Doctor: I Can Synthesize Infinite Entries

Chapter 42: Chapter 42: The Rehydration Plan Is a Great Success

As the massive machine that was City First Hospital whirred into action, the first batch of burn patients was soon brought in.

Following the established plan, the patients were given a preliminary triage based on the severity of their symptoms.

Critically ill patients were immediately sent to the intensive care wards, while those with burns covering less than 30% of their bodies were successively placed in the general wards.

The ward under Qin Donglai’s team also received four or five patients at once.

Two of the patients had burns covering over 20% of their bodies and had already gone into burn shock.

Since all the senior deputy chief physicians had gone to the intensive care wards, the burn department physician assigned to assist in the ward Qin Donglai was responsible for was only an attending physician, Wu Youtu.

After a preliminary assessment, Dr. Wu said to Qin Donglai:

”Dr. Qin, the patients’ burns have caused plasma extravasation, leading to insufficient effective circulatory volume. We need to begin fluid replacement therapy immediately.”

”The thing is, the calculations for fluid replacement therapy rely on various clinical formulas. But there are significant individual differences between patients, and clinical indicators tend to lag. This means there’s always a discrepancy between the formula’s calculation and the actual volume of fluid needed. We have to rely on the physician’s experience.”

”I’m ashamed to say that when it comes to fluid replacement, the plans have always been formulated by our department’s deputy chief physicians or their superiors. Now, the situation is critical and we lack effective monitoring. I only know one method: the Third Military Medical University’s burn fluid replacement formula. But that formula requires the burn area percentage and the patient’s weight. Normally, with a single patient and plenty of time, that would be fine.”

”But with this many burn patients at once and the general chaos, it’s difficult to weigh everyone in the limited time we have. Besides, it’s not advisable to weigh severely burned patients in the early stages, so...”

Dr. Wu looked ashamed.

Qin Donglai furrowed his brow.

”We can’t worry about all that now. Let’s just make a rough estimate based on the burn area and start the fluid replacement. We’ll have to monitor the patients’ conditions as we go.”

Dr. Wu looked at the patients still being wheeled in, knowing that the department’s senior doctors had no time to check on the patients in this particular ward.

Dr. Wu couldn’t make a decision. The truth was, this was the first time he had ever been involved in treating a mass burn casualty incident.

’It’s a true dilemma. Starting fluid replacement could cause problems down the line, but without it, the patients might not survive.’

”Dr. Wu, Dr. Qin, you must not administer fluids blindly! Massive fluid replacement can cause acute heart failure, cerebral edema, pulmonary edema, deepening of the wound surface, and abdominal compartment syndrome...”

Suddenly, a young voice spoke up. It was, of course, Wu Ting. During his last encounter with Shen Guofeng, he had acquired the ”Fluid Replacement Master (Purple)” entry. Therefore, at this perilous moment, Wu Ting had no choice but to step forward.

Hearing Wu Ting’s words, Dr. Wu was, of course, well aware of the dangers involved. He was just puzzled as to how this young doctor knew the details so clearly.

Qin Donglai also looked at Wu Ting in surprise. Gazing at this young man who had repeatedly worked miracles, he asked with a budding sense of hope:

”Wu Ting, do you have an approach?”

The situation was critical, so Wu Ting didn’t beat around the bush and said directly:

”I’ve had a few discussions with Professor Shen Guofeng from Jinggang University Affiliated First Hospital before. I later studied some of his papers and happened to learn about the Haijin Gang Burn Fluid Replacement Formula, which was originally developed by his team. The formula was only proposed recently, so it hasn’t been rolled out to community hospitals yet.”

Upon hearing Shen Guofeng’s name, both Qin Donglai and Wu Youtu naturally understood the weight it carried.

Wu Youtu asked excitedly, ”Dr. Wu, please explain in detail.”

Wu Ting nodded. ”Professor Shen’s Haijin Gang Burn Fluid Replacement Formula was developed during the treatment of a mass burn casualty incident. At the time, they admitted 29 injured people, 19 of whom had severe, complex burns. All of them were young or middle-aged, with burn areas ranging from 40% to 80%. The circumstances were very similar to what we’re facing now.”

”If you use traditional fluid replacement formulas, they cover all age groups, but they require both the burn area and the patient’s weight. Collecting that data is time-consuming and complex, which makes it hard to manage an emergency like this. So, Professor Shen’s team modified the formula right on the spot, pioneering a version that can be calculated using just a single metric: the burn area.”

”Of course, the formula’s limitation is that it only applies to young and middle-aged people. But for this rescue effort, the patients themselves are all young, able-bodied workers, so they fall perfectly within its scope.”

”Using the Haijin Gang Burn Fluid Replacement Formula to calculate the fluid volume for the first 8 hours can significantly shorten the calculation time. This allows us to implement effective fluid resuscitation much faster, laying a solid foundation for subsequent treatment.”

After finishing his explanation, Wu Ting immediately wrote down the Haijin Gang Burn Fluid Replacement Formula from memory and handed it to Dr. Wu Youtu.

As an attending physician in the burn department, Wu Youtu had a discerning eye. After reading the formula, he was visibly thrilled.

Qin Donglai didn’t understand the technical details, so he waited to the side and asked, ”Dr. Wu, how is it?”

Wu Youtu let out a long sigh of relief and said with deep emotion:

”Because the Haijin Gang Burn Fluid Replacement Formula relies on a single metric and the calculation method is simple, it’s fast and accurate. It truly allows mass burn casualties to receive effective fluid resuscitation much sooner. And the timely correction of burn shock lays a solid foundation for all subsequent treatment!”

”This formula couldn’t have come at a better time!”

Wu Youtu was a quick thinker. Overcome with excitement, he immediately said:

”Wu Ting, you’ve performed a great service!”

”This Haijin Gang Burn Fluid Replacement Formula will play an irreplaceable role in the early anti-shock treatment of mass burn casualties. It has immense practical value. Here’s the plan: go find our department’s Director Wei right now. Have Director Wei notify all our department’s physicians to urgently study and implement it.”

”If we can roll this out immediately, it will dramatically increase the success rate of this entire rescue operation!”

A brilliant light danced in Wu Youtu’s eyes.

”Okay, I’ll head over right now.”

’I didn’t expect Professor Shen Guofeng’s formula to be this effective,’ Wu Ting thought to himself.

”Dr. Qin, we’ll proceed according to the Haijin Gang formula that Dr. Wu provided. As soon as I’ve calculated the fluid replacement plan, we’ll begin immediately.”

Wu Youtu had only been lacking an approach. Now that he had one, his solid fundamental skills were more than enough for him to handle the situation with composure.

”Understood.”

Qin Donglai immediately began to assist, overjoyed. ’This Wu Ting is a true lucky charm!’

Luo Ming and Cheng Feng exchanged a look, their eyes filled with utter shock.

’Wu Ting... is truly incredible.’

...

...

In the command center office, Dr. Lu Yu, the deputy director of the burn department, was currently reporting the situation to the two directors.

Lu Yu was a senior deputy chief physician with ample experience in burn fluid replacement, but at this moment, she was growing anxious.

”Director Wei, Director Huo, the number of burn patients this time is simply overwhelming. We have far too few physicians in our department with enough experience to manage burn fluid replacement.”

”With my level of experience, I can still manage. I can optimize and adjust fluid replacement plans according to each patient’s condition. However, the average attending physician can only follow the classic formulas, which have major limitations.”

”I just did rounds in several different wards. Clinicians with varying levels of experience are devising different fluid replacement plans, but there’s a general trend toward giving too much volume. This can easily lead to adverse reactions like acute heart failure, cerebral edema, pulmonary edema, deepening of the wounds, and abdominal compartment syndrome. Furthermore, the infusion rate also affects resuscitation. Infusing too quickly can cause a rapid spike in drug concentration in the blood, which narrows the therapeutic window or even causes toxic effects from certain drugs, compromising the treatment.”

”So, Director Wei, is it possible for us to develop a universal, rapid fluid replacement formula on short notice...?”

Lu Yu’s idea was a good one, but how could they possibly create a fluid replacement plan that was simultaneously fast, simple, and accurate on such short notice?

Just as Wei Guoqiang, Huo Yun, and Lu Yu were discussing the matter, their heads aching from the complexity of the problem...

Wu Ting rushed into the command center office.

Seeing the young doctor burst in, Wei Guoqiang was confused.

Lu Yu, on the other hand, frowned. ’At a time like this, what is a junior doctor doing, running around like a headless chicken?’

Huo Yun, however, recognized Wu Ting and was familiar with his way of doing things. He immediately asked:

”Wu Ting, you’re not in the wards assisting with the rescue. Why have you come here? Is there an urgent situation to report?”