The Enhanced Doctor-Chapter 404 cold? No

(Special thanks to cool friends, KuKu’s wolf, Shu Qianji, book friend 20180602234327808, Northern Night Wolf, book friend 150512195143202, zwf1987127, Sunshine’s Jiaqi, advancing cloud, book friend 121025081245993, ziluo134, and Society’s Zuei Grandfather for the monthly ticket encouragement!)

The medical staff of the Emergency Center talked a lot about the three cases today. This was Liu Banxia’s first day back after returning to work, and it was just as successful as ever.

However, Liu Banxia didn’t dwell on it; he just observed them during his rounds that night. All three individuals were in pretty good shape, especially the last young man he had diagnosed, who was sleeping soundly.

Indeed, this was also the joy of rounds: seeing patients receive proper care and gradually recover brought a good mood to every medical staff member.

Of course, not every patient in every ward would be like this; there were also some critically ill patients.

Having had a good night’s sleep, and since he was considered "wounded," no one called him in too early to cover a shift.

In fact, this was also a matter of unspoken understanding. Whether one could get a bit more or less rest depended on relationships. If the relationship was solid, being half an hour late wasn’t an issue. If it wasn’t? Even a single minute could cause friction.

"You’re quite something, kid. Causing such a stir as soon as you come back. I heard about it even at home," Shi Lei said when he arrived for work in the morning.

"Is it that big a deal? I didn’t even resuscitate any patients," Liu Banxia replied.

"It’s about the patient Director Xu invited you to consult on. I just looked at the case file. The surgery can probably be done this afternoon; his condition isn’t as bad as we thought," Shi Lei said.

"That works. You’ll be doing the surgery anyway," Liu Banxia said. "Honestly, my hands are really itching to operate. But I can’t get my stitches out until the day after tomorrow, so I have to keep waiting."

"It’s a good thing if you can stay away from the operating table. It just means our Emergency Center can still manage the workload, and we don’t have that many emergency patients needing resuscitation," Shi Lei said with a smile.

"However, I took a peek, and it seems quite a few people are waiting for you to perform your minimally invasive appendectomies. Looks like you’ve really become the ’Appendix Prince’."

"You’re too kind, you’re too kind. Compared to you, Boss, our ’Love Daisy Prince,’ I’ve still got a long way to go," Liu Banxia said with a straight face.

"Get lost! I’m never covering for you again," Shi Lei glared at him.

Liu Banxia wasn’t afraid at all; their relationship was very "complex." They were mentor and apprentice, friends, and brothers. In fact, bantering with Shi Lei actually strengthened their bond.

Wei Yuan could also perform the surgery on the patient with celiac artery compression syndrome, but Shi Lei would still be the first person Liu Banxia thought of.

After the idle chatter, it was time to dive into intense work. As surgeons in the Emergency Center, besides handling their scheduled surgeries, they also had to be ready to receive emergency patients at any moment.

Some patients came because it was less crowded here; others were genuine emergencies. When the number of patients increased, Liu Banxia couldn’t just stand by; he had to help with consultations too.

"I see that your chief complaint during registration was a cold?" Liu Banxia asked.

The young woman sitting opposite him nodded. "It’s been a few days. But I have exams coming up, so I’ve been busy studying. I thought I could push through it, but today I feel quite unwell."

Liu Banxia nodded. "I need to perform a physical examination, which includes auscultation, measuring your blood pressure, and taking your temperature, before I can make any further judgments."

This was something he had to explain clearly to the young woman. If it weren’t so busy today, he would have asked Liu Yiqing or Xu Yino to conduct the examination.

"Teacher Liu, her temperature is very high, 39.2 degrees Celsius. Her blood pressure is very low, 60/80 mmHg," the nurse reported quickly after completing the checks.

Liu Banxia, who was auscultating, frowned. He had also heard faint crackling sounds from her chest, suspecting fluid accumulation.

"Doctor, is my cold very serious?" the patient asked hastily, noticing Liu Banxia’s concerned expression.

Liu Banxia hung up his stethoscope. "Right now, it’s not just about a cold. Have you also been feeling very fatigued recently?"

The patient nodded. "Isn’t that normal when you have a cold? Your body feels tight, and you have no energy."

"Do your legs also feel a bit swollen?" Liu Banxia continued to ask.

The patient glanced at him. "Yes, a little. It only started in the last couple of days."

"Roll up your trouser legs, let me take a look," Liu Banxia said, sighing inwardly. This doesn’t look good.

The patient rolled up her trouser legs. Liu Banxia gently pressed a finger on her leg, leaving a small indentation.

"High fever, pitting edema, fatigue, low blood pressure, plus the suspected fluid in your chest from auscultation—I believe you might have a heart problem," Liu Banxia stated.

"Your blood pressure is so low, yet it doesn’t seem to be caused by anemia. This indicates that your heart’s pumping ability is insufficient. In layman’s terms, your heart isn’t working at full capacity; it’s operating at less than half its normal efficiency."

"Next, I recommend an echocardiogram to check the condition of your heart. Then, I’ll call a cardiologist to consult with me. He’s the expert in this area. Is that okay?"

"Yes, thank you, Doctor." Listening to Liu Banxia’s calm explanation, the patient’s anxiety eased slightly.

"Xiao Wang, have someone bring the portable ultrasound machine over. And please call Director Meng from Cardiology for me," Liu Banxia said to the nurse.

"Okay, I’ll go right away," Nurse Xiao Wang replied and hurried out.

"Please lie down slowly on the examination bed. How long have you been feeling like this?" Liu Banxia asked the patient again.

"About four or five days, I think? I’ve been so busy studying for my exams that I didn’t pay much attention," the patient said.

"Generally, heart conditions require hospitalization for observation. Can you contact your academic advisor or class teacher?" Liu Banxia asked further.

"Huh? I need to be hospitalized? Then... what about my exams?" the patient became anxious.

"Don’t worry, the exams should still be a few days away. The sick leave certificate I issue is recognized by all schools. I can also help you communicate with your school. We can see if it’s possible for you not to fail if you miss the exam," Liu Banxia said comfortingly.

He didn’t dare let the patient get too agitated. She already showed symptoms of heart failure, and excessive excitement could potentially trigger a cardiac event.

Just then, Meng Qingfan, the associate chief physician of Cardiology, walked in with a nurse pushing a portable ultrasound machine. Liu Banxia leaned closer to Meng Qingfan and quickly briefed him on the patient’s basic condition.

"Let’s do the ultrasound first to see the specific condition of the heart," Meng Qingfan said.

"This is our hospital’s associate chief physician, an expert in cardiology," Liu Banxia introduced Meng Qingfan to the patient, still aiming to calm her.

The patient nodded and cooperated well with the examination.

Looking at the images on the monitor, Meng Qingfan frowned. "The left ventricle is somewhat dilated, and the wall motion is very weak. Let’s get her on a cardiac monitor; her heartbeats are feeble."

"My preliminary diagnosis is heart failure, which is quite uncommon for your age. It could be caused by a thyroid imbalance, kidney disease, a viral infection, or other factors. We’ll need to do further tests."

The patient let out a long breath. So, my heart has a problem, but it’s not that it can’t work anymore. It’s caused by something else.

BEEP! BEEP! BEEP!

At that very moment, the cardiac monitor started blaring frantically.

"Ventricular fibrillation! Get the defibrillator! Charge to 200 joules! One unit of adrenaline! I’ll start chest compressions!" Liu Banxia shouted.

"Teacher Liu, charged!"

"Clear!"

ZAP!

"Charge to 200 joules!"

"Clear!"

ZAP!

"Alright, we have a pulse and heartbeat now," Liu Banxia said, setting down the defibrillator paddles and wiping sweat from his brow.

"Let’s send her to the catheterization lab first. I suspect a thrombus. I’ll do a more detailed examination in the cath lab. It’s likely viral myocarditis," Meng Qingfan stated.

Liu Banxia nodded and, without wasting words, immediately helped the nurses push the patient out.

The patient’s condition had only temporarily improved. Without immediate intervention, ventricular fibrillation could recur. Moreover, if it truly was viral myocarditis, the subsequent management would be very challenging.

*Ding! Patient Consultation Completed*

*Gained 200 experience points and 200 diagnostic proficiency points.*

You just never know when a critical situation will arise, Liu Banxia thought with an inward sigh after returning to the reception hall.

"Teacher Liu, do you have any patients right now? If not, could you take a look at this one for me?" Xu Yino called out to him before he even reached the consultation room.

Liu Banxia nodded and walked over to the examination bed.

"Teacher Liu, the patient came in on her own after a fall. She has a laceration on her leg and back pain," Xu Yino explained.

"What do you need my help with?" Liu Banxia asked.

"Could you examine her back? She was diagnosed with breast cancer two years ago and underwent chemotherapy. She’s recovering well now, but the chemo caused some nerve damage, so she sometimes has difficulty walking," Xu Yino said.

Liu Banxia frowned. "You suspect a spinal injury?"

Xu Yino nodded quickly. "The patient says it’s nothing, but I’m worried. She doesn’t want to undergo any imaging tests, so... so..."

Xu Yino trailed off, unable to continue.

What was he supposed to say? This girl apparently thought he was an orthopedic X-ray machine, hoping he could confirm things by palpation.

It was because she cared about the patient, but that wasn’t the right way to handle things. This is a female patient. If it really is a spinal injury, it would require careful palpation to detect.

"If you suspect a spinal injury, an X-ray or CT scan is necessary for a clear view. After this fall, does your back hurt more?" Liu Banxia asked the patient.

The patient frowned slightly. "It seems to hurt a little more, but not terribly. If the spine were really injured, wouldn’t the pain be excruciating?"

"Not necessarily. It depends on the extent of the injury. How long have you had trouble with your leg?" Liu Banxia asked.

"About half a year, I think? They said the pain in my back is also nerve pain caused by the chemotherapy. It’s not actually that severe," the patient replied.

Liu Banxia frowned. "I agree with Doctor Xu’s concern. However, I don’t recommend an X-ray. I suggest a spinal CT scan, which will provide a clearer image."

"Even though you’ve been diagnosed at other hospitals, your back pain and difficulty walking make us consider the possibility of a spinal injury. Xu Yino, that’s my recommendation. Please discuss it with the patient."

After saying this, he walked out.

This was a test for Xu Yino. Ultimately, she needed to learn how to manage such patients herself.