　Sometimes, unexpected situations can cause chaos in the emergency scene during a disaster.

　A multiple-vehicle collision on the highway. About 50 injured people.

　The Northern Emergency Center is already overwhelmed.

　Gradually, the injured people are also transported to the Castle Ring Emergency Center.

　In case of a disaster, the condition of the patients who are transported changes rapidly and drastically. For the severely injured, that change can make it impossible to escape from the brink of death.

　In the midst of that, a new emergency call rang out.

　This is the Northern Fire Rescue

　A 15-year-old male, hit by a ball on the left side of his head during baseball practice.

　He was conscious at the time of the impact, but when we arrived, his level of consciousness dropped sharply.

　We request JCS300.

　He has no spontaneous breathing. His pupils are unresponsive.

　His blood pressure is low but he is barely maintaining it.

　The Northern Emergency Center says they cannot accept him due to the previous accident victims. We would like to request acceptance at your Castle Ring Emergency Center....

　The voice of the firefighter echoed in the treatment room.

　Hearing that information, Ishimika took over the hotline receiver from Nakaoka.

　"How long has he been unconscious?"

　"About 10 minutes."

　"This is bad. If it's a subdural hematoma, we have little time left. Tanabe-kun..."

　Ishimika looked at me with a piercing gaze.

　Soon, the severely injured from the highway accident will be brought in. I have no idea how many will be transported.

　On top of that, there is a suspicion of a subdural hematoma. If we don't hurry up with the treatment, this boy's life is over.

　"Can you handle it?" I asked Ishimika.

　"Yes." I felt confidence in her reply.

　"Got it. Accept him!!"

　I left those words and headed to the heliport with Nurse Nishina.

　The helicopter had already landed.

　We moved the injured to a stretcher. I looked at the triage tag on his wrist.

　The color was red.

　The name field said Ito Masao. 56 years old, male.

　The diagnosis was "chest compression with internal rupture". He had not undergone thoracotomy.

　He started vomiting blood as we tried to move the stretcher.

　I heard sirens from several ambulances.

　We entered the treatment room and moved the injured to the operating table with a "one, two, three" count.

　Immediately, fluid lines and sensor lines were attached.

　The monitor displayed his heart rate, blood pressure, and other values.

　"Ito-san, can you hear me? Ito-san..." The nurse called his name. But there was no response.

　Chest echo, I slid the probe over his chest. But the image was not clear.

　Then the monitor beeped differently.

　"It's VF."

　"Open his chest. It must be cardiac tamponade."

　I applied brown disinfectant and inserted the scalpel.

　Fellow Nakaoka, who was assisting me, peered into the surgical field.

　"Tanabe-sensei..." He uttered my name.

　I saw his swollen heart.

　"First, suction the bleeding area. Then drain the pericardial fluid."

　Nakaoka carefully suctioned the accumulated blood.

　But more blood seeped out.

　Then a doctor who was off duty, Namimura Tokushi, came in.

　"Sorry for being late. How is he?"

　"He has cardiac tamponade. There is also bleeding from other organs. We are about to perform an emergency drainage."

　He looked at the monitor and surgical field in an instant and said

"Let me take over. Tanabe-sensei, please be prepared for any unforeseen circumstances."

"Understood."

I moved to where Namimura-sensei stood.

He was a senior doctor than me. And he specialized in cardiac surgery. In this case, it was safer to leave it to an experienced doctor. I became a sub.

But even if he was an experienced cardiac surgeon, it was risky to insert a needle into a heart that was moving slightly.

If he damaged the heart itself, massive bleeding would be inevitable.

He carefully inserted a needle into the pericardium. Blood mixed with pericardial fluid was drained.

"There is blood in it." He said as he inserted a tube into the pericardium.

"His heartbeat is back." The nurse who was monitoring said.

"Phew, that should take care of the cardiac tamponade for now. Next is the other bleeding areas."

"Yes, but we couldn't identify specific locations with chest echo. It would be better to move him to the OR after CT."

"Yeah, he should have some leeway for now. Then secure the CT room and the OR."

The nurse confirmed. "Both are available."

"Then let's move." Namimura said calmly.

The number of operating tables in the emergency room was limited.

And we still didn't know how many injured people would be brought in. There were already injured people on stretchers, starting treatment.

Among them was the boy who was hit by a ball on his head.

I saw Ishimika treating him. "How is he?" I asked.

Ishimika calmly said

"He has a subdural hematoma as expected. I'm going to perform a craniotomy."

There was already another injured person on the empty operating table.

"You're doing it here?"

"Yes, I'm doing it here. I can't wait any longer."

She prepared the craniotomy set herself and held the scalpel. I didn't feel any hesitation in her action.

She made a hole in the skull and drained the hematoma in a matter of minutes.

The accumulated hematoma overflowed from his head.

She was skilled. I wondered how much experience she had accumulated...

The pressure from the hematoma should be relieved, and he should regain consciousness... normally.

But the boy was still unconscious.

Ishimika's expression clouded.

She performed a temporary head echo again and ran the probe over his head.

She covered his entire head quickly.

And she muttered "This is bad."

"Tanabe-kun, can you get a CT right away? There might be another hematoma somewhere else. Or there might be a possibility of a congenital brain tumor."

"Brain tumor?"

"Yes, there is a possibility that the tumor ruptured due to this impact. I can't say for sure until we do a test."

"Got it. Let's get him to CT first."

"Yes, please. And keep his body as cool as possible."

She said that and started to treat the next patient.

＊＊＊＊＊＊

The copyright of this novel belongs to "Etuha Sakakihara さかき原枝都は".

Copying or resembling this novel is prohibited.

Click here for the original Japanese text

emergency doctor

https://kakuyomu.jp/works/1177354054883893123