Ning City, Provincial People's Hospital, Department of Intervention.
A quick phone call rang.
"There is an emergency patient!"
As if they heard an alarm bell, the members of the department who were resting jumped up one after another and activated the cath lab with one click to prepare for the operation.
"I'm Li Qing, how is the patient?" Li Qing took the call and asked carefully.
As deputy chief doctors, he and Director Yao each led a team, rotating day and night, always ready to operate on patients.
Director Yao is currently not in the department, and he will be fully responsible for emergency surgery.
"The patient is 72 years old and was admitted to the hospital due to acute myocardial infarction. His vital signs are extremely unstable. After emergency defibrillation, he suffered repeated ventricular fibrillation on the operating table and stopped breathing. His condition is very critical."
"In this case, the emergency department is no longer able to take over, and needs to be sent to you for aortic interventional surgery. It may be possible to rescue him."
After hearing about the condition, Li Qing's face became extremely solemn, and he said in a deep voice: "Okay, send the patient's film first. I am making preoperative preparations here and will perform the operation as soon as the patient arrives."
After hanging up the phone, he clapped his hands and gathered the members of the department.
Looking at the patient's examination report on the screen, everyone's expressions became extremely solemn.
Advanced age, acute myocardial infarction, apnea, and possible underlying medical conditions.
In short, this patient's condition is very dangerous.
Li Qing looked at everyone's faces, smiled slightly, pointed at the scanned image of the patient, and said.
"Although the patient is in danger, there is still a high possibility of being rescued. Look here, the aorta of the heart is severely blocked, which leads to acute myocardial infarction."
"I plan to install aortic balloon counterpulsation on the patient, open the blood vessel, send a guide wire through the occlusion, and then install a stent, so that the patient can be rescued."
"We have performed the same surgery before and have rich experience. We can definitely save the patient from the hands of death by using our tricks."
After this encouragement, the morale in the department was immediately boosted.
Not long after, the patient was sent to the interventional operating room.
After some communication with the family members, everyone learned key information such as the location of the patient's disease and the degree of stenosis of the blood vessels in a short period of time, and determined the surgical plan.
Li Qing came to the changing room, put on a blue and light isolation gown, and then went to the washroom next to him to wash his hands.
After washing his hands, he carefully picked up a dark blue vest-like robe hanging on the hanger next to him, and his hands suddenly sank.
This gown is an interventional surgeon's gown, stuffed with thick lead to block radiation during surgery.
Since interventional surgery requires doctors to have extremely high operating sensitivity, an angiography machine must be used during the surgery. The X-rays emitted by it will be combined with the contrast agent to make the blood vessels in the human body look clearer, which is helpful for doctors to diagnose and perform surgery.
During the operation, doctors and nurses must stand in front of the operating table. Although the lead clothing can block the radiation, the parts below the knee joint, arms, hands, face, etc. are all exposed and exposed to radiation.
There are also lead glasses to protect the eyes, but often wearing glasses during surgery will affect the operation, so doctors simply don't wear them.
Interventional surgery generally takes nearly an hour, and complex conditions may take even longer. As a result, the X-rays released by the angiography agent will affect medical staff and cause radiation damage to them.
Although the lead clothing can block two-thirds of the dose, one-third of the dose will still be absorbed by the medical staff, which will cause great damage to the body over a long period of time.
Exposure to X-rays for 10 hours is equivalent to taking 4,000 X-rays continuously.
Healthy people should control the number of X-rays taken less than 5 times a year. Otherwise, they may suffer from radioactive diseases due to receiving a large amount of radiation in a short period of time. In severe cases, they may die.
It can be said that the work of an interventionalist is to injure the enemy a thousand times and injure oneself eight hundred.
What you fight is the disease, what you save is the patient, but what you hurt is yourself.
Because the lead coat is so heavy, weighing about 30 kilograms, it cannot be lifted with one hand and requires two hands to lift it.
So he had to raise both hands at the same time and put it on his body with great difficulty, tightly protecting his entire torso, down to his knees.
If Li Qing hadn't worn it every day and was already used to it, I'm afraid that just by picking it up, his legs and feet would go weak and his waist would flash.
The lead coat is one-piece, and there is also a split style on the hanger, but he found it inconvenient to wear, so he kept using this one.
After putting on the lead suit, except for the freedom of movement of the arms, no other movements can be made, and even moving the body will be a bit difficult.
Li Qing then put on the lead neck muff, which was used to protect the thyroid gland on his neck.
In addition, there are lead caps, lead glasses, etc., but he is not used to using the latter and rarely uses them.
After putting on various protective measures, Li Qing walked into the operating room of the interventional department.
Several doctors and nurses were busy in the operating room. Everyone was wearing heavy lead suits and their movements were very clumsy, but they were still well prepared for the operation.
The surgical process is very stressful, including incision, tube insertion, identifying the blockage point, and inserting the stent...
The entire operation was performed very smoothly and skillfully.
After a 2-hour operation, my whole body was dripping with sweat.
Li Qing walked out of the operating room and took off his lead gown. The surgical gown was soaked and stuck firmly to his back, making him very uncomfortable.
When he put the lead clothes on the hanger, his legs gave way and he fell sideways. If he hadn't been quick to grab the cabinet door, he would have almost fallen to the ground.
He wiped the cold sweat from his forehead and thought with some fear: "It seems to be too heavy. Maybe I'll wear a separate one next time."
After trying again, I struggled to put the lead coat back on the hanger.
By this time, his whole body was sore and he was so tired that he just wanted to find a chair to sit down and rest.
"After working for more than ten years, I am getting older after all, and my physical strength is not as strong as before."
Li Qing lamented the passage of time and walked out of the dressing room.
Next, it was another busy day. Li Qing performed 7 operations in a row, with a cumulative operation time of nearly 12 hours.
By the time he got off work, he was already slumped on the sofa in the lounge, panting from exhaustion and too lazy to move a finger.
Although these surgeries were laborious and laborious, what bothered him the most was the 30 to 40 kilograms of lead clothing.
After each operation, I took it off lightly, but soon I had to have another operation and had to put it on again.
It was simply a 12-hour, heavy-duty battle that took a huge toll on the doctor's mental and physical strength.
Just when Li Qing squinted his eyes and wanted to take a break, the door was pushed open hard.
Director Yao with a red face appeared at the door. His sharp eyes scanned the whole place. At first sight, he saw Li Qing who was huddled in the corner with his eyes closed, and he immediately strode over.
"Hey, how tired are you? There are a lot of surgeries today?" Director Yao couldn't help but joked when he saw Ai Jiang looking like he was dying.
Li Qing lazily opened his eyes: "I'm just waiting for you to come so I can finish my shift."
As soon as he finished speaking, Director Yao's expression changed and he came over.
"No, no, can't I get up?" Li Qing looked at the director's big face and immediately begged for mercy.
Unexpectedly, the director remained unmoved and kept staring at his forehead.
Li Qing casually touched his face and said blankly: "Director, what's wrong with you? Are there flowers growing on my face?"
"Don't move, there seems to be a swelling on your forehead." Director Yao looked at it for a long time and then said, "Do you have allergies on your face? How long have you had it?"
Li Qing shook his head: "No, when I washed my face in the morning, my face was still fine."
After saying this, he suddenly fell into deep thought.
After a while, he suddenly slapped his thigh: "No, this is not an allergy at all. Could it be..."
He looked up at Director Yao, and their eyes met in the air. In a flash of lightning, they exchanged countless information and reached a consensus.
Director Yao nodded heavily: "That's right, look at your ray measurement pen, I estimate that 80% of it has already exceeded the limit."
Li Qing suddenly became dejected. He took out a white and orange cylindrical pen-like object from the pocket of his work clothes. This is a ray pen provided by the hospital for medical staff who have been exempted from radiation all year round. It is used to detect the annual radiation dose.
Generally speaking, the dose standard set by the International Atomic Energy Agency is that the maximum radiation dose in the year does not exceed 50 millisieverts, and the average radiation dose accumulated over five years does not exceed 20. However, this standard is difficult to comply with, and there is no clear definition in China. It's up to the hospital to control it themselves.
He took one look at the numbers on it and immediately jumped up and exclaimed.
"I checked, and it turned out to be 120. It has long exceeded the standard. It is almost enough to kill 200 from severe radiation sickness."
"No wonder I get tired so easily day by day. I thought I was getting old, but it turned out to be mild radiation sickness. The redness and swelling on my face was also caused by reduced immunity."
A radiation dose of more than 20% will cause damage to the human body. Within 100%, the immune system will be reduced and white blood cells will be reduced.
100-200 will cause mild radiation sickness within a few hours, causing symptoms such as vomiting, diarrhea, fatigue, and a significant decrease in resistance.
200-300 is a lethal dose, which can cause severe radiation sickness. 30% of patients will die after 30 days.
By analogy, if the number exceeds 400, it is an emergency, and the 30-day mortality rate is as high as over 70%.
As for 1000, that is equivalent to swallowing a piece of heavy metal directly, and the chance of failure within a few days is 100%.
Li Sin's number of 120 is already quite dangerous, exceeding the international standard of 50 by a full 2.4 times.
Many people are very unfamiliar with radiation diseases, and they often don’t expect mild symptoms to come from it.
Fortunately, Li Qing is a professional and has always been cautious about this, so he reacted immediately when symptoms appeared.
Director Yao said with a serious look: "You need to get treatment quickly, and then take radiation leave, which is guaranteed for two weeks, and you can't come back until the white blood cell data is normal."
Li Qing patted his forehead and said with a regretful look on his face: "I don't know why this thing was muted, so I didn't hear the alarm."
"You also know that this disease is difficult to cure. There are currently no particularly effective symptomatic drugs. I can only try to enhance my immunity..."
"Wait a minute, who said there is no right medicine." Director Yao suddenly interrupted him and said, "You interrupted me as soon as I came in, which made me almost forget the important matter."
"I was about to tell you that Sanqing Group has developed an antioxidant drug that can enhance the secretion of antioxidant enzymes in the human body, enhance human immunity, and has a strong scavenging effect on free radicals."
"You also know that the principle of ionizing radiation is caused by free radicals running around, so this drug is quite symptomatic for radioactive damage."
"It is currently undergoing phase III clinical trials in our hospital. As soon as I heard the news, I knew that this drug is definitely suitable for our interventional department."
As Director Yao spoke, his face was filled with joy, but at the same time there was a hint of fear.
"Our department has always been very manpower-strained, and there are many surgeries. As a result, everyone is often exposed to radiation, and there is no time to take the statutory radiation leave. In fact, I feel guilty in my heart, for fear of harming everyone."
"You came here halfway. I'm afraid you don't know. Before I became director, the department was even busier. There were no shifts yet. Everyone was working 24 hours a day. As a result, two tragedies happened."
"One was exposed to radiation for a long time and eventually developed leukemia. There was also a female doctor whose white blood cells dropped to 1,000 and her chromosomes also suffered aberrations, so she had to be transferred from her post."
At this point, he fell silent and continued for a while.
"Since I became the director, I have increased the number of staff and divided them into different teams to perform surgeries in turns, so the radiation dose in the entire department has been reduced."
"Look at you, you are a living example. I almost had an accident. All my efforts were in vain."
Director Yao showed an expression of hatred, and then became excited again.
"But now with this new drug, you don't have to worry about your radiation dose."
"Everyone in our interventional department, from residents to deputy seniors, including nurses and anesthetists, all have to test drugs."
With a wave of his hand, he called all the staff in the department and told them the good news.
"All of you, those with radiometric pens over 50, go to the clinical building early tomorrow morning and apply for the Phase III clinical trial of this new drug."
"You, you, you, I remember you haven't taken a vacation for more than a year. It must be too much. You must go this time. I'm keeping an eye on you."
Director Yao stretched out his finger and clicked one by one. The faces of the people he clicked showed moved expressions.
Soon, everyone checked their radiography pens and found that more than half of the people in the entire department were over 50.
In addition to Li Qing, two other nurses also exceeded 100.
"This..." Director Yao suddenly felt a little embarrassed: "Everyone has gone to participate in clinical trials, who will do the work? What if a patient comes for surgery?"
Someone immediately said: "Director, I can still hold on for a while. Let's try the medicine when I exceed 100."
"It doesn't matter, I'll take the responsibility for this," Director Yao thought about it again and again and finally made up his mind.
"You all go for surgery, leaving only a few of you. I will do all the surgeries during this period. I just took a vacation a few months ago and should be able to survive for a while. I will go again when you are all cured and come back." Test the medicine.”
"If the patient really can't stand it, let them be transferred to a higher-level hospital. Anyway, I'm risking my life and can't control that much."
He touched his sparse forehead. There were only a few stray hairs left on it, and he couldn't help but laugh at himself.
"When I woke up in the morning, I lost a few more hairs. I applied Sanqing hair tonic, but it didn't work. It seems that God has destined me to sacrifice this beautiful hair."
"I thought I used to be handsome and handsome back then, but I didn't expect that I chose interventional surgery because of a mistake. From then on, my beautiful hair was no longer with me."
When Director Yao, who is in his fifties and has a round figure, starts performing every day for ten years, he remembers his youth with a sigh on his face.
Everyone couldn't bear to watch and turned around one after another. Those who came off work and those who worked, no one wanted to stay to cheer.
Even Li Qing, dragging his tired body, ran faster than anyone else.
Director Yao shook his head and sighed. He took a closer look and found that the entire department was empty and no one was missing.
He could only shake his head and curse in his stomach, "These little bastards."
The next day, a group of more than 20 people from the interventional department came to the clinical building to sign up for the clinical trial.
The doctor in charge of registration was shocked.
"Let me go, so many people, all of them are suffering from radiation sickness?"
"What happened? It couldn't be a medical accident."
"Your interventional department was taken over?"
(End of chapter)
