top student at medical school

Chapter 319 The Patient with the Broken Needle (Second Update, Please Subscribe)
"Huh? The needle broke? In the femoral vein?" Fang Ziye's first reaction upon receiving the call was shock. After listening, he replied, "Okay, I'll be right there."

A young man brought to the emergency room by the police arrived; the needle had broken off in his femoral vein.

This location is actually very dangerous because the femoral vein and femoral artery are very close. Even many trauma surgeons dare not perform punctures here casually. These guys are really "ruthless" and dare to do it anywhere.

"Brother Fang, could you help me check the four pre-transfusion markers? I wouldn't dare to operate without them," Fang Ziye asked.

The four tests before blood transfusion include infectious disease screening, which is mandatory if the patient has a history of prostitution or drug use.

Although it still requires processing and operation after the procedure, the level of protection is completely different.

Moreover, there are broken needles inside, which can easily puncture the operator's gloves or even pierce the skin. No amount of caution is too much.

Upon arriving at the emergency department, Fang Ziye saw the patient and the patient's 'special guardian'.

"How long has it been since the needle broke? How is your skin condition now?" Fang Ziye asked.

"You'd better tell the truth. This is seriously affecting your treatment. The hospital we took you to before didn't dare to remove it for you!" A man's voice was stern and expressionless.

"Three, three days. It hurts a bit." The patient was a thin young man, almost skin and bones, with a standard sallow complexion. He spoke weakly, his Adam's apple bobbing up and down, and he lay flat on the examination bed with listless eyes.

Fang Ziye tried his best to conceal his 'biased' gaze: "Do you have any symptoms now?"

Fang Ziye started to get sterile surgical gloves, intending to give him a physical examination.

The pants were loose, and after Fang Ziye drew the curtain, he did not ask the police to leave. Of course, the broken needle in the femoral vein would not expose his private parts.

During the physical examination, Fang Ziye was extra careful, afraid that he might accidentally press inside.

There were hard lumps inside, which I imagine were caused by local soft tissue hyperplasia due to a broken needle or foreign object.

"Did he get an X-ray or CT scan? That would be the best angle to view the broken needle," Fang Ziye asked.

His gaze suddenly sharpened, and his tone was one of astonishment: "You've had more than one broken needle? There's a broken needle inside an artery too?"

As he spoke, Fang Ziye withdrew his hand in astonishment!
Young people these days are really reckless; they'll do anything to seek thrills!

He dared to perform arterial injections on his own, and didn't even bother to fix the broken needle.

The reason they don't deal with it is probably not because they don't want to, but because they dare not.

"No photos taken. Should we take a photo of this one?" The policeman frowned upon hearing that there were other broken needles.

“It’s absolutely necessary. He definitely has more than one broken needle.” Fang Ziye took off his gloves and continued, “Let’s get the X-rays taken first. Your foreign body removal surgery will require pre-operative examinations later.”

Beside him, Fang Songlin, who was on duty, quickly filled out the examination form into the electronic medical order, printed out the barcode, and said, "You can scan the code to pay or go outside to pay. If you have medical insurance, you can also get reimbursed."

The police officer gave a helpless, bitter smile: "They usually don't have health insurance, just scan the code..."

I took the phone and started scanning the code myself. I didn't have any money, but at this point I needed them to pay for it upfront, and then it was taken to the X-ray examination room…

After the person left, Fang Songlin asked, "Is this situation under your jurisdiction or the vascular surgery department's jurisdiction? It would be great if we could get rid of it."

"I don't know either, I've never seen this before. I'll ask my master..." Fang Ziye said, quickly sending a voice message to his teacher with a concise explanation. The broken needle removal procedure would definitely need to be performed if he requested treatment, but it might not be Fang Ziye who would do it.

Soon, Yuan Weihong replied: "You've also encountered this kind of person? You'd better be careful. Removing a broken needle from a major blood vessel requires extreme caution."

"Since you have two, you need to be even more careful!"

The fact that Yuan Weihong didn't return to another department for treatment indicates that this indeed falls under the jurisdiction of trauma surgery. Generally, these types of injections are administered to superficial blood vessels, most directly in contact with the blood vessels in the limbs.

“Yes, Master.” Fang Ziye frowned upon hearing this.

If this surgery were replaced with a large-incision surgery, there would be no problem at all. At worst, the entire lump of flesh could be cut off without any issue. Many open surgeries are much larger than this one.

"By the way, Brother Fang, you've had your blood clotting function checked, right?" Fang Ziye asked cautiously.

"Of course, I had all the routine preoperative blood tests done in the emergency room."

“Exactly, his is an artery and vein together. If you remove two, how can you apply pressure to stop the bleeding? If it were just one, you could quickly apply pressure to stop the bleeding after pulling it out.” Fang Songlin frowned.

If it's a single needle puncture, the surgery is considered complete once the needle is removed. Arterial puncture holes are much larger than needle puncture holes, and with pressure bandaging for a few days, everything should be fine.

However, there are two needles. After removing one, you cannot apply pressure to stop the bleeding, otherwise the other needle will go in.

"We'll see when the time comes. We'll find a few assistants to check all the needles first, and then take both at the same time. So we need to know the direction of the diameter of these two broken needles." Fang Ziye said, feeling quite helpless.

It's really a lot of trouble and not worth getting a headache over something as trivial as an emergency that isn't a medical condition.

After the X-ray results came out, Fang Ziye said to the police and the patient himself, "Your situation is more complicated now!"

The epidemiological examination results for the young man were confirmed to be negative, but he had clearly concealed his medical history. The needle had broken at his intravenous site, indicating that it had been there for quite some time, as there were already some calcifications, suggesting it was at least three months ago.

Moreover, his broken needles weren't just on the side he mentioned; there were also some on the other side. I really don't know what he was doing, breaking one after another.

"There are three broken needles, two on the left and one on the right. The left one has both arteries and veins, while the right one is only in a vein."

The police then gleaned other information: "We knew he wasn't a novice who broke the needle, nor was he a new offender. We need to interrogate him thoroughly again."

"With so many instances of toxicity, there must be quite a few upstream sellers..."

As he spoke, the policeman went to make a phone call...

Seeing this, Fang Ziye hesitated and said, "Should we remove the needle? If we do, he'll need to go into the operating room."

"Dr. Fang, I'm sorry, but is there any immediate danger to his life if this needle is still in his body? If there's no immediate threat to his life if we don't remove the needle, then we might not be able to remove it so easily!" the police officer said.

"Well, all I can say is that it definitely needs to be removed, and it needs to be removed as soon as possible. A broken needle inside a blood vessel is not only a common foreign object in the body that is not good for health, but if it is accidentally pushed deeper due to local pressure or other reasons, it may even be penetrating a blood vessel, which will be more troublesome to remove then." Fang Ziye could not speak in any other capacity, so he could only speak from the perspective of a doctor.

"Doctor, I want it removed, it hurts a lot." The young man suddenly remembered and asked for it.

"Where were you all this time?" The policeman handcuffed to him glared at him.

(End of this chapter)