Surgery Godfather

Chapter 245: Chapter 0229: Joining the Palace Bridge

Tokyo winters almost always include snow.

However, the snow in Tokyo is exquisite and delicate, unlike Hokkaido, where each snowfall is lavish and extravagant.

A few days ago, a light snow fall left a thin layer on the rooftops, and the snow accumulated on the roads was promptly cleared away by people.

Yet, mini snow plows could still be seen patrolling the streets, ready to remove newly fallen snow and ensure smooth traffic. The snow wasn’t heavy; the plows seemed to be of little use.

The streets were slightly moistened, with no snow visible; heaps of piled-up snow could be seen at intervals along the roadside, and there was the occasional snowman.

People were not slowing down because of the snow; men were wearing trench coats, women wearing hats, and occasionally there were girls in short skirts, hustling down the street.

On the highway, there was no trace of snow to be seen at all.

Yoshino Kohama was sitting in an ambulance, followed by several more behind him.

They had received news of a pile-up involving seven cars on the Sengoku bridge, which had resulted in numerous casualties.

Yoshino was no stranger to this stretch of road, known for its high accident rate in Tokyo. The almost right-angled turn had caught many distracted drivers off guard.

A few years ago, when he was still an assistant, he had participated in the emergency rescue of a car accident on this same stretch.

Unexpectedly, a few years later, he was back; this time he was a lecturer.

Due to the accident, a traffic jam had ensued for several tens of kilometers. There were no illegally parked vehicles in the emergency lane, not even a tire out of place.

This facilitated the rescue operation. The fleet of ambulances, with flashing red lights, rushed forward at full speed and quickly reached the scene of the accident.

Scattered car parts were everywhere at the scene. The traffic police had sealed off the area, and a rescue team was already in place, conducting rescue operations.

The hospital’s helicopter had already arrived, parked on the highway in front of the accident scene, with two doctors and a nurse having completed preliminary checks on the victims.

Each victim’s wrist was adorned with an identification band. Green represented stable vital signs, not required for immediate medical attention; Yellow indicated the need for immediate medical treatment, but was not life-threatening; red represented unsteady vital signs, indicating the individual’s life was seriously threatened.

“Yoshino Kohama of Tokyo University Hospital!” Yoshino jumped out of the ambulance and took in a breath of air.

A police officer wearing a reflective vest saluted him slightly.

“Mr. Yoshino, we really need your help. There are many casualties,” the officer explained.

Watanabe, the command leader from the helicopter advance team and a senior lecturer-level doctor, rushed over to brief Yoshino on the preliminary check results.

There were fifteen casualties in total: one was unfortunately already tagged with a black label indicating decease; out of the remaining fourteen, four had red labels, eight had yellow ones, and two were green.

All the ambulances had their doors open. Without Yoshino’s command, each had already divided into teams: those with green bands could wait, each with red ones would be tended by a separate team, and those with yellow ones would receive timely grouped treatment.

The members of each group often cooperated with each other, whether during regular training or on emergency calls, their pairing was fixed and the teamwork was seamless.

The head and tail of a Toyota hatchback were completely crushed. Only after the rescue team cut it open with tools, was the casualty moved onto flat ground.

“He’s unconscious, multiple fractured ribs, serious pulmonary contusion, hemothorax, tension pneumothorax, and fractures all over the body,” reported the doctor who was carefully assessing the patient.

“Perform a thoracic needle aspiration!” The doctor adjusted his gloves and ordered.

Before the order had time to echo, the nurse had already retrieved the thoracic needle aspiration kit from the ambulance.

The scalpel stabbed between the ribs and with a hiss, a high-pressure airflow rushed out, making a short and forceful noise. The drain tube was quickly inserted, and a series of bubbles immediately popped from the water-sealed bottle.

The patient’s breathing gradually eased, and his complexion improved slightly. The doctor’s hands didn’t stop; he was examining the throat area.

“Perform a tracheotomy!” He issued a clear and concise order.

The nurse handed over the tracheotomy kit. The doctor worked skillfully and in less than a minute, had completed the tracheotomy and inserted the tube.

At the same time, taking advantage of the interval of the doctor’s operation, the nurse had already carried out blood sampling, attaching a label – this was Sengoku Bridge casualty number two.

“Time to load him up, we can head back now.”

The doctor changed his gloves, and the garbage from the operation was put into a yellow bag.

After opening the stretcher, two stretcher-bearers moved the casualty onto it, then loaded him onto the ambulance. They had to stay with the red-coded patient in a one-on-one arrangement.

The damage to another Honda SUV was hardly any better. It was seriously deformed.

“Femoral artery rupture, needs on-the-spot surgery. Open the suture kit,” commanded the doctor, using his bare hand to apply pressure to stop the bleeding.

The nurse opened the suture kit, and the two of them started suturing the femoral artery on the spot, with the doctor clamping the femoral artery.

He asked the nurse to observe the blood supply to the lower limbs, to which the nurse responded, “Blood circulation is satisfactory!”

“We can apply a temporary tourniquet”, the doctor judiciously suggested and applied a simple tourniquet treatment.

The situation with the third car was extremely grim. There was blood all over the ground, still spreading. Yoshino went from red to yellow, then to green, questioning every casualty himself.

“Comminuted pelvic fracture, internal pelvic organ damage, serious perineum rectal tear, extreme bleeding. I used an intra-aortic balloon to stop the bleeding, but it’s not effective,” the doctor, seeing Yoshino approaching, promptly reported.

Yoshino briefly gauged the patient’s height and said, “Push the balloon up another five centimeters. Next time remember, judging the bleeding position requires experience. People of different heights have anatomical landmarks with variations.”

“Understood!”

The doctor cautiously deflated the balloon, then pushed it up another five centimeters and re-inflated it.

Just as Doctor Yoshino advised, the blood did not spurt from the severely mutilated lower limbs and perineum once the balloon was moved up another five centimeters.

A compact car had suffered the worst fate. The driver had already been labelled black, denoting decease, while a woman in the backseat was unconscious. She was Sengoku Bridge casualty number one.

The injured with the black tag were still moved aside, a group of medical staff performed standard cardio-pulmonary resuscitation, checked repeatedly only to finally give up.

“She’s pregnant, things went awry, something has pierced her abdomen, the fetus has been injured?”@@novelbin@@

The patient had already been moved to a flat stretcher, and the doctor had completed a tracheotomy, connecting to a simple ventilator.

Hemorrhagic shock, blood type identified, cross-matching blood, transfusion!

“Yoshino, she’s in bad condition, her pupil has dilated on one side!” The doctor needed Yoshino’s assistance.

Intracranial hemorrhage, increased intracranial pressure, brain hernia forming. Yoshino used two fingers to pry open the patient’s eyelids, observed the pupils, and quickly made a judgment.

Before becoming a trauma surgeon, he had received rotations in internal and general surgery; he could independently perform emergency trauma surgeries on any part of the body.

“A quick drip infusion of 20% Mannitol! Open the surgery first aid kit, no time to get to the hospital, perform a bone flap decompression!” Yoshino decided without hesitation.

If cranial pressure is not relieved on the spot for this patient, she won’t make it to the hospital. Years of experience led him to make this precise judgment.

The injured was taken to an ambulance that could perform surgeries, and the surgery first-aid kit was opened.

An electric razor was used to shave the head, sterilized sheets were laid out, hands were sprayed with disinfectant. He wore double gloves, the scalp was cut open, a nurse handed over an electric cranial drill, Yoshino drilled a few holes, then used a saw to cut around the circumference, a large piece of skull was lifted off, and brain tissue instantly swelled out.

A specially designed sterile protective cover was placed over the skull defect, the removed piece of bone was carefully wrapped by a nurse then set aside.

“Call a helicopter, get her on it?” Yoshino instructed.

Stretcher bearers lifted the patient along with the ventilator onto the helicopter, which also carried blood samples from each casualty for cross-matching back at the hospital.

“Take off!” The doctor responsible for the pregnant woman ordered.

The helicopter slowly ascended, the strong airflow flattened the grass on the roadside of the highway.

The pregnant woman was transferred via helicopter while all other red and yellow-tagged casualties were dispatched via ambulance back to the main hospital.

Yoshino looked up at the sky, re-entered the vehicle, pulled out his laptop, and wrote a report on the patients’ conditions to send back to the hospital, where someone was ready to receive it.

“Help me!” someone waved and shouted.

A passenger was trapped in the driver’s seat of a Volvo XC90 and needed the vehicle to be cut open to be extricated.

He was a green tag, the remaining group of doctors went to see him only now.

“The Volvo saved him, the extremely strong A-pillar amazingly did not deform, the maintained space saved his life. This is the life space.” A rescue worker said.

“Boron steel, regular cutters will take a long time!”

The rescuer was very familiar with these vehicles’ construction, the most difficult to cut during rescue was Volvo.

“Use the laser cutter!” another team member suggested.

A laser cutting machine was brought down from the vehicle and placed nearby.

“Clear out!”

The rescuer put on protective goggles, the doctors and nurses stepped back.

Laser cutting, the water jet helped to cool and quickly evaporated into gas.

Upon completion of the cutting, the driver was carefully taken out, doctors checked him again, vital signs were stable, he still had a green tag.

“Help me, I can’t do it, get me to the hospital with a helicopter!” The man was very nervous.

Yoshino patted him: “You’re rather lucky, you’re the last one to get in the vehicle.”

“Oh my god, where’s my wife, she’s still in the car!” The driver suddenly remembered.

“No worries, she got in long ago and is waiting for you, if there’s no complications, you guys can go watch a movie tonight.” Yoshino reassured him.

His wife was also a green tag, with minor soft tissue contusions. His wife sat in the back seat of the car, the car door could be easily opened, so she was rescued earlier.

The last one was put in the ambulance, Yoshino was soaked in sweat. Luckily, no one honked their horns among the stuck vehicles behind, everyone silently waited.

Some people stepped out of their cars, constantly rubbing their hands, or making phone calls, explaining to their companies or homes for being late.

A man in a windbreaker came over, “Do you need help?”

The policeman stopped him: “Thank you! Not needed, professionals are here, we’ll be done soon, return to your spot, wait quietly.”

“You’ve worked hard, Dr. Yoshino!” The policeman still remembered Yoshino’s name.

Yoshino waved: “To be honest, I hate to see you, hope to never meet again!”

The policeman laughed: “Hopefully.”

The last ambulance started, speeding towards the hospital.

Yoshino leaned back in his seat to rest, feeling a bit regretful, yet another person was tagged black.

Each time, he hopes for as many black tags to come back as the ones he took out.

But this time, he was short by one.

If only they could have arrived a bit earlier, but, they were already fast.