Chapter 31
Chapter 31
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Translator: crow
Chapter Title: Securing the Airway is Important (4)
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Boring compression time. I stared blankly at the clock on the station wall.
Time dragged on agonizingly slow. The vital signs on the monitor were peaceful, and the patient grimaced uncomfortably but wasn't spitting up any more blood.
‘See? It’s nothing big.’
I let out a sigh of relief inside.
Those crazy ghosts must have stirred up all that chaos on my off day just to scare me during training.
Reality isn’t that dramatic.
Blood spraying like a fountain, turning blue from not breathing—stuff like that only happens in dramas…
That’s when it hit.
The patient suddenly jerked with a choking ‘gack’ sound.
A sinister sensation welled up from deep in his throat.
The suppressed cough burst out reflexively.
“Gah! Hack, hack!”
And then.
Pffftshhhhhh—
The long Kelly in my hand was shoved away with a snap, and bright red blood erupted from the patient’s mouth like a fountain.
The vessel we’d barely compressed had burst completely under the pressure of the cough.
“Argh!!!!!”
Red blood splattered across the patient’s chest, my gown, and the floor everywhere.
Blood gushed from the patient’s mouth in waves.
At the same time, the monitor started screaming like mad.
Beep-beep-beep-beep!
Oxygen saturation plunged straight from 98% to 90, 85.
A clot of blood had blocked the airway.
“What, what is this!”
My brain froze.
Where had the peace from moments ago gone? Hell had unfolded right in front of me.
Blood clots, not just blood, were surging back up from the patient’s throat.
A gurgling sound echoed horrifically.
The patient’s face turned blue in an instant.
“Doctor! Patient’s sats are dropping! Down to the 70s!”
“Suction! Get the suction now!”
It was chaos.
My hands trembled.
ENT still hadn’t arrived?
Third-year resident Han Jae-yeon had gone to see another patient?
Think.
Think.
Think, right now.
‘Hey! Patient’s gushing blood from the throat!’
‘This is about airway security. Airway first, you idiot!’
‘Grab the biggest laryngoscope blade, sweep the tongue and clots aside at once, then shove the tube in as fast as possible to secure the airway and inflate the cuff so blood doesn’t go into the lungs!’
Airway, airway!
The ghosts’ comments rang in my head like tinnitus.
“Anesthesia hasn’t come yet, right? They’re far?”
“Yes! No word yet!”
Do it.
The decision took one second.
I rushed to the patient’s head and shouted.
“The intubation kit we prepped earlier! Hand it over now! Blade and 7.5 tube! With the suction tip!”
At my desperate cry, the nurse fumbled and thrust the tray forward.
I gripped the laryngoscope with shaking hands.
‘Left hand. Laryngoscope always in the left.’
I readjusted the laryngoscope in my left hand and pried the patient’s jaw open.
I swallowed at the sight before me.
Hell.
The patient’s mouth was already a sea of bright red blood.
Swirling blood and clots mixed so thick I couldn’t tell tongue from throat.
‘Suction first! Can’t intubate if you can’t see! Shove the biggest one in and suck it all up!’
Anesthesia ghost had said that.
I grabbed the thick suction tip with my right hand and jammed it deep into the patient’s mouth.
Grrrrrrgl!
The suction screamed as it pulled in clots.
But it was useless.
Blood surged from the depths faster than we could suck it out.
My view was still filled with red.
I couldn’t see a thing.
Oxygen sats monitor had started its countdown to cardiac arrest.
Fuck.
Can’t see.
Nothing visible.
Can’t intubate like this.
‘If suction alone fails, use the blade like a dam! You moron!’
Yeah, I’d seen that comment during gallery training.
‘In that case, don’t hesitate—just shove it in! Use the blade tip to sweep the tongue root and clots all to the left, make space even for a second! Be aggressive!’
I abandoned reason.
I shoved the laryngoscope blade deep into the patient’s mouth with my left hand.
Then swept the tongue and surging clots entirely to the left.
“Guh!”
For a split second, the blood ebbed, opening a fleeting gap.
But swollen, blood-blown mucosa hid the epiglottis and cords—I had no clue where they were.
Lost.
‘Where! Where to shove it!’
Monitor read 55%.
‘Can’t see? Press externally. Know BURP? Have the nurse push the thyroid cartilage backward, upward, rightward! Cords will drop right in front of you!’
I snatched the fidgeting nurse’s hand.
“Doctor! Here! Patient’s neck! This protruding bone—press down hard! Downward, and toward me!”
The nurse pressed hard on the patient’s neck.
That instant.
My view shifted slightly.
Through the blood haze, the faint outline of the epiglottis appeared—and beyond it, a V-shaped white structure flashed.
Vocal cords!
Found you, bastard!
In exhilaration, I drove the tube in my right hand toward that white gap. Almost done.
Just insert it and…
Ting.
The tube tip hit something.
It wouldn’t go in.
“Why won’t it go!”
Worst case.
Laryngospasm.
Oxygen sats 50%.
It’s over.
‘Spasm in that situation? Don’t force it—you’ll tear it! Hold the tube tip steady at the cords! Steady pressure till the spasm relaxes!’
…Right.
Last hope.
I held the tube steady at the cord entrance, neither pushing nor pulling.
1 second, 2 seconds, 3…
Monitor heart rate slowed.
Please.
Please open.
Please.
And.
Sliiiick.
The resistance at the tube tip vanished like a lie.
I seized the moment and shoved the tube all the way in.
Done.
It’s in.
“Phew…”
The moment I sighed in relief and wiped sweat from my forehead.
“Hey! What the hell are you…!”
Third-year Han Jae-yeon burst through the curtain and froze at the sight.
Blood-soaked patient, and a first-year resident casually auscultating with a tube jammed in the mouth.
Han Jae-yeon’s eyes shook.
Her gaze flicked between the laryngoscope in my hand, the tube in the patient’s mouth, and my blood-drenched gown.
“Sudden cough made it burst.”
My voice didn’t tremble.
“Massive bleeding blocked the airway, sats to 70s, so I intubated on my judgment. 7.5 tube in, cuff inflated. Just bagged both lungs—breath sounds good, tube position fine.”
Han Jae-yeon’s expression changed as she heard my report.
She snatched the stethoscope from my hand and pressed it to the patient’s chest herself.
Verify.
That’s the senior’s job.
“Breath sounds bilateral… tube’s in right.”
She muttered briefly, then switched to commander mode.
“You—stay right by the patient, hold the tube so it doesn’t slip. I’ll hook up the vent.”
Then she started directing the nurse.
“Pump a liter of normal saline through the line you’ve got. Gotta volume-load first.”
“Yes, doctor!”
“And check with the blood bank if the crossmatched PRBCs can come down right now.”
“I’ll confirm and let you know!”
“Just in case, mix a norepi amp and prep it on a pump line. If BP drops below 80, we’ll start it.”
“Got it!”
“Prep an A-line kit too. If BP keeps fluctuating, we’ll put in an art line.”
Han Jae-yeon headed to the station without looking back.
I nodded and wiped blood from my lips with gauze.
I actually did it.
I shoved a tube down the throat of someone gushing blood.
It didn’t feel real.
Soon Han Jae-yeon wheeled back the hefty ventilator.
Machine beeps and screen lit up. Fingers flew over the touchscreen.
Hiss— The machine forced oxygen into the patient’s lungs.
Chest rose and fell rhythmically.
Sats climbed grudgingly: 80, 85, 90… finally 95%.
Crisis averted for now.
Han Jae-yeon shouted at the nurse without looking at me.
“Nayeon! Call anesthesia and ENT again right now—tell ’em patient blew and intubation’s done! Get down here ASAP!”
“Yes, doctor!”
Then she turned to me.
What?
“Han Hyun-jae.”
“Yes.”
“Pharmacy—grab two amps midazolam and one roc. Patient’s gonna wake soon; gotta resedate.”
Reality sank in.
I bolted to the crash cart.
Sedative midazolam, paralytic roc.
Drugs to plunge the patient into deep sleep and paralyze muscles for full vent compliance.
As I grabbed them, the scene replayed in slow motion.
…I actually pulled it off.
A hollow laugh escaped. Hands still trembled faintly.
Back at the patient, Han Jae-yeon nodded at the syringes.
“Got ’em? Push through the IV.”
I hooked the syringe to the three-way on the patient’s arm saline line.
Midazolam first. Clear fluid surged into the vein. Then roc.
“Okay. Secure the tube now.”
Han Jae-yeon cut long medical tape.
We taped around the mouth to lock the tube tight.
“Call portable X-ray for tube depth check.”
No breather in her orders.
I picked up the intercom and called radiology.
Moments later, the tech wheeled in the mobile X-ray.
Shooting done quick.
Less than a minute, the fresh X-ray popped on the station monitor.
“Let’s see…”
Han Jae-yeon and I stood side by side, hunting the tube tip.
Perfectly placed.
“Depth’s spot on.”
She murmured low.
I swallowed dryly instead of answering.
Then she took charge.
Han Jae-yeon palpated the patient’s radial artery at the wrist, found the pulse, and stabbed in the needle without hesitation.
Arterial blood filled the syringe in gushes.
“Send this to the lab stat!”
Nurse dashed off with the blood-filled syringe.
Now just wait for results.
The chaos settled like a dream; ER returned to calm.
Only the steady ventilator beep remained.
All initial measures done. Patient stabilized.
Hands shaking, heart pounding.
I… I did it.
Am I crazy?
Really.
What is this feeling? This inexplicable racing heart.
Only then did Han Jae-yeon shove hands in pockets, lean against the wall, and look at me.
Unreadable expression.
“Hey.”
“…Yes, senior.”
“What you just did.”
She chose her words.
“Fucking nailed it.”
“…Pardon?”
“How? Blood spraying everywhere, and you didn’t shake a bit—intubated solo?”
No way I could say ‘Ghosts force-prepped me days ago.’
The most textbook answer slipped out.
“Just did what I learned.”
She smirked at my reply.
“Bullshit.”
“If everyone could pull it off just like that, why do patients code?”