Chapter 286: Chapter 286

Liu Banxia hadn’t expected Han’s condition to suddenly worsen, and it scared the living daylights out of people like Manager Qu.

Especially when they saw Han connected to machines, a tube inserted in his mouth, and even hooked up to an oxygen supply. In their minds, it seemed like Han was about to leave them.

"Heart rate 133, blood oxygen 86. His condition improved after oxygen was administered," Liang Xiaolin reported after connecting the oxygen.

"Contact CT for an urgent head and lung scan immediately. From my auscultation, it looks like a pulmonary embolism causing supraventricular tachycardia. Call Cardiovascular Surgery for a consult in the CT room," Liu Banxia said after his examination.

Upon hearing his words, the group rushed the gurney toward the CT room.

Pulmonary embolism is a high-mortality condition, often only discovered post-mortem. The most common cause is a venous thrombus from the lower limbs dislodging and traveling to the lungs.

Unfortunately for Han, although only a small thrombus was found during his examination, part of it might have already dislodged and traveled to his lungs when he moved during the exam.

Liu Banxia was very concerned about Han’s brain. He still needed to determine if there were any potential risks before deciding on a treatment approach for the pulmonary embolism and the deep vein thrombosis in Han’s leg.

"Dr. Liu, how’s Han?" Manager Qu, who was following, asked worriedly.

"A part of his thrombus has dislodged and moved to his lungs, causing difficulty breathing. But he’s been intubated and is on oxygen now, so his life isn’t in immediate danger. We’ll know more when the test results are out," Liu Banxia said.

He was genuinely anxious because everything has two sides. People like Manager Qu didn’t understand the full situation, but he was acutely aware.

If Han had received standard treatment—blood thinners, heparin to be precise—he might not have developed a pulmonary embolism.

But Liu Banxia was worried that Han’s past boxing career might have caused head injuries. Using blood thinners could cause any seemingly minor old injuries to rupture and bleed.

This concern was why they had to wait for the test results. If the tests showed no issues, it would mean he had delayed treatment.

Even if there was nothing procedurally wrong, he would still agonize over it. He was in a dilemma, not just because Han was introduced by an acquaintance, but more so because Han was his patient, and he was responsible for him.

Just as they arrived at the CT department, the patient Wei Yuan and his team had been resuscitating was wheeled out.

"Dr. Liu, good timing, I..."

"Dr. Zhang, please wait a moment. Liang Xiaolin, take our patient in," Liu Banxia interrupted Zhang Zhiyuan, the ICU attending physician, just as he started speaking.

Liang Xiaolin nodded and guided the staff to push Han in.

"Sorry about that, we had a sudden pulmonary embolism in the ER. Dr. Zhang, what’s the situation with your patient?" Liu Banxia asked.

Zhang Zhiyuan nodded. "I understand. This patient’s condition isn’t optimistic either. We were planning to transfer him to our ICU, but his brain CT results aren’t good."

"He has subdural edema, and the brain has shifted significantly to the left; it’s severely compressed. Although he’s still breathing spontaneously on oxygen, he’ll likely need ECMO in the ICU before long."

"Doctor, can he be saved?" the patient’s wife asked.

"The scans aren’t out yet, but I can explain the situation," Liu Banxia said.

"Given his current condition, if we attempt to save him, our only option is a craniotomy to address the brain swelling. Only after that could we deal with his abdominal organ injuries."

"However, his brain edema is extensive. The leftward shift of the brain indicates severe compression, which has likely already caused substantial brain damage. Even if we could relieve the swelling, drainage tubes would be necessary because the edema would continue to accumulate."

"The chance of him successfully surviving the surgery isn’t high, probably less than thirty percent. If the surgery is successful, he’ll need to be observed in the ICU. Only if his vital signs improve can we proceed with a second surgery."

"The second surgery will also be a major challenge for him. Furthermore, during his ICU stay, he’ll likely need to be put on ECMO."

"This isn’t just about the financial cost; this is our best-case scenario for the patient. Even if all surgeries are successful, we’ll have to see how severe the brain damage is when he wakes up and which neurological functions are affected."

"Doctor, are you saying... he’s beyond saving?" the patient’s wife asked, grasping Liu Banxia’s arm.

"It’s not that he’s definitely beyond saving, but the chances are extremely low. I have a responsibility to you, so I must explain all possible outcomes. I can’t, in good conscience, tell you there’s no problem, let you spend a fortune, and then still lose him," Liu Banxia said calmly.

"You have about half an hour to decide. If you want us to do everything possible to save him, I’ll contact a neurosurgeon for a craniotomy."

"If you don’t want him to suffer anymore, I can arrange a room for you in the Emergency Department so you can be with him in his final moments."

Liu Banxia spoke calmly, but internally, he was deeply troubled. He could foresee the worst-case scenario for this patient who had fallen from a height, but conveying all this to the family felt incredibly cruel.

However cruel, he had to say it. Moreover, he had to deliver it in an absolutely neutral, almost cold, manner to avoid misleading the family. Doing otherwise would ultimately cause them and the patient even greater harm.

The area outside the CT room was very quiet. Even passing patients and their families tried to walk as lightly as possible. Those who might normally enjoy watching a commotion chose to keep their distance, not wanting to add any burden or disturbance to the sobbing family.

In truth, Liu Banxia wanted to advise them to let go. But hospital policy didn’t allow it because, medically speaking, there was still a chance of success, however slim.

"No more surgery. Don’t let him suffer so much. My poor son..." After more than ten minutes, the patient’s mother made her final decision.

Liu Banxia nodded. "Alright. We can transfer him to a room in our emergency ward. We’ll find a larger one for you."

That was the most help he could offer this family; there was nothing more.

Hospital rules normally didn’t allow families to occupy empty beds, but since no other patients were currently being admitted to the emergency department, an exception was made for them.

"Sigh... I feel terrible just watching this," Manager Qu said.

"We see this kind of thing far too often, especially Dr. Zhang here. His ICU witnesses several partings due to death every day," Liu Banxia said.

"Well, there’s nothing more for me here. I need to get back," Zhang Zhiyuan said.

"Sorry to trouble you, making you come all the way down from upstairs," Liu Banxia said.

"Don’t mention it. I’m off," Zhang Zhiyuan said, heading directly to the elevator.

"Dr. Liu, what about Han? Should we contact his wife?" Manager Qu asked.

"Yes, contact her. Regardless of the treatment plan, he’ll need to be admitted," Liu Banxia said after a moment’s thought.

Manager Qu nodded, took out his phone, and stepped aside to make the call.

They had all been so worried earlier that they’d forgotten this. Although they were good friends with Han, they were only friends and couldn’t make medical decisions for him.

"Are the test results back yet?" Chen Xuehai asked, stepping out of the elevator just then.

"Still waiting. It’s a lower limb deep vein thrombosis that dislodged, causing a pulmonary embolism," Liu Banxia quickly explained.

"The patient has a boxing history of about ten years. We were concerned that past head trauma might make thrombolytic agents dangerous, so we haven’t administered any medication directly."

Chen Xuehai frowned, then nodded. Such caution was warranted. Although the risk was small, it was a valid medical concern.

"Dr. Liu, I’ve contacted Han’s wife. She’s on her way, but she’s quite far and said it’ll take about an hour and a half," Manager Qu reported, returning after the call.

"Once the CT results are out, we’ll update her. But until she arrives, we’ll have to proceed with diagnosis and treatment based on our best medical judgment," Liu Banxia said.

Just then, Liu Banxia’s phone rang again. "Brother Wei, is that patient settled in?"

"We didn’t even get to settle him in. He’d just gotten to the ward—we hadn’t even filled out the admission forms or gotten him bedding—and he passed away," Wei Yuan said, his voice low. ʀᴇᴀᴅ ʟᴀᴛᴇsᴛ ᴄʜᴀᴘᴛᴇʀs ᴀᴛ 𝓷𝓸𝓿𝓮𝓵※𝓯𝓲𝓻𝓮※𝓷𝓮𝓽

Liu Banxia gave a bitter smile. "I understand. Ask Sister Wang to help them with the arrangements; otherwise, they won’t know what procedures to follow."

With that, he hung up.

"Your emergency department is either dead quiet or completely swamped, no in-between," Chen Xuehai remarked.

"We’ve actually been quiet for a long time. Then today, we get a case ," Liu Banxia said with a helpless sigh.

"Dr. Liu... Oh, Dr. Chen. The scan results are out! No hematoma, just an old hygroma," Liang Xiaolin reported, running out.

She hadn’t expected the consult from Cardiovascular Surgery to be her own brother. Given the relationship between Liu Banxia and him, she worried there might be a minor clash.

"Dr. Liu, what’s your take? Is it congenital, or caused by trauma from boxing?" Chen Xuehai asked Liu Banxia after a moment of thought.

Others might not have understood the implication, but Liang Xiaolin did, and the question startled her.

"I still believe this hygroma developed from an old hematoma caused by boxing. I suggest we don’t proceed with invasive tests immediately. Let’s first get an X-ray to get a general idea of the pulmonary embolism’s extent," Liu Banxia said after considering.

"If it’s not too severe, I recommend observation first. Once he’s past this critical period, we can consider interventional treatment. And during any such procedure, we’d need a neurosurgeon on standby."

"Alright, that’s very reasonable. Call me if you need me again," Chen Xuehai said, nodding after a moment’s thought.