Chapter 1131: Chapter 1131: Are These Symptoms Caused by a Cold?
(Thanks to the book friend 20181204200731883 for the reward and encouragement, and thanks to the King of Gluttons Xiaohuang, Noble Bookworm, and Pacific Wild Wolf for the monthly ticket encouragement)
"First perform airway protection, suction out the vomit from the trachea, connect the ECG."
Liu Banxia said upon rushing over.
The nearby nurses began to move, and Liu Yiqing also pried open the patient’s mouth to check carefully.
"Describe the situation briefly." Liu Banxia continued.
"Came for a cold, with symptoms of headache, fatigue, vomiting, low fever, normal heart and lung sounds, and blood test results not yet available," Liu Yiqing said.
At this time, the suction machine was also pushed over, and they began to suction the vomit from the patient’s trachea.
This intervention was also very timely, as the patient lost consciousness during vomiting, with some vomit remaining in the esophagus and also in the trachea.
From the patient’s blood oxygen concentration and complexion, it was evident that the patient’s breathing was affected.
"Blood oxygen has risen to 98, Teacher Liu, should we intubate?" Liu Yiqing asked.
"Not for now, his heart rate is indeed a bit low, only 48." Liu Banxia said, frowning.
"Draw blood again for a biochemical analysis to check the electrolyte balance in the body, notify the lab for urgent handling. Also, get an ECG to monitor the heart rate."
The situation here also attracted the attention of nearby patients.
However, they dared not come closer; this person didn’t look like they had a cold, perhaps it’s some infectious disease?
Liu Banxia examined the patient again carefully, but the findings were consistent with what Liu Yiqing had reported.
The only silver lining was that the patient’s heart rate was maintained at 48 and didn’t continue to drop.
"Also have a defibrillator ready nearby, this ECG doesn’t show much." Liu Banxia said.
"The patient is still very young, did he mention his occupation? For example, athletes or fitness enthusiasts often have lower heart rates."
"He didn’t say, but he shouldn’t be an athlete. He mentioned taking a day off to come, so we can’t determine his fitness habits." Liu Yiqing said.
"Okay, you stay here, and prepare adrenaline. If the heart rate drops below 45, inject immediately." Liu Banxia said.
For some athletes and physical laborers or generally fit young individuals, their heart rates often tend to be lower than others.
Although their heart rates are low, the stroke volume is significant each time, thus meeting the body’s demand.
But the current patient’s occupation status is unknown, making it difficult to accurately determine whether this syncope was caused by heart rate issues or if syncope caused the heart rate change.
There is some uncertainty, making it hard to determine if the symptoms are caused by the cold.
"Could it be induced by a heart condition?" Qi Wentai asked.
"Currently, it’s hard to determine, there’s only the symptom of bradycardia. However, his value isn’t particularly low; if he exercises regularly, below fifty is possible." Liu Banxia said.
At that moment, paramedics outside wheeled in another patient.
"I’ll take this one."
Huang Bo said as he went over to receive the patient.
"It’s truly difficult to ascertain this patient’s condition, let’s wait half an hour to see if he regains consciousness. If not, then a brain CT and an echocardiogram might be necessary," Liu Banxia continued.
Qi Wentai nodded, as this was the only course of action.
The patient’s current presentation indicated stable vital signs, even with bradycardia, the impact wasn’t severe.
There are many potential causes for syncope, and a preliminary judgement can only be made after the blood test results are available. Otherwise, too many examinations would just trouble the patient.
Back in the office, he was pondering how to document the medical record for today’s case.
Technically, it’s not his responsibility, but due to some controversial issues in the surgical process, it’s a task that he has to handle.
In truth, there’s no alternative, everything has already been communicated to the patient’s family, just document everything truthfully.
There’s no need for any guilt, the procedures at the time were completely standard.
"Teacher Liu, the blood test results for that patient are out, everything is normal. The patient has not regained consciousness and his heart rate is unchanged."
A while later, Liu Yiqing walked in.
"Then take the patient for an echocardiogram and brain CT, perhaps we’re overreacting. It might just be a reaction caused by vomiting. Notify me when the patient regains consciousness." Liu Banxia said.
"Okay."
Liu Yiqing responded and walked out.
The normal blood test results put Liu Banxia somewhat at ease.
Just as he was about to resume writing, Huang Bo ran back in.
"What’s going on?" Liu Banxia asked.
"Teacher Liu, the patient I just admitted suddenly had a seizure, and I’ve given a sedative," Huang Bo hurriedly said.
"Blood pressure is 130/80, heart rate is 80, showing signs of muscle weakness, but not too severe. The seizure occurred during blood sampling; luckily, the nurse reacted quickly and didn’t injure the blood vessel."
"Did you communicate with the patient?" Liu Banxia continued to ask.
"Yes, the discomfort started yesterday, symptoms included fatigue, difficulty breathing, slightly high temperature. Cold medicine taken at home had no effect, and he came for treatment today after experiencing muscle weakness," Huang Bo reported.
"Muscle weakness, huh. Lately, we’ve been dealing with this symptom a lot. Have you asked the internal medicine doctors?" Liu Banxia rubbed his forehead.
"Teacher Wang and Teacher Xu both have patients in their consultation rooms, so I came to find you," Huang Bo quickly said.
"Alright, run a complete blood count, blood biochemistry, and do a brain CT. Pay attention to airway protection and thoroughly question the patient," Liu Banxia instructed.
"Got it."
After acknowledging, Huang Bo hurried out, as this patient’s situation was beyond his ability to handle.
Having finished sorting the medical records and realizing it was almost time to eat, Liu Banxia left the office.
There were still many patients in the hall, most were due to colds.
The nurses were also performing the mandated disinfection tasks, a precaution to protect the patients.
The hospital naturally has a lot of bacteria, and failing to do the disinfection correctly could lead to big problems.
"You all go eat now, I’ll keep an eye here," Qi Wentai said.
"Alright, we’ll try to be quick. If there’s an emergency patient, call me or Brother Wei. Shi Lei should be back soon, right?" Liu Banxia asked.
"Yes, he has morning classes today," Qi Wentai replied with a smile.
"I know his schedule better than his students now; otherwise, I wouldn’t have called you directly today. If Shi Lei were here, he could help too."
"Just let him treat us to a meal later, anyway, he’s living quite comfortably now," Liu Banxia quipped.
"Looks like today will be busy, there weren’t this many cold patients yesterday. Thankfully the six of us can help with admissions, otherwise, it wouldn’t be manageable," Wei Yuan said.
"Surgical doctors sometimes seem relaxed, but it’s actually quite tiring," Liu Banxia commented.
"Coming to the emergency department, when internal medicine doctors can’t keep up, we surgical doctors have to step in. Just now there was another patient with muscle weakness, dealing with such patients makes me a bit anxious these days."
"What did the director say about today’s surgical patient’s condition?" Wei Yuan asked.
"The director said it’s fine, our judgment at the time was correct," Liu Banxia replied with a smile.
"Honestly, hearing that from the director relieved me a lot. But whether the patient’s parents will sue me is still uncertain."
"Their family suffered significant financial loss from this incident, and they haven’t paid the hospitalization fees yet. Their son was the troublemaker, while the other party might have been acting in self-defense."
"Even compensating them, how much can be given? It’s merely humanitarian aid. Let’s see how things unfold now."
"Sigh... Sometimes it feels disheartening, but there’s little room to complain. Not everyone understands our work, many still don’t know anything," Wei Yuan sighed.
Even though it’s understandable, the discomfort remains.
Take today’s patient as an example; if Liu Banxia hadn’t acted decisively, the chances of patient survival would have been over ninety percent.
This was the outcome he reached after carefully reviewing the situation back in the office.
At the time, the patient’s bleeding was excessive, and their blood pressure was critically low. If Liu Banxia hadn’t prioritized stopping the bleeding but instead opted for defibrillation, it would have delayed treatment by more than thirty seconds.
This is under ideal conditions, with a single successful defibrillation.
Stubbornly sticking to protocol, one could have performed defibrillation while halfway through suturing.
However, for a surgical doctor, if the operation rhythm is disrupted, adjusting back also takes time.
Back then, Liu Banxia was at his operational limit; even as first assistant, his attending role was challenging with that speed. Adding the rapid suturing afterward, it’s not something that can be paused and resumed later.
Because he knew how much Liu Banxia contributed and endured for this patient, Wei Yuan felt uneasy about the situation today.
Ultimately, it’s a life saved, yet the cost was family misunderstanding. Or even if understood, they still wish to reduce financial losses through this incident.
"We’re eating a bit late today, let’s hurry up and get back to relieve them," Liu Banxia said.
"There really are quite a few cold patients today; how’s the patient who fainted while vomiting?" Wei Yuan asked.
"They went for a CT and echocardiogram; currently, heart rate is stable at 48. I’m worried it might drop further, let’s see how it develops, and then decide whether to consult cardiology or neurology," Liu Banxia said.
"Each profession has its expertise; we can handle emergency situations, but detailed work needs their attention. Everybody’s busy though, as soon as the weather gets colder, patient visits increase significantly."
Wei Yuan nodded, finished his meal, and quickened his pace as well.
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