Chapter 4 — Emergency Night Watchman

But it was clear in my heart—one strike of this knife, right cut, the child lived. Cutting even just a millimeter wrong, the carotid artery, thyroid gland, any other structure is damaged, it is a disaster. More importantly—I don't have a doctor's license. The back-up doctor performed an emergency cricothyroidotomy, without a superior doctor at the scene signing off, if any problem occurred - It was an operation that violated regulations. Even if I could save my life, there would be another blemish in Trieu Due Minh's assessment, and my career of redemption could directly end. Eight minutes. The child's lips turned from purple to blue. The oxygen saturation dropped from 82 to 76. His small hand unconsciously grabbed the bed sheet, his nails turned white. His father knelt down.
“Doctor, please, he is only six years old, please save him…”
I took a deep breath.
“Tieu Manh, povidone iodine, gauze, mosquito clip.”
“Uncle… Doctor Tham, do I have to call my superiors for this—”
"There's no time. Please cooperate with me and help me fix its head."
My left index finger and thumb grasped the child's thyroid cartilage, pulled it up, and my right index finger reached down to reach the upper edge of the cricoid cartilage. The depression between the two—the cricothyroid membrane. On an adult, this slit is about nine millimeters high. On this child's body, there are only four or five millimeters. I closed my eyes for a bit. Then open your eyes. The nose is cut horizontally, the skin layer is shallow. Blood flowed out, the child instinctively moved a little.
“Fixed!”
Tieu Manh used both hands to firmly press the child's shoulders and chin, his face as white as paper. I used my left thumb and middle finger to spread the skin on both sides of the cut, revealing the pale yellow fascia underneath. But it was clear in my heart—this one stab of the knife, cut right, and the child lived. Precisely cut open the cricothyroid membrane.
“Phew—”
A jet of air shot out from the cut, carrying pale pink foam with it. The airway is clear. I quickly inserted mosquito forceps into the cut to spread it open, then inserted a makeshift tube—made from a syringe shell, not a standard tracheostomy tube, but able to maintain ventilation. The child's chest bulged again. Once, twice. Oxygen saturation begins to jump.
78
79
80
81
The child's blue-violet lips slowly faded, returning to pink. His small hand let go of the bed sheet. My hand that was holding the temporary tube finally started to tremble. The blood-red text faded away, replaced by: 【Open airway. The immediate risk of suffocation has been eliminated. An official tracheostomy or endotracheal intubation is needed later.】 I turned around: "Tieu Manh, call for an emergency consultation with the ENT department, tell them there is a patient with acute epiglottitis who has had an emergency tracheostomy, and needs to replace the official tracheostomy tube. Tell the PICU to prepare a bed."
“Okay, okay!” Tieu Manh ran to make a call.
The father was still kneeling on the ground, his forehead pressed against the cold tile, his shoulders shaking from crying.
“Thank you… thank you doctor…”
I squatted down and pulled him up: "Don't kneel anymore. The child is okay for now. But after that, we still need specialized treatment, please sign." When he stood up, his knees were weak and he had to hold on to the bed railing to steady himself. I turned around to write the emergency report. When the tip of the pen touched the paper, I realized my entire back was soaked. Ten minutes past three in the morning. The ENT doctor on duty came over and took over the treatment afterward. He looked at the cricothyroid membrane opening I made and was silent for a few seconds.
"Who do?"
"I."
He evaluated me from top to bottom.
“Retreat doctor?”
"Correct."
He said no more, nodded once, and began to operate. I retreated outside the emergency room door, leaned against the wall, raised my head and looked at the white fluorescent light tube on the ceiling, looking until my eyes stung. Two already. Two night shifts, two lives. A person is considered "overqualified". This person— Once Trieu Due Minh knows, what will he say?
“A medical doctor like you dares to open the cricothyroid membrane when there is no superior on the scene?”
“If something happens, who is responsible?”
“Do you know this is a violation of regulations?”
I can think of them all. But I don't regret it. What happens after dawn is what happens after dawn. Now, that child is breathing. That's enough. 【Chapter 3】 I guessed half right. After dawn, the storm really came. But the direction it came from was beyond my expectations. Eight o'clock in the morning, briefing. Trieu Due Minh knew what happened during the night, right in front of the whole faculty asked: "Shen Yen, did you open the ring armor last night?"
"Correct. Acute epiglottitis, third degree laryngeal obstruction, oxygen saturation dropped to 76, no time to wait for consultation.”
“Who told you to do it?”
“No one told me to do it.”
“So what do you rely on?” He stood up, his finger almost poking me in the face, “Are you qualified? Do you have a practicing certificate? If a medical accident happens, can you pay for it? Do you know what the nature of this matter will be when reported to the Medical Department?
The whole office was so quiet that you could hear a pin drop. Everyone is looking at me. There are sympathetic eyes, gloating eyes, more than a cold look like "what does this have to do with me?" I looked at Trieu Due Minh.