At dawn on September 28, Jodek Fortress on the Bohemian Front
The light rain that fell all night finally stopped, and fog rose in the sky, which gradually receded until the sun fully rose. The Third Army had been stationed here for a night. As the head of the army's surgeon, Lockard would definitely have a separate house as a private rest room.
But considering the tug-of-war on the northern front, he needed to launch the legion's temporary field hospital as soon as possible. He spent the whole night dealing with tents, medical supply boxes, and the increasing number of casualties.
No one in the Austrian army expected that the Prussian army had quietly crossed the mountains of northern Bohemia. Not only that, they also crossed the border, bypassed the Jodek Fortress as the frontline position of Bohemia, and inserted a small force between the Olmitz Fortress behind them.
They would never have imagined that the mighty Third Army would suffer considerable casualties in its first encounter with the Prussian force.
On the first day alone, the entire Third Army suffered more than 4,000 casualties, almost as much as a local battle. The ensuing mountain pursuit increased the number to 6,000. Even excluding some stragglers, those who were lost, and those who were missing, the number of casualties exceeded 5,000.
This was not what Count Kram Glass, commander of the Third Army, wanted to see.
The 58,000-strong Third Army only encountered a small force and suffered so many casualties that it is difficult to say it without being embarrassed. However, it is a shame to be ashamed. As the commander-in-chief of an army, he must adjust his condition in time to prepare for the next series of fierce battles.
He quickly found the answer from the captured Prussian artillery and guns, and immediately sent an urgent letter to Archduke Brecht and King Franz in Vienna. 【1】
It emphasized the superiority of the opponent's weapons in terms of firepower, and implicitly expressed the desire to continue to obtain reinforcements.
He knew that a letter alone could not accurately convey his thoughts, and at this time he should stand still and wait for news from the headquarters. However, out of considerations of avenging his son's injury and claiming credit for himself, he sent a large number of reconnaissance posts to the mountainous areas near the border and asked the 6th and 7th Infantry Divisions to continue advancing forward.
The departure time was set after lunch.
Lockard had watched this whole journey and knew that he would definitely encounter trouble if he went there, so he could only integrate the medical resources in his hands. On the basis of maintaining sufficient surgical personnel at Jodek Fortress, he also expanded a considerable number of surgical assistants to the two infantry divisions.
The number of personnel has changed from only one accompanying doctor at the battalion level to a combination of one doctor + one assistant.
With the basic establishment of three battalions as a regiment, the regiment-level unit can have a complete surgical team. If the brigade is used as a combat unit, it is not a problem to set up a simple medical team of more than a dozen people.
The assistants that Yodek Fortress is short of for a short period of time can be temporarily replaced by soldiers and surgeons from the villages around the fortress.
This decision was very wise. The two infantry divisions were blocked one after another in the subsequent mountain battles, and the expanded surgical team was able to barely maintain frontline medical operations.
Of course, it can only be done reluctantly.
Because not everyone can understand Kawei’s transfer principles like Lockard did, and no one can guarantee that everyone can understand Kawei’s military medical manual. Even the Olmitz Fortress Hospital further back will have it. Figures like Dr. Delvaux.
Lockard was unable to leave the Yodek Fortress, and the quality of the frontline army doctors could only be maintained at the passing level. The soldiers could only settle for their own destiny.
At 4 o'clock in the afternoon on the 28th, four carriages brought a large number of wounded people back to Jodek Fortress from the front line. Lockard promptly formed several emergency surgical teams and began to deal with them one by one. The surgeries that could be performed were done in Jodek as much as possible, while those that could not be handled could only be transferred back to Olmitz.
After all, there was the real rear hospital of the Austrian army there.
After four months of careful preparation by Kawei, the staffing, hospital conditions, and inventory of equipment and drugs far exceeded those of Lockard's temporary military hospital. And in terms of technology alone, Kawi's team is much better than Lockard.
The wounded soldier on Lucius's operating table was a captain of the 1st Mountain Brigade of the 6th Infantry Division of the Third Army.
"Rogerini, 23 years old, has gunshot wounds on his left chest and left upper arm." Lucius briefly introduced the medical history. "He was still conscious when he came here. He only said that there was pain in the gunshot wound and a little difficulty breathing. There are no other symptoms. I saw that the amount of bleeding was not too much, and I did a simple test. The blood pressure was 115/75, the heart rate was 113, and the respiration was 30."
"You guys take a rest first." Kawei stopped the discussion, simply packed up his things and followed him out of the conference room.
rest?
If time went back an hour, they might all want to stay in bed and have a good rest. But now that the state has been adjusted to the work area, taking a sudden break is a kind of torture. And most importantly, a wounded soldier who Lucius couldn't deal with was much more interesting than sleeping.
The people in the conference room quickly followed Kawei out in twos and threes.
"Why did you come out?"
"Specially wounded soldiers naturally need to observe and study hard."
"Yes, surgery is better to stay in the operating room and study."
"So studious?"
Kawei didn't care. He had often encountered this situation during meetings before, and the seminar would continue in the form of another surgical observation. However, the originally prepared meeting content must be continued, so this approach will greatly lengthen the meeting time, which is also a double-edged sword for time-strapped teams.
Doctors lined up in the hospital corridors, just like the ward rounds in a modern hospital.
Occasionally, someone would be called away by a wounded soldier. After answering a few questions, he would immediately return to the team, for fear that he would fall behind everyone else.
"Because the location where the bullet was inserted was not very good, I did not strictly follow the vital signs to determine the order of the surgery, and immediately took him to the operating room. I planned to check his condition while performing debridement."
Lucius was a little unsure and just pointed to his left chest wall with his right hand. "The bullet penetrated very strongly and did not burst. The diameter of the three wounds was all about 1.5cm. It penetrated the left upper arm from the outside. It penetrated directly into the chest, near the mid-axillary line, and the height was exactly at the fifth intercostal space.”
"It must be where the heart is!"
"Yes, to be precise, it's the apex of the heart."
"This position is really bad and the wounded can easily die."
"If there is a blood pressure problem, it means the heart has been damaged. But now the blood pressure and heart rate of the wounded person are pretty good. Personally, I think it is a simple hemothorax. The bullet happened to stop in the lung tissue outside the apex of the heart."
This was a good judgment, and Lucius thought so at the beginning, but in Kavi's view, it is meaningless to look back at the process of judging the situation of the injured.
"These are meaningless." That's not what Kawei wanted to hear. "Just tell me the reason why you came to me."
"Because he said before that he had difficulty breathing and the wound was painful, I gave him some medicine and performed a thoracentesis on him." Lucius gained confidence from Kawei, and the operation became more and more bold, "Immediately Approximately 500ml of non-coagulated blood was shed.”
"Yeah, well done."
"I asked the nurse to put in the infusion and start matching blood at the same time. I gave him the infusion as soon as he got off the operating table." Lucius is already very skilled in the treatment of hemothorax caused by thoracic trauma, but often at this time, special circumstances will come to mind, “But.”
"But what happened?" Kawei seemed to have guessed the special situation. "Did he have shock symptoms during the infusion? And then he became very irritable?"
When Lucius heard this, he couldn't believe his ears: "How did you know?"
The voices of other doctors also came from behind the two of them: "Yes, how do you know this?"
"No one saw it, but you just heard a few words and guessed the symptoms?"
"Before you are surprised, do you have to ask the person involved first?"
Lucius nodded repeatedly: "The symptoms are the same as what Dean Carvey said. The wounded patient showed symptoms similar to mild shock. For example, his lips were blue, his limbs were cold, and he started to sweat. I had no choice but to continue to give him input. I need fluids, but I don’t know what to do, so I came to you to ask about the situation.”
Unconsciously, the team of doctors left the hospital area and walked into a small building in the distance.
That is where the first and second operating rooms are located. A huge post-operative observation button was built around these two rooms. The layout of the building completely inherited the style of the Municipal General Hospital.
The operating room is a space that is relatively isolated from the outside world. In order to teach well in the operating room, Kawei cannot be too strict with them. He can only warn: "Lucius and I wash our hands. It doesn't matter if you don't. But don’t get too close to the operating table, and wear a mask and hat.”
"We understand, come on in."
"Let's go, let's see if the wounded man is still alive."
The wounded man named Rogerini was still lying on the operating table. It seemed easier to take his life here than in the jolting carriage. Because thoracentesis and disinfection do not cause much harm, even ether anesthesia was omitted this time.
However, after saving the anesthesia, the patient's emotions seemed a little uncontrollable: "I feel a little uncomfortable, really, really uncomfortable! I feel like I'm going to die, I'm really going to die!"
"Don't worry, I've never seen a dying person say the words 'I'm dying' loudly and loudly in such clear and standard German." The sober state gave Kawei a better opportunity to ask: "Where? uncomfortable?"
"Here, here, and here. It hurts so much!" Rogelini raised his hand and pointed at the bullet wound and his chest, "It hurts so much!"
"Chest tightness? Asthma?"
"Yes. Yes." He pointed to his head again, "I feel like my head was also hit by a bullet. Why don't you check it too?"
"Head?" Kawei glanced at his scalp, which was stained with dust and a few blades of grass. After a brief examination, he shook his head: "The head is fine."
"What about my belly?"
"Your stomach is fine!" Lucius replied, "There are only three wounds on your body, all from the same bullet."
"What kind of bullshit bullets are so powerful?"
Rogelini's voice became louder, but the clarity was slowly declining. At the same time, it seemed that his reason was also declining: "I don't dare to join the army. What a bullshit captain. It's useless. To get the military rank is to serve on the front line." Cannon fodder! Look at those officers, and then look at you doctors, all of them are hiding behind nothing, they are so happy, so happy!!!"
"What are you waiting for?"
Kawei moved his eyes upward, gently raised his chin with the fingers of his left hand, gently pressed the liver with his right hand, and then looked at the jugular vein: "He is talking nonsense, give him anesthesia to make him quieter."
"But his condition doesn't require surgery. It's just a chest injury. He also received a thoracentesis from Dr. Lucius, and his breathing problem has been resolved. And no matter how you look at it, his heart should be fine."
"Yeah, if I were hit in the heart, I wouldn't be able to survive here."
"And the military medical manual clearly states that ether should not be abused because it has strong side effects."
Although others thought this move was a bit strange, the nurse on the side still brought an ether inhaler and put the mask on Rogelini's face at Kawei's signal: "You, you want to do it? It's unreasonable. Fourth, the 1st God’s Brigade drops the dew, the sun clothes are imitating the mulberry position, no”
The sound became even stranger after being processed by the mask.
Kawei looked at the captain who slowly closed his eyes and corrected their thinking: "Ether should not be abused for postoperative pain relief, but if it is determined to be an operation, it must be used. Of course, if there is chloroform as a substitute Not too bad.”
"He needs surgery? I think he is quite normal."
"The newly measured heart rate is 118 and the blood pressure is 103/66. Although there are some changes from before, the values are still normal."
"A heart rate of 118 is not considered normal, and his lips are bruised, which is a sign of shock and hypoxia." Kawei is much more sensitive to vital signs than these beginners. "Blood pressure is a physical concept and only represents pressure. The numerical value of the environment does not represent everything. Sometimes it is necessary to look at these numbers more systematically and give me a stethoscope.”
Taking the stethoscope from the nurse's hand, he placed the stethoscope head in the fifth intercostal space where the apex of the heart is located.
As expected, Rogelini had the typical Beck's triad, coupled with shock, rapid heart rate, and weak pulse, the diagnosis was very clear: "Look at his neck, the veins are bulging, and considering this series of symptoms, I There is reason to believe the bullet had struck his heart and he had cardiac tamponade.”
"Shot in the heart? How can he still survive here?"
"I heard that the fighting has advanced to the border. It will take at least half a day's carriage ride to retreat from there to Olmitz."
Everyone couldn't believe their eyes because they had never seen such wounded people.
"Pericardial tamponade-type heart injury is not uncommon." Kawei explained, "It's normal if you haven't seen it before, because the only symptom of such injured people is cardiac tamponade. They will die slowly under your eyes. If you don't An autopsy will not reveal the cause of death at all. Give me a syringe and prepare surgical instruments, I will use them later."
[Take a nap and finish this chapter when you wake up. If nothing else happens, there should be two more chapters today]
(End of chapter)
