Chapter 404 - Aspiration Was Key

Chapter 404: Aspiration Was Key

“Oh,” Zheng Ren uttered a monosyllable reply.
Su Yun assessed the operating room and saw the basin of iced saline solution.
This… Zheng Ren was already fixing the ribs?
Su Yun was on his way to wash his hands but when he saw Zheng Ren fixing the ribs, he stopped. He approached the operating table to investigate.
Three rib fractures had been stabilized. The fix was not important because even without it, the fractures would fuse and heal on their own after a few days.
More importantly, Su Yun wanted to know how the patient’s lung was dealt with.
The tools used for stabilizing the rib cage were gone. The self-retaining retractors had also been removed. Su Yun could not see what was going on.
“Boss, what did you do?” Su Yun scanned his surroundings and found nothing odd. If a lobectomy was performed, he would have to present the damaged lobes to the family.
“Suturing. Didn’t you just speak of it?” Zheng Ren answered matter-of-factly.
Su Yun was speechless.
“Scrub in,” Zheng Ren told Su Yun.
“Do you still need me? Does my presence even make a difference?” Sarcastic Su Yun was back.
Brother Yun’s sarcastic remarks came whenever he felt like it.
An unhappy Su Yun would deliver a few lines of sarcasm.
A happy Su Yun would do the same.
The habit would be incredibly unflattering if it was anyone but Su Yun.
Su Yun had the skills and swagger to make derisive but honest comments because no one could fault him.
This was exemplified by the number of buddies he had back in Imperial Capital.
If he ever wanted to go drinking, there was a long list of contacts he could pick from.
Zheng Ren ignored Su Yun’s pointless question and continued with the surgery.
As usual, despite his complaints and rants, Su Yun went to wash his hand and put on the surgical scrubs.
He came back to the operating table fully-dressed. He used one hand to feel the right lung.
He could feel the thick double-stranded No. 7 suture in a figure-of-8 suture pattern.
It was the same technique Su Yun had in mind. Did Zheng Ren have some background in cardiothoracic surgery?
From a cardiothoracic standpoint, what Zheng Ren had done was extremely daring.
Su Yun had spent a lot of time thinking about the various methods to seal the two wounds while speaking to the family.
He landed on the same solution as Zheng Ren.
When he returned to the operating room, Zheng Ren was already done.
Su Yun glanced at Zheng Ren as he was fixing the rib fractures.
Zheng Ren’s attention was fully on the procedure, unaware of any unwelcoming stares.
The ribs fixation was a tedious process.
The actual procedure was not difficult but the damage to the rib cage extended from the second rib all the way to the ninth rib. They had to maneuver the clips in a restrictive operative field.
30 minutes later, the internal fixation surgery was completed. They checked for any active bleeds before closing up the chest.
“Su Yun, we’ll have to pay attention to the patient’s airways,” Zheng Ren instructed.
Zheng Ren was referring to whatever fluid that was lodged in the patient’s airways. After the surgery, the blood in the patient’s airways had to be aspirated.
“Don’t worry. The reason why I’m staying in the ICU tonight is to make sure all the blood is removed from his airways. If we followed the standard treatment workflow, the patient could lose up to 40% of his lung capacity.”
“Hmm, thank you then.”
“Yes, thank me.” Su Yun’s eyes shifted to Xie Yiren, then back to Zheng Ren. His eyebrows were questioning.
He was asking if Zheng Ren had made any progress.
This man was too nosy for his own good.
Zheng Ren said nothing but nodded before shaking his head.
Su Yun shook his head, his eyes crinkling with a smile.
Once the patient woke from the general anesthesia, he was transported to the ICU.
Cao Guozhen accompanied the entourage to the ICU. He wanted to keep an eye on the patient, ignoring the jabs thrown at him by Su Yun.
If it were not for the two surgeons from the emergency department, Cao Guozhen would have seen his entire career flushed down the drain.
Death or a fate worse than it would take him.
When the patient arrived at the ICU, the vital sign monitor was displaying a steady electrocardiogram. The patient’s blood pressure was also in the normal range at 120/72 mmHg while the blood oxygen level was at 94%.
The numbers were satisfactory.
Unless an unforeseen event happens, the patient would survive.
Regardless, Su Yun was stringent with post-surgery monitoring. A set of aspirators was brought to the patient’s bed and Su Yun began the process of suctioning the fluids from the patient’s airways.
The specialized hard-tube aspirator was only available in the ICU.
As the tube was not flexible, it stimulated the airways and made the respiratory muscles contract, forcing the trapped fluids outward.
The device could not be used mid-surgery but once the rib fractures were stabilized, they would not have to worry about the patient’s coughing. There was a lower risk of damaging the lungs once the rib cage was fixed.
Su Yun was relieved at the sight of dark red fluid that crept up the aspirator tube.
The blood in the airways was only starting to coagulate. Su Yun could remove the fluid that was accessible.
As for the blood trapped deeper in the lungs, he would try his best, but the remainder would have to be dealt with through the natural absorption by the body.
“I’m leaving,” Zheng Ren announced once the patient was stable. The dark blood being pulled out of the patient’s airways was reassuring.
Su Yun did not bother to look at Zheng Ren. He waved his hand as if shooing a fly.
Cao Guozhen followed Zheng Ren and uttered softly behind the surgeon, “Chief Zheng, thank you for today.”
Zheng Ren smiled. “It’s alright, Chief Cao.”
Cao Guozhen was smart enough to know what Zheng Ren and Su Yun had saved him from.
“Let us have lunch together one day,” Cao Guozhen said with gratitude.
The two men parted ways outside the ICU department.
Zheng Ren did not communicate with the patient’s family. Su Yun would handle all of it.
He texted Xie Yiren as he walked.
It was almost 10:00 pm, too late for a date.
After all, it was improper for a girl to be out late.
Of course, it was unavoidable in this line of work, but work was an exception. Zheng Ren would have to be on standby tonight for any emergency surgery as Su Yun would be busy in the ICU.
He should go home and rest.
Chu Yanran was staying over at Xie Yiren’s house tonight so it was unlikely that anything would transpire between Xie Yiren and him.
Xie Yiren, Chu Yanran, and Zheng Ren went back to the neighborhood. Zheng Ren recalled the memory of holding Xie Yiren’s hand while they were walking down the streets searching for food. It was a sweet one.
After saying goodbye, Zheng Ren went in and took a shower. Xie Yiren and he texted for a while before he went to bed.
The next day, Zheng Ren made a pit stop to the ICU before taking over the shift in the emergency department.
The patient was in good shape. He only complained about the lack of rest due to the suction procedure.
The charts showed a total of 400 ml of gunk removed from the patient’s airways.
Su Yun’s presence in the ICU really made a difference. If the surgeon was not available, no nurse would dare to perform a suction in 20-minute intervals.
There was a risk of damaging the trachea.
After seeking the ICU chief’s opinion, the patient was transferred to the emergency wards alongside the patient who was stabbed in the heart.