Chapter 17
Chapter 17
Triage (2)
Thump, thump, thump.
Loud music blared through the night streets.
A sleek car cut through the rain, its tires slick on the wet asphalt.
“Whoa, is this your dad’s car?”
“Awesome. I’ve never been in a Bentley before.”
“Me neither!”
The high school students in the car were excited.
They even had bottles of alcohol in their hands, seemingly determined to enjoy a night of rebellion.
“But are you sure it’s okay to steal your dad’s car?”
“It’s fine, I tell you. My dad has so many cars, he won’t even notice if one goes missing for a bit.”
“Damn…”
“As expected of a rich kid.”
While everyone was expressing their admiration, the girl in the passenger seat asked anxiously,
“But do you even have a license?”
“Dude, what kind of question is that? How can a first-year high school student have a license?”
“Honestly, as long as you know how to drive, who needs a license? This country has too many restrictions on minors.”
“Hehehe, true.”
“Hey, floor it. I want to see how fast it can go.”
“Okay. Here we go!”
The boy in the driver’s seat turned up the music and stepped on the gas pedal.
The eight-cylinder engine roared.
“Hey, slow down! I’m scared!”
The girl in the passenger seat screamed in fear, but the boy in the driver’s seat only sped up.
Whoosh!
Honk, honk—!
The cars they overtook honked their horns loudly.
But since it was an expensive foreign car, everyone hurriedly moved out of the way.
“Whoa, awesome!”
“Hehehe, look at them getting out of the way for an expensive car.”
“Haha, losers! See ya!”
The boy gripping the steering wheel yelled excitedly, sticking his head out the window.
Just then, unable to see clearly due to the rain, he unknowingly crossed the center line.
“Hey, you’re driving in the wrong lane!”
“Whoa!”
Before the startled boy could hit the brakes, a van coming from the opposite lane swerved and skidded.
Screeeech!!!
The cars crossed paths on the rain-slicked road.
A violent collision followed, and the cars spun.
Crash! Crash! Crash!
The sound of a chain reaction of crashes echoed from the opposite lane.
The high school students’ car skidded on the wet road, barely managing to regain its balance and come to a stop.
“Ugh…”
“Hey… are you guys okay?”
“Oh shit, my neck…”
Although they had collided with another car, they weren’t seriously injured thanks to the deployed airbags.
They only suffered minor injuries like a broken nose or a busted lip.
“Holy crap, we’re alive because it’s a Bentley.”
“Hey, this is bad. Come out and see.”
The high school students stepped out of the car and were speechless.
“Gasp!”
“What do we do…”
They couldn’t believe the scene unfolding before their eyes.
The van coming from the opposite lane had flipped over completely while trying to avoid the collision, and several other cars were damaged in the aftermath.
The worst hit was a compact car that collided directly with the van.
Its body was crumpled like aluminum foil, and through the shattered window, they could see a young woman covered in blood, moaning with her head slumped.
They were the ones at fault, yet a major accident with casualties had occurred in the opposite lane.
“Holy shit… what do we do?”
“S-Shin-il, can you use your dad’s connections to fix this?”
The students asked, their faces pale.
But amidst all this, the driver was only concerned about his car, his face crumpled in distress.
“Oh shit, this car cost three hundred million won, and it’s all dented… If my dad finds out I wrecked it, he’ll kill me…”
No one was thinking straight.
The only one who seemed to have her wits about her was the girl, who, with a trembling voice, called the emergency services.
“H-hello, is this 119…?”
“Hey, hey, don’t call them! If you report this now, they’ll find out we were drinking!”
“But what do we do? People are hurt because of us!”
While the high school students argued, the rain poured down even harder.
***
“Underage drunk driving?”
“Apparently so.”
“Idiots.”
The emergency medicine professor gave his brief assessment.
We nodded in response.
The professors and EM doctors were gathered in the ER, fully prepared.
Including the paramedics and nurses, there were over 30 people.
Although the accident was caused by reckless high school students, it was up to us medical professionals to deal with the aftermath.
“Apparently, most of the students who were involved in the drunk driving incident only have minor injuries.”
“Of course. They were in an expensive, safe car. If they want to die, they should die alone. Why drag innocent people down with them?”
The professor clicked his tongue.
But what was done was done, and the professor didn’t waste any more time blaming the students.
“So, how many patients are there?”
“They said nine, and no CPR cases, but…”
Just then, a paramedic received a call and shouted,
“Eleven TA patients are almost here. They’re estimated to arrive in ten minutes!”
“What? They sent two more?”
The professor clicked his tongue again.
Eleven!
It was rare for so many trauma patients to arrive at once.
Some of them might have serious injuries.
“Why do the 119 guys always send so many patients to our hospital? Even if it is Yeonguk University Hospital…”
“What are we going to do with 11 patients suddenly arriving… We already have so many patients to treat…”
A nurse said with a worried expression.
There were already over 30 patients waiting for treatment in the ER, as usual.
“It can’t be helped. We have no choice but to ask the less urgent patients to wait a little longer.”
The ER had limited manpower.
So, they had to allocate their limited resources effectively and treat the most critical patients first.
This was where triage came in.
It was the process of prioritizing patients based on the severity of their condition so that the most urgent cases received treatment first.
Dr. Yeo Bong-cheol, who had changed into his scrubs, was talking to the paramedics.
“Did they give you more details about the patients’ condition?”
“Most are between level 3 and 5, but there’s one level 2 patient.”
“Level 2… The 119 guys are probably too busy to assess them properly. Let’s assume it’s a level 1 patient and move them to the resuscitation room as soon as they arrive.”
Yeo Bong-cheol’s expression became serious.
Emergency patients were assigned different levels based on the severity of their condition.
Level 1 – Cardiac arrest, shock, unconsciousness.
Level 2 – Severe trauma, moderate respiratory failure, severe pain, fever.
Level 3 – Mild dyspnea, moderate pain.
Level 4 – Mild pain.
Level 5 – Wound disinfection, medication prescription.
In other words, level 1 emergency patients needed to be treated with the highest priority.
Yeo Bong-cheol shouted,
“Patients who walk in holding the back of their necks can generally be considered level 5, but just in case, we need to make sure they undergo all the basic tests. Make sure all the imaging tests in our trauma set are done without fail!”
“Yes, sir!”
“Interns, stay alert. Got it?”
“Yes.”
We nodded.
Soon, this place would become a chaotic battlefield.
And…
Only I knew the future.
‘A medical accident will occur due to an intern’s mistake.’
It was highly likely that a serious mistake would happen while treating a critical patient.
Could I identify and prevent the mistake?
‘Let’s do this!’
I glanced to the side.
Joong-won hyung was more tense than usual.
“Come to think of it, this is the first time we’re dealing with such serious patients while working in the EM, isn’t it? It’s a good opportunity, so we should learn as much as we can.”
He said, clenching and unclenching his sweaty hands nervously.
It was ironic to call people getting hurt an “opportunity,” but it was the truth.
For those of us who were still just trainees, the amount of experience we gained was crucial.
And So-dam…
Surprisingly, she was no different than usual.
She wasn’t overly tense or losing focus; she was just quietly waiting for the patients.
“I won’t make any mistakes this time.”
She was reaffirming her resolve.
But where was Jo Jin-gi?
I hadn’t seen him around.
“Hyung, where’s Jin-gi?”
“What would he do with trauma patients when he can’t even use his hands? He can just focus on getting consent forms signed.”
“That’s true.”
That was a relief.
I sighed.
It was better to have one less person who could potentially cause an accident.
Just as I was thinking that, I heard the siren of an ambulance.
Wee-woo—
Clank!
The ER doors flew open, and a bloodied patient was brought in, wearing a neck brace and an oxygen mask.
“Level 2 patient!”
“To the resuscitation room!”
Dr. Yeo Bong-cheol started directing the chaos like a commander on a battlefield.
***
Shim Yoon-jin.
A female office worker in her mid-20s.
It seemed she got into an accident while returning home from a late-night shift.
She must have instinctively protected her head because she only had bruises and a minor laceration on her head.
But the critical injury was on her upper body.
Her left side, covered by a white blouse, was completely soaked in blood.
“Gasp.”
Joong-won *hyung* let out a gasp.
No matter how used to seeing patients doctors were, the sight of someone bleeding profusely and dying being rushed into the ER was undeniably overwhelming.
“What’s the patient’s condition?”
“She lost a lot of blood. We performed primary hemostasis, but there might be more bleeding sites. She was already drowsy when we arrived.”
“Oh dear… Understood.”
The EM doctors quickly took over the patient from the paramedics.
The paramedics and nurses busily checked her blood pressure and attached a pulse oximeter to her finger.
Soon, Yeo Bong-cheol clicked his tongue.
“Saturation isn’t stable… and what’s with this blood pressure of 85? Prepare for intubation!”
He shouted urgently.
The most crucial thing for sustaining an emergency patient was oxygen supply.
And the next most important thing was preserving blood.
“Shin Seon-han, Ham So-dam. Help the paramedics remove her clothes and carefully examine the bleeding sites!”
“Yes!”
So-dam, along with the paramedics, helped cut away the blouse.
Rip—
The patient’s blood-soaked torso was revealed.
Assuming a bleeding rate of 1cc per second, almost 1 liter of blood would be lost in 15 minutes.
For every minute’s delay in stopping the bleeding, the patient’s survival rate decreased by 3 percent.
Therefore, we had to find the source of the bleeding as quickly as possible.
‘Where is it? We need to find it fast…’
We quickly examined the patient’s body.
It wasn’t easy to assess the situation calmly in such an urgent situation.
Just then, So-dam exclaimed,
“I found it!”
On the inside of her limp arm.
A long, vertical laceration was gushing blood.
“There’s heavy bleeding from a laceration on her left arm!”
“Apply pressure to stop the bleeding!”
“Yes!”
So-dam and I disinfected the wound and started applying pressure to stop the bleeding using gauze and bandages.
“…”
I glanced at So-dam.
Surprisingly, she was working swiftly and efficiently.
Was she the type who performed well under pressure in major incidents like this?
‘We’re safe for now.’
Everything was going smoothly, and everyone was following the manual without making any mistakes.
Yeo Bong-cheol examined the patient’s eyes and said,
“Her pupils seem fine… We have the sono (ultrasound) ready, right?”
“I’m looking at it.”
“Ah, the professor is on it.”
Yeo Bong-cheol looked slightly embarrassed.
The emergency medicine professor was examining the critical areas with the ultrasound.
“Hmm… There are no abnormalities on the ultrasound. No fluid collection in the heart, abdomen, or chest…”
The professor muttered to himself.
While Yeo Bong-cheol was intubating the patient and the emergency medicine professor was conducting the ultrasound examination, the nurses were securing a peripheral IV line in her arm and administering fluids.
Everyone was moving in sync, like a single organism, without needing any instructions.
“Are the ABGA (arterial blood gas analysis) results ready yet?”
“W-we’re working on it.”
In response to the professor’s question, Joong-won hyung answered, sweating profusely.
His hands were fumbling more than usual.
“You’re too slow. Are you going to do the test after the patient dies?”
The professor frowned.
It was a reprimand from the professor, so anyone would flinch.
Yeo Bong-cheol stepped in and said,
“Joong-won, step aside. I’ll do it since we need to get an A-line anyway.”
A-line.
It referred to inserting a thin plastic tube into an artery to continuously monitor blood pressure and perform arterial blood gas analysis (ABGA).
Yeo Bong-cheol quickly secured the A-line, drew arterial blood, and handed it to Joong-won.
“Here, quickly run this through the ABGA machine!”
“Yes, sir!”
Joong-won hyung took the arterial blood from Yeo Bong-cheol with trembling hands.
He shook the syringe up and down to mix it with the heparin (anticoagulant) inside, but his hand slipped.
Slip!
“Gasp!”
“Hey, hey!”
He almost dropped the syringe, causing everyone around him to gasp.
He managed to catch it with his body before it hit the floor, but he couldn’t avoid the sharp glares from the other doctors.
“What the hell is wrong with him?”
“I’m sorry. I-I’ll run the test and be right back!”
Joong-won hyung left the resuscitation room.
…I had a bad feeling about this.
In his current state, it wouldn’t be surprising if he made a mistake.
Suddenly, a scenario flashed through my mind.
“Hyung, wait a moment!”
I hurriedly called out to Joong-won hyung.
—————
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