Before Kawei traveled, he stayed in a trauma center based on a large general hospital, which mainly dealt with burns, traffic accidents, high falls and some complex trauma. He was transferred to work there from the very beginning of the center's establishment and worked there for more than 30 years.
When it comes to dealing with trauma, it’s no exaggeration to praise him for his ease.
Li Ben had numerous wounds on his body, involving his maxillofacial region, nose, forearms, thighs and, importantly, his neck.
Knife wounds need to be classified into types. Transverse cuts are often shallower than longitudinal stabs and are less likely to touch deep tissues. However, because the injury range is larger, important superficial nerves and blood vessels will be more affected.
Judging from Li Ben's reaction and the amount of blood loss at the scene, Nora's attack was all too light. He was not killed on the spot due to his limited height and strength.
As long as there is a chance, Kawei will save him, not because of the lofty concept of "saving people is a doctor's bounden duty". Saving people has already been engraved in the bone marrow, and it is considered instinctive.
What really drove him to make his decision were more selfish things, such as "satisfying his own little vanity by completing some difficult challenges." Otherwise, he wouldn't have been able to entertain himself and work in the trauma center for so many years.
Of course, from the 21st century to the 19th century, the lack of medical standards and systems and the existence of surgical theaters fostered a certain evil in his heart. Although it does not mean to obliterate the most basic professional ethics, it can still be done by adhering to contemporary "medical standards" to disgust the scum.
The premise of disgusting people is that the other party is still alive, and Li Ben must be revived first.
The current situation is not complicated. East Nellington Street is populated by poor people from the lower class. To order a carriage, you have to go to Hoints Street, which is crowded with people. And those rickshaw drivers will not pay attention to the poor. Only when the police come can they be persuaded to go into the dark alley to save people.
Waiting for the carriage to arrive and loading the person into the carriage, I am afraid it will be an hour before they actually enter the hospital. The bleeding must be stopped on the spot.
What Kawei has to do is to first make a simple judgment on the wound that may cause heavy bleeding, and then sort out the order of suturing and tying to stop the bleeding, and perform ligation in sequence.
Judging from these active bleeding wounds, the more important ones are the neck and thighs.
"The neck and thighs are covered. Let me see how your legs are injured first."
Kawei checked his pulse first, and when he found it was still OK, he cut open his pants. The blood hidden inside flowed down, and an unpleasant smell of blood filled the air.
Li Ben's left thigh suffered a knife wound from the outside inward. Because of its low position, it avoided the superficial femoral artery and vein and deep femoral artery and vein that ran high, and only incised the vastus lateralis muscle and the deep femoral artery. Rectus femoris.
The blade did not penetrate too far and left the thigh without touching the vastus medialis muscle close to the blood vessel. Judging from the trajectory, it should have injured some branches of the descending branch of the lateral femoral circumflex artery. It's just that the amount of bleeding from the leg wound is average and can't be seen yet. 【1】
In comparison, the neck wound was much more serious.
If placed in modern times, such a neck incision injury of approximately 10cm, regardless of the degree of injury, should still be bandaged first, and then be carefully explored in a well-equipped operating room.
But now Kawei has no operating room, no trustworthy trauma team, no stable anesthesia, and a long time before entering the hospital. Bandaging first will definitely further affect the airway, so he still wants to take the risk and rely on his own experience to determine the specific location. 【2】
Kawei picked up a candle that was still lit from the ground and leaned over: "Keep pressing your legs, let me take a look at your neck."
Li Ben slowly removed his hand, and soon a lot of blood oozed from the wound on his neck, and the amount of bleeding was considerable.
The skin on the entire neck was tight and felt hard to the touch, and it seemed that a small hematoma had formed. After a brief glance, Kawei put his hand back to its original position and pressed it down. It was initially determined that the deep blood vessels had been damaged, the anterior cervical muscles were ruptured, and the sternocleidomastoid muscle was damaged. .
The deep large blood vessels are protected by the carotid sheath, but their shape is superficial. The internal jugular vein may have been ruptured, and the condition of the artery being deeper is unknown. 【3】
Li Ben could clearly feel his neck bleeding, and his survival instinct made him say again: "You are a doctor, you must save me..."
Kawei sighed, patted his shoulder without saying anything, and checked the condition of his arm again.
There were two obvious cuts on the left forearm. The luck was better than that on the thigh. They only cut the lateral brachioradialis and extensor carpi longus muscles, but did not touch the blood vessels under the muscles. The amount of bleeding was limited. 【4】
Others, such as the face and nose, although they look exaggerated, are actually just ordinary cutting injuries that do not damage important blood vessels and will soon stop bleeding on their own.
Now the order is very obvious, neck > thigh > forearm. We can wait to discuss facial problems until we go to the hospital.
He needed to find the ruptured blood vessel in his neck as soon as possible and sew it if he could, or bandage it if he couldn't. When he returns to the hospital and finds Yingenatz and Herman, he should be able to survive with help.
But Kawei couldn't cheer up...
Li Ben watched him retreat slowly, found a chair and moved it to his side, and sat down firmly. He really didn't understand what kind of medicine was sold in the gourd: "Doctor, I am in pain, why are you still standing there? "
"It's okay, I've already asked someone to call the police."
"police?"
"Um."
Probably because he lost a lot of blood, Li Ben was dazed after hearing this: "What's the use of the police coming?"
"It's very expensive to ask the police to find a carriage and send it to the hospital." Kawei paused and continued, "By the way, I can also help you identify the injury, whether it is a minor injury or a serious injury."
"I'm almost dead!"
Li Ben’s voice was not loud, but these words were full of momentum. It’s a pity that Kawei didn’t accept this trick: “According to Hippocrates and Galen’s four-fluid theory, bloodletting is good for health. I just read it, but it’s just not very good. It's just a big wound, it will heal slowly."
"Uh-huh?"
If the physical sensation hadn't been too intense, Li Ben would have almost believed it: "You can't just do bloodletting... The wound is so big, I feel like I'm going to die soon."
"I'm just a little assistant, how can I save you?" Kawei replied casually, picked up the rag on the side and wiped his hands, "I think it's better to ask the police to call the carriage first, and wait until I go to the hospital to ask Yingnaz Teacher, please save me, he is much better than me."
"The assistant is half a doctor, and I am the patient." Li Ben was a little dizzy. He knew that he could not waste time and could only insist on maintaining the patient-patient relationship between the two. "It is only natural for doctors to save patients."
"Oh, you said you were a patient and I wanted to save you. When you bullied Nora, did you ever think that she was also my patient? Should I save her?"
Kawei felt extremely bad when he thought that the perfect surgery he had just performed was almost ruined by the man in front of him: "I don't care about her life or where she goes in the future. I only care about her wounds. She is me." The first patient to undergo surgery.”
"..."
The dripping blood gradually overflowed outwards, and Li Ben kept sliding down because of the sticky blood around his body. He pressed his leg with his left hand and blocked his neck with his right hand. He could only rely on his right leg to push on the ground to maintain his sitting position: "It's my fault, I don't know... I didn't know she was your patient."
"I know now."
"I apologize, I admit my mistake."
"Just an apology?"
"I'll pay, I can pay!" Li Ben looked down at his pocket, "I have 237 crowns on me, all for you, you must save me!"
"That's pretty much it."
Kawei nodded slightly and gave him a brief introduction: "The left leg injured a muscle and a branch blood vessel. It is not practical to suture, but local compression can be done. The left arm only injured a muscle, not too deep, and there is no serious blood vessel problem. .The face and nose are fine..."
"What about the neck?"
Cavett deliberately left the neck that was bleeding the most for last: "The problem is the neck, Sir, this neck is not easy to deal with."
"Is it difficult to handle? Why is it difficult to handle?"
Li Ben was also a person who had been on the battlefield. He knew very well that the neck bleeds the most, followed by the legs. If the bleeding in the neck could not be stopped, he would definitely be dead.
At this time, he no longer cared about status and appearance. He quickly said: "Your name is Kawei. I have read the newspaper. You are the youngest genius surgeon they say. I am still alive now. I am still alive." You can definitely do it!”
"No, Mr. Li Ben, you misunderstood."
Kawei made a gesture and corrected the misunderstanding in time: "I mean, the neck muscles are very thin, the blood vessels are richly arranged and very close to the skin. Neck wounds can easily damage blood vessels, and once a blood vessel is injured, it will be extremely difficult to stop bleeding. ...
...so you have to pay more! "
Li Ben didn't understand what he was talking about at all, so he just asked: "How much does it cost?"
"I helped Mr. Laszlo perform an intubation, and he gave me an apartment. You are a knight of the great German Empire, and this neck must be worth 2,000 crowns."
"What?!"
Li Ben's broken anterior neck muscles affected the movement of his throat, and he had to continue to put more strength on his neck, but his momentum had been reduced by half, and his head became more and more dizzy: "2000? Where can I find 2000 kronor? !”
"Speak softly and don't yell." Kawei advised, "Your neck is bleeding again."
"You might as well just kill me..."
"Don't be ridiculous. I'm a doctor. How can I kill people?" Kawei stood up and moved the equipment box. He took out his wallet from his trouser pocket and took away two 100-kronor bills: "Collect people's money and help them eliminate disasters." . The legs are 100 crowns, the arms are 50, and the face and nose are 50 together, which is exactly 200. You can keep the change for yourself and buy some delicious food."
"Where's the neck?"
"2000, I just said it."
Kaweike couldn't care about this. He had to work after receiving the money. Sewing the wounds on his arms and legs first could also reduce the bleeding: "The heart rate is over 100, and the bleeding is indeed a bit much."
"I'm dizzy and have no energy..."
"It's okay, I think you can still handle it."
Kawei looked at his neck again and found that it was the same as before, so he took the crow's beak pliers and tweezers from the box. He handed the candle to Li Ben and took advantage of the light to search for the blood vessels in his legs. Every step he made would make Li Ben scream like a pig.
"Hey, put the candle in a straighter position. I can't find the blood vessels like this."
Kawei used gauze to press hard on the blood-soaked wound. The pain made Li Ben tighten his muscles: "It's too... it hurts too much."
"Nonsense, can it not hurt?"
"Can you......"
"It's not easy! Also, please relax!" Kawei patted the muscles around his wound and helped straighten the candle. "Don't move again this time. If you do, I won't look for him."
Li Ben gritted his teeth and nodded: "...Okay!!!"
The condition of the thigh was indeed similar to what Kawei thought. Several small blood vessel branches were broken, but fortunately the descending branch of the lateral femoral circumflex artery was not broken, so he was lucky. There was definitely no way to suture the delicate blood vessels. All he could do now was to sew up the bleeding points that kept bleeding out as quickly as possible.
As for the blood supply problem on the corresponding muscles and skin, forget it.
Without any worries about the prognosis, Kawei worked very quickly. He stopped the bleeding with catgut, then sewed the muscles and fascia, and finally sewed the skin with silver thread. The process was completed in one go. The incision on the arm was simpler. By the time Kawei did the exploration, the bleeding had basically stopped and only simple sutures were needed.
Li Ben was in terrible pain, but he still had to sigh: This guy's skills are so good.
"Don't worry about the split nose. You can go back to the hospital." Kawei picked up the candle and looked carefully at the injuries on his face. "The knife wound on his face is okay. I will stitch it up for you now. It's just But what’s the matter with that circle of teeth marks around your mouth?”
Li Ben said helplessly: "She bit me."
Kawei smiled and shook his head: "I can't sew the tooth marks, and there's no need to sew them, so just keep them."
Li didn't have time to look in the mirror, but he basically guessed that his face must be unreadable: "It's too ugly to keep it."
"Do you want to dig it out?" Kawei explained with a smile, "The bite is not easy to deal with in the first place. It's good if it can grow back and not rot. Do you still care about whether it looks good or not?" [5]
Li Ben had no choice but to agree with his solution: "What about my neck?"
"2000 crowns."
"Farewell, Doctor Kawei, you know, I don't have that much money." Li Ben smiled bitterly, almost worshiping him as God, "Let's change the conditions. As long as it can be done, I will agree."
Kawei checked his pulse again, his heart rate was slightly faster than before, and the bleeding in his neck continued. Considering that a lot of blood will be lost during the exploration, Li Ben must have enough blood volume and cannot delay it any longer.
"It's not impossible." Kawei said, "You have to admit that you were the one who made the first move."
"No problem, it's me who wants to have sex with her, it's my fault, it's my fault!"
"No, that's not it." Kawei rummaged through the kitchen, picked up the stick used by Fuleni from the floor, and stuffed it into his hand. "You have to admit that you were the one who wanted to kill her first. She completely It was out of necessary resistance that I hurt you like this with a knife."
Li Ben looked at the stick and shook his head quickly: "This doesn't make sense. If she hadn't attacked me in a sneak attack and injured my leg first, how could she have beaten me?"
"Are you talking to me about logic? According to logic, don't sew your neck, just wait for the carriage."
"Don't, don't, don't..."
Li originally wanted Kawei to save him, but he didn't want to admit that he had done these things, so he had to use his trump card: "If it really doesn't work, you can talk to Mr. Mick. He should help pay."
Kawei never wanted money, but to get Nora off the hook.
Now that Leng Buding heard Mick's name, it stimulated his nerves even more. He picked up the box and prepared to go out: "I'd better go and see if Nora is injured. Please take care of yourself."
"Don't, don't go!" Li Ben said quickly, regardless of the bleeding from his neck, "I am very useful to Mr. Mick. He will not refuse to save you. You can negotiate many conditions with him. Believe me, this is all it is true!!!"
"I'm not interested in your affairs." Kawei sighed and turned around and said, "If you don't agree, just sit and wait for the carriage. It should be here soon."
－－－－－－Digression－－－－－
Mick has been completely reduced to a marginal role. There is no need to worry about intersection, but you still have to use it.
I'm on duty tonight, there should be another update in the middle of the night, please don't come to the emergency room.
