Chapter 296: Chapter 296

"Dr. Wei, alert the operating room. We need to perform emergency surgery. You’re coming with me," Liu Banxia shouted as she cleaned the patient’s ulcerated area.

"Doctor, what’s wrong?" the patient asked, enduring the pain. He figured if surgery was necessary, things must be serious.

"You have toxic epidermal necrolysis. If you don’t receive immediate hospital treatment, you may not survive the next 72 hours. Considering the current severity of your condition, our time is limited," Wang Huan said.

"We need to remove the necrotic tissue and then use medication for corresponding adjustments and treatment. You need to contact your family immediately. This is not a joke; it’s very serious."

The patient was shocked by Wang Huan’s words and was left speechless for a while.

"This disease progresses rapidly. Although only these few large blisters are visible now, the surrounding rashes also need to be cleared," Liu Banxia said, carefully drawing blood from the patient as she spoke.

"With some luck, two or three surgeries might be enough to remove all the necrotic tissue. We need to act now; otherwise, it might be too late."

"Su Wenhao, contact the isolation ward. We have a patient with toxic epidermal necrolysis who needs to be isolated for treatment after surgery. Liu Yiqing, start an IV infusion of immunoglobulin and methylprednisolone."

Liu Banxia’s voice lost its usual calm, betraying her inner panic.

She couldn’t afford to scare the patient further at this point, but with these symptoms, she genuinely didn’t know if she could save him.

The onset of toxic epidermal necrolysis is incredibly swift, and the mortality rate is extremely high. If the patient had sought medical treatment when the rash first appeared, his chances would have been better.

Many factors can cause this disease, but all of them are drug-induced reactions, for example, to sulfa drugs, quinolones, barbiturates, and so on.

She now wondered if the metronidazole the patient took had caused this reaction; metronidazole-type drugs had been known to trigger such responses in past cases.

Regardless of the cause, the priority now was to save the patient’s life.

"Doctor, you... you aren’t trying to scare me, are you? It’s just a few blisters, isn’t it?" the patient asked.

"There’s no need to scare you. This disease is a drug reaction, similar to a drug allergy. Does that make it clearer for you?" Liu Banxia replied.

"But I only took metronidazole and no other medication. I haven’t even had any alcohol. How could I be allergic?" the patient asked, bewildered.

"The specific pathological cause isn’t fully understood in medical science. However, when it comes to allergic reactions, just because you don’t react to a drug one time doesn’t mean you’ll never react to it in the future," Liu Banxia explained.

"Normally, if you notice any abnormal symptoms, you should consult your attending physician. That way, any issues can be promptly addressed."

"You’ve been symptomatic for several days now. I’m not even sure if we can control your condition after we remove the necrotic tissue. And after the debridement, you’ll have to stay in an isolation ward for treatment to prevent external bacterial infections."

"Don’t delay any longer. Contact your family and tell them to come immediately. The mortality rate for this disease is very high—over 60%. Why else do you think we’d be so anxious?"

What she didn’t mention was that although there didn’t appear to be many rashes and blisters at the moment, the skin had become so loose that it came off with a simple wipe, proving the condition was already worsening.

Although the condition was urgent, it was different from trauma patients who needed immediate resuscitation.

The patient was currently conscious, so his signature was required before surgery could proceed. And because of the disease’s high mortality rate, every detail had to be thoroughly explained during the discussion.

And the patient? Even after his family arrived at the hospital, he still hadn’t signed the consent form.

Liu Banxia had talked herself hoarse, but the patient still insisted on consulting Qin Hai. However, despite numerous calls and sending photos and messages, Qin Hai hadn’t responded.

"You’re his family! He’s only 43 years old. Are you really going to stand by and give up on him?" Liu Banxia pressed, growing desperate.

"It’s been over 50 minutes since the diagnosis was made. Every minute of delay increases the threat to his life. Don’t you feel afraid looking at these blisters on him?"

"Doctor, can’t we just use other anti-allergic drugs?" the patient kept insisting.

"Sigh..." Liu Banxia exhaled. "If you choose to give up, you’re forfeiting the little chance of survival you have left. Honestly, even with surgery, it’s a fifty-fifty chance at best. I’m done."

After saying that, Liu Banxia walked out of the internal medicine consultation room. Fresh chapters posted on 𝘯𝘰𝘷𝘦𝘭•𝘧𝘪𝘳𝘦•𝘯𝘦𝘵

She really couldn’t persuade him anymore. Even if an energy tonic could restore her physical strength, it wouldn’t soothe her parched throat.

The rest was up to Wei Yuan and Wang Huan; she felt truly helpless now.

At that moment, the patient’s phone rang. Seeing it was Qin Hai calling, he hastily answered, "Director Qin..."

"Get the surgery immediately, don’t delay. I’m on my way to the Second Hospital now."

He was cut off by Qin Hai before he could finish speaking.

"Yes, yes, I’ll do the surgery! Doctor, I’ll do it!" Hearing Qin Hai say this, the patient truly panicked.

"Then don’t wait any longer. Hurry to the operating room. The family should stay here to fill out the paperwork and make the payment, then wait outside the operating room," Liu Banxia said.

"Brother Wang, since we’re still not sure how many patches the patient has, Brother Wei and I will have to do the surgery. Please watch over things here. Sister Li, if any patients need emergency care, call us in advance, and one of us will come out immediately."

"Don’t worry," Zhou Li nodded vigorously.

They couldn’t worry about other things now. Even if the emergency room was temporarily without a surgeon, they had to manage. As Liu Banxia had said, missing even one spot could pose new dangers to the patient.

"Dr. Liu, we’ve been waiting for so long. What took you?" the anesthesiologist, Zhao Feng, asked as Liu Banxia and the others entered.

"Sigh... He only just agreed. No history of hypertension or diabetes, but it’s toxic epidermal necrolysis. Dr. Wei and I will need to carefully examine every area later," Liu Banxia sighed.

Zhao Feng nodded; she knew this condition very well. Indeed, surgical treatment was merely the most basic step. His survival would depend on the subsequent treatment.

"Six visible necrotic patches on the chest, three on the outer left arm. No abnormalities observed in the oral or ocular mucosa," Liu Banxia reported after her examination.

"Agreed. Banxia, you’re fast. You take the chest, and I’ll handle the arm," Wei Yuan said, having also completed his examination.

"Alright then. Sister Zhao, please begin anesthesia," Liu Banxia nodded.

This surgery was actually very simple; it was just the debridement of necrotic skin tissue. But they also needed to race against time because the debridement area was large, and infection could easily set in.

And this was only the first one. Within the next 24 hours, a second or even a third operation might be necessary. This was assuming the disease’s progression allowed for it; if it progressed too rapidly, it would ultimately spread throughout the entire body.

Liu Banxia’s speed was impressive, and Wei Yuan was not slow either. Both were very meticulous during the procedure. After Liu Banxia finished with the fifth patch on the chest, Wei Yuan had already dealt with the arm.

However, Wei Yuan didn’t leave immediately. Instead, he thoroughly re-examined the patient to check for any newly appearing patches.

The patient was currently in the active phase of toxic epidermal necrolysis, so new patches could appear at any moment.

"That should be all of them, but you should check again. I’ll head back to the emergency department first in case anything unexpected comes up," Wei Yuan said after his examination.

"Alright. Thanks for your hard work, Brother Wei," Liu Banxia said.

"Dr. Liu, do you think there’s much hope for this patient?" Zhao Feng asked.

"It’s hard to say. The mortality rate for this disease is too high. Although early detection offers a better chance, it’s not necessarily decisive," Liu Banxia responded.

"When he first came in, he didn’t even want an examination. He also has diverticulitis, but we’ll deal with that later after this is managed. Sister Zhao, I’m finished with the debridement; you can wake him up now."

DING! Debridement complete.

Gained 20 experience points, 1 diagnostic skill proficiency point, 5 dressing change skill proficiency points.

Patient consultation complete. Gained 50 experience points, 30 diagnostic skill proficiency points.

Looking at these pitiful rewards, Liu Banxia felt completely indifferent. Although it was a severe, life-threatening condition, the indicators had been too obvious, so the rewards weren’t substantial.

Once outside, not only was the patient’s family there, but Qin Hai was also present.

Liu Banxia merely glanced at him. "The debridement is complete. He’ll be sent to an isolation ward next to prevent infection. The next 24 hours are critical. If there are no new developments in his condition, he should pull through."

"Director Qin, could you please ask the hospital to use the best medicine for him?" the patient’s family appealed to Qin Hai.

Qin Hai looked troubled. He knew Liu Banxia was correct and, furthermore, knew there was no specific cure for this disease. The current standard treatment involved a combination of immunoglobulin and corticosteroids, so there wasn’t really a "better" or "worse" option regarding the medication itself.

As for any electrolyte imbalance, that could be managed with appropriate adjustments. The patient currently had several IV bags connected; Liu Banxia had surely already made those adjustments.

Liu Banxia said nothing. After a nurse escorted the patient away, she returned directly to the emergency department.

"Banxia, Qin Hai might be facing a lawsuit this time," Zhou Li said, moving closer to her.

"I overheard something. It seems that before the patient came to the hospital, Qin Hai was the one who advised him on his medication. Then, when the patient mentioned some skin reactions, Qin Hai told him it was nothing."

Liu Banxia shook her head resignedly. She felt neither happy nor disappointed; on the contrary, she was calm.

Qin Hai had probably meant well but just hadn’t been careful enough. Now, regardless of whether this patient could be saved, it would also depend on what his family decided. A lawsuit in this matter was almost certain; whether the hospital would be implicated, however, was hard to say.