Chapter 47 Assessment (VII) Cardiopulmonary Resuscitation
While the old physician was still excitedly holding Li's father's hand and passionately praising Li San Niang, Physician Sun cleared his throat and, after the murmurs subsided, said, "Of the millions of people in the Tang Dynasty, how many can truly afford to see a doctor?"
It's only in Chang'an that our medical alliance still has some semblance of its former self. Outside of Chang'an, other branches of the alliance in the Tang Dynasty don't have nearly as many physicians.
Third Sister is right. Since we doctors have encountered this, we should certainly treat her!
However, we will discuss the post-treatment issues afterward. If necessary, we can submit an order to the relevant department to ensure that doctors are not extorted by families for failing to save a patient despite their best efforts.
"Dr. Sun is right. We must save lives, but we must also not let good people lose heart. Only in this way can a virtuous cycle continue in the long run!" Dr. Gao said with great satisfaction.
"If Dr. Sun still has any questions, please ask her after the meeting. Time is short, so next, San Niang will talk to everyone about CPR."
Then, people were organized to put the two long tables together as a demonstration area.
"I have already told you all that this method can be used to save people who are drowning or who have suffered sudden cardiac arrest due to accidents. Next, my second brother and eldest brother will demonstrate it for you."
As he spoke, Li Dalang appeared, moving his hands back and forth as if swimming in the water. Suddenly, he stopped moving and then fell to the ground with a "plop".
Then Li Erxiong appeared, performing the act of swimming vigorously to Li Dalang and dragging him to the side from behind.
To save a drowning person, you must approach from behind to prevent the rescuer from being dragged down by the instinct for survival.
Of course, the truth is that Li Dalang stood up on his own, pretended to lean on Li Erxiong's back, and then lay down in the middle of the long table.
"Ladies and gentlemen, no matter what kind of cardiac arrest has occurred and someone has stopped breathing, the first step in saving them must be to ensure our own safety. Otherwise, if we fail to save the person and end up losing another person, it will truly be a loss."
Furthermore, when implementing this method, a wide-open and flat site is most suitable.
Li Erxiong looked at Li Dalang, who was lying down with his eyes closed and pretending to hold his breath. He first looked around to make sure it was a safe environment. Then, Li Erxiong suddenly knelt down on one knee and patted Li Dalang's shoulder hard, shouting, "Young man, are you alright?" He repeated it three or four times to see if Li Dalang would react.
After confirming there was no response, Li Erxiong first checked Li Dalang's breathing with his fingers, then felt for a pulse in his neck artery, and finally listened to Li Dalang's chest to see if there was still a heartbeat.
"After we confirm that the scene is safe, the first thing we need to do is to determine whether the person is still breathing, has a pulse, and a heartbeat."
While listening to Li San Niang's explanation and watching Li Er Xiong and Li Da Lang's demonstration, everyone present found it vivid and easy to understand. They all watched attentively, afraid of missing something if they blinked.
"Ladies and gentlemen, once it is determined that the person is unconscious, has no breathing, pulse, or heartbeat, cardiopulmonary resuscitation (CPR) must be performed. This is what I explained earlier using the anatomical diagram drawn by my second brother. We need to use external force to press on the heart to ensure a continuous blood supply and prevent the brain from losing blood supply and causing death."
Li Erxiong then untied Li Dalang's belt, lifted his clothes, and unbuttoned his undergarments. Apart from Li Sanniang, there were only two women present: Li's mother and Li's grandmother. Li Sanniang was his aunt, so it didn't matter. He had asked Li Dalang himself before, and he said that he often went shirtless when practicing martial arts. If it was for the purpose of demonstrating clearly, there was nothing wrong with exposing his body.
"As for the human body structure, I think that Physician Sun, who specializes in ulcer treatment, should know it best." Taking the opportunity to flatter Physician Sun, who had always supported her, Li San Niang continued, "Everyone, please come closer and take a look, this is very important."
Li Erxiong placed the bottom of one hand directly on the lower third of Li Dalang's sternum, then placed the bottom of the other hand on top of the first hand, interlacing the fingers and keeping them pointing upwards. Having found the correct position and assumed the ready posture, he remained still, watching Li Sanniang wait for the next step.
Li San Niang thought to herself, "Luckily, this table is wide, long, and tall enough. Otherwise, the demonstration wouldn't be able to be clearly seen by all thirty or forty people in the room."
“Please look closely at where my second brother’s hands are folded,” Li San Niang said, pointing to the jujube branch she had used to explain the anatomical diagram. “This is the heart. By pressing this area regularly in this position, we can stimulate the heart and restore its pumping function.”
Li Erxiong pretended to stretch out his arms and press down vertically using his own weight. Of course, he didn't actually press down. Li Dalang was a healthy, normal person, not a modern simulated plastic mannequin. It would be strange if he didn't have a problem if he went down like that.
Therefore, Brother Li Er was only maintaining this posture to make it easier for everyone to watch and for Sister Li San to explain.
"Ladies and gentlemen, this pressing is the key. The trick here is to press enough times and to the right depth."
Furthermore, when pressing, don't just press down hard all at once; allow the sternum sufficient time to rebound. Notice how my second brother's palm heels; when pressing down firmly and waiting for the rebound, the palm heel shouldn't leave the skin to avoid displacement and ineffective pressure.
"Why don't you have your second brother subdue us, Third Sister?"
“My eldest son is a healthy man, so we can’t just use this method on him. This is for saving someone who is on the verge of death!”
As he spoke, Li Dalang straightened his clothes and got down from the table. He bowed to those around him and walked towards his father and mother.
Before he even stepped inside, Li's mother, feeling sorry for him, quickly brought him a cup of tea.
Seeing that Li Dalang had already left, Li Sanniang asked Li Erlang to bring over a large piece of pork with skin that he had brought from home and place it on the long table. She then gestured to Li Erlang to press the pork.
Li Erxiong frowned and asked Li Sanniang with his eyes, "Are you serious?"
Li San Niang nodded, "Otherwise, what can we do? We can't just use this on a real person!"
Brother Li then gritted his teeth and pressed on, saying, "Everyone, watch closely. This frequency, depth, and technique."
At least 100 presses per minute, with a depth of at least 5 centimeters according to modern calculations, and the pressing and relaxing time each accounting for about half. When relaxing, the heel of the palm should not leave the chest wall to avoid displacement of the pressing point.
"Ladies and gentlemen, it's not very obvious on this pork, but please remember that the effective pressing depth is the width of three fingers. Alright, Second Brother, come down now, thank you for your hard work."
Li Erxiong quickly stopped the embarrassing demonstration and took the pork off the table. Li Dalang, who was observant, took a rag and came up to wipe the greasy table.
"Ladies and gentlemen, chest compressions are very physically demanding. As Dr. Sun has personally experienced it, he should understand the difficulty involved."
Sun, the medical supervisor whose name was called, naturally cheered, since he had indeed used this method to save a drowning soldier. Although he himself did not perform it in such a standardized way at the time, he was indeed involved.
"Yes, I just roughly followed the method I heard from Di Shaoqing that day, and used it as a last resort. According to San Niang, chest compressions are extremely strenuous. I didn't press down at least three finger widths as San Niang said, but after pressing back and forth twice, my arms were already very sore."
If what Third Sister said is true, it must require considerable strength and endurance.
After listening to Dr. Sun's explanation, Li Sanniang nodded in agreement. "The most important part of this method is chest compressions. They must be quick and forceful, and as uninterrupted as possible. If there are too many interruptions, the blood supply may be interrupted, reducing the probability of successful resuscitation."
It already relies heavily on luck; if this continues, the chances of saving the patient are even lower.
"Then I ask you, if even a skilled surgeon like Dr. Sun, who spends his years in the military camp, finds it difficult, how did Li San Niangzi, a delicate young woman, manage to save the daughter of the Duke of Liang?"
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