Chapter 1219 - The Rescue
While scrubbing up, Ai Beibei kept a watchful eye on the birth attendants' hand disinfection procedures, ensuring they followed protocol precisely, all while listening to the nurse read patient charts.
Of the six women in labor, five had no major issues—their prenatal exams showed correct fetal position, normal fetal heartbeat, and satisfactory indicators across the board. They should be able to deliver naturally. But one pregnant woman had a narrow pelvis, and it remained uncertain whether she could deliver without intervention.
What worried her was that all the maid patients were first-time mothers. Compared to women who'd given birth before, their probability of difficult labor was much higher. Moreover, the first batch of maids, owing to regional and ethnic factors, tended to be petite with a high proportion of narrow pelvises.
Having scrubbed, donned surgical gowns, and disinfected, she was already sweating. She followed the birth attendants into the delivery room, hands raised, monitoring them as they entered. Unless there was a difficult birth, she wouldn't intervene personally—she needed to remain ready at any moment for a cesarean section, while also monitoring whether the attendants' procedures were correct and thorough.
"Since the natives don't understand why things have to be done this way, just teach them that they must be done this way." That's what Director Shi had said at the Health Department training meeting. Ai Beibei could only adopt this approach.
The pregnant women were wheeled in one by one. Ai Beibei gazed with some pity at these women who could only be called "girls"—in the old timeline, they should still be in school.
She asked casually: "Are the family members here?" By convention, families were to be notified before delivery—especially when it involved transmigrators' dependents giving birth.
"Three Chiefs have come. The other three said they'd come after the baby was born. A representative from the Government Office is also here."
The Government Office representative was there to register the "household registration"—once a child was successfully born, they would be entered into the Government Office's transmigrator family register.
At least three transmigrators came—at least they're treating them decently! Ai Beibei felt somewhat comforted. Though all six were already dilated to ten fingers, delivery would still take at least one or two hours. She was about to examine each in turn when a nurse suddenly rushed in:
"That naturalized patient is showing signs of difficult labor! Fetal heartbeat is unstable!"
"Don't panic—which bed?" Ai Beibei said with weary patience. These basic rules still couldn't be taught. Though she knew perfectly well which pregnant woman it was.
This was a naturalized citizen's wife—the husband worked at the shipyard, the wife at a clothing factory. Because the woman was older and a first-time mother, and prenatal exams had revealed incorrect fetal position, they'd planned to schedule a cesarean section.
But now the fetal heartbeat had become unstable. Ai Beibei quickly instructed a naturalized female medic to stay and supervise, while she herself ordered the pregnant woman wheeled into the operating room immediately for surgical preparation.
"Get Dr. Zhang for anesthesia!" Ai Beibei ordered while hurrying toward the operating room.
"Spinal anesthesia—inject 12 milligrams of tetracaine hydrochloride. That's the standard dose. Then position supine." Zhang Tumu spoke while performing the puncture-anesthesia with clean, precise movements. Behind him, a naturalized anesthesia medic watched intently, as if trying to absorb every detail whole.
The anesthesia proceeded smoothly. Ai Beibei examined the patient carefully, waiting for the anesthetic to take effect. She was just testing the block level when the patient suddenly stopped responding to questions. Ai Beibei's heart lurched—she noticed the patient had lost consciousness.
"Cardiac arrest!" screamed the naturalized nurse monitoring the equipment. She'd been trained to be extremely sensitive to all data on the oscilloscope. "Respiratory arrest!"
"Quick, prepare the laryngoscope! Oral intubation!" Zhang Tumu—who'd worked emergency medicine—reacted fast and shouted: "Prepare for CPR! One milliliter epinephrine intracardiac injection!"
Ai Beibei was startled—this was total spinal anesthesia! The most feared complication during surgical anesthesia. She quickly assisted with external cardiac massage. Finally, the lines on the ECG began moving again, but the heart rate was rapid and irregular.
"Please get Dr. Shi for consultation!" Ai Beibei had to invoke this trump card. She was essentially a research physician with extremely limited emergency experience, and being a doctor meant relying on accumulated experience.
When Dr. Shi arrived, after about fifteen minutes of resuscitation including artificial respiration, Zhang Tumu reported: the patient showed no signs of consciousness or breathing recovery. She had cyanosis over her entire body, blood pressure 180/90 mmHg, temperature 38.5°C, no urine output. The ECG showed supraventricular tachycardia with frequent multifocal ventricular premature contractions, accompanied by frequent whole-body convulsions. The fetal heartbeat, however, was still normal on auscultation.
Amid the somewhat chaotic resuscitation, the transmigrator doctors at Bairren General Hospital unanimously diagnosed the patient with "post-cardiac arrest hypoxic brain injury."
"Begin brain resuscitation! The sooner the better!" Shi Niaoren commanded. "Prepare ice cap and ice packs!"
The nurses scrambled to retrieve ice caps and ice packs from the refrigerator. Because medical conditions in this timeline were so poor, some early medical techniques had been revived. Bairren General Hospital had improvised ice caps early on.
"Dr. Shi, according to the latest international medical journal articles, focused head cooling in this situation has no practical significance..." Ai Beibei said cautiously.
"Significant or not, we can only try and see," Shi Niaoren replied. "Focused head cooling, whole-body ice pack cooling! Diuretics for dehydration!"
But these measures produced no obvious effect. Watching the patient remain in a coma with no spontaneous breathing, urinary retention, flushed skin, frequent multifocal ventricular premature contractions, and increasingly frequent convulsions—how to proceed? Bairren General Hospital was at a complete loss.
In the old timeline, there would still be various techniques available, but without identifying the cause, targeted treatment couldn't be implemented.
In a flash of insight, Shi Niaoren remembered a similar case he'd seen in a medical journal. He immediately proposed his theory: at this point, the pregnant woman's abdominal muscle tone and diaphragm tone had completely disappeared. The huge uterus was pushing the diaphragm up into the chest cavity, drastically reducing thoracic volume, displacing the heart, causing incomplete lung expansion, twisting the great vessels at the lung hilum, and causing insufficient gas exchange. Therefore, although the patient wasn't severely hypoxic under artificial respiration, the coma and convulsions were increasing, blood pressure remained high, ventricular arrhythmias persisted, temperature was elevated, and skin was flushed and hot—all indicating that carbon dioxide couldn't be fully eliminated from the body. Based on these signs, he judged that besides being in a "post-hypoxic brain injury" state, the patient was also in "carbon dioxide narcosis." The coma, frequent convulsions, and multifocal ventricular premature contractions were all caused by impaired carbon dioxide elimination leading to severe accumulation in the body. If the carbon dioxide buildup wasn't resolved promptly, the result would be another cardiac arrest with no hope of resuscitation. Accordingly, Shi Niaoren believed they should immediately and decisively perform a cesarean section to remove the fetus, relieving the upward pressure of the diaphragm on the chest cavity and improving respiratory gas exchange.
"Performing surgery in this condition—she won't be able to handle it!" Although Ai Beibei agreed with Shi Niaoren's diagnosis, the thought that the patient might die on the operating table—one body, two lives!—made her eyes redden. She wasn't like the other transmigrator doctors who'd done long-term clinical work in the old timeline and had already hardened their hearts.
"If we don't do this, she won't make it anyway!" Zhang Tumu also supported Shi Niaoren's plan. "At worst, at least we can save the baby!"
"I know that proposing a cesarean section in this clinically critical state is taking an enormous risk." Shi Niaoren acknowledged that by conventional wisdom, performing major surgery with the patient in such critical condition seemed like malpractice—unthinkable. "But this is the only measure that can save her life. We have no other choice."
"Should we get the family to sign..." Zhang Tumu reminded. Though they were naturalized citizens, they should still respect their basic rights.
"Where's the family?"
"At work. According to regulations, paternity leave isn't allowed until after the baby is born. He said he'd come after work," the nurse answered.
Ai Beibei couldn't contain herself: "What kind of person! No humanity at all! She's dying!" She could barely hold back her tears.
"Fine, no need for family signatures," Shi Niaoren decided. "I'll sign. Proceed with surgery immediately!"
The cesarean section delivered a healthy baby boy. The patient's color immediately began normalizing, her dilated pupils gradually recovered, heavy sweating stopped, and ventricular premature contractions essentially disappeared. Her condition clearly improved, but she remained in a coma with urinary retention and whole-body convulsions. Shi Niaoren ordered continued aggressive brain resuscitation and follow-up care.
Over an hour after surgery, the patient's spontaneous breathing finally returned. Shi Niaoren breathed a sigh of relief at last.
"Go to the delivery room," Shi Niaoren told Ai Beibei. "They need you there too. And give this baby a thorough examination—make sure there are no lasting effects!"
"Right, I'm going now." Ai Beibei hurried off.
Shi Niaoren instructed Zhang Tumu to keep watch, then stepped out of the operating room, removed his gloves, dropped them in the disinfection wash tank, and walked to the rest area. A nurse wiped his sweat and lit him a cigar. Something about this case was peculiar—similar incidents rarely occurred in the old timeline, and the anesthetic used was from the old timeline, not a homemade product from the pharmaceutical factory. Frankly, with the pharmaceutical factory's current level, he wouldn't be surprised at all if an allergic reaction to antibiotics or a vaccine problem caused a fatality—that was practically unavoidable. But this tetracaine hydrochloride was authentic goods—first-tier controlled material never used unless for major surgery...
Shi Niaoren suddenly shuddered, remembering the Planning Commission's recent notice: due to approaching expiration dates, first-tier controls on multiple drugs had been lifted.
Could this tetracaine hydrochloride be expired stock? he wondered. Though in this timeline he could basically do as he pleased, this incident was a very bad sign. If something like this happened to a transmigrator—that would be terrible!
(End of Chapter)