Chapter 28

Tension pneumothorax refers to a condition where a larger lung bubble ruptures, or a larger and deeper lung laceration or bronchial rupture occurs. The tear communicates with the pleural cavity and forms a one-way valve, also known as a high-pressure pneumothorax.

After a tension pneumothorax forms, during inhalation, the pressure in the pleural cavity decreases, the valve opens, and air enters the pleural cavity; during exhalation, the pressure in the pleural cavity increases, the valve closes, and air cannot be expelled from the pleural cavity.

The more the patient breathes, the higher the pressure in the pleural cavity becomes, compressing the lungs tightly. Eventually, the lungs are completely compressed and cannot expand...

No matter how hard the patient tries to breathe, they cannot take in a single breath.

This is one of the most critical emergencies. Apart from a cut to the carotid artery or a rupture of the aorta in the chest or abdomen, no other internal bleeding can be as fatal as this.

Death by suffocation can occur in an instant.

Priest?

The Temple of the War God is indeed next to the camp. Running there and back would take no more than 5 minutes. However, the patient on the ground cannot wait for 5 minutes!

"50ml syringe!"

Gret shouted.

No response.

No one gave him anything. No syringe, no needle, no drainage tube...

No one knew what he needed, why he needed it, or what the patient's condition meant.

This is a different world, not their hospital, not the emergency department where he has worked for over a decade.

Gret looked around. The faces around him were anxious, staring at the patient, looking at the temple not far away, and hoping for the priest to run over. Some were even calling for the door to be dismantled, taking a large shield, and trying to carry the patient to the temple...

By the time you carry him there, he will be dead!

Gret was in a panic. He stood in front of the patient, one arm spread out, the other arm extended forward, and grabbed Knight Flynn:

"I am a healer! I can save him! Captain, help me!"

"Can you save him?"

Knight Flynn immediately stopped. Gret nodded forcefully:

"He is dying! I can save him! I need some things, Captain, help me!"

Knight Flynn hesitated.

Gret had just learned the healing technique, which he had just heard from Captain Karen; but no matter how much he trusted Karen, hearing it was not the same as seeing it with his own eyes.

Moreover, the healing technique of the Temple of the War God was something they had seen clearly for decades.

"You..."

"Look at his face! His face is turning purple, he can't breathe, he is dying! I can buy him some time! Until the priest arrives!"

His tone became increasingly urgent. Knight Flynn stopped, glanced at the patient on the ground, and looked intently at Gret.

This young man is telling the truth.

His intuition told Knight Flynn as much. But, the healing technique he had just learned, and the 50—50 what—really useful?

"Captain, trust him!"

Karen squeezed through the crowd. At the same time, the patient's struggles became more desperate and more feeble.

Knight Flynn made up his mind instantly.

"What do you need?"

"Needle! A thick, hollow needle!" Gret answered without hesitation. It was his mistake earlier; saying "50ml syringe" in this place clearly made no sense, and they might not even have the concept of milliliters. A needle should be understandable! A thick, hollow needle!

He received a chorus of headshakes. Gret did not lose heart:

"Then a thin steel tube! No? Iron? Copper? Any hard tube! As thick as a pinky!"

"Yes, yes!"

Finally, someone reacted, ran off, and returned, handing Gret something he had used just two days ago, very familiar—

A chicken leg bone.

Gret: "..."

Am I destined to deal with chicken bones these days?

The key was that two days ago, it was a cricothyrotomy, and he could directly pierce with the chicken bone; today, it was a thoracostomy to relieve pressure, without a syringe or a needle, using a chicken bone that was dozens of times thicker than a needle to pierce the chest?

Do you think I'm Superman?

Gret raged in his heart. Nothing was available, and this surgery was lacking everything. He hoped the priests from the temple would arrive quickly, or he wouldn't even be able to control the infection—

"Give me a dagger! Quickly!"

At the second intercostal space along the midclavicular line on the right side, Gret stabbed without hesitation. Stab... stab... couldn't pierce through!

Are the warriors, or knights, in this world so physically strong!

"Who can help me!" Gret shouted. He measured with his pinky:

"Just... this deep! Pierce in! Pull out, then, insert the chicken leg bone!"

"I will!"

Knight Flynn took the dagger without hesitation.

The knife went in, the knife came out, and the chicken leg bone followed. A huge pressure, with a hissing sound, instantly spurted from the center of the bone.

It worked!

Gret's whole body relaxed. He knelt beside the patient, watching his breathing, and listening to the airflow through the chicken bone. He covered the top of the chicken leg bone with his thumb, pressing and releasing it at intervals.

—After decompression of the pleural cavity, a one-way valve device should be connected externally to facilitate the expulsion of high-pressure gas from the pleural cavity and prevent external air from entering. In emergencies, experienced doctors have used surgical gloves, soft plastic bags, or balloons, cut to fit over the needle, as a substitute for the valve.

Gret had no surgical gloves, so he had to use his thumb to control the rhythm on the spot...

As he did, the swelling on the patient's right chest gradually subsided, and his complexion visibly improved. Anyone could see that this life had been pulled back from the brink of death.

"Saved?"

"Saved!"

"Seems like he's really saved!"

"I remember Old Xieko died this way too, his ribs were broken, and he passed away in no time. The priest hadn't even arrived..."

The warriors around them were discussing. Knight Flynn's gaze towards Gret softened, and he asked:

"Little Gret, what should we do next?"

Next? Insert a drainage tube, perform a closed thoracostomy, take an X-ray, realign the ribs, and if unlucky, perform thoracotomy to repair the lungs...

But now, with nothing available, I can't do any of these...

Gret rolled his eyes. Well, if it were in the modern world, and the emergency department was too busy, they would hand it over to the cardiothoracic surgery department; now, in this different world, then... call the priest?

A large group of footsteps finally sounded. Gret glanced to the side, and the crowd around him had already bowed and lowered their heads:

"Your Excellency, the Bishop."

"Your Excellency, the Bishop—"

Gret curiously turned his head to look. As for bowing, since he was already kneeling beside the patient, he didn't bother with the extra effort.

In the center of the crowd was a robust middle-aged man, broad-shouldered and large-waisted, with a shiny bald head. If you ignored his Western features, his bald head could easily be mistaken for Lu Zhishen.

The white robe had a shield embroidered on the chest, but not in dark brown, rather in brilliant silver thread. On the shield, a war hammer and a staff crossed.

Apart from that, there were no other accessories. Only a large fist held a staff, with a few gems embedded at the top, indicating the Bishop's noble status.

Beside the Bishop, a group of seven or eight priests, all muscular, looked more like warriors than clerics. The young priest John, whom Gret knew, was among them, the youngest and the thinnest, clearly only a priest's apprentice.

The group surrounded the Bishop and brought him to the patient's side. The bald Bishop first examined the patient, then looked at Gret and the chicken leg bone in his hand. After a moment of observation, he smiled:

"Child, I am here, and your responsibility—pointing to the chicken leg bone—can end now."

Gret smiled in return. His tone was respectful and polite, yet calm, firm, and without hesitation:

"Please treat him first. I will remove it at the appropriate time."