Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 17

#17 Triage (2)

Boom, boom, boom.

Loud music pulsed through the night.

The sleek car sliced through the rain-slicked road.

“Wow, is this your dad’s car?”

“Awesome! It’s my first time in a Bentley.”

“Me too!”

The high school students in the car were buzzing with excitement.

Judging by the liquor bottles they clutched, they were deliberately indulging in a rebellious joyride.

“But is it okay to, like, steal your dad’s car?”

“It doesn’t matter. My dad has so many cars, he won’t even notice one is gone for a while.”

“Amazing…”

“You’re so rich!”

While everyone was marveling, the high school girl in the passenger seat asked anxiously, “But do you even have a license?”

“Hey, how can a first-year high school student have a license? Don’t be ridiculous.”

“Honestly, you only need to know how to drive. Why do you need a license? There are too many things minors aren’t allowed to do in this country.”

“Hehe, that’s right.”

“Hey, floor it! I’m curious how fast this thing can go.”

“Okay, here we go!”

The high school boy in the driver’s seat cranked up the music and slammed on the accelerator.

Soon, the V8 engine roared to life.

“Hey, slow down! I’m scared!”

The high school girl in the passenger seat screamed, but the more she protested, the faster the boy drove.

Whoosh!

Honk, honk!

The cars being overtaken blared their horns.

But since it was an expensive foreign car, everyone was quick to give way.

“Wow, awesome!”

“Hehehe, look at them avoiding us because it’s an expensive car.”

“Haha, losers! See you later!”

The high school boy gripping the steering wheel rolled down the window and shouted excitedly.

At that moment, he drifted over the center line without realizing it, visibility hampered by the heavy rain.

“Hey, you’re driving in the wrong lane!”

“Huh?”

Before the surprised high school boy could react, a van approaching from the opposite direction swerved sharply, tires screeching.

Screech!!!

The vehicles converged in the downpour.

Then, with a deafening crash, the car spun violently.

Bang! Bang! Bang!

A chain reaction of collisions echoed down the road.

The high school students’ car, miraculously, regained its balance and skidded to a halt.

“Ugh…”

“Hey… are you okay?”

“Ah, damn it, my neck…”

Although they had collided with another car, the airbags had deployed, preventing serious injuries.

They mostly suffered minor injuries like broken noses and split lips.

“Crazy, we survived because it’s a Bentley.”

“Hey, this is a disaster. Let’s get out of here.”

After a moment, the high school students stumbled out of the car, speechless.

“Gasp!”

“What are we going to do about this…?”

They couldn’t believe the scene unfolding before their eyes.

The van coming from the opposite direction had completely overturned in the rain while trying to avoid the collision, and several other cars caught in the aftermath were mangled.

Particularly devastating was the compact car that had collided head-on with the van.

The car’s frame was crushed like aluminum foil, and through the shattered windows, they could see a young woman, covered in blood, slumped over and groaning.

They were at fault, but a major accident had occurred on the other side of the road.

“Oh my god… what do we do?”

“Shin… Shinil, can your dad fix this with his connections?”

The students, their faces drained of color, pleaded.

But the driver, tears streaming down his face, was only concerned about his car.

“Ah, damn it, this is a 300 million won [approximately $225,000 USD] car, and it’s all crushed… I’m going to get so grounded if my dad finds out I wrecked it…”

Everyone was losing their minds.

The only high school girl who was still thinking clearly, sobbing with a frightened voice, dialed the emergency number.

“H-hello, is this 119 [South Korea’s emergency services number, similar to 911]?”

“Hey, hey, don’t report it! If we report it now, they’ll find out we were drinking!”

“Then what do we do? People got hurt because of us!”

While the high school students argued, the rain intensified.

* * *

“Underage drunk driving?”

“That’s what they’re saying.”

“Crazy bastards.”

The emergency medicine professor succinctly stated his opinion.

We nodded in agreement.

Currently, EM [Emergency Medicine] doctors, led by the professor, were gathered in the emergency room, fully prepared.

Including paramedics and nurses, there were more than 30 people.

Although the accident was caused by reckless high school students, it was up to us medical professionals to deal with the consequences.

“The students who were actually drunk driving mostly have minor injuries.”

“Of course. They were in an expensive and safe car. If they want to die, they should do it themselves, why drag innocent people down like water ghosts?”

The professor clicked his tongue.

But since it had already happened, he didn’t waste any more time blaming the students.

“So, how many patients are there?”

“They said nine, but no CPR [Cardiopulmonary Resuscitation] needed…”

Then a paramedic shouted after answering a call.

“Eleven trauma patients are inbound! Estimated arrival in ten minutes!”

“What? They sent two more?”

The professor clicked his tongue again.

Eleven people!

It was rare for so many trauma patients to arrive at once.

Some of them were bound to have serious injuries.

“Why do the 119 guys always send so many to our hospital? Even if it’s Yonsei University Hospital [a prestigious university hospital in South Korea].”

“What are we going to do if eleven people suddenly show up…? We already have so many patients to treat right now…”

The nurse looked distressed.

There were already more than 30 patients waiting for treatment in the emergency room, as usual.

“There’s nothing we can do. We’ll just have to ask the patients who aren’t urgent to be patient.”

The manpower in the emergency room was limited.

So, we had to allocate resources effectively and treat the most critical patients first.

This is where triage comes in.

It’s the process of classifying patients according to the severity of their condition, ensuring that the most urgent cases receive immediate attention.

Yeo Bong-cheol, already changed into his scrubs, was speaking with a paramedic.

“Did they give you more details about the patients’ conditions?”

“Most are between levels 3 and 5, but they said there is one level 2 patient.”

“Level 2… The 119 side must be too busy to assess properly. Let’s assume it’s a level 1 patient and move them to the resuscitation room immediately upon arrival.”

Yeo Bong-cheol’s expression turned serious.

Emergency patients are categorized into levels based on their urgency.

Level 1 – Cardiac arrest, shock, unconsciousness

Level 2 – Severe trauma, moderate respiratory distress, severe pain, fever

Level 3 – Mild shortness of breath, moderate pain

Level 4 – Mild pain

Level 5 – Wound disinfection, prescription refills

In other words, a level 1 emergency patient takes absolute priority.

Yeo Bong-cheol raised his voice.

“Patients who walk in holding the back of their necks can be considered level 5, but just in case, make sure they all get basic tests. Ensure they can all get the imaging tests in our trauma SET [Standardized Emergency Treatment]!”

“Yes, I understand!”

“Interns, stay alert. Got it?”

“Yes.”

We nodded.

Soon, this place would become a chaotic battlefield.

And…

Only I knew the future.

‘There will definitely be a medical accident due to an intern’s mistake.’

Perhaps a critical mistake was more likely to occur when dealing with critically ill patients.

Would I be able to identify and prevent the mistake?

‘Let’s do whatever we can!’

I glanced to the side.

Joong-won hyung [older brother/male friend] was more nervous than usual.

“Come to think of it, isn’t this your first time dealing with such serious patients while working in the EM? It’s a good opportunity, so you should learn well.”

He said, clenching and unclenching his sweaty hands anxiously.

It was ironic to describe people getting hurt as an ‘opportunity,’ but it was undeniably true.

Because experience was absolutely crucial for us, who were still only residents.

And Sodam…

Surprisingly, she was no different from usual.

She wasn’t overly nervous, nor had she lost her focus, but was simply waiting silently for the patient.

“I won’t make a mistake this time.”

She said, reaffirming her resolve.

But where was Jo Jin-gi?

I hadn’t seen him since earlier.

“Hyung, where’s Jin-gi?”

“What’s he going to do seeing trauma patients when he can’t even use his hands? He should just get consent forms.”

“I guess so.”

That’s a relief.

I stroked my chest.

It’s better to have even one less person who might cause an accident right away.

As I was thinking that, the siren of an ambulance wailed.

Wee-ooo!

Thump, thump, thump!

Soon, the doors of the emergency room burst open, and a bloody patient was wheeled in, wearing a neck brace and an oxygen mask.

“Level 2 patient!”

“To the resuscitation room!”

Yeo Bong-cheol began directing the chaos, shouting instructions.

* * *

Shim Yoon-jin.

A working woman in her mid-20s.

She had likely been involved in the accident while driving home late after working overtime.

Fortunately, she seemed to have instinctively protected her head, so the head injuries were limited to bruises and minor lacerations.

But the critical issue was the upper body injury.

The left side of her upper body, covered by a white blouse, was completely soaked red with blood.

“Gasp.”

Joong-won hyung gasped.

No matter how often doctors see patients, the sight of someone being wheeled into the emergency room bleeding profusely and on the verge of death was uniquely overwhelming.

“What’s the patient’s condition?”

“She’s lost a lot of blood. We performed initial hemostasis [stopping blood flow], but there may be other bleeding sites. When we arrived, the patient was already in a drowsy state.”

“Oh no… I understand.”

EM doctors quickly took over the patient from the paramedics.

Paramedics and nurses busily took blood pressure readings and attached oxygen saturation monitors to her fingers.

Soon, Yeo Bong-cheol clicked his tongue.

“Saturation is dropping… and what’s with the blood pressure of 85? Prepare for intubation here!”

He shouted urgently.

The most crucial factor in saving an emergency patient’s life is ensuring an adequate oxygen supply.

And the next most important thing is preserving blood volume.

“Shin Seon-han, Ham Sodam, remove her clothes with the paramedics and carefully check for bleeding areas!”

“Yes, sir!”

Sodam and I, assisted by the paramedics, cut away the blouse.

Rip-

The patient’s bare body, drenched in blood, was revealed.

Assuming a blood loss rate of 1cc per second, nearly 1L of blood would be lost in 15 minutes.

The patient’s survival rate drops by 3 percent for every minute that hemostasis is delayed.

So, we needed to locate the bleeding site as quickly as possible.

‘Where is it? I need to find it quickly…’

We rapidly examined the patient’s body.

It was difficult to remain calm under such pressure.

Then Sodam shouted.

“I found it!”

Inside the limp arm.

A long, vertically torn wound was gushing blood.

“There’s significant bleeding from a laceration on the left arm!”

“Apply pressure to stop the bleeding!”

“Yes!”

Sodam and I disinfected the bleeding area and began applying pressure hemostasis using copious amounts of gauze and bandages.

“…”

I glanced to the side.

For some reason, Sodam’s movements were precise and efficient.

Was she the type who thrived in high-pressure situations?

‘For now, things are stable.’

All processes were running smoothly, and everything was proceeding according to protocol without any apparent mistakes.

Yeo Bong-cheol, examining the patient’s eyes, said,

“The pupils seem okay… We have sono [sonography/ultrasound] prepared here, right?”

“I’m watching.”

“Ah, the professor is watching.”

Yeo Bong-cheol looked slightly embarrassed for a moment.

The emergency medicine professor was examining critical areas using ultrasound from the side.

“Hmm… there’s nothing particularly concerning on the ultrasound. Inside the heart, abdomen, chest… no blood pooling.”

The professor muttered to himself.

While Yeo Bong-cheol was performing intubation and the emergency medicine professor was conducting the ultrasound, the nurses were establishing peripheral IV lines in the patient’s arms and administering intravenous fluids.

Everyone was moving in perfect synchronization, as if they were a single entity, without needing explicit instructions.

“Is the ABGA [Arterial Blood Gas Analysis] result back yet?”

“I… I’m doing it now.”

In response to the professor’s question, Joong-won hyung answered, sweating profusely.

It was obvious that his hand movements were much clumsier than usual.

“Too slow. Are you going to run the test after the patient dies?”

The professor frowned.

Anyone would be intimidated by the professor’s scolding, let alone someone already nervous.

Yeo Bong-cheol approached and said,

“Joong-won, step aside, I’ll do it since I need to secure an A-line [arterial line] anyway.”

A-line.

It’s a catheter inserted 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 ABGA machine!”

“Yes, I understand!”

Joong-won hyung received the arterial blood that Yeo Bong-cheol handed him, sweating profusely.

He shook the syringe up and down to mix the blood with the heparin (anticoagulant) inside, but his hand slipped.

Slip!

“Gasp!”

“Hey, hey!”

He nearly dropped the syringe, shocking everyone around him.

He hurriedly caught it with his body as it was about to fall to the ground, but he couldn’t avoid the cold stares of the other doctors.

“What’s wrong with him?”

“I’m sorry. I… I’ll go run the test!”

Joong-won hyung hurried out of the resuscitation room.

…I felt a sudden chill.

In that state, it wouldn’t be surprising if he made a mistake.

Suddenly, a scenario flashed through my mind.

“Hyung, wait a minute!”

I called out to Joong-won hyung urgently.