Chapter 61 Emergency Rescue
Lin Che was wrapped up tightly by Lu Yu and escorted to the door of the pediatric clinic. Lu Yu carefully checked his scarf and hat again, making sure no cold wind could get in, before stuffing the bag containing the insulated lunch box into his hands - inside was the breakfast that Lu Yu had carefully prepared early in the morning.
"Eat it hot at noon, don't make do with the cafeteria." Lu Yu whispered, his fingers gently brushing over a strand of hair on his forehead that was pressed up by his hat, the concern in his eyes almost overflowing, "Call me immediately if anything happens, don't force yourself, do you hear me?"
Lin Che felt warmed by this meticulous care, yet also a little helpless. She could only nod, "I hear you, Driver Lu. Hurry up and get to the company. You'll be late if you dawdle any longer."
Only then did Lu Yu reluctantly let go of his hand and watched him turn and walk towards the clinic.
Lin Che had just walked to the nurses' station and was about to turn into the doctor's office when she almost bumped into a hurried man holding a half-full cup of espresso.
"Ouch!" The other person exclaimed and quickly steady the coffee cup in his hand. A few drops of dark brown liquid splashed onto the cuffs of his white coat.
Lin Che was also startled and quickly took a step back: "Sorry, sorry, I didn't look where I was going..."
He looked up and saw who was coming. It was Gu Yaoxi, who had two obvious dark circles under his eyes and his hair was a little messy because of the surgical cap.
Gu Yaoxi had obviously just finished a long night shift. The look behind his glasses showed fatigue from staying up late and a slight distraction from high concentration.
When he saw that it was Lin Che, he was stunned for a moment, and then his tired eyes immediately lit up, as if he had discovered something rare.
"Lin Che?!" Gu Yaoxi's voice was hoarse from staying up late, but the surprise and teasing in his tone instantly dispelled his sleepiness. "What a rare visitor! So early in the morning... I thought I was seeing things. Did you actually come back to work?"
He looked Lin Che up and down, his eyes especially lingering on the smoky grey cashmere scarf that Lu Yu had tied around his neck meticulously, the down jacket zipped up to the top, and the obviously expensive insulated lunch box in his hand. The corners of his mouth curled up in a meaningful arc.
"Tsk, tsk, tsk," Gu Yaoxi shook his head, leaning closer, lowering his voice with a heavy dose of teasing, "Look at this gear, this complexion... Tsk, tsk, have they been treating you like a greenhouse flower for a month? You're all wrapped up like you're going on an Arctic expedition."
He extended his finger and lightly tapped Lin Che's scarf and hat, then pointed at the lunch box bag. "This loving breakfast must be very rich, right? The steamed buns in our cafeteria really can't compare."
Lin Che's ears were burning with his series of teasing. The warmth she felt when she was "packed" by Lu Yu in the morning was mixed with the embarrassment at this moment.
He waved his hand helplessly: "Brother Gu, please stop making fun of me. Just got off the night shift? You must have worked hard."
"Hard work is the norm. I'm used to it." Gu Yaoxi took a big sip of coffee, trying to dispel the weariness, but his eyes still lingered on Lin Che's face with an inquiring smile. "Honestly, how do you feel? You haven't been to the hospital for a month, and you're working in the outpatient department right after returning. Can you handle it? I see the way you walk..."
He glanced at Lin Che's legs, "Still a little dizzy?"
Lin Che nodded calmly, "I do feel a little weak. I get tired easily after standing for a long time. But I'll get used to it slowly. I have to come back eventually."
"Well, do what you can. Don't try to be too aggressive." Gu Yaoxi's tone became more serious, tinged with concern. "Health is the capital of revolution. You've just recharged your capital, so spend it slowly. Director Zhang asked about you this morning. I guess he's worried about your condition."
When Lin Che heard Director Zhang, his heart moved, and he immediately remembered the rumors that Li Qiuyi mentioned a few days ago.
He hesitated for a moment, then asked, "Brother Gu...is it true that the hospital is planning to set up a pediatric acute abdomen collaboration group? Is Director Zhang pushing for it?"
Gu Yaoxi's eyes behind his glasses flashed with understanding and admiration, and he nodded. "There are indeed rumors. Director Zhang has been in meetings with general surgery, anesthesia, and imaging departments recently. There's been a lot of resistance, after all, Li Ming's incident dug too deep a hole. But Old Zhang is determined this time."
He looked at Lin Che, his eyes becoming serious. "Junior Brother, if this were to succeed, it would be an absolute daunting task. The idea you proposed was a good one, but when it comes to actually implementing it, the workload, pressure, and difficulty of coordination would increase exponentially. Can your current body... handle it?"
Lin Che met Gu Yaoxi's scrutinizing gaze without flinching. "Even if I can't handle it, I have to take it. This opportunity is rare, so I have to take it no matter how difficult it is. As long as Director Zhang needs it, and as long as it's beneficial to the children, I will do my best."
"Good boy! This is the Lin Che I know." He grinned, and the fatigue from staying up late seemed to be diluted a little by this smile. "Okay, with your words, Old Zhang is more confident. But..."
He changed the subject and resumed his mischievous tone, pointing at the insulated lunch box in Lin Che's hand. "Before that, digest this heavy dose of love from your boss, Mr. Lu, and replenish your energy. Those little devils in the clinic this morning won't show any mercy."
Lin Che was amused by his last sentence, and the heat on her face, which had just subsided, returned a little. He nodded, "I understand. Senior brother, go hand in your shift and rest. You look like you have dark circles under your eyes."
"Understood!" Gu Yaoxi gave an exaggerated, non-standard salute, then, holding the remaining coffee cup, he walked towards the lounge with unsteady but clear steps, muttering as he walked, "I need to catch up on some sleep. Even if the sky falls, I'll wait until I wake up..."
Lin Che watched Gu Yaoxi's slightly tired but still upright figure disappear around the corner of the corridor. He lowered his head to look at the warm lunch bag in his hand, then raised his eyes to look at the corridor of the clinic where patients and their parents were already beginning to move around.
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Just as it was about to get off work at noon, Lin Che had just finished treating a 4-year-old child with intestinal obstruction and sent him to the hospital for observation when he received a call from Zhang Mingli.
"Hello, Director Zhang?" Lin Che picked up the phone immediately, a strange premonition crossing his mind.
"Are you still in the outpatient clinic?" Director Zhang Mingli spoke rapidly, his voice tinged with urgency. "The emergency department just called me. They've admitted a newborn less than 48 hours old, and they highly suspect meconium peritonitis. An immediate multidisciplinary consultation is needed. General surgery, neonatology, and anesthesiology have all been notified. Please come quickly and work with general surgery and neonatology! The child's abdominal signs and X-rays all point to this condition. You have experience in both pediatrics and general surgery, so please go take a look."
Meconium peritonitis!
These words hit Lin Che's heart like a hammer. This was one of the most dangerous emergencies in neonatal surgery. Meconium entering the abdominal cavity caused severe chemical peritonitis and infection. The mortality rate was extremely high, and rescuing the patient was a race against death.
"Understood! I'll be right there!" Lin Che didn't hesitate at all, instantly switching back to work. He grabbed the white coat he had just taken off and hurriedly put it on, not even taking the time to tie his scarf. He grabbed his phone and stethoscope and rushed out of the clinic.
At the door of the emergency room, the atmosphere was so solemn that it seemed as if water could be squeezed out of it.
Under the glaring light, a newborn with purplish skin and an abnormally distended abdomen lay on a small emergency bed, uttering faint, intermittent moans. A nearby electrocardiogram monitor blared a sharp alarm, its heart rate showing a rapid and irregular beat, its oxygen saturation hovering dangerously low.
The child's parents were stopped outside the door, and the mother collapsed in her husband's arms, her suppressed sobs heartbreaking. Nurses moved quickly, pushing the emergency cart and connecting various tubes.
When Lin Che rushed in, Director Zhao from the General Surgery Department and Director Liu from the Neonatology Department were already gathered around the bed, and the anesthesiologist was also on standby.
"Doctor Lin is here!" Director Li of the emergency department immediately waved at him upon seeing him. "Hurry! The baby is 38 weeks gestational age, delivered vaginally. 24 hours after birth, abdominal distension began, and the baby is refusing milk, with symptoms progressively worsening. He's now in the early stages of shock! An upright abdominal X-ray shows free air below the diaphragm, extensively dilated bowel, and large fluid-air levels and calcifications in the abdominal cavity! It's highly consistent with perforated meconium peritonitis!"
Lin Che quickly donned gloves and leaned in close to the child. The child's abdomen was as taut as a drum, its skin stretched to a sheen, and even the dilated veins were visible. He gently palpated the abdomen, revealing a hard, board-like surface with noticeable tenderness and rebound pain. Under the stethoscope, bowel sounds were almost absent. Breathing was shallow, rapid, and labored, and the lips were cyanotic.
"The signs of peritonitis are very typical, indicating septic shock." Lin Che's voice was calm and quick, carrying unquestionable professional judgment. "Surgical exploration is necessary immediately! Director Zhao?"
"Agreed!" Director Zhao of the General Surgery Department's face was stern, and his voice was equally rapid. "Time is of the essence! Immediately open a second major intravenous line, rapidly infuse fluids to combat shock, administer broad-spectrum antibiotics, and cross-match blood for preparation. The anesthesia department should prepare for intubation. Also, immediately notify the operating room and prepare the operating room for an emergency laparotomy of the newborn. Dr. Lin, I'm leaving the neonatal circulatory support and correction of internal environmental disturbances to you and Director Liu. Preoperative preparations must be expedited!"
"Quick! Expand the volume with normal saline! Rapidly infuse 20ml/kg!"
"Adrenaline micro pump standby!"
"Draw blood gas! Urgent check! Electrolytes, lactic acid, infection indicators, all!"
"Prepare for intubation! Laryngoscope! 3.0 tube!"
"Attractor! Quick!"
"Keep warm! Turn up the temperature on the radiation table!"
The cacophony of commands, the clatter of instruments, the sound of nurses repeating orders... all these sounds intertwined, creating a tense, almost suffocating atmosphere. Everyone was racing against time.
Lin Che stood at the head of the bed, his eyes sharp, closely watching every change in the numbers on the monitor while quickly issuing medical orders: "Expand the volume faster! The lactate level is too high. Dilute 5ml of sodium bicarbonate and slowly administer it to correct the acidosis! Increase the dopamine micropump to maintain blood pressure! Pay attention to urine output!"
He leaned over and personally adjusted the ventilator parameters to ensure adequate ventilation support.
The blood vessels of a newborn are delicate, and the second venous channel was punctured several times before it was successful. Sweat was dripping down Lin Che's temples, but he was completely unaware of it.
Director Zhao of the General Surgery Department and his assistants were already making the final preoperative disinfection preparations. The anesthesiologist successfully intubated and connected the child to the ventilator. The child's chest rose and fell rhythmically with the machine. Although weak, his vital signs were temporarily stabilized.
"Blood pressure has risen! Heart rate has stabilized slightly!" the nurse reported.
"Okay! Hold on! Send him to the operating room immediately!" Director Zhao gave the order.
Lin Che and Director Liu of the Neonatal Department escorted the patient all the way, pushing a rescue bed with a ventilator, a monitor, and various life-sustaining tubes. Amid the shrill sound of alarms, they quickly crossed the corridor and rushed to the operating room.
The heavy automatic door of the operating room closed behind him, isolating him from the anxiety and prayers outside.
But inside the door, there is another war without the smoke of gunpowder.
Lin Che and Director Liu stayed in the conversation room outside the operating room, closely watching the situation inside through the observation window, ready to deal with any crisis that might arise during the operation.
The child's blood gas results came out, and his internal environment was in a mess. They immediately adjusted the intravenous medication plan based on the results, maintaining the child's fragile vital signs and buying time for their comrades on the operating table.
Time passes by minute by minute, and every second seems so long.
Lin Che leaned against the cold wall, his white coat stained with sweat and unknown liquids, but his eyes were fixed on the small figure under the shadowless light in the observation window and the busy silhouettes of the doctors.
After an unknown amount of time, the operating room door finally opened. Director Zhao walked out. Although he was wearing a mask, the solemn expression on his face had eased slightly.
"How is it?" Lin Che and Director Liu immediately surrounded them.
"We found it! It's definitely a perforation of the terminal ileum. The abdominal cavity is heavily contaminated with meconium and pus." Director Zhao's voice was hoarse and tired from the surgery, but more of a sense of relief. "We repaired the perforation and flushed the abdominal cavity with copious amounts of warm saline. The procedure went smoothly, and the child's vital signs have stabilized for now. However, the infection is severe, and the child hasn't passed the postoperative stage yet. He needs to be sent to the NICU for close monitoring. We must not slack off on anti-infection, nutritional support, or circulatory and respiratory support."
Hearing "vital signs are stable," Lin Che's tense nerves relaxed slightly, and a strong sense of fatigue instantly swept over him. He breathed a long sigh of relief, and the cold sweat on his back finally felt cool.
"That's great..." Director Liu also breathed a sigh of relief. "We will fully take over the NICU."
The subsequent handover, explaining the patient’s condition to the family, and completing the medical records...are another series of tasks.
Director Zhao took off his mask, leaving a noticeable mark on his face. He rubbed his reddened eyes and spoke in a heavy voice, his gaze sweeping over Lin Che and Director Liu:
"Director Liu, Doctor Lin, thank you for your hard work today. This child's life has been saved for now, but every step was a tightrope." He turned, tossed his mask into the trash can, and continued with a serious expression, "Opening intravenous access, preoperative shock control, correcting the internal environment, maintaining the operation... A single step, a lack of coordination, or a drastic change in the outcome could have made all the difference."
He paused, his fingers unconsciously tapping the table, making a soft clatter. His eyes sharpened. "Today's case is the perfect example! With neonatal acute abdomen, especially something as dangerous as meconium peritonitis, time is of the essence. But it's also the time most easily wasted on process integration and multi-disciplinary wrangling!"
Lin Che and Director Liu both nodded in agreement.
Although today's rescue was intense and efficient, some of the subtle blockages, such as the waiting time for consultation and the short communication costs when multiple departments initially reached a consensus, can only be deeply understood by those who are in it.
Every second of delay is a fatal threat to that fragile little life.
"So!" Director Zhao's voice was firm and undeniable, with an undeniable urgency. "Establishing a collaborative group for pediatric acute abdomen is urgent! We can't wait any longer! We must break down departmental barriers and establish a standardized, streamlined rapid response mechanism. Starting with emergency pre-screening and triage to identify high-risk children, to the coordinated efforts of general surgery, anesthesia, imaging, laboratory testing, neonatology, and pediatrics, to the seamless integration of operating room green channels and postoperative monitoring, we must do it just like today, or even faster, more stable, and more coordinated than today! This isn't just the responsibility of one department; it's a hospital-wide effort to protect the right to life of children with acute illnesses!"
He looked at Lin Che, his eyes filled with hope and expectation. "Doctor Lin, you've worked in general surgery before, and now you're in pediatrics. You're familiar with both sides, and the one-stop collaborative process you proposed is very forward-looking. Director Zhang told me you're pushing it. How's it going? Can you handle it? If this collaborative group really gets off the ground, you'll definitely be the core backbone, and the burden will be heavy."
Lin Che leaned against the cold wall, Director Zhao's resounding words still ringing in his ears. The words "no time to lose" struck his heart like a hammer.
He looked down at his fingers, which were trembling slightly from the excessive force of the penetration. The feeling of weakness rising from deep within his body was so real.
"Director Zhao," Lin Che's voice was a little hoarse with fatigue, but surprisingly clear and powerful. "I'm fine. As long as the hospital approves this collaboration group, and as long as Director Zhang and you need it, I'm ready. I'll sort out the procedures, formulate the system, coordinate with the departments... Whatever you need me to do, I'll do my best. The child's life can't wait."
Director Zhao patted Lin Che's shoulder firmly. "Great! I feel more confident now that you've said that! Once the child's condition stabilizes, we'll meet with Director Zhang and get the framework set up as soon as possible!"
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