5 golden rules for saving patients

An urgent surgery performed by Dr Le Duc Tuan from FV Hospital’s General Surgery Department to save a female student in a critical situation has evoked strong sentiments about medical ethics in urgent surgical cases.

Life-or-death decisions

After being struck by a truck after school, a female student of Ton Duc Thang University, HCMC, was brought to the A & E Department of FV Hospital. Head of A& E Department Dr. Hai revealed that the patient was in trauma shock with deep coma and deep wounds all over her body, a broken arm and a suspected broken leg. Immediately, emergency team provided anti-shock procedures and preoperative tests.

Dr Le Duc Tuan, the surgeon on-call on that day, immediately presented at the patient’s bedside upon being notified about her case. Screening results showed that the patient had multiple serious injuries and abdominal hemorrhaging.

After a quick consultation with Dr. Le Trong Phat, Head of Orthopaedics, and Dr Vincent Blondeau, former Head of General Surgery, Dr Tuan decided to process the patient straight into the Operating Theatre without waiting for her family to arrive and complete the legal documents because she was in such a critical condition that required immediate surgery. It was a very brave yet difficult decision for Dr Tuan and his team to make because the patient was diagnosed with severe, complex injuries, and there was a risk that the patient could die on the operating table. Upon Dr Tuan’s final touches on the case, Dr Phat immediately started to treat the young girl’s broken bones. The six-hour surgery wrapped up in resounding success. The patient made a gradual recovery and was deeply moved have been given the chance to live, thanks to the doctors’ quick decision making.

Mr. T.M.V., 38, from District 7, HCMC, was brought to FV Hospital’s Accident & Emergency Department with a knife embedded deep in his abdomen. The knife was causing severe hemorrhaging leading to shock with pale skin and mucosa, hypotension and tachycardia, even though the patient remained conscious. Mr. V. was taken straight into the recovery room and anti-shock and hemorrhage therapy performed immediately.

Dr Phan Van Thai, General Surgery Department, was on-call that day and was invited to give a quick emergency consultation. The ultrasound revealed that the blade had penetrated the patient’s liver, tearing the tissue and causing severe internal hemorrhaging. Dr Thai ordered an emergency surgery to “patch” the liver and stop the bleeding to save the patient.

After being made a priority during all lab tests and admission procedures, patient V. was directed into the Operation Theatre within 20 minutes of being admitted. Dr Thai has extensive experience in handling liver diseases and in patient V.’s case, after making an incision adjacent to the wound, he carefully stopped the bleeding while slowly pulling the knife out of his liver – if it had been removed too quickly, it might have caused further hemorrhaging.

Patient V. received an infusion of four blood units during the five-hour surgery. The liver pieces sliced apart by the knife were stitched carefully back together to save the patient’s life.

A thorough service

Emergency care is a broad, complex and diverse field. Therefore, in order to support a patient quickly in any situation, the Accident & Emergency Department of FV Hospital always has a team of doctors and special nurses working in collaboration with doctors from other departments to perform emergency procedures to JCI international standards.

This process is built on five principles:

• Evaluate patients at the triage room
• Prioritise patients in the most serious situation for examination
• Give pain control without delay in accordance with the scale of pain
• Patients should wait no more than one hour to see a doctor
• Patients must be treated in the Accident & Emergency Department within a maximum period of four hours. Then, the patient will either be discharged or admitted for intensive treatment.

In addition to applying and constantly updating the most advanced medical care processes in the world, the Accident & Emergency Department of FV Hospital is also investing continuously in infrastructure, equipment and training of human resources to make sure patients feel completely assured when using emergency services at FV.

The project to build and upgrade the Accident & Emergency Department of FV Hospital has been one of the hospital’s major pushes to improve the quality of service offered, giving patients the best possible care in the safest environment.

FV Hospital’s Accident & Emergency Department has a full range of function rooms, including a triage room, a negative-pressure infection isolation room, a decontamination room for patients who have come into contact with chemicals, several minor surgery rooms and recovery rooms for patients in a severe condition. All treatment rooms are fully equipped with equipment for examination, monitoring and treatment, as in-wall oxygen regulators, monitoring systems, viscous suction machines and portable ventilators and defibrillators.

Hygiene and infection control are a top priority at the Accident & Emergency Department. All infection control procedures are strictly followed. Patients with suspected infectious diseases will be isolated from their initial assessment, the bed sheets will be replaced immediately after the patient leaves the room and doctors will always wash their hands before and after the examination.

FV Hospital’s Accident & Emergency Department is equipped with FAST, an ultrasound machine used to diagnose problems inside the abdomen and chest trauma.

Other facilities and medicines used in the Accident & Emergency Department and on ambulances are managed in accordance with JCI standards: they are checked daily with the operating condition and quality and quantity of equipment and medical supplies constantly recorded to ensure that they are always ready in the event of an urgent case.