American Medicine: I survived the death knell thanks to the devil.

Chapter 101 Life-or-Death Rescue

Lynn stepped forward and grabbed the patient's right ankle.

The muscles on the front of the calf were swollen, the skin was taut and shiny, and it felt as hard as a stone when pressed.

He twisted the patient's toes.

The moment the patient was passively stretched, he was in so much pain that he almost jumped off the bed, letting out a piercing scream.

"Compartment syndrome".

Lin En released his grip and explained his condition.

"The window of opportunity is four to six hours, and three and a half months have passed since the injury."

"Once the window of opportunity is missed, the muscles will die, the nerves will suffer irreversible damage, and the leg will be useless."

Brian's expression changed, but he still stubbornly adhered to the bottom line of the system.

"I've already called the orthopedics department; they'll arrange for an operating room—"

When is the orthopedics appointment?

Brian's Adam's apple bobbed.

He made four phone calls.

The on-call orthopedic surgeon replied in a routine tone, "It's scheduled after the third knee replacement, about two hours away."

Two hours.

The patient only has one and a half hours left to see a doctor.

"I'm an orthopedic surgeon, I know better than you that it's too late."

Lynn glanced at the medical equipment cart.

"No. 10 blade, chlorhexidine alcohol, sterile towels."

Brian with curly hair stood in front of the equipment cart, his arms outstretched.

"You overstepped your authority."

His pupils contracted, and the muscles in his cheeks tensed into a line.

"The emergency room lacks a sterile laminar flow environment and anesthesia support. Performing surgery here carries an infection rate exceeding 30%, and if it leads to osteomyelitis, it results in lifelong disability."

"According to the standards I've learned, fasciotomy must be performed in a standard operating room."

"What you're doing isn't saving lives, it's an illegal operation, and I have an obligation to stop you."

He had already reached for the emergency call button on the wall.

Once that button is pressed, security guards and the duty manager will arrive within three minutes.

Lynn grabbed his wrist.

Lynn would never allow death to occur on his operating table without infringing upon his own interests.

"You press the button, security arrives, and the process takes twenty minutes."

"After two hours of orthopedic doctors deflecting the issue, the muscles in this leg have already started to liquefy."

"The person who will sign the amputation consent form will be you, not me."

Brian's curly hair was hanging in mid-air.

His eyes were bloodshot, and his teeth were clenched so tightly they were making a grinding sound.

The iron cage of rules built up by four years of training at Tufts University is being broken piece by piece by the reality before our eyes.

Just then.

In the corridor, the electrocardiogram monitor in Trauma Room No. 2 started beeping.

The piercing VT alarm shattered the partition wall.

Then came the sycophantic Sofia's voice, a hoarse cry escaping her lips.

"We need help here!"

"The bleeding is out of control, the tourniquet is slipping!"

The call lights at the nurses' station turned on simultaneously, and red lights flashed alternately on the corridor ceiling.

Head Nurse Patricia's voice came through the walkie-talkie.

"The pulsatile bleeding in room two has worsened, and the blood pressure has dropped to 75/40!"

The patient in room number one is screaming in agony.

The alarm in room number two was blaring.

The nurses were running around in the corridor.

Brian with curly hair finally pulled his hand away from the call button.

The situation is completely out of control.

Every rule and procedure he had memorized since childhood became invalid at this moment.

There is no operating room.

No anesthesia was administered.

There is no designated doctor.

There were only two patients who were dying at the same time.

Lynn had already put on sterile gloves.

"Incision of the anterior compartment, 30 seconds. After 30 seconds, I'll go to room number two."

"Hold his legs down."

Brian's hands were trembling.

He stood there, listening to Sofia's increasingly desperate cries coming from next door.

Looking at this person of the same age in front of me.

There was not a trace of hesitation in his eyes.

As cold, precise, and irresistible as a scalpel itself.

He pressed down on the patient's legs with both hands.

The knuckles are turning white.

Lynn's knife tip pressed against her skin.

With a flick of the wrist, make a cut along the outer edge of the tibia.

The incision is precise and straight, with a depth that just penetrates the skin and subcutaneous fat layer.

The taut deep fascia is exposed, like a layer of plastic wrap stretched to its limit.

Below are bulging, shiny, dark purple muscles.

Insert the tip of the scissors into the edge of the fascia.

One pick.

"laugh""

The fascia has torn.

Dark red blood and pale yellow edema fluid gushed out simultaneously, splashing onto Lynn's forearm and Brian's glove.

The ischemic and swollen muscle bulged out of the incision, like a piece of meat that had been vacuum-packed for too long suddenly being decompressed.

The moment the tissue was released, a smell of rust mixed with a sweet, decaying odor filled the air.

The patient let out a howl that sounded inhuman, arched his back, and gripped the bed rails tightly with both hands.

Brian, with curly hair, got splashed with edema fluid in his face and instinctively tried to back away.

"Hold it down!"

Lynn's voice pierced through the patient's screams and the alarm next door.

Brian with curly hair gritted his teeth and pressed down again.

Lynn's fingers probed into the incision.

Use your fingertips to locate the anterior tibial artery and deep peroneal nerve.

The intermuscular spaces are opened, and the pressure in the fascial compartments drops sharply.

"Feel the dorsalis pedis artery."

Brian, with trembling hands, reached out.

Place your fingertips on the back of the patient's foot.

weak.

Although very faint—

But it is indeed jumping.

"Pulse has returned."

"Cover the incision with a wet gauze dressing, and strictly avoid applying pressure. Keep an eye on the dorsalis pedis artery pulse."

"If you disappear, call me on the walkie-talkie."

Lynn ripped off his gloves, which were stained with blood and edema fluid, and threw them into the biological waste bin.

He pushed open the door and went out.

The VT alarm in room number two is still going off.

The red call lights in the corridor are flashing.

Time: 7:16.

Trauma Room No. 2

The smell of blood was so strong it was nauseating.

Sofia, the sycophant, stood by the hospital bed, her goggles smeared with blood, making it almost impossible to see anything.

Her right hand gripped the tourniquet winch tightly, her fingers already cramping.

But it didn't work.

The tourniquet was placed too high on the proximal part of the upper arm, compressing the middle of the humeral shaft.

The shard of glass was located in the distal third of the glass, a full ten centimeters from the tourniquet.

The strap was covered in blood, and it slipped every time it was twisted.

The patient was a white man in his thirties who had his right upper arm pierced by broken glass during a bar fight.

The seven-centimeter-long gash resembled a mouth, gushing out bright red blood every half second.

Pulsating bleeding.

Tear of the brachial artery.

The blood on the ground had formed an irregular oval shape and was spreading towards the foot of the bed.

The nurse was squatting by the bedside administering an IV drip. The second bag of saline solution was almost finished, and the blood pressure was still dropping.

Sofia's face was covered in blood, and her lips were trembling.

Just a few minutes ago, she was still wondering which attending physician she should wait for to pass by.

How can I phrase my request to simultaneously convey both a sense of seeking help and my professionalism?

She can't think of anything now.

No one answered the phone at the vascular surgery department.

The consultation with the orthopedic department next door is scheduled for two hours later.

Smith is still in the toilet.

She twisted the tourniquet with all her might, and blood seeped out from under the tourniquet, running down her glove.

Twist once, slide once.

Twist it again, and it slips again.

Blood dripped onto her shoe, still warm.

"Dr. Lin!"

She saw a figure at the doorway, the sound like a drowning person grabbing onto a piece of driftwood.

Lynn strode to the bedside.

He did not take the equipment that Sofia offered.

The left index and middle fingers were inserted directly into the wound.

The moment his fingertips pierced flesh, warm blood instantly flooded his fingers.

The inside of the wound was a chaotic mess.

Torn biceps muscle fibers, broken connective tissue, blood clots, and shards of glass were mixed together.

In this swamp of blood and flesh, nothing can be seen.

But Lynn's fingertips don't need to be seen.

The index finger slides in along the medial groove of the humeral shaft, while the middle finger provides support on the lateral side.

Use your fingertips to identify the fascial space along the medial border of the biceps brachii.

through.

The sensation of the median nerve snaking across his fingertips caused him to instinctively avoid it.

Go another half centimeter deeper.

A tubular structure pulsates beneath the fingertip, and with each pulsation, a stream of heat gushes out from a crack in the side wall.

Got you!

Brachial artery.

Lynn pressed down with his index finger.

The fingertip precisely presses the ruptured brachial artery onto the bone surface of the humeral shaft.

It's like pinching a hose that's spraying water and then pressing it against the wall.

Pulsating bleeding, which stopped instantly.

The entire Trauma Room No. 2 fell silent.

The monitor stopped screaming.

Sofia's hand was still clutching the tourniquet, frozen in place.

The nurse looked up at the stable waveform on the monitor, her mouth agape, forgetting to breathe.

From the moment Lynn stepped through that door until the bleeding stopped.

Nine seconds.

The blood stopped spurting.

But he couldn't loosen his fingers.

The point where the index finger presses on the artery is the only dam between this patient and death.

"Coolly vascular clamps."

Sofia was startled, threw away the tourniquet, and turned to rummage through the medical cart.

The gloves were covered in blood and slippery.

I couldn't hold it the first time.

It took a second time to get a firm grip.

Lynn took the hemostat with his right hand.

Slowly release the pressure point with your left index finger, and the moment you release it, the tear starts to bleed again.

The jaws precisely engaged at the proximal end of the brachial artery tear within 0.3 seconds.

Click.

The latch is stuck.

The bleeding has completely stopped.

"6-0 Priligy sutures, heparin saline."

Sofia did not hesitate this time.

Lynn rinsed the sutured area with heparinized saline solution, picked up the sutures, and began repairing the arterial wall.

The needle spacing is precise, and each needle avoids the curled edge of the inner membrane layer, making precise entry and exit in the outer and middle membrane layers.

Seven needles.

Tighten, tie a knot, and cut the thread.

"Loosen the tourniquet."

Tourniquet release.

Blood flowed back to the distal end.

Lynn placed her fingers on the patient's wrist.

The radial artery pulse has returned, strong and even.

"3-0 Vichy muscle layer, skin 3-0 nylon simple interrupted suture."

He glanced at Sofia.

"Is it possible?"

Sofia nodded vigorously.

"It's possible."

She removed her blood-covered goggles, revealing a pair of bloodshot eyes.

She suddenly realized that all the social skills, upward management principles, and precise climbing strategies she had painstakingly cultivated—all of it—had been undone.

In the face of true technology, everything else is rubbish.

Lynn took off her gloves again.

Time: 7:25.

corridor.

He passed by the observation window of Trauma Room No. 3.

A pair of hands peeked out from the gap in the curtain.

Holding tweezers in the left hand and a needle in the right, the movements were slow but rhythmic.

It's Cheng Lan.

She was stitching it up by herself.

Number three was the only quiet person in the entire emergency trauma ward at that moment.

Lynn looked away.

The walkie-talkie crackled to life.