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Chapter 6: Back to reality
“Such a nosy looser. Are you going to ruin the day when everybody has gathered?”
“come back right now!”
At Taeho’s shout, Giseok turned around.
Taeho’s face softened by that sight.
“Hey, you think helping someone in need is nosy looser?”
Giseok glared at Taeho.
Then he realized instinctively. Now is the time to say goodbye to Taeho’s circle of friends.
“You call yourself a doctor when you ignore a patient. Shame on you”
Giseok poured sharp words at Taeho.
Giseok, after giving a piece of his mind, approached the collapsed quickly.
Taeho disappeared, leaving the loud noise behind.
“Are you alright?”
Giseok repositioned him and shook his shoulder.
A male, somewhere in his mid-40s, was completely unconscious.
Sensing gloomy foresight, Giseok used the eye of Hippocrates on him.
Chief complaint: Chest pain/breathing difficulty/low blood pressure/slow pulse
Current status: Urgent
Progress: Very bad (near death)
[Due to low passive level, more detailed analysis is unavailable]
The chill ran through his spine after studying the patient.
Giseok then did thorough assessment on the person.
He estimated his temperature, putting his hand on the person’s forehead then checked his breathing and pulse.
The temperature is normal.
The breathing was so faint that it was about to stop and the blood pressure hit the bottom. Despite of this, his pulse was running like a wild horse
Pulse being this high means there is a problem with ejection volume.
Unable to ignore a nagging feeling, Giseok took the person’s top off.
There was a big, blue bruise on his left chest.
Giseok let a groan pass, without realizing it.
The person was suffering acute cardiac tamponade (pressured heart).
When there is pooled blood around pericardium, the heart is pressed against the pressure. Therefore, the ejection volume decrease and the pressure on pericardium increase.
Based on the bruise on his chest, it is cardiac tamponade.
“119. I am at the corner of 00 bar….”
Giseok looked around after calling EMS.
This requires pericardiocentesis. Using a very sharp tool, the blood around pericardium has to be removed. But he had no such a tool to pierce the chest and get the blood out.
Giseok ran to the closest pharmacy like a mad person.
If he waits until the 119 arrives, the person will die.
“Please give me the syringe, needle and povidone-iodine”
The pharmacist started at Giseok with surprised look.
“Syringe, needle and povidone-iodine!”
“Wh..what are you going to with them?”
“There is person dying. Gauze and plasters as well. Quick!”
Giseok’s pressing voice made a suspicious pharmacist got what he needed.
Giseok paid for the goods and went back to the person like a bullet.
[Encouragement skill failed. Encouragement can’t be used on unconscious person.]
[Must Save skill is in use]
[Skill levels, including surgical and clinical skills are increased by one level.]
[Cold-hearted skill is in use]
[Worry, anxiety, nervousness disappeared]
[Now you can assess the situation clearly]
After using his skills, his head cleared.
His heart swell with confidence that he can save this person.
Giseok first sat the patient up against the wall. Then he applied povidone-iodineon the skin liberally.
Then he held a syringe, out of its packaging.
Now he has to perform pericardiocentesis without ultrasound. If the needle pierce lungs, not a heart then it can’t be reversed but he must do it.
Giseok smoothed his breathing and looked at the wallet, beside the man.
In it, there was a picture of his family with bright smiles on their face.
Only if I can save those smiles….
Giseok’s eyes sparked with brightness.
The area is between left chest bone and 5/6 th rib cage.
The needle pierced and entered the chest in a decisive manner.
Piercing feeling was lingering on the tip of his fingers but the treatment was not done yet.
[Successful emergency treatment. You succeed on pericardiocentesis]
[With acquired bonus, Body buff is in action temporarily]
[Steel-strength Physical: Your physical will decrease at lower rate temporarily]
He felt as if he was saved.
There was no mistake.
The needle pierced the pericardium with precision.
Giseok slowly pulled the plunge back now that the needle is in place. The syringe was holding red pericardiac sample.
Pericardiocentesis was success.
He felt like as if he came from the death.
Then he realized he was drenched in cold sweat.
He pulled the needle and syringe back, sterilized the scar with povidone-iodine and covered with gauze.
Chief complaint: Cardiac arrest/not breathing
Progress: Very bad (near death)
[Due to low passive skill, more detailed analysis is unavailable]
Giseok bit his lips after assessing the patient again.
It’s not done yet.
The heart stopped beating from complication of pericardiocentesis.
Giseok secured the man’s airway and placed his laced hands on the chest
He started on chest compression (CPR)
Each push made the man’s body fluttered like a wave.
This is the reason why many people’s rib cages are fractured.
Giseok swiftly performed 30 CPR and blow air to the man’s mouth twice.
His arms getting sore and his forehead produced large sweat bubbles but CPR didn’t slow down.
Thanks to Steel-strength physical, CPR was bearable.
‘not any more…’
Giseok’s face darkened.
Even with proper CPR, breathing and pulse weren’t coming back to normal.
Continued like this, his brain will be damaged.
“Here! I have a patient right here!”
Giseok shouted, continuing CPR.
Only if he had..
Only if he had that thing he could save this man.
While his shout scattered through the air, someone opened the bar door and appeared.
It was Seolhwa Jung.
Seolhwa became wide-eyed after noticing Giseok and the patient.
“Down the street! AED!”
Although Giseok’s instruction was unclear, Seolhwa nodded and left the scene.
Shortly after, Seolhwa reappeared and her hands held AED (Automatic external defibrillator)
Their gaze met each other’s.
Without sounds, both nodded.
Giseok continued on CPR and Seolhwa began to unpackage and press the on button.
Then she placed the pad on the right side below collarbone and left side below the nipple.
[Analyzing the heart rhythm]
Then the machine gave the sign to release the shock.
Seolhwa distanced herself and pressed the orange button
The electrical sound roared and the man’s body fluttered.
Giseok checked his breathing and pulse and frowned.
Not much difference from the beginning.
Anxious feeling overwhelmed Giseok but he shook it away.
He can’t give up at this point.
Giseok kept on CPR like a mad fanatic.
Then the machine blinked with another shock sign.
“One more time!”
Seolhwa activated the button again.
The man’s body fluttered more strongly.
After the second shock, Giseok checked the breathing and pulse again.
The pulse was coming back.
Breathing was getting better.
With the eye of Hippocrates, his progress changed from very bad to bad.
Giseok pressed cheer hard.
It was too early to get relieved.
A little later, there was no need to continue using AED.
Same with CPR.
With Seolhwa, they brought the patient back to normal state.
Giseok and Seolhwa smiled at each other.
Right at the moment.
[You succeed on emergency treatment]
[New skill: Rapport has been acquired]
[Rapport indicates the relationship to patients or colleagues]
[You just formed first rapport with Seolhwa Jung]
[You will gain bonus skill and faster speed if performed with Seolhwa]
Giseok checked the rapport with physician mode.
Undoubtedly new skill rapport was flashing underneath the reputation.
NEW Rapport formed
NEW Seolhwa Jung (Physician) Level 1 – friendly
Sirens were nearby.
EMS arrived at the site and paramedics came by.
“What’s going on?”
Agent Seongchul Gwak spoke.
“I found this person collapsed by chance. There was compression around his heart so I performed pericardiocentesis. Then we had cardiac arrest so we did CPR and used AED.
Giseok swiftly relayed the progress.
Seongchul, dumbfounded, started at both Giseok and the patient.
“You did all assessment and treat this person?”
“She and I are doctors.”
Giseok pointed at Seolhwa.
Then Seongchul nodded, that now he understood. After assessing the patient, he said awkwardly.
“Well, he is stable now. But he has to be monitored so I will bring him to the nearest hospital. You guys did awesome job.”
Paramedics started to load the man behind the EMS car.
“Just a moment.”
Giseok took the syringe with the sample.
If they took this to the lab, it would be easier.
“I will be right behind.”
Giseok ran towards the EMS and Seolhwa followed.
Ga-hyun Hospital emergency room.
Giseok and Seolhwa were sitting by the patients bedside.
They were waiting for Daehyun Song, who just went in for tests.
Short silence followed and Giseok broke the silence.
“You showed up at the right time. If it weren’t you that person would have died by now.”
“I didn’t do anything. You did everything.”
Seolhwa shook her head.
Giseok assessed the patient and performed pericardiocentesis.
Not only that, he performed CPR at steady pace for 10 minutes.
All those treatments supposed to happen at ER, he did by himself outside the facility.
That was unbelievable, considering they just passed their licensure exam.
‘Is this Giseok that I know?’
Seolhwa stole a glance of him.
“Is there something on my face?”
“Oh.. no.. nothing.”
Seolhwa avoided Giseok’s gaze, waving her hands. And Giseok giggled.
“But how did you know where the AED was?”
“It’s a habit. I always check where the AED is wherever I go. I know, it’s weird.”
“No. That’s great.”
Giseok scratched his head.
“What are you going to do with Taeho?”
Seolhwa changed the topic.