The Enhanced Doctor-Chapter 513 Difficulty Breathing After Surgery

A hot and lively "lucky dumplings" meal left the doctors who had come to help feeling quite satisfied. In reality, being a doctor is a highly stressful job; whether in the inpatient unit or the emergency center, they work under immense pressure daily. Having a little fun once in a while could help them unwind to some extent. 𝒻𝓇𝑒𝘦𝘸𝑒𝒷𝓃ℴ𝑣𝘦𝑙.𝒸ℴ𝘮

The subsequent patients confirmed Liu Banxia’s earlier speculation. Starting from one o’clock in the morning, patients with kidney stones began to arrive in a steady stream. However, the emergency center was just a transfer point; once diagnosed, they were directly sent to the lithotripsy center.

"How many so far?" Liu Banxia asked with a smile.

"Seven so far. Four of them have kidney stones large enough to require lithotripsy. Two have smaller kidney stones and are currently hopping. There’s also one patient with gallstones who is receiving IV fluids," Huang Bo reported.

"Great. Lithotripsy will only be needed if they can’t hop them out," Liu Banxia nodded.

"Don’t look so glum. Who knows, you might all become nephrology experts in the future. Keep your spirits up, smile, and tomorrow you can all sleep in."

Liu Yiqing forced a big, bitter smile.

Liu Banxia was on duty tonight with her and Huang Bo. They were the designated team for stone-related cases, so they had to carry out their duties diligently.

Just as he spoke, three more people walked in. The one in the middle was bent over, clutching their lower back. Kidney stones, most likely, Liu Banxia thought, giving Liu Yiqing a knowing glance, letting her take the lead and gain experience.

"Doctor, my back started hurting in the middle of the night," the patient said.

"It might be a kidney stone. It’s not abdominal pain, is it?" Liu Yiqing asked.

The patient quickly nodded.

"Have you urinated?" Liu Yiqing asked again.

"No, I haven’t. The pain is unbearable! Can you give me something for it?" the patient asked urgently.

"Let’s do an ultrasound first to check for kidney stones. If your bladder isn’t full enough, you might need to drink some more water. Let’s take a look; that should tell us," Liu Yiqing said.

Remarkably, the ultrasound was successful on the first try. His stone was quite large, so he would have to be scheduled for lithotripsy. He could try hopping, but judging by his current difficulty even walking, hopping was out of the question.

"I wonder if tonight’s count will exceed..."

Before Huang Bo could finish, an alarm light in the emergency hall began to flash. Liu Banxia glanced at the room number indicated—213, a surgical patient admitted earlier today.

Not even bothering with the elevator, Liu Banxia ran directly upstairs.

"Teacher Liu, the patient is having difficulty breathing! The monitor shows a blood oxygen level of 92, and her temperature has risen to 38.4 degrees Celsius," Xu Yino hurriedly reported.

Liu Banxia frowned. This was the young woman whose bilateral hip dislocation he had reduced earlier. However, there was no time to dwell on that now; he quickly took out his stethoscope to auscultate her heart and lungs. There were distinct moist rales in her lungs, and her heart rate was rapid, with a slight friction rub.

"Does the patient’s medical history mention smoking or asthma?" Liu Banxia asked.

"I didn’t see anything like that in her records. No history of hypertension or diabetes either," Xu Yino quickly replied.

Not pneumothorax, not asthma... She just had a dislocation reduction... Damn it, this could be a pulmonary embolism! Liu Banxia’s thoughts raced before he suddenly yelled, "Administer oxygen! Call cardiology! Notify the OR!" Sweat beaded on his forehead.

It wasn’t the first time he had encountered a patient with a pulmonary embolism. The first one he had diagnosed was a post-operative patient with a high fever during his visit to Wang Mingxing, where Zhou Shuwen had cornered him in the patient’s room. However, that patient had chronic pulmonary embolism and was diagnosed directly after a series of examinations.

But he suspected this patient had an acute pulmonary embolism; the onset was too rapid. Even after administering oxygen, her blood oxygen level on the monitor had dropped to 88%.

"20 units of etomidate, 100 units of succinylcholine, prepare for intubation! 4,000U of heparin, IV push!" Seeing that the cardiologist hadn’t arrived yet, Liu Banxia issued the orders directly.

"What’s the situation?"

Liu Banxia was in the process of intubating when Chen Xuehai rushed in.

"Respiratory distress, elevated temperature, blood oxygen at 88%. Suspected pulmonary embolism. Gave 4,000U of heparin. Intubation complete," Liu Banxia said, then asked, "What’s her oxygen level now?"

"It’s risen slightly, up to 94% now," Xu Yino quickly reported.

*Ding! Emergency Mission Completed.*

*Received: 50 Experience Points, 100 Proficiency Points in Diagnostics.*

"Let’s get an ultrasound and a blood gas analysis. Her recovery is quite rapid, so even if it’s a pulmonary embolism, it’s likely a smaller one. Thrombolysis should be sufficient," Chen Xuehai said.

"Man, that scared me," Liu Banxia said, wiping the sweat from his forehead.

"Doctor, what exactly happened?" the patient’s friend, who was accompanying her, finally asked, her voice trembling. That was so intense just now, watching all those doctors rushing to save her. I really thought...

"The dislocation likely caused a deep vein thrombosis. A clot then traveled with the blood to her lungs, resulting in an acute pulmonary embolism," Liu Banxia explained. "When people sit for long periods, or after they’ve experienced fractures or trauma, blood clots can easily form in the veins. These smaller clots can then travel through the bloodstream and lodge in narrower vessels, causing a blockage."

"Everyone, listen up. This patient is a good reminder for us. We’ve seen many fracture patients today, so we need to be extra vigilant. Fracture patients have a very high risk of developing pulmonary embolisms."

Everyone nodded in agreement. They were aware of this risk, but a high probability didn’t guarantee it would occur in every fracture case; it was a statistical likelihood.

"Not bad, you reacted quickly. It’s already the first day of the Spring Festival; this is quite the ’first catch’," Chen Xuehai remarked.

"Don’t praise me; you have no idea how scared I was just now," Liu Banxia said with a bitter smile. "It’s a good thing I’ve encountered pulmonary embolism patients before; otherwise, I might have delayed the diagnosis. Honestly, I’m still a bit rattled. I wasn’t entirely sure if it wasn’t lung inflammation or some other respiratory issue."

"The ultrasound and blood gas results will tell us for sure. It should be clear then; I’m making the same call," Chen Xuehai said. "Forget it, I’ll stay up here in the on-call room with you. There are indeed more fracture patients today. Is everything under control downstairs?"

Liu Banxia shook his head. "Downstairs, it’s mainly kidney stone patients. We just process them and send them directly to the lithotripsy center. We had another one right before I came up. I expect we’ll see even more in the next day or two."

"Well, it’s the New Year, so everyone’s finally able to relax. At home, people are mostly sitting or lying around. If they maintained their usual activity levels, the situation might be better," Chen Xuehai commented. "However, for a dislocation patient to develop venous thrombosis, especially when blood flow wasn’t compromised, is still relatively rare. So, I think you really should go buy a lottery ticket or something."

"You’re pulling my leg again," Liu Banxia said. "Speaking of which, is Cardiovascular Surgery back from their Spring Festival holiday? Will they be sending anyone to reinforce us? Or are there any rumors about which departments here will get new staff first?"

"Orthopedics and OB/GYN. So, the operating rooms are going to get even busier," Chen Xuehai replied.

Liu Banxia nodded. Hospital operating rooms are often like refrigerators at home; no matter how many you have, there are never enough, and they always get filled up. With an OB/GYN department, that ’refrigerator’ would fill up even faster. OB/GYN has a high volume of surgeries, and many women opt for C-sections these days. And then there’s the particular situation with patients opting for vaginal births. Labor is unpredictable, so an OR often has to be kept on standby as soon as relevant symptoms appear. But no one can predict how long it will take—it could be half an hour, one or two hours, or even longer.

"Well, at least it’s a step forward for the hospital," Liu Banxia said. "What about your Cardiovascular Surgery department? Aren’t you getting another doctor?"

"We should have enough, shouldn’t we? Linlin graduates next year, and she’ll be able to contribute," Chen Xuehai said casually.

"Actually, I think her progress is really fast. You should encourage her more," Liu Banxia said.

"That won’t work. If I praise her, she gets complacent. You don’t see her at home; she can be quite a handful," Chen Xuehai said.

"A handful? When have I been a handful? I haven’t even been home in ages!"

As soon as Chen Xuehai finished speaking, Liang Xiaolin’s voice came from behind him.

"You set me up," Chen Xuehai groaned, shooting Liu Banxia a reproachful look.

"Hehe, just trying to liven things up!" Liu Banxia said with a grin. "Doctor Liang isn’t really angry. It’s just family banter. No hard feelings, Doctor Liang, right?"

"I don’t have time for you two," Liang Xiaolin said, rolling her eyes. "The ultrasound results are back. It is indeed a pulmonary embolism, but it’s a smaller one. Thrombolysis will be sufficient."

"See? I told you Doctor Liang is making great progress! You can’t hold back praise and rewards just because she’s your sister. Tomorrow noon..."

"Today’s lunch is on you."

Chen Xuehai interrupted before Liu Banxia could finish.

"Alright, lunch is my treat," Liu Banxia said helplessly.

There was no getting out of this one. Zhou Shuwen himself had ordered it, so he had to treat them to this meal.

After the thrombolytic medication was administered, the patient’s condition improved significantly, though she would need to continue medication for the next few days. Even a small thrombus wouldn’t dissolve instantly; it’s a gradual process.

After chatting with Chen Xuehai and the interns for a while and checking on the situation downstairs, Liu Banxia dozed off in the on-call room.

Tomorrow was another long day. Patients didn’t care if it was the first day of the Spring Festival; when illness struck, they came to the hospital. If he didn’t get any sleep, even his strong constitution wouldn’t hold out.

"Teacher Liu, Teacher Liu, wake up! There’s another fracture patient who’s feverish and having difficulty breathing!"

Sleeping soundly, Liu Banxia heard Xu Yino’s voice in his ear. He woke up immediately, rubbed his face to make himself more alert, and then ran out with Xu Yino.

A sense of dread washed over him. Not another acute pulmonary embolism, please...