Chapter 469: The Rescue

Ai Beibei scrubbed her hands, watching to see if the midwife’s hand-washing and disinfection procedures were strictly followed, while also listening to the nurse read the patient’s medical records.

Five of the six expectant mothers had no major problems. The prenatal examinations showed that the fetal position was correct, the fetal heartbeat was normal, and all indicators were up to standard. They should be able to have a smooth delivery. However, one of the pregnant women had a narrow pelvis, and it was uncertain whether she could deliver naturally.

What gave her a headache was that all the maids were first-time mothers. Compared with women who had given birth before, the probability of a difficult delivery was much higher. Moreover, the first batch of maids, due to their regional and ethnic background, were often petite and had a high proportion of narrow pelvises.

After washing up, putting on her outer clothes, and disinfecting, she was already sweating. She followed the midwives into the delivery room, holding up her hands to supervise them as they entered. Unless there was a difficult delivery, she would not personally intervene—she had to be ready to perform a cesarean section at any time, while also monitoring whether the midwives’ operating procedures were accurate and in place.

“Since the natives won’t understand why we do this for a while, we just need to teach them that they must do it this way,” Dean Shi had said at a training meeting of the Ministry of Health, and Ai Beibei could only adopt such a method.

The pregnant women were pushed in one by one. Ai Beibei looked with some pity at these pregnant women, who could only be called “girls.” In the old world, these girls should have been in school.

She asked casually, “Have the family members arrived?” According to convention, the family members had to be notified before the delivery, and this was no exception—especially when it involved the birth of a member of an elder’s family.

“Three of the chiefs have arrived. The other three said they would come after the baby is born. A representative from the General Office has also arrived.”

The representative from the General Office was there to register the “household registration.” Once the child was born safely, it would be registered in the General Office’s elder household registration book.

Three elders had come, which was at least a decent gesture towards them! Ai Beibei felt a little relieved. However, although they had all dilated to ten fingers when they were pushed in, it would still be at least an hour or two before the delivery was complete. She was about to check them one by one when a nurse suddenly ran in:

“That naturalized citizen expectant mother is showing signs of a difficult labor! The fetal heart rate is unstable!”

“Don’t panic, which bed is it?” Ai Beibei said helplessly. These basic rules were still not being learned. Although she knew very well which pregnant woman it was.

This was the wife of a naturalized citizen. The man was a worker at the shipyard, and the woman worked at the clothing factory. Because the woman was older and it was her first pregnancy, and a prenatal examination had revealed an incorrect fetal position, they had planned to schedule a cesarean section on another day.

Unexpectedly, the fetal heart rate had become unstable. Ai Beibei quickly instructed a naturalized female medical officer to supervise the scene, while she herself quickly ordered the pregnant woman to be pushed into the operating room to prepare for surgery.

“Please ask Dr. Zhang to administer the anesthesia!” Ai Beibei ordered as she hurried towards the operating room.

“Spinal anesthesia, inject 12mg of tetracaine hydrochloride—this is the standard dose. Then turn to the supine position,” Zhang Tumu said as he cleanly and neatly completed the puncture and anesthesia. Behind him, a naturalized anesthesiologist watched his every move intently, as if trying to swallow everything whole.

The anesthesia was administered smoothly. Ai Beibei carefully looked at the patient, waiting for the anesthetic to take effect. Just as she was testing the level of the block, the patient suddenly stopped responding to her questions. Ai Beibei realized something was wrong. She noticed that the patient had lost consciousness.

“Cardiac arrest!” the naturalized nurse monitoring the instruments screamed. She had been trained to be extremely sensitive to all the data on the oscilloscope. “Respiratory arrest!”

“Quick, prepare the laryngoscope! Oral intubation!” Zhang Tumu—he had worked in the emergency room and reacted quickly—shouted. “Prepare for cardiopulmonary resuscitation! 1ml of norepinephrine for intracardiac injection!”

Ai Beibei was startled. This was “total spinal anesthesia”! It was the most feared complication during surgical anesthesia. She quickly helped with external cardiac compressions. Finally, the lines on the electrocardiogram began to jump again, but the heart rate was fast and irregular.

“Please ask Dr. Shi for a consultation!” Ai Beibei had no choice but to resort to this last measure. She was essentially a research doctor, with very limited experience in emergency medicine. And being a doctor mainly relied on the accumulation of experience.

When Dr. Shi arrived, after about a quarter of an hour of rescue measures such as artificial respiration, Zhang Tumu reported that the patient showed no signs of regaining consciousness or breathing, was cyanotic all over, had a blood pressure of 180/90 mmHg, a temperature of 38.5°C, no urine output, and the electrocardiogram showed supraventricular tachycardia with frequent multifocal ventricular premature beats, as well as frequent generalized convulsions. The fetal heartbeat was still normal on auscultation.

Amidst the somewhat chaotic rescue, the elder doctors at Bairen General Hospital unanimously diagnosed the patient with “post-cardiac arrest hypoxic brain sequelae.”

“Start brain resuscitation! The sooner the better!” Shi Niaoren said. “Prepare an ice cap and ice packs!”

The nurses scrambled to get the ice cap and ice packs from the refrigerator. Due to the extremely poor medical conditions in this world, some early medical methods had been picked up again, so Bairen General Hospital had made its own ice caps early on.

“Dr. Shi, according to the latest articles in international medical journals, focused cooling of the head in this situation has no practical significance…” Ai Beibei said cautiously.

“Meaningful or not, we can only try and see,” Shi Niaoren said. “Focus on cooling the head, and use ice packs to cool the whole body! Diuresis and dehydration!”

But these measures did not achieve any obvious effect. The patient remained in a coma, with no spontaneous breathing, no urine output, flushed skin, frequent multifocal ventricular premature beats, and increasingly frequent convulsions. How to proceed? At this moment, Bairen General Hospital was at a loss, confused and helpless.

In the old world, there were of course several other methods that could be used, but regardless of the method, targeted treatment could not be implemented without finding the cause of the disease.

In a flash of inspiration, Shi Niaoren remembered seeing a similar case in a medical journal years ago. He immediately proposed that at this time, the pregnant woman’s abdominal muscle tension and diaphragm tension had completely disappeared. The huge uterus was pushing the diaphragm up into the chest cavity, causing a sharp decrease in chest cavity volume, a change in the position of the heart, incomplete lung expansion, distortion of the large blood vessels at the hilum of the lung, and insufficient ventilation function. Therefore, although the patient was not severely hypoxic under artificial respiration, the coma, convulsions, rising blood pressure, persistent ventricular arrhythmia, elevated body temperature, and flushed, hot skin all indicated that carbon dioxide could not be expelled from the body. Based on these signs, he judged that in addition to being in a state of “post-hypoxic brain sequelae,” the patient was also in a state of “carbon dioxide narcosis.” The coma, frequent convulsions, and multifocal ventricular premature beats were all caused by the severe accumulation of carbon dioxide in the body due to impaired expulsion. If the problem of carbon dioxide accumulation was not resolved in time, the result would be another cardiac arrest with no hope of rescue. Based on this, Shi Niaoren believed that a decisive cesarean section should be performed immediately to remove the fetus, so as to relieve the upward pressure of the diaphragm on the chest cavity and improve respiratory and ventilation function.

“Operating under these circumstances, the person won’t be able to take it!” Although Ai Beibei agreed with Shi Niaoren’s diagnosis, the thought that the patient might die on the operating table—a double tragedy!—made her eyes well up. She was not like the other elder doctors who had worked in clinical practice for a long time in the old world and had hardened their hearts.

“If we don’t do this, she won’t be able to take it much longer!” Zhang Tumu also supported Shi Niaoren’s plan. “At the very least, we can save the child!”

“I also know that proposing to perform a cesarean section in this clinical near-death state is indeed a huge risk.” Shi Niaoren admitted that according to convention, performing a major operation on a patient in such a critical condition was simply a violation of regulations, unthinkable. “But this is the only measure to save the patient’s life. We have no other choice.”

“Should we get the family’s signature…” Zhang Tumu reminded him. Although the other party was a naturalized citizen, it was still necessary to respect the necessary rights.

“Where is her family?”

“At work. According to the regulations, he can’t take paternity leave until the child is born. He said he would come over after work,” the nurse replied.

Ai Beibei couldn’t help but curse: “What the hell! No humanity at all! The person is about to die!” As she spoke, she could barely hold back her tears.

“Alright, we don’t need the family’s signature,” Shi Niaoren said. “I’ll sign it. Let’s operate immediately!”

A healthy baby boy was delivered by cesarean section. The patient’s complexion immediately returned to normal, her dilated pupils gradually recovered, the heavy sweating stopped, and the ventricular premature beats basically disappeared. Her condition had clearly improved, but she was still in a coma, with no urine output, and accompanied by generalized convulsions. Shi Niaoren ordered to continue with active brain resuscitation and other follow-up treatments.

More than an hour after the operation, the patient’s spontaneous breathing finally resumed. Shi Niaoren finally breathed a sigh of relief.

“You go to the delivery room,” Shi Niaoren said to Ai Beibei. “They need you there too. And give this child a good check-up, don’t let him have any sequelae!”

“Okay, I’ll go right away,” Ai Beibei said and hurried away.

Shi Niaoren instructed Zhang Tumu to keep an eye on things for now. He walked out of the operating room, took off his gloves, and soaked them in the disinfection and cleaning tank. He went to the lounge. A nurse wiped his sweat and lit a cigar for him. This matter was a bit strange, because similar incidents rarely occurred in the old world, and the anesthetic used was also a drug brought from the old world, not a counterfeit product made by their own pharmaceutical factory. To be honest, they couldn’t produce tetracaine hydrochloride at the moment—he wouldn’t be surprised at all if an allergic reaction to an antibiotic or a fatal case caused by a vaccine occurred. Given the current level of their pharmaceutical factory, this was simply inevitable. But this tetracaine hydrochloride was the real deal—a level-one controlled substance, not to be used unless it was for a major operation…

Shi Niaoren suddenly shuddered, remembering the notice the Planning Institute had given them last time: because the expiration date was approaching, the level-one control on many drugs was lifted.

Could this tetracaine hydrochloride be expired? Shi Niaoren thought. Although he could basically do whatever he wanted in this world, this was a very bad signal. If such a major incident happened to an elder, it would be a disaster!