Chapter 904: [904] Debate whether to transfer to another hospital or not Chapter 904: [904] Debate whether to transfer to another hospital or not At Level Three, weâre looking at splenic hilum rupture, and at Level Four, the most severe, a serious splenic fragmentation where the whole spleen may need to be removed.
Doctor Zhou was so astonished because when the child had been brought into the county hospital, he had already made it clear: their surgery department was not equipped to operate on infantsâthere was no doctor capable of doing it.
âWeâll have to send her to a higher-level hospital,â Doctor Zhou said hurriedly to Xie Wanying and Nie Jiamin, instructing the nurses to call and contact the nearest city hospital that could take the child.
Seeing that Doctor Zhou might not have understood Teacher Nieâs intention, Xie Wanying stepped in to clarify, âDoctor Zhou, weâre not sending her to the city hospital. Teacher Nieâs thinking is that the surgery must be done here in the OR because there isnât time to transport her to the city hospital.â
Doctor Zhou, agitated and on edge, protested, âYouâre not unawareâIâve already told you, no one here can do it. We need to start an IV and give her a blood transfusion, give her more to keep her alive until she can be transported to the city hospital, where there are doctors who can operate. Itâs about a two-hour drive.â
âTwo hours will be too late; sheâs had a splenic hilum rupture and is severely hemorrhaging,â said Xie Wanying.
Her words caught Nie Jiaminâs attention. Turning his head, he saw a glint of understanding in her eyes: she must have also interpreted the ultrasound images herself, just like him, to have noticed the splenic hilum rupture based on the brief report from the ultrasound doctor.
âAbsolutely not,â Doctor Zhou insisted on his view, betraying his fear of the child dying on the operating table here and expressing strong displeasure to Xie Wanying, âYouâre just a student; you havenât seen this type of patient before. Iâve seen many similar cases. Even more severe than hers have been safely transported for surgery in the city.â
âHow much more severe? If she doesnât have an abdominal exploration to stop the bleeding soon, the blood loss will be unimaginable. Sheâs an infant.â
Doctor Zhou was utterly astounded by her statement, âWhere did you draw that conclusion from?â
âSplenic hilum rupture, bursting of the splenic artery and vein. If you percuss her abdomen again, youâll find shifting dullness,â stated Xie Wanying.
In adults, shifting dullness typically suggests an intra-abdominal fluid volume close to or exceeding 1000 milliliters; certainly, the situation for infants is even worse. Doctor Zhou found himself at a loss for words, âThisââ Realizing she was citing data, he would have to bring up relevant data to refute her.
Someone couldnât help but laugh.
Doctor Zhou turned his head and saw the reserved specialist, Teacher Nie, smiling.
Some people use their eloquence for sophistry, others use it to demonstrate competence. The laughter that Nie Jiamin couldnât suppress indicated he found genuine and straightforward advocacy from such a person, clearly of the latter kindâa delight that sprung from within.
Hearing her teacher laugh, Xie Wanying halted her explanation, reflecting that perhaps she had spoken too much in front of Teacher Nie, engaging in showing off before an expert.
With the student pausing, Nie Jiamin quickly said, âPerform an abdominal paracentesis to confirm the diagnosis, then send her to the OR.â
âBut, but the Chief Surgeonââ Doctor Zhou, looking at the specialist from the Capital, blinked desperately: Boss, please donât make things difficult for us, even if youâre from Guoxie, we mustnât act recklessly. No one here can be forced into surgery.
Teacher Nie was humble, but Doctor Zhou didnât seem to get the message.