My Medical Skills Give Me Experience Points-Chapter 1247 - 491: Unexplained High Fever Reaction, Multifocal Hemorrhage (Part 3)
Based on Zhou Can’s clinical experience and knowledge of pharmacology, a high fever reaction is unlikely.
Does a blood transfusion cause a high fever?
This is truly the first time I’ve heard of such a thing.
"Doctor Ai, call the nurse who administered the infusion and cared for the patient to the office for a discussion about the condition."
Zhou Can needs to first exclude the possibility that the infusion or blood transfusion caused the fever.
For instance, there could be a problem with the saline solution used for the infusion.
This must be checked first.
Some saline solutions may have issues due to various reasons during storage or production.
Such as the appearance of flocculent matter inside the bottle.
An experienced and sufficiently meticulous nurse will not only triple-check and compare seven factors when administering an infusion to a patient, but also shake the infusion bottle deliberately to see if there are any issues with the saline solution mixed with medication.
Saline solution is the most consumed drug category in hospitals.
When hospitals procure them, manufacturers use all sorts of tricks.
It’s not impossible for some unscrupulous manufacturers to sell substandard saline solutions to hospitals after securing orders.
Of course, manufacturers fear accidents and want to continue business long-term, so they certainly try their best to ensure product quality, especially with regards to safety.
However, workers doing the job or the manufacturer’s technology might be lacking, or hardware facilities might be outdated, leading to problems with the saline solution produced.
Not every bottle will necessarily have issues.
Even if only one in ten thousand bottles has a quality issue, it becomes a ticking bomb.
If used on a patient, that unfortunate patient will most likely encounter trouble.
In the office, the nurse administering the infusion, Doctor Ali, and Zhou Can began discussing the patient’s condition.
Zhou Can was the leader.
"Did Teacher Zhao check the medication bottle when administering the infusion?"
Zhou Can would never ask such questions in front of the patient or their family.
This is also why Ali and the nurse were called to the office.
"I deliberately checked at the time and found no issues. Director Niu instructed us repeatedly to be extra careful when handling clinical nursing and changing medications, prioritizing safety. We are always particularly cautious when administering infusions to each patient."
Zhao Qian and Zhou Can are quite familiar with each other.
She does work very hard.
She has been promoted to nurse practitioner, but there is still a long way to go before she can become a supervisory nurse practitioner.
Nurse promotions are not easier than physician promotions.
It’s relatively easier for doctors to be promoted to attending physician.
For nurses aiming to be supervisory nurse practitioners, they either need to accumulate experience or pursue further education. Of course, connections aren’t included.
Society runs on personal connections, especially in our country, where inter-personal relationships are rampant in certain organizations. For instance, a certain railway corporation, or hospitals, where high-paying, easy management positions are mainly dominated by the second generation.
Zhou Can has an understanding of Zhao Qian’s work style.
She works seriously and diligently.
Since she carefully checked the infusion beforehand and found no issues, it’s generally excluded that the infusion solution itself had any problems.
Upon thorough consideration, Zhou Can suspects the patient may be suffering from multisource gastrointestinal bleeding.
What does multisource bleeding mean?
It means there is bleeding originating from multiple places.
The patient’s bleeding site is likely not limited to the upper gastrointestinal tract.
The upper sections of the small intestine and colon should be key areas for investigation. Additionally, the gastric juice should be monitored.
Because the patient has had black stools for over a month, the possibility of significant stomach bleeding cannot be completely ruled out.
In medicine, unless there is definitive diagnostic evidence, no possibility should be ruled out. Some possibilities are simply more likely and checked first.
Especially in such diagnostically challenging cases, they are often triggered by causes that are easily overlooked.
The essential nature of complicated cases is that they involve relatively rare causes and symptoms that cannot be addressed using textbook content.
They require doctors to flexibly diagnose based on clinical battle experience.
"Doctor Ai, I suggest we first start monitoring the patient’s gastric juice regularly to assess the stomach bleeding situation. Meanwhile, further auxiliary diagnostic methods should be used to investigate the possibility of bleeding sources in the small intestine and colon."
Zhou Can offers a specific suggestion for further diagnosis.
