The Enhanced Doctor-Chapter 514 Emergency Center’s Grand Opening (extras for loneliness, emptiness, and cold 671112, 6/8 added)
After arriving at the ward, Liu Banxia’s heart lurched. The patient Dr. Chen was examining was the same elderly man for whom he had performed a femur fracture reduction the previous day.
"How is he doing?" Liu Banxia asked after Dr. Chen finished his examination.
"He’s experiencing respiratory distress, showing signs of cyanosis, chest tightness, and sweating, with wheezing on auscultation. Heart rate is 130, blood pressure 100/170 mmHg, blood oxygen saturation 90%. Administer oxygen," Dr. Chen reported.
"Does the patient have a history of smoking? And did he just have breakfast?" Liu Banxia asked.
"Bilateral breath sounds are symmetrical. He only had a little millet porridge for breakfast; his family members ate the solid food. You should take a listen too. I’m somewhat unsure," Dr. Chen said.
Liu Banxia hurriedly took out his stethoscope and began to examine the patient.
As Dr. Chen had said, his bilateral breath sounds were normal, though with audible wheezing.
"His heart rate, blood pressure, and blood oxygen level are all dropping!" Liang Xiaolin suddenly called out.
Instinctively, Liu Banxia moved his stethoscope to the patient’s heart. After listening for just a moment, he froze, his brow furrowing.
Friction rub, muffled heart sounds.
"Dr. Chen, listen to this. Don’t you think it sounds like cardiac tamponade?" Liu Banxia said quickly.
Chen Xuehai paused for a moment, then quickly placed his own stethoscope on the patient’s chest.
When he had auscultated earlier, he had also listened to the heart sounds and found no significant issues, just a slight friction rub, which can also be present in patients with pulmonary embolism.
"Local anesthesia! Prepare for pericardiocentesis! Contact the OR!" Dr. Chen ordered immediately after listening.
DING!
Emergency Mission Complete.
Gained 50 Experience Points, 50 Skill Proficiency Points in Diagnostics.
Liu Banxia quickly found a syringe from the crash cart. He had performed on-site pericardiocentesis before, but with Chen Xuehai present, it wasn’t his place to take the lead.
When a patient’s life was on the line, if a doctor from the relevant department wasn’t present, another doctor could step in. Alternatively, it was permissible with authorization from the attending specialist, like the previous instance of draining cerebrospinal fluid.
Everyone’s expression turned grim when they saw the blood aspirated into the syringe.
This was hemopericardium.
This indicated significant damage to major blood vessels within the heart or pericardial cavity, or a rupture of the heart or coronary arteries. Infectious causes like viral pericarditis, or primary or metastatic cardiac tumors, could be provisionally excluded.
Because the patient’s oxygen saturation and heart rate had improved when Chen Xuehai aspirated the fluid, it couldn’t have been a misplaced puncture. It could only be an acute hemopericardium caused by the rupture of certain blood vessels or the heart itself.
"Draw the curtain! We’re doing an on-site thoracotomy! Quickly get blood units! Liang Xiaolin, first assist!" Chen Xuehai ordered while still aspirating blood.
"I’ll get the blood," Liu Banxia said.
"Doctor... Doctor..." The patient’s son was growing anxious.
"Please step aside for now. Give the doctors space to work," Liu Banxia said as he gently pulled him away.
Even during an emergency operation, the patient’s family couldn’t be allowed to witness a thoracotomy. The sight would be too traumatic and could easily lead to complications.
With Chen Xuehai and Liang Xiaolin present, even Liu Banxia couldn’t go behind the curtain and risk becoming a hindrance.
Though it was just a ward bed, it had now become a makeshift operating table. Space was limited, so all available room had to be reserved for the attending surgeon and assistant.
As soon as he ushered the patient’s son out, Liu Banxia bolted. He ran for his life. He had to get plasma for the patient, who was currently only on a saline drip.
Some of the early-rising patients’ families intended to greet Liu Banxia, but he WHOOSHED past them.
Going down the stairs, Liu Banxia jumped the last few steps. Even though the impact made his feet throb with pain, he couldn’t be bothered with it now.
He was very glad when he reached the blood bank that he hadn’t overlooked doing the blood compatibility tests the previous night; otherwise, getting blood today would have been difficult.
He grabbed two units of blood and raced back like the wind.
Going up the stairs, he also took several steps at a time.
"Good, the bleeding’s stopped!" As soon as he ran back into the ward, he heard Chen Xuehai’s voice.
"Blood... blood..." Liu Banxia gasped out, panting heavily.
Xu Yino took the blood bags and quickly ducked behind the curtain.
"Myocardial infarction leading to cardiac rupture. He’s stabilized for now," Chen Xuehai said curtly as they hurriedly wheeled the patient out.
Leaning against the doorframe, panting heavily, Liu Banxia waved his hand to acknowledge.
HUFF... HUFF... HUFF...
Liu Banxia took several deep breaths. "Let’s clean up the ward and get rid of the smell of blood. It’s been a long morning. I’ll treat everyone to extra dishes at lunch."
"Dr. Liu, you should go rest over there," a nurse suggested.
"I was in such a hurry just now. Who did I bump into when I ran out?" Liu Banxia asked.
Zhou Qian raised her hand with a wry smile. "I was just on shift in the ward last night."
"You get an extra chicken drumstick! Definitely an extra chicken drumstick!" Liu Banxia quickly said.
"Dr. Liu, what just happened? Didn’t he just have a leg fracture? How did his heart rupture?" a relative of another patient in the ward asked.
"Sigh, it’s a very rare complication. Unfortunately, this gentleman experienced it," Liu Banxia said with a wry smile. "Many factors can trigger it—trauma, stress, it’s all possible. Fortunately, we caught it early. The tear wasn’t large, so there’s still time to get him to the OR for proper repair. He’ll just have to stay with us for a longer period, though, especially since we performed a thoracotomy."
In fact, he felt a lingering fear now. If they had treated it as pulmonary embolism, what would the outcome have been? The patient would likely have died right there on the hospital bed. Because the standard emergency treatment for pulmonary embolism is to administer heparin for thrombolysis. If a patient with a cardiac rupture is given heparin, the consequences are unthinkable.
"Teacher Liu, why didn’t we initially notice the abnormal heart sounds?" Xu Yino asked curiously after they stepped out of the ward.
"A myocardial infarction is also a heart condition. Have you forgotten the peculiarities of heart disease? Their onset isn’t always marked by obvious symptoms," Liu Banxia said. "And another crucial factor: the patient had no prior history of heart disease, only hypertension. His presenting symptoms were primarily chest tightness and respiratory distress, not chest pain."
"We were lucky this time. The rupture likely just occurred, and the tear was still small when we performed the pericardiocentesis to relieve the pressure. If we’d delayed even by half a minute, that tear would have enlarged."
"Frankly, if this patient pulls through, it can only be described as a miracle. If it had been me, I doubt I could have performed the thoracotomy and emergency suturing that quickly."
"It was this series of coincidences that gave us the chance to save him. Otherwise, this patient would have truly been in peril."
Xu Yino carefully mulled over Liu Banxia’s words and nodded.
The patient was fortunate, and so were the doctors. It was incredibly dangerous; any further delay, and they really would have lost him.
"What just happened upstairs?"
When they returned downstairs, Shi Lei saw them and asked curiously.
Liu Banxia gestured for Xu Yino to explain, while he sat down to rub his aching feet.
Those few jarring landings still made his feet ache. He didn’t even know if he had a hairline fracture or something. He hoped not; otherwise, he’d be as stiff as a board for the foreseeable future.
"Well done! You managed to save both a pulmonary embolism and a cardiac rupture case! That’s an auspicious start for our Emergency Center. Those ’lucky dumplings’ of yours really worked; we were quite lucky." After listening to Xu Yino’s account, Shi Lei clapped Liu Banxia on the shoulder.
"Gently! I haven’t recovered yet. Besides, it wasn’t really me; Dr. Chen’s skills are truly solid," Liu Banxia said.
"Don’t be modest. Modesty is just another form of pride," Shi Lei said with a straight face.
Liu Banxia shot him a glare. "I’m not helping you find a girlfriend anymore! If you’re so capable, why don’t you get the director to treat us to extra dishes again tonight?"
"Actually, we can indeed add more dishes. We absolutely must."
Just as Liu Banxia finished speaking, Zhou Shuwen’s voice drifted over from behind him.
Seeing the smirk on Shi Lei’s face, Liu Banxia was thoroughly exasperated. He’d just used this tactic on Chen Xuehai, and now Shi Lei had immediately turned it back on him.
"Both of these cases hold significant learning value. You can discuss them in detail during your case reviews," Zhou Shuwen continued. "The presenting external symptoms were remarkably similar; the only key difference lay in the heart sounds. Your meticulousness, combined with a touch of luck, allowed us to successfully rescue these two patients."
"Director, I’ll accept the credit for the first patient. But the second one really had little to do with me; I just helped fetch the blood," Liu Banxia hurriedly said.
"No one said it was all your doing. How’s your foot? Need an X-ray?" Zhou Shuwen asked.
"It should be fine; it doesn’t hurt much now. I’ll wait and see. If it still hurts later, I’ll get one then," Liu Banxia replied.
"Alright. You’ve been swamped these first few months. Take this morning off to rest properly. If you feel any discomfort, get that X-ray immediately. Don’t delay," Zhou Shuwen nodded.
There was no need for further instructions; they were all doctors and knew what to look out for.
Liu Banxia rubbed his foot a bit more, then flexed it. It felt fine, no significant discomfort.
"Boss, I’ve realized something," Liu Banxia said.
"What’s up?" Shi Lei asked with concern.
"I haven’t had breakfast yet," Liu Banxia said with a perfectly straight face.
He’d genuinely forgotten. Normally, he was the most eager one for breakfast each morning. But today, being on duty, he’d woken up a bit late, and then the emergency had driven it completely from his mind.
Shi Lei rolled his eyes at him. "Go on then, there are still dumplings. I heard Zhou Qiang made them last night. Go on, eat up."
Liu Banxia grinned. "There are still dumplings, huh? I’m actually craving some millet porridge, a couple of tea eggs, and some pickled vegetables."
"Heh, like it or not, you have to eat them. Never mind if it’s superstition; these lucky dumplings must be eaten," Shi Lei said, grinning.
Liu Banxia nodded. Alright, I’ll force them down. I have to. Sometimes, in the hospital, you really do attach importance to these things. Regardless of whether there’s any actual correlation, everyone hopes for a positive outcome. It’s much the same in everyday life, really. Just human nature, I suppose.
