Chapter 153 Resident Training In Emergency And Anesthesiology III
Edited by: Kanaa-senpai
”Ichijou-sensei, there’s no pulse!”
”Tch… is it PEA?”
※PEA (Pulseless Electrical Activity) is a type of cardiac arrest where a waveform appears on the ECG, but no pulse is felt. In other words, the heart looks like it’s working on the monitor, but it’s actually not pumping blood.
Haruto didn’t waste a second. He began chest compressions immediately, his hands pressing down in rhythm over the patient’s chest.
While working, he spoke into the radio.
”Doctor helicopter, connect me to Chiba University!”
”This is Chiba University. Go ahead.”
”We’ve confirmed PEA.”
”Understood. Preparing for admission.”
Haruto kept compressions going, even as he watched the monitor closely.
”Administer adrenaline.”
※Adrenaline is a drug used in cardiac arrest situations to help restore spontaneous heartbeats.
”Roger!”
Minutes passed—hard, tense minutes.
”…I feel a pulse!”
”Good! Doctor helicopter, inform Chiba University!”
”This is Chiba University. Go ahead.”
”ROSC achieved.”
※ROSC (Return of Spontaneous Circulation) means the heart has started beating on its own again after cardiac arrest.
”ROSC confirmed.”
Once they landed, Haruto moved quickly to transport the patient into the hospital and over to the CT imaging room.
As the scan began, he handed off the patient to the surgical team and stepped back.
(This time… the ability didn’t declare death.)
He remembered the incident where he mistook a woman for his mother—and how, back then, the mysterious ability within him had declared her death.
But this time… silence.
(Is it only when the heart completely stops…?)
He thought back to what he’d studied. There were four recognized types of cardiac arrest:
—
・Ventricular Fibrillation (VF):
The ventricles are trembling in a rapid, chaotic motion. They’re not pumping blood properly. An AED shock is necessary to reset the rhythm.
・Pulseless Ventricular Tachycardia (VT):
The heart’s beating too fast and forcefully to actually move blood. It looks active, but there’s no output. This also needs an AED shock.
・Asystole:
The heart has come to a complete stop. A flatline. No AED shock is given—only chest compressions.
・Pulseless Electrical Activity (PEA):
Electrical signals are still visible on the ECG, but there’s no mechanical pulse. The heart’s not pumping. Again, no shock—only compressions.
※AEDs automatically check the ECG and decide whether a shock is needed. If not, chest compressions are the only course of action. The device will guide the rescuer accordingly.
(I still can’t say for sure. I need more real cases. More time…)
That night, Haruto made a choice.
For his second-year residency, he would go into emergency medicine.
It would be brutal—mentally and physically. But nowhere else could he gain this kind of firsthand experience.
That conclusion felt unshakable.
As he reflected, his PHS rang—the line dedicated to emergency calls from the doctor helicopter.
He didn’t hesitate. He ran.
There was no uncertainty in his eyes anymore.
No fear about the strange ability he couldn’t yet control.
Just focus.
That’s how Haruto closed out his first year as a resident.
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Edited by Kanaa-senpai.
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