When medicines and equipment are limited, the order of treatment for the injured will definitely be followed. Often, try to stabilize the situation slightly better and then make every effort to rescue the poor.

The injured soldier who was just sent to the operating room had poor vital signs, low blood pressure, high heart rate, and had hemorrhagic shock. If he did not stop the bleeding without surgery, suturing blood vessels or directly choosing to amputate the limbs, he would eventually die in the church.

In comparison, the lieutenant deputy company commander named Oper seemed much easier.

From Mendestein's oral statement, it can be seen that he accidentally injured his face by a stone. According to this logical idea, the damage is one-time, at most there are single fractures and skin muscle cutting injuries, and generally there will be no major damage.

hinder.

But when Oper was carried into the church, Carvey realized he had been cheated.

Whether in the 21st century or the 19th century, the words of "family members" are of course important, but when obtaining this information, you still need to maintain a certain degree of alertness.

"This was smashed too hard!" Kawei blurted out, but immediately realized that this was not a good topic, so he hurried back to the wounded himself, "It looked like he was hit seven or eight times, nose, left ear, left eye

, the lips were lacerated, and the jawbone was broken..."

The content he talked to himself was simple, but being able to make Kawei say it already represents its seriousness.

Oper's nose bridge collapsed again, and blood still oozed at the left nostril. The left eye socket was bruised and swollen. As he breathed, the skin that was cracked in the under-orbital was still fluttering. You can still see the outer canthus (outer corners) of the left eye.

In the pits smashed by stones, deep skin lacerations and internal blood vessels, active blood seepage can be seen.

In addition, the upper part of the left auricle was broken, and the skin on the upper and lower lip was lacerated several times, and the upper and lower jaw bones were obviously broken.

The maxillofacial trauma is so serious that the first thing to pay attention to is not the amount of bleeding, but the injury's own consciousness and some more unexpected things.

Consciousness represents the possible damage to the brain. In a time when there is no imaging examination, a simple question, check the child's hole and do some pathological reflex physical examinations can make a general judgment. The judgment may not be 100% accurate, but it can be slightly more capable.

I saw some problems.

"May I have your name?"

Seeing that it was the doctor, Oper quickly moved his mouth, but unfortunately the pain and some invisible factors made him unable to speak well.

"Does your head hurt?" Kawei added as soon as he asked, "It's not the pain of the wound, it's inside the head."

Oper shook his head gently.

"Are you dizzy? Vomiting?"

Oper still shook his head.

Kawei asked while looking at Tong Kong, then looked at his shattered upper and lower jaw bones, and immediately realized something bad: "Do you feel breathless?"

Oper's breathing cannot be called rapid, but the frequency is faster than usual, increasing from about 20 times per minute to 25 times. Even he himself did not realize what he was feeling uncomfortable.

After all, a resting state that is lying flat for a long time does not require too much oxygen.

Oper shook his head at first, but after taking a few conscious breaths, he changed his head to nodding: "There is... something."

Kawei knew that his injury was beginning to worsen, so he turned around and found Damirgaon, who was still "examination and treatment" for the patients before: "Damir, come here with my instrument box."

"good."

Mendestein had never seen this kind of consultation method that could predict symptoms, and always felt that the young man in front of him was very different from the surgeon he knew: "Dr. Kavey, what is the situation now in Oper? Why do he get angry

But he is angry? I think he is pretty good."

"The airway is blocked." Kawei said the reason directly, "The damage will not only cause bleeding from the epidermis, but also cause bleeding from the inside of the mouth. Look at the upper and lower jaw bones are broken. The bones are broken and the tongue will lose support.

It falls backwards into the air duct, and blood flows into the body, causing blood clots to accumulate..."

Mendestein seemed to be listening to a heavenly book, and Kavi stopped talking and said, "I have to cut his trachea open."

"Cut the trachea?" It hurts a lot. Mendestein looked at his comrades and continued to ask, "Where is cutting it?"

"Here." Kavi pointed to his neck, "A very small incision, and then insert a tube, and breathing can improve."

This preventive tracheotomy of Kave is definitely the product of a large amount of emergency surgery experience and belongs to the branch of the otolaryngology department.

Not to mention these surgeons nowadays, even in modern times, surgeons who usually have no experience in ENT injuries without several years of experience in emergency surgery, they will not be able to judge the tracheotomy at this stage.

Mendestein now has no support and is willing to trust the doctor's judgment, but his preconceived idea still builds an invisible wall in front of "believe".

Oper's face was smashed by the soldiers of the blocking team. No matter whether these people were Italian or Austrians, he could not fully trust the other party, and would silently doubt in his heart whether the other party was deliberately revenge: "I see his

I breathe quite well, why do I need to do this kind of surgical operation?”

"He himself admitted that he was not breathing well."

Kavey got the instrument box and, according to his usual working habits, ignored Mendestein's suggestion: "The blood stasis has begun to block the throat, and he needs to do a tracheotomy immediately."

"Don't you do intubation?" Damir was also honest and asked a question that shouldn't be asked at this time.

Kawei turned his face and glared at him, and quickly explained: "Intubation requires tilting your head and opening your mouth. His upper and lower jaw bones are broken, his tongue is falling back, and blood is accumulated in his mouth. There is no way to intubate it."

Damirgaon immediately realized that he had said the wrong thing and nodded repeatedly: "So that's how it is, I learned it."

Getting this out, Kawei looked at Mendestein again, and according to the method of dealing with his family, he began to use some slightly "intimidating" words: "Maxillofacial damage is not uncommon, I have seen it with my own eyes suddenly after being smashed three hours later.

A patient with difficulty breathing. Because the doctor who had not received the doctor did not perform a tracheotomy in time, he died in less than an hour."

Mendestein frowned, obviously frightened.

Oper was his old comrade-in-arms, and he slowly climbed from a soldier to his current position. The injury made him feel very uncomfortable. If he even lost his life, he would never accept it.

In just a moment, the Prussian captain's eyes changed that ordinary people could not find, but Kavey could still find this change in the other party's tone and attitude: "Okay, I'm willing to believe you, I'll make a decision for Oper.

, agree to do what you just mentioned to tracheostomy."

"Damir, give me a scalpel..."

"Don't be anxious first." Mendestein interrupted him, "I need to tell you something before the operation."

Kavi:???

"I have no other requests, I just hope you can handle Lieutenant Oper's injuries." Mendestein gently patted his old comrade's legs, saying to Kavey as if comforting him, "He is mine."

Old comrade, I don't want him to have any accidents."

Kawei had to sigh that in the early stages of modern medicine, the doctor-patient relationship was still pretty good.

Although the other party was a hostile officer, he had a gun in his hand, and had a death threat in person, compared with the various sneak attacks with knives he had encountered before, and directly beat them. The vast number of court summons even rose to a threat to his family.

Because it is at least straightforward.

Kavi is like an old monk who has experienced all kinds of hardships, showing no fear of this threat: "I do my best."

"Please."

"But I can't do anesthesia," said Kavey. "The wounded soldier is in a more serious condition and he can't save ether."

"It doesn't matter. As long as he tells him that it is for use for Oper, he can tolerate it..."

Seeing his comrades talking like this, Oper raised his arm and pulled his sleeve with difficulty, then shook his head repeatedly. The shaking of his head was obviously much larger than before, for fear that Mendestein would not be able to see:

"At one...nothing..."

Perhaps because of the muscles' strength and difficulty speaking, after fighting for initiative in anesthesia, Oper's breathing frequency was faster than before. After lying down, simple breathing could no longer satisfy his lungs, so he needed to breathe hard.

.

Without further ado, Kavi could also see the ups and downs of his chest and abdomen: "It must be painful to cut open, but you still have to endure it."

Opper nodded: "Come..."

He is also a soldier fighting on the front line. The same tracheotomy shows a completely opposite reaction in Laslow and Oper. Although individuals feel differently about pain, when the pain reaches a certain level, it reaches a certain level.

Later, this gap is not big.

Laslow almost fainted from the pain at the beginning, but Oper relied on his tight muscles to withstand the cutting of the surgical blade without saying a word.

"Fortunately, I was not injured in my neck and I could still touch the midline." With the help of Damiergaon, Kave quickly separated the muscles and exposed the tracheal ring. He didn't care about the others and cut it out with one touch, "Gauze, hemostatic forceps."

As soon as he finished speaking, some bloody secretions in the trachea sprayed out with the airflow.

"Captain, don't be nervous, it's okay!" Kavey immediately stabilized Mendestein, who was standing aside and was extremely worried, quickly sucking away secretions with gauze in his hand, and then carefully separated them with hemostasis in a blood-red patch of blood.

Incision, "Hothorn Tube."

"Give it." Damirgaon looked at Kavi's operation in blind vision, protecting the incision with one hand and bringing the tracheal casing with the other.

Compared to the horn tube that Yonnac used on Laslow's neck, Kavey's tube has an additional silver casing. If Yonac's tube is blocked from secretions, it is necessary

Replace a new one because it cannot be cleaned.

But with the inner tube, cleaning will be very convenient and reduce the pain caused by replacing the tube.

Oper's condition is different from Laslow, far from suffocation, but he still needs to consider the severe pain caused by no anesthesia. Kavi's hand speed is already very fast, and it originally took about 15-20 minutes to cut it.

It was completed in less than 10 minutes under his operation.

"It's okay, your breathing should be smooth now, right?"

Oper could feel a foreign object stuck in his throat, and the surrounding tissue was being held up and painful, but if we put aside these, the originally struggling breathing was indeed much better: "Hmm..."

"Okay, your breathing is steady, and the next thing is to deal with these wounds."

No filming is needed. Just a simple examination of the wound can show that Oper's nasal bones, upper and lower jaw bones have fractures, and they are comminuted fractures. He can do very limitedly in dealing with these fractures, and the conditions are so harsh. Incision is used for reduction.

It's very irresponsible.

"Decontaminate first?"
To be continued...