"Do not forget your beginner’s mind and keep your mission in mind. Never hesitate to do what should be done!" The words of leadership gave us the courage to put ourselves on the stick. On February 15, 2018, on the Lunar New Year’s Eve, multidisciplinary healthcare workers in our hospital took the risk and successfully rescued a French patient suffered aneurysm rupture.
On the morning of February 15, Dr. Jiachang Chi from Department of Tumor Invention received a consultation call for assistance and received a CTA video from a foreign medical institution. The French patient was treated for abdominal pain. Jiachang Chi carefully watched the film and found that the patient had an aneurysm on gastroduodenal arterial arch which had ruptured and caused bleeding. Dr. Chi immediately informed them that the patient was in critical condition with a risk of abdominal bleeding at any time, and recommended the patient for surgery at nearby agency as soon as possible.
According to Jiachang Chi, the patient's aneurysm is caused by the erosion of the artery. When the artery wall ruptures, the tumor expands like a balloon, reaching a maximum diameter of 4 cm. Judging from past experience, the aneurysm rupture bleeding when the patient reached the hospital is a false precursor bleeding, which means that at any time there will be dangerous bleeding! Once the aneurysm ruptures or the embolization is unsuccessful, the following open surgery that can only be taken also faces great challenge.
Due to the critically ill condition of the patient and the disease involved multiple disciplines, as well as the patient was a foreigner, several 3A top hospitals in the vicinity were unable to accept the patient's referral. Finally, the hope of the patient for treatment falls on the shoulders of Renji. Jiachang Chi and the head surgeon on duty Hong Zhou had an urgent discussion of the patient's condition, and reported to the superiors. The departments and leaders of medical departments attached great importance to the patient’s critical illness! The words of Hui Cao, Director of Department of Gastrointestinal Surgery, let Jiachang Chi as a doctor of tumor intervention has a reassurance: "We would always hold up the end. Once the emergency calls, we would come for surgery even if in the evening!" When received the report from the departments, Jidong Zhang, Director of Department of Medical Affairs gave the instructions: "Do not forget your beginner’s mind and keep your mission in mind. Never hesitate to do what should be done!" Jiachang Chi said, "The leadership gave us the courage to put ourselves on the stick."
Under the direction of Jidong Zhang, Director of Department of Medical Affairs, the treatment plan has been promptly implemented: the Department of Tumor Intervention implements aneurysm embolization surgery, and once the incidence of aneurysm ruptures or enteric embolism, a laparotomy would be carried out by Department of Gastrointestinal Surgery. Both the surgical care room and operating room should be on standby status. From the patient’s referral to the deployment of treatment power and care ward arrangements, Yiling Fan, Deputy Director of Department of Medical Affairs conducted a positive coordination. At about three o’clock in the afternoon, the patient finally reached Department of Emergency in our hospital. Yiling Fan carried out preoperative communication in fluent French with the families of patients, to ease the anxiety of patients and their families. President Weiping Li, Vice President Yu Wang and others, who were giving condolences to first-line workers in Department of Emergency, also directed to cure the patient at the utmost when informed with the situation.
In the operating room, Dr. Jiachang Chi methodically prepared surgical instruments. Dr. Hong Zhou from Department of Gastrointestinal Surgery observed the patient's vital signs. Radiotherapy Technician Shuai Zeng and Nurse Jiaying Chen from Department of Tumor Intervention did the final equipment debugging. After the operation began, Jiachang Chi skilfully manipulated the catheter guide wire, and found a "time bomb" on the bowel of the gastroduodenal in less than 10 minutes. The horrible thing was that this "bomb" still risked "sparking". The extravasation of contrast agent indicated that the aneurysm is still bleeding, and the situation is very critical.
A speeding between life and death began immediately. Jiachang Chi firstly constructed a distal vessel embolization of the aneurysm quickly using micro-coil spring, followed by continued packing at the proximal end of the aneurysm by retreat of the catheter. A micro-coil was released to the parent vessel and the aneurysm was completely embolized without injuring the rest normal blood vessels! The entire operation took only half an hour. The patient was transferred to intensive care unit for further observation. On the third postoperative day, the patient left the surgical care unit smoothly and was transferred to the gastrointestinal surgery ward.
After completing the operation that day, Jiachang Chi returned home at already half past eight pm. Although missing the reunification of the family dinner once again, this Multidisciplinary team of Renji which " come at the first call, fight as soon as they come, and win when they fight", as well as the benevolent and humane spirit of the people who never forget their beginner’s mind, keep their mission in mind, and have the courage to undertake, let his heart full of pride and satisfaction. (Reporter Minjie Huang and Shan Tan)