episode_0029

Episode 29. Severely Traumatized Patient (1)

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Under the sky, above the earth.

The Imperial domain was everywhere the wind blew and the sunlight touched, but that couldn’t change Princess Mint’s mood.

Princess Mint was worried.

Even if I came to the academy, everyone was afraid of me because I was the princess. Other than the fact that I had less time to see certain people… … I just wish they would go back to the palace with me.

****

It looks like my personal information has been leaked somewhere.

Spam emails arrive in this world too.

It could simply be that the Academy of Healing is bringing me all the letters that come to me. Either way, the spam is piling up. It’s hard to read them all.

The only things I read were letters from people whose names I knew. Like the Baron of Lapis.

– I have a public health issue on which I would like to ask Professor Asterix for his opinion. I would appreciate it if you could reply to my letter as soon as you see it. I appreciate your time.

– Baron Olympus of Lapis.

This was a letter that needed to be answered.

Prince.

– How’s Mint? There’s been no reply.

– You idiot, you’re trying to pretend you didn’t get the letter. This is an imperial document. Please fill out two pages of the answer.

No, I didn’t even look at your face. How did I know you weren’t going to answer? As expected, he’s not a prince for nothing. His intuition is superhuman.

A few letters from people I know that I absolutely have to see. I don’t know what else I’m getting. Oh. Could it be that there’s a fresh graduate school application mixed in?

I searched through the pile of letters for a long time, but there was no application for graduate school. Of course, if I was a student thinking about going to graduate school, I would have come here first.

ha.

So then, what is this much stuff?

Most of the letters were from healers outside the academy. Half of them were rebuttals. Your opinion is wrong, can you try the experiment, what didn’t work, this seems reasonable.

I don’t think it would be possible to read them all one by one.

I’ll have to ask Istina later.

anyway.

The academic situation is chaotic, but work must be done. I must see patients and guard the ward. If I don’t do it, Istina will have to do it.

However, only a small number of patients come to me. Most of them come with simple illnesses and return after receiving healing magic.

‘It’s fortunate that there aren’t many hospitalized patients.’

I muttered softly.

As soon as I said that it wasn’t that much, there was a knock on the lab door.

Bang bang bang.

An urgent knock can mean only one thing.

Istina poked her head into the study room in a hurry. I sighed inwardly.

“Professor, we have a new patient admitted.”

“No, is talking to yourself also a flag?”

“Did I hear that wrong?”

“No. What kind of patient is this?”

Istina opened her notebook.

“There are several. First, one patient came in with a bruise on the left upper abdomen, dizziness, and difficulty seeing, and another patient said he heard a loud bang from his ankle-”

It was a creepy sound.

“Wait a minute. You can’t see because of the bruise on your left upper abdomen? How much time has passed?”

“I don’t know how many hours have passed since the accident, I just came into the hospital and said, Professor-”

I ran towards the ward.

“Professor! The patient is just a little sleepy, but he received a lot of healing magic when he came in, and he took some painkillers and got better-”

“No, if you fall asleep like that, you’ll lose it!”

Of course, the patient may be sleepy. He may be tired. However, a patient with massive bleeding should not fall asleep just because he is sleepy.

“You didn’t cover me with a blanket?”

“A blanket? It’s in the ward.”

Oh no! This is a big problem.

You shouldn’t cover me with a blanket.

“Istina! Go and fill the bucket with water.”

Boom! I ran to my ward.

Well, the trauma patient that Istina was talking about, it seems like his eyes are still open. That’s fortunate.

This time, a young male patient. However, he doesn’t seem to be old enough to be an academy student.

Judging by his clothes, he doesn’t seem to be a commoner.

Her complexion is pale, and her eyelids and eyes are droopy, indicating that she seems sleepy. The most likely explanation is a loss of consciousness due to bleeding.

The cause of the bleeding is trauma. It is not known which organ was damaged, but it is most likely the spleen.

I immediately snatched the blanket the patient was covering himself with, threw it on the floor, and shook the patient awake.

“Patient! If you sleep now, you will die!”

“Yes?”

“Wake up now!”

“Ugh. I’m tired… … .”

Hey, don’t close your eyes.

“Please tell me the patient’s name!”

“Kailas Copperfield. Uh, after some training at the Academy’s training grounds. That, uh, ah.”

The state of consciousness is fluctuating.

This patient is dying.

Actually, it doesn’t matter who this patient is. What matters is that the patient came in with upper abdominal trauma and was unconscious.

First of all, I heard the name.

Istina came back quickly. She put down a bucket full of water next to me, and I poured the water over the patient.

“Huh, what the-!”

“Wake up, please?”

The patient and those around him were drenched in water. I picked up the towel I had brought. Everyone looked at me like they were crazy… … .

****

There was a good reason.

During World War II, or maybe World War I, anyway, during a time of war and a lot of people getting shot, something like this happened.

Field surgeons have found that soldiers who are left unattended and not even covered with a blanket have a higher survival rate than soldiers who are covered with a blanket after being shot.

why?

There are many reasons, but the most important one is this. When the surroundings are warm, the parasympathetic nerves in the blood vessels at the edge of the body are activated.

When the surroundings become warm and peripheral blood vessels expand, blood flow to the brain and heart decreases.

If it overlaps with a large hemorrhage, the brain will not be able to secure enough blood flow to function properly, so you will feel sleepy. If you just sleep because you feel sleepy at this point, you will die.

This patient is suspected of having internal bleeding. Considering the location of the bruise, it is likely to be the spleen.

“Would someone who is sleepy be more important than someone who has a torn ankle tendon?”

“Even if the ankle tendon breaks, you won’t die.”

Achilles heel. Even if you can’t do that, you could probably walk with a pair of crutches.

On the other hand, bleeding due to internal injuries and subsequent loss of consciousness is a life-threatening condition that can lead to death within hours.

The patient with the bruises was looking at me with a puzzled expression, holding onto his damp hospital gown. He was shaking.

I felt sorry, but if I didn’t shake, I could die. I pressed my finger on the patient’s neck and took his pulse. 18 times in 10 seconds.

I think it’s within the normal range.

It might be a little faster.

“Are you feeling better?”

“It’s cold.”

“Come to your senses.”

Come to think of it, I should have made a blood pressure monitor.

I need to know my blood pressure.

I suspect internal bleeding, but when I checked the patient’s vital signs, I found that there was no blood pressure cuff. Since he was injured, his blood pressure would have dropped.

Is there a way to measure blood pressure without a blood pressure monitor?

Let’s think about it.

Blood pressure. What can replace blood pressure? Pulse? No. If you press your wrist, you can’t feel the difference in blood pressure…

Let’s think again about what blood pressure is. Blood pressure is the pressure at which blood flows through the arteries. Usually, systolic and diastolic numbers are measured together.

Wait a minute, why do we need to check blood pressure? Isn’t the point of checking blood pressure to see if the patient has insufficient blood flow?

Oh, come to think of it, there was a way to find out, albeit indirectly. I tried to feel the pulse of the patient’s wrist, but I couldn’t.

Although it varies from person to person, systolic blood pressure must be over 80 to be able to take a pulse at the wrist.

There is another way to measure it indirectly.

This is not a method of measuring arterial blood pressure, but rather venous blood pressure. It involves pressing the jugular vein to determine where the jugular pulse is felt.

I pressed the patient’s neck with my index finger. The jugular pulse was felt 3 centimeters above the sternum. The expected central venous pressure was 2 mmHg.

I have low blood pressure.

Pallor, decreased consciousness, absence of wrist pulse, decreased central venous pressure. Several factors suggest that blood pressure is very low due to bleeding.

There is one thing to do.

“Patient! You must select ”

“What?”

I wish Mr. Kailash would come to his senses and think things through. This patient’s consciousness is so impaired that I feel like whatever choice he makes will be a decision made while asleep.

It’s a life-or-death choice.

“To be brief. It seems like the patient is bleeding inside his body. If we leave it like this, I don’t think there’s a chance of him waking up tomorrow.”

“Yes?”

“The healing magic has already been used. If you refuse the surgery, we will try to keep you alive as much as possible with healing magic and medicine until you fall asleep.”

“Oh, it’s not that bad-”

It’s strange. If my spleen ruptured, it would hurt so badly. Why is it fine? It might have hurt when it burst and then the pain subsided, or it might not hurt because of the healing magic or drugs.

That’s not important.

“I think I need surgery. However, I cannot guarantee my survival after the surgery, I cannot be certain of the success of the surgery, and the surgery I am about to have will definitely have side effects.”

“If you don’t do it, you die?”

I struggled with my words. This is often the case with doctors. We tell patients that they have the right to decide about their medical treatment… … .

Well, even if you threatened me with a knife, I don’t think you could have come up with a more biased option than this.

If you don’t have surgery, you’ll die.

Are you going to have surgery?

All I could do was ask, “Do you want to die?” The patient had no choice but to nod. Well… … Let’s start the surgery as soon as possible.

It is a sin that can be forgiven if only the person is saved.