained the burning tube inserted into the horse's belly, as if he were examining a patient, rather than just gossiping.

"What about treatment? Can we just release the air?" the head of the ward asked casually.

"Immediately after the onset of the disease, acupuncture points such as Houhai, Qihai, and Dachangshu should be performed."

For severe intestinal distension, the intestines should be punctured and gas released as soon as possible. Usually, a thin, closed needle is used to puncture the cecum in the right flank and the left large colon in the left flank. Fermentation agent can be injected through the puncture needle hole.

同时可取硫酸钠300g、鱼石脂或松节油10-15g，加水500-1500ml一次灌服，或水合氯醛15-25g、樟脑粉4-6g、酒精40-60ml、乳酸10-20ml、松节油10-20ml，混合后加水500-1000ml一次灌服。”

"Horses have acupoints too?" the hospital director asked in surprise.

"Of course, everything has a spirit. That's what I thought at the time too. I was very puzzled. Boss Xia said that horses also have acupoints. I'll study animal acupoints when I have some free time."

"Luo Hao, do you think bamboo has acupoints?" Chen Yong asked.

"Yes, I felt it when I was setting its bones."

Speaking of this, Luo Hao fondly recalled the wild bamboo in the Qinling Mountains. He thought, "I'll find an opportunity to go see the bamboo and try to bring it to the Northern Zoo as soon as possible."

When the time comes, the Third Prince of the Northern Movement will soon become the true King of the Northern Movement after Zhu Zi leaves.

As the saying goes, a man is a boy until he dies.

While we were talking, my phone rang.

When the hospital's general manager saw that Chen Yan had turned it on, he handed the phone to Luo Hao.

"Director Chen."

"Professor Luo, I'm in the operating room." Chen Yan's voice was somewhat serious. "A patient who fell from a building has a ruptured liver. During my examination, I discovered a space-occupying lesion in the liver."

"I gonna go see."

Luo Hao sprang up from his chair and strode out.

Chen Yong and Zhuang Yan followed behind without asking any questions, without saying a word.

The entire medical team operated like an emotionless machine, leaving only Old Meng and "Little Meng" to look after the house.

"Old Meng, you're telling me that Professor Luo is busy all day, exhausted, and still has to help Director Chen."

"Just in case it's needed, hybridization surgery, it doesn't make sense," Meng Liangren said with a smile.

"Hey, our hospital's emergency surgery, going straight for hybrids? Old Meng, are you still asleep?"

……

"Director Chen, we can't find the urethral opening." The nurse was sweating profusely, and her disposable sterile cap was already soaked.

"What are you good for!" Chen Yan was extremely impatient. As soon as he heard that the urethral opening could not be found and the catheter could not be inserted, he started cursing.

"Director Chen, if you're unhappy, just say so. Why are you swearing?" The circulating nurse immediately retorted, "The patient was conscious when he came up, and he wasn't in such a hurry. Why didn't you insert a catheter down there?"

Chen Yan snorted coldly.

The airtight lead door opened silently, and Luo Hao walked in while putting on his mask.

He heard the second half.

"I can't find the urethra, Sister Li, let me help you," Luo Hao said with a smile.

"Little Luo's here." The circulating nurse turned her head, rubbed her sterile cap with her shoulder, and launched into a sarcastic tone, "Some people get older and older..."

"Sister Li, let me do it. Some patients with hemorrhagic shock will experience similar symptoms, which is related to the bag being too thick."

As Luo Hao spoke, he walked to the circulating nurse's position. The circulating nurse knew that Luo Hao was a peacemaker, and given the patient's special condition, she didn't want to argue.

After making way, Luo Hao put on his gloves and took a look.

"Patterned pliers".

"Okay, just a moment." The circulating nurse quickly went to find the forceps.

"Xiao Luo, are you busy?" Chen Yan asked calmly as Luo Hao came up.

Chen Yan thought the patient couldn't really blame himself.

Not only was the house a mess, but the various pre-operative preparations were also very difficult, and they couldn't even insert a catheter.

That's ridiculous.

"Not bad, why is Director Chen so angry?" Luo Hao said with a smile.

"Ugh."

"It's okay, my blood pressure seems fine."

Luo Hao glanced at the electrocardiogram monitor and saw that the high voltage was around 80 mmHg, knowing that it was deliberately maintained.

This blood pressure level ensures adequate nutrition to all vital organs without causing excessive bleeding due to excessively high blood pressure.

The First Affiliated Hospital of China Medical University has a very high level of expertise in emergency and critical care.

"Take a look. The patient has cirrhosis. Should we remove the liver? Or should we pack it with gauze to stop the bleeding?" Chen Yan handed the question to Luo Hao.

Both of these methods are standard surgical procedures, but each has its own advantages and disadvantages in terms of choice.

Hepatectomy is appropriate when there is a localized lesion, the bleeding originates from the rupture of a severely cirrhotic nodule in a segment of the liver or from a tumor, and the remaining liver function is still compensable.

Surgical assessment showed the patient was Child-Pugh A, with good liver function and no severe jaundice, ascites, or coagulation disorders.

Another factor is that the technical conditions allow it, the surgeon has experience in precise liver resection, and can avoid important blood vessels.

This is not a problem for the First Affiliated Hospital of China Medical University and for Chen Yan.

The surgical procedure is also very simple, mainly involving anatomical resection—removing the diseased liver segment according to the Couinaud segmentation to reduce the risk of ischemia in the remaining liver.

In the past, there was also a non-anatomical resection method in the surgical procedure—only the liver tissue around the bleeding site was removed, which was suitable for emergency hemostasis.

This approach has significant advantages, primarily in its radical hemostasis, directly removing the source of bleeding and preventing further bleeding. It also reduces the risk of infection: avoiding abdominal infections caused by residual foreign objects (gauze).

However, the disadvantages are also obvious, namely the high surgical risk – the liver tissue of patients with cirrhosis is fragile and prone to massive bleeding during surgery.

Another risk is postoperative liver failure: if the remaining liver volume is insufficient, especially when combined with portal hypertension, it may lead to liver decompensation.

Gauze packing is suitable for emergency treatment when the patient's hemodynamics are unstable and rapid hemostasis is required.

Another type is diffuse bleeding – cirrhosis leads to widespread bleeding on the surface of the liver, without any clear local bleeding points.

Preoperative grading of Child-Pugh B/C indicates poor liver function and inability to tolerate extensive hepatectomy, requiring tamponade for hemostasis.

The surgical procedure is simpler: the abdominal cavity is packed with gauze, and the bleeding area is compressed with sterile gauze or special hemostatic dressing.

However, the trouble lies in the fact that the packing gauze needs to be treated in stages: the gauze needs to be removed after a second abdominal surgery 48-72 hours later, and the need to assess whether further surgery is required.

If we were to use absorbable gauze—absorbable gauze has become a high-value consumable, and the First Affiliated Hospital of China Medical University has stopped using it for some time now.

Chen Yan simply didn't try to figure it out himself, and handed this multiple-choice question over to Luo Hao.

Seeing that there was no rush, Luo Hao waited for the circulating nurse to bring over some forceps and then inserted the catheter.

He glanced at the patient's genital area—severe local deformity had completely distorted the normal anatomical structure, leaving only a mass of scarred, contracted skin where the urethral opening should have been.

Luo Hao reached out and took the pliers; the metal instrument flashed a cold light under the operating lamp.

With two fingers of the left hand, the contracted skin folds were precisely separated, while the right hand gently probed with forceps—the tip of the forceps paused subtly for half a second on the seemingly solid scar tissue, and then suddenly pressed down.

“Got it.” With a deep voice, he pried open a thin membrane with the tip of the pliers, revealing a tiny, dark hole. Pale red urine immediately seeped out, refracting into tiny spots of light on the gleaming silver tips.

The circulating nurse knew that Professor Luo's work would be quick, but she didn't expect it to be this fast.

She gasped, the circulating nurse stammering, "How...how did you find it?"

Luo Hao had already taken the 12Fr super-slippery catheter. He gently pushed the tube head with the forceps, and the rubber tube slid into the almost invisible channel like a snake returning to its nest.

The urine drainage bag instantly rippled with a pale red color.

Not much, but there was urine, and Chen Yan and Luo Hao both breathed a sigh of relief.

"The urethral opening has shifted to the back of the scrotum." Luo Hao released the forceps, the metal instruments clanging crisply onto the instrument table. "Scar tissue obscures the opening like a thin slit, but palpation reveals cord-like structures underneath."

The anesthesiologist stared at the blood pressure, which had instantly risen to 90/50 mmHg, and his Adam's apple bobbed. "The way you probe the urethra with your hand, anyone who didn't know better would think you were a urologist."

"It's from practice." Luo Hao pulled off his gloves, which were still stained with blood. "Not many people like me. Didn't I used to work as Boss Xia's assistant?"

Uh……

How could there be any connection?

The anesthesiologist knew about the relationship between Professor Luo and Boss Xia, but Boss Xia was a zoology expert, so how exactly did Professor Luo connect them?

Before he could ask any further questions, Luo Hao had already gone to wash his hands and change his clothes.

The circulating nurse hung up the urine bag, praising Luo Hao as she did so.

Seeing Luo Hao return after washing his hands, the circulating nurse rushed ahead of Zhuang Yan to tie the straps of Luo Hao's sterile gown.

He rushed forward in three strides, and as soon as he raised his fingertips, he softened his movements behind Luo Hao.

Her hands, which were usually so nimble that she could open an IV set packaging with one hand, were now handling it as if it were something fragile.

"Professor Luo, throw the strap over here."

Chen Yan was taken aback and looked up.

Modern sterile gowns are all disposable and have been improved, unlike the old-fashioned surgical gowns from over a decade ago that required someone to tie the straps for them.

Nowadays, disposable surgical gowns are tied by the surgeon themselves.

What's wrong with the circulating nurse? Is she being so meticulous in her flattery?

Chen Yan felt a pang of jealousy. He hadn't received such treatment when he went on stage, but Professor Luo had quietly enjoyed such high-level treatment.

"Professor Luo, please raise your hand." Her voice was eight octaves lower than usual, her fingers deftly moving, the knot she tied fitting perfectly in the center of Luo Hao's lower back—this was her unique technique, developed through repeated observation, ensuring it wouldn't hurt the surgeon and that the sterile gown wouldn't come loose during the operation.

After tying the straps, she gently stroked Luo Hao's back to make sure the fabric was completely smooth. The action was so quick it was almost an illusion, yet it made the scrub nurse next to her raise an eyebrow.

As Luo Hao put on his gloves, the circulating nurse suddenly squatted down.

She crouched behind Luo Hao, walking in a squatting posture like a martial arts performer in Peking Opera, maintaining a standard sterile distance, and lightly lifted the hem of her sterile gown with her fingers, giving it a shake from side to side.

The light from the operating lights shone on the top of her head, and a few strands of white hair could be seen gleaming silver under the operating lights and inside the sterile cap.

"You go about your business." Her voice carried a certain certainty that a young nurse would never possess.

As soon as Luo Hao slightly lifted his heel, she deftly straightened the drooping hem of his clothes—a trick she learned from the old director thirty years ago, which could smooth out the wrinkles in the surgeon's clothes and make the surgery more comfortable.

When I got up, the circulating nurse immediately moved aside, clearing the sterile area, without making any unnecessary movements.

But it is precisely this that encapsulates both the proper demeanor and the inappropriate attentiveness of a circulating nurse in this single action.

She took two steps back to examine her work, her eyes looking like those of an old orderly helping a general put on his armor.

Chen Yan felt a pang of bitterness welling up inside him.

Luo Hao doesn't usually come to the operating room, so how come he's doing this just because he's inserting a catheter...?

No, it should be through Liu Yiyi. Contact Chen Yong through Liu Yiyi, who is the small boss of Luo Hao's medical team.

In an instant, Chen Yan understood everything.

Doctors in hospitals are a bit easier to deal with, but nurses who want to get promoted or publish papers have to beg and plead to have their names added to their names.

Chen Yong was able to publish papers, and Luo Hao led him into the field; the paper quickly took shape.

It turned out to be the case.

Chen Yan sighed.

Luo Hao, however, didn't have so many thoughts; he carefully examined the surgical area.

Upon examining the patient's liver and considering the history of hepatitis B, cirrhosis is a clear diagnosis. Apart from cirrhotic nodules, no obvious neoplastic lesions were observed on the surface of the right lobe of the liver.

However, it is impossible to determine whether the rupture of the left lateral lobe of the liver is due to the rupture of cirrhotic liver tissue or the rupture of a tumor. There is no time to determine this. Saving his life is the top priority. Other things can only be considered after his life is saved. Otherwise, he may die on the operating table.