Chapter 994: Chapter 994: Su Wenhao’s Patient Admission Teaching
(Thanks to Qianxianwanfu, the hateful Xiaoqiang, Moshangshuang, reader 33021212107632, a cup of tea half a page of a book, O94 HanJian Ze for voting)
"What’s up? Didn’t have a good lunch? Why do you keep glancing over here?"
"Nothing, Teacher Liu, are there no other patients?" Xu Yino asked with a smile.
"Not for now, we’ll see when they come." Liu Banxia replied casually.
He was a bit puzzled, wondering what was going on with them. It seemed like after lunch, their spirits changed a bit.
"Doctor, doctor, please take a look at my son."
Coincidentally, within a minute, a father and son walked into the emergency room. The child looked about sixteen or seventeen, appearing quite weak.
"What exactly is the situation?" Su Wenhao, who approached them, asked.
"He caught a cold, and after lunch, he vomited, even bile." The child’s father said.
"Okay, first help him to the examination bed. We will check him first and also move your car to avoid obstructing emergency vehicles." Su Wenhao instructed.
"Alright, I’ll move the car right away." The child’s father replied hastily.
Finally arriving at the hospital brought some relief to his anxious heart.
Liu Banxia glanced over and gathered other interns and resident doctors to join him.
"Your temperature is quite high. Is this the first day it’s been like this?" Su Wenhao asked as he helped the child onto the examination bed.
"No, I’ve had a cold for the past few days. It’s been three days, and the Contac hasn’t helped. I took the Compound Paracetamol and Amantadine Hydrochloride Tablets last night, but it didn’t work either." The child replied weakly.
Su Wenhao frowned, "Lie still. I’ll listen to your chest and do a simple physical exam first."
He wasn’t sure if the current condition was a drug reaction due to excessive cold medicine usage, but he had to proceed according to protocol.
The emergency center had seen similar cases; cold medicine shouldn’t be taken recklessly.
"Temperature is 39.5 degrees."
Intern Zhang Hongfei reported.
Su Wenhao nodded slightly while listening.
"Doctor, doctor, how is he?" The father rushed back at that moment.
"Still checking, the heart and lung sounds are fine, but the temperature is 39.5 degrees, and he’s a bit weak." Su Wenhao explained.
"Did he only vomit after lunch today, or has he been feeling nauseous these days? How many times did he take both cold medicines together?"
"He only vomited today, twice: last night and this morning." The father replied.
"He has been listless at school, very tired during class, I thought using both would work faster. Doctor, what kind of cold is this?"
"It’s not yet possible to diagnose, but never take two kinds of cold medicine together again. It can cause significant harm, possibly even kidney failure." Su Wenhao advised.
"You should only take one type of cold medicine, following the prescribed dose. Many cold medicines have similar ingredients, so there’s no need to overthink it. Do you have abdominal pain or sore throat symptoms?"
He asked the last question to the patient lying on the bed.
"My stomach hurts a little, and my throat is a bit sore." The patient replied.
"Open your mouth, let me check your tonsils." Su Wenhao instructed.
The patient opened his mouth, and Su Wenhao examined carefully. The tonsils were slightly inflamed but not showing signs of pus.
"Doctor, is it serious? Is it due to taking the medicine?" The father asked anxiously.
"Although he somewhat overdosed, it shouldn’t cause such significant effects. Let’s do a blood test and check liver and kidney functions, just to be safe." Su Wenhao responded.
"Alright, I’ll go pay right away." The father said promptly.
"Register first, worry about the rest later, I haven’t finished yet." Su Wenhao instructed.
"Although the heart and lung sounds were normal during the check, let’s also get a chest X-ray. The child’s breathing is a bit fast, as is the heart rate. It could be due to the high fever, but it’s better to be cautious."
The father nodded and hurried to register.
It’s the standard reception process; the child’s condition still requires examination results for confirmation.
"Alright, you just saw Su Wenhao’s reception process, which can be considered a teaching moment in patient reception. Tell me, were his actions during reception standard, and what judgments can you make from his process?"
After the child was taken for the chest X-ray, Liu Banxia spoke.
A few people looked at each other, unsure of how to respond to such a direct question from Liu Banxia.
"Just say what’s on your mind," Liu Banxia said with a smile.
"Well, let’s not focus on finding faults with Su Wenhao. Based on his recent patient encounter, how would you make an initial diagnosis for this patient?"
"I think it might be pneumonia," Li Tianyang said.
"Ordinary colds rarely cause such high fevers, and the patient also has swollen tonsils. Even though there are no symptoms of coughing, sputum, or chest pain, we can’t rule out pneumonia, so a chest X-ray is needed."
"Anything else? It can’t be just that; there are many conditions that cause high fever. Or, how did you rule out other high fever conditions in your mind?" Liu Banxia continued.
"Uh... Teacher Liu, it couldn’t be a malignant tumor, could it?" Cui Jia asked tentatively.
"You, it’s like you’re ready to send them off directly," Liu Banxia joked.
"It seems you’re not yet accustomed to my teaching style, so let me show you an example. Dr. Su, please share your thought process during the recent patient encounter with everyone."
"I also considered whether it could be a drug reaction due to an overdose of cold medicine, so we need to check liver and kidney functions," Su Wenhao said.
"The patient has the three major symptoms of nausea, vomiting, and high fever. I also considered whether it could be an acute liver disease, such as acute hepatitis, so I checked the patient’s sclera and complexion and found no jaundice."
"But even though there are no symptoms, we can’t completely rule it out. As with the overdose of cold medicine, we need to rely on test results."
"As for the possibility of pneumonia I mentioned earlier, everyone can see that, so there’s no need to elaborate. I have another hypothesis that such a high fever is consistent with the onset of an infectious disease."
"With symptoms of nausea, vomiting, and mental dullness, I also thought it might be encephalitis or meningitis. But since the patient’s symptoms are not obvious now, we didn’t rush for tests in this area."
"Also, epidemic encephalitis mostly occurs in children under ten years old, and though this patient is also a child, he’s more of an older child."
"Considering the father’s anxiety and the potential for over-medicalization, while waiting for the chest X-ray results, we can consider physical cooling for the child."
"Once the blood test results are out, we can consider more detailed symptomatic checks. If the chest X-ray is negative, evaluating such a high-fever patient becomes more challenging."
Liu Banxia nodded in satisfaction and gave a thumbs up, "That’s exactly what I thought. However, since I’m the deputy director of the emergency center, I’m a bit bolder and might directly order a brain CT to see what’s going on."
"But Su Wenhao’s approach and judgments in this case are very appropriate. There are indeed many diseases that cause high fever, and there’s currently no specific indication suggesting a head infection."
"If the patient had even mentioned a headache, you could have confidently ordered tests. But the patient only showed signs of low spirits and fatigue, with no clear indicators."
"Teacher Liu, why did you ask if there was a misdiagnosis just now?" Zhang Pengfei asked curiously.
"I was setting a trap for you, luckily you were cautious and didn’t forcefully find faults," Liu Banxia shrugged.
There was a look of resentment on this small group; they knew Liu Banxia occasionally played tricks on people, but who would’ve thought he’d be so blatant about it?
"Keep at it; there are countless pitfalls ahead of us. We’ve stepped through them before, and it’s been okay," Su Wenhao said with a smile.
"Keep it up, victory is waving at you. Pay extra attention to the previous patient. High fever is a symptom we must pay a lot of attention to in emergency cases; it’s on par with acute abdominal pain and chest pain," Liu Banxia said.
"High fever is often synonymous with infection; the higher the fever, the worse the infection. And if the infection is bad? That can lead to many problems."
"Yes, Teacher Liu,"
They all responded in unison.
Liu Banxia was quite satisfied with their state. Although it’s tough and tiring, passion is necessary. Otherwise, your mood could directly affect the patient and cause discomfort.
"Xu Yino, come here," Liu Banxia waved.
"Teacher Liu, what’s up? I swear I didn’t talk bad about you," Xu Yino said as she rushed over.
"You’re confessing before being accused; that’s not what this is about," Liu Banxia said.
"In a few days, once we’ve coordinated the schedule, the surgical interns and resident doctors will come to our emergency center for wound cleaning and suturing assessments."
"At that time, you six should come up with a grading standard, with a wider range of scores so that the evaluation is more detailed through smaller scores."
"But this standard has to be established by the six of you together, as you’ll be the examiners. We can’t have a mess. How does that sound, no problem right?"
"I thought it was a big deal; it’s simple. We’ll just adjust the original three points for minor items to five points," Xu Yino said casually.
"I knew I could count on you, go ahead and get busy," Liu Banxia nodded with a smile.
Feeling pleased, Xu Yino went over to Liu Yiqing to share the news.
"Nuonuo, are you working on the side for Teacher Liu again?" Liu Yiqing asked after hearing it.
"Uh... am I? Oh my gosh, it seems like that’s what happened. He should be the one setting the standards; how did it become our job?" Xu Yino was stunned and felt a bit upset too.
It’s hard to guard against; Teacher Liu has too many tricks.
