Section 2

As we all know, the femoral artery is a very important artery in the human body.

The pressure in arteries is higher than that in veins. Once the blood vessels rupture and bleed, the pressure in the blood vessels will eject the blood in a jet shape.

Under extremely high pressure, blood can shoot out more than two meters!

So it is conceivable that a large amount of blood is lost in this very short period of time. If the bleeding is not stopped in time, the mortality rate will be very high!

Seeing the patient showing a series of blood loss symptoms such as night sweats, rapid breathing, and pale complexion, Zhang Yi knew that the strange scene in front of him was indeed real.

At this time, the emergency doctor said while carrying the patient into the emergency room:

"This man was hit by a motorcycle traveling in the opposite direction. When we arrived at the scene to rescue him, he could still speak and respond. But he suddenly stopped working. About a minute ago, his heart rate and breathing accelerated. Blood pressure is also dropping!”

Chen Fang frowned and asked, "Are there any other injuries? Have you checked for fractures or pneumothorax?"

The emergency doctor shook his head: "No, we checked it when we first arrived at the scene, and he himself said there was nothing wrong, except that his knee was scratched."

Zhang Yi glanced at the emergency doctor and frowned.

So, the emergency doctor didn’t detect the patient’s closed fracture before getting in the car?

There are significant differences between closed fractures and open fractures.

A closed fracture means that the skin or mucous membrane at the fracture site is intact and is not connected to the outside world. Therefore, this type of fracture will not cause infection due to external contamination. It is not easily discovered except for patient self-report and instrumental examination.

But open fractures are connected to the outside world, that is, the fracture section pierces the skin and is exposed to the air.

This kind of fracture can easily infect the patient himself due to the wound being exposed to the outside world, and the doctor can also detect it immediately.

After thinking for a moment, Zhang Yi understood the patient's current problem.

First of all, the car accident caused a closed fracture of the femur, and it was a closed oblique fracture.

Judging from the time, it should be that the patient's fracture section punctured the artery after getting into the ambulance!

This is why the current femoral artery bleeding is caused!

I have to say that this is a very rare case!

For a moment, Zhang Yi felt that this patient was a bit unlucky?

Before Chen Fang could speak, Zhang Yi asked directly:

“Before getting in the car, the patient could answer your questions clearly, but now he suddenly has symptoms similar to blood loss.

That can only mean two problems. One is that you didn't check carefully before getting in the car.

The second is that the symptoms the patient is experiencing are caused by an accident while the ambulance is driving.

I would like to ask you if the ambulance was very bumpy on the road?

Or is there some relatively large fluctuation that caused the patient to have this situation? "

The emergency doctor looked at Zhang Yi in surprise, who still had an intern's job badge.

Faced with the questioning of an intern, the emergency doctor felt a little unhappy.

But when I think about it carefully, I still think that this is really the case.

The emergency doctor nodded and said:

"It's really possible according to what you said... I remember that there was a child crossing the road at the intersection of Yuhong Road, and the driver braked at that time.

There was indeed a hard jolt inside the car, but when we observed the patient, we found nothing unusual about him.

How can you determine that the patient's hemorrhagic shock was caused by the brake? "

Emergency doctors with many years of first aid experience will definitely not admit that they did not check properly or had an accident during the rescue.

Zhang Yi didn't have time to explain. He quickly pressed the patient's right thigh with both hands, turned to Chen Fang and said:

"Teacher Chen, hurry up and get the tourniquet and reboa supplies! The patient is in very danger! There is a possibility of shock at any time!"

Chen Fang was a little puzzled by Zhang Yi who was suddenly so nervous and excited.

What's going on with Zhang Yi today?

Aren't they usually the interns who follow me and silently take notes?

Why are you suddenly giving me advice today?

You know, even if he is the best among the interns, he is still just an intern in the end!

Where did he get the courage to command his own teacher? !

"Zhang Yi, you..."

While everyone was surprised...

Suddenly, an unusually loud voice sounded from behind:

"How did you determine that this patient was about to go into hemorrhagic shock? What if he had a closed pneumothorax or just car accident stress disorder?"

Everyone turned around and looked with surprised expressions on their faces!

Chen Fang naturally recognized the person in front of him!

He is the vice president of Tianshui First People's Hospital!

Qian Zhenggang!

Chapter 3 Actually showed off in front of the dean

Everyone was shocked and found it strange!

With such a busy workload, Director Qian rarely comes to the hospital unless the hospital holds internal meetings.

What kind of wind was blowing today? It actually brought Dean Qian here!

However, Chen Fang and several other emergency doctors knew the vice president.

But Zhang Yi doesn’t know him.

As a young intern, the biggest leader in the hospital he had ever seen was the director.

Worse still is the chief director of surgery and internal medicine.

Where has he seen the dean?

Those who don’t know are fearless.

Zhang Yi faced Qian Zhenggang's scrutinizing gaze and said word by word:

“When the patient came in just now, I noticed that the patient’s right foot was slightly swollen and almost pale in color.

Combined with the patient's current symptoms such as decreased blood pressure and accelerated breathing, it is not difficult to suspect that the patient may have lost blood.

But we checked again and found that the patient had no external injuries.

That’s why I concluded that this patient’s symptoms were most likely caused by internal bleeding! "

“As for the bleeding site, I guess it’s the right leg.

As for the closed pneumothorax or car accident stress disorder you mentioned, this is not difficult to rule out.

You can tell if it's a pneumothorax by listening with a stethoscope. "

In patients with pneumothorax, the breath sounds disappear during auscultation and appear as tympani upon percussion.

But this patient obviously had no symptoms of pneumothorax except for a rapid breathing rate.

At this time, after listening to what Zhang Yi said, there were gasps from several interns around him!

"Awesome, can you see this?"

"Huh? Is Zhang Yi agitated by not being kept in the hospital today?"

"I think so too! Why are you so bold to say it all of a sudden?"

"Ouch... This Yi is really a newborn calf who is not afraid of tigers! Doesn't he know that the person in front of him is Vice President Qian? How dare he beep in front of the Vice President?!" Someone behind him whispered.

Chen Fang was shocked!

He looked at Zhang Yi for a moment!

This Yi...why does it look like he has changed? !

When did he observe patients so carefully?

Even Chen Fang didn't notice that the patient's right leg was gradually becoming pale.

After all, it is difficult to tell the difference with only the ankle exposed.

At this time, Qian Zhenggang couldn't help but feel shocked.

He slowly moved his gaze to the patient's ankles.

If you look closely, the right leg has clearly turned into a pale color caused by blood loss.

For a moment, Qian Zhenggang's eyes changed when he looked at Zhang Yi.

This intern observes very carefully! good!

Immediately afterwards, Qian Zhenggang asked again:

“The right leg is quite large and has many blood vessels.