The Enhanced Doctor-Chapter 560: Patients allergic to anesthetics
Back in the emergency center, Zhang Xiao and Peng Bo both sang Liu Banxia’s praises. However, Liu Banxia wasn’t fooled and still insisted on the pig trotters he was owed.
In fact, regarding today’s case, Liu Banxia didn’t really think it was anything special. There was an element of guesswork to his success; it wasn’t entirely based on a clear diagnosis from his medical knowledge. As he himself said, it was partly due to luck, and the situation did match his initial assessment, thus making him seem very capable.
This led to a new question: What is the true significance of diagnostic skill proficiency? Initially, he understood diagnostics to be all-encompassing, but now it seemed that wasn’t the case. It had its own limitations, and these limitations were related to his own knowledge base. Despite his high level in diagnostic skills, approaching level five, it didn’t mean he could diagnose every illness. The improvement in diagnostic skill proficiency merely allowed him to take fewer detours during the diagnostic process. And this was still related to his own knowledge reserves and diagnostic experience. With this realization, a new question arose: What kind of impact did skills like wound dressing and suturing have on his improvement? They likely also provided a bonus based on his existing foundation, rather than meaning that with these two skills, he could clean any wound or handle any suturing difficulty. These three basic skills were, in fact, an enhancement of his actual abilities. To truly improve his medical proficiency, he still had to work hard. The system was purely auxiliary; it wouldn’t just hand him freebies. To gain more, he needed to contribute more. To get stronger physically, attribute points were important. To get more time, Glory Points became important. Because the improvement from attribute points was also an enhancement based on one’s own foundation. His innate conditions were what they were; later on, he could only rely on attribute points to build them up. To put it colloquially, striking iron requires one’s own strength.
"President Liu, a patient who fainted will be arriving soon."
Just as Liu Banxia was pondering this, the dispatch nurse called out.
"Su Wenhao will take the case. I’ll observe," Liu Banxia replied.
Hearing Liu Banxia, Su Wenhao quickly began to prepare.
Less than ten minutes later, the ambulance arrived at the entrance of the emergency center.
"46 years old, fainted, regained consciousness in the ambulance. Blood pressure 70/100. Complaining of chest pain. Oxygen administered, and sublingual nitroglycerin given," the paramedic reported.
"Resuscitation Room 1. Does your chest still hurt?" Su Wenhao asked.
The patient nodded with difficulty.
"Call a cardiologist. After moving him to the bed, connect the monitor," Su Wenhao instructed.
Once in Resuscitation Room 1, Su Wenhao first listened to the patient’s heart sounds.
"Heart sounds are diminished, pericardial friction rub. EKG, CBC, and blood chemistry panel," Su Wenhao ordered after the auscultation.
"Doctor, do I have a heart condition? My chest still hurts a bit," the patient asked.
Su Wenhao thought for a moment and nodded. "Let’s look at the EKG first. You should be past the acute phase now. Try to relax; you’re in the hospital."
The patient nodded.
"Dr. Su, I’m here." At this moment, Liang Xiaolin also walked in.
"The patient fainted before arrival; we suspect a heart condition. The EKG will be ready soon," Su Wenhao said.
Liang Xiaolin nodded and waited by the EKG machine.
"Do you have a history of heart disease, hypertension, or diabetes?" Su Wenhao asked the patient.
"I’ve had occasional chest pain before but didn’t pay much attention. This must be it, right?" the patient replied.
"What about hypertension or diabetes? Is there a family history of these conditions?" Su Wenhao continued.
The patient shook his head.
"The ST segment is somewhat elevated. Let’s skip the echocardiogram and go straight for a coronary angiography. It’s likely a heart attack," Liang Xiaolin said, looking at the EKG.
"Doctor, does a heart attack mean I need surgery?" the patient asked.
"It depends. If it’s just the capillaries, thrombolysis will be sufficient. Coronary angiography can show us the situation directly and save a lot of time," Liang Xiaolin explained.
The patient nodded.
"Dr. Liu, I’ll take the patient now then? Can you handle the paperwork when the family arrives?" Liang Xiaolin asked.
Liu Banxia nodded. "Don’t worry, I can handle that. Relax, there probably aren’t many blocked vessels, or you wouldn’t be this alert right now."
This last sentence was to comfort the patient. To a patient, a heart attack is a terrifying illness. Even with Liang Xiaolin’s reassurance, he was still extremely nervous. In terms of comforting the patient, neither of them had been meticulous enough. But that was alright; it also depended somewhat on the patient’s condition.
"Forty-seven years old, already in the high-risk age group," Liu Banxia remarked after the patient was wheeled away. "When the patient’s family arrives, you explain the situation and get the paperwork done. Doctor Liang ordered this, so it must be done thoroughly, or there’ll be trouble."
Su Wenhao was amused. Among all the interns in the emergency center, Liang Xiaolin was probably the only one who truly didn’t take Liu Banxia seriously.
"Dr. Liu, have you set a date for your honeymoon yet?" Qing Kewa chimed in.
"We haven’t been able to set one. But if there’s a chance, we’ll definitely visit you at your place. Not much time left, are you a bit reluctant to leave?" Liu Banxia said with a smile.
Qing Kewa nodded. "I am a bit reluctant. I feel like there are so many delicious foods and fun things I haven’t enjoyed yet. I don’t know when I’ll be able to come back next time, and work will be busy when I return home."
"In that case, how about I give you a green light?" Liu Banxia asked after a moment’s thought.
"A green light? Are you going to make things easier for me?" Qing Kewa asked curiously.
Liu Banxia nodded. "Consider it a convenience. At least for the remaining time, you can rest normally and not have to burn the midnight oil like us. During your breaks, you can find Qiaoqiao and have her take you out. You’ve participated in most of the surgeries you can. If there are any specific surgeries you want to observe, let me know, and I’ll arrange it." 𝑓𝑟𝑒𝘦𝓌𝑒𝑏𝑛𝑜𝘷𝑒𝘭.𝒸𝘰𝑚
"Wow, thank you, Dr. Liu!" Qing Kewa exclaimed happily.
"No need to be so polite with me. After all, I can’t just eat your family’s caviar for free," Liu Banxia said with a straight face.
Qing Kewa was delighted. "It’s no problem! If you like it, I have more here."
She was genuinely generous, which amused Liu Banxia. That caviar was quite expensive; how could he have the nerve to ask for so much?
More trauma patients came in, but Liu Banxia didn’t need to worry about them. Was his role like that of a firefighter, only needed where the flames flared up?
"How did it go?" Liu Banxia asked when he saw Liang Xiaolin return after a while.
"I initially thought a stent would be enough, but it turns out he needs a bypass," Liang Xiaolin said. "Coronary atherosclerosis. Multiple severe stenoses in the right coronary artery and the left anterior descending branch. For it to reach this stage, his usual symptoms must have been significant, yet he endured it."
"Sigh... these things can’t be helped. Often, patients think they can just hold on for a few more days and only go to the hospital when they absolutely can’t bear it anymore. Is Dr. Chen available?" Liu Banxia said.
Liang Xiaolin nodded. "He’s scheduling the OR. But once this surgery starts today, it’s going to take a long time."
She didn’t have time to chat with him; she still had to explain the surgical procedure and potential risks to the patient and his family. This was a major operation, much more complex than stenting. But in the patient’s current condition, a stent could no longer solve the problem, so a bypass was necessary. As the name suggested, a bypass meant creating a detour for the blood flow, avoiding the congested sections. Normally, such a surgery might be delayed, but doing it today definitely meant the patient’s stenosis was too severe, with a risk of another heart attack at any moment.
Liu Banxia went upstairs to the wards for a quick round. He only had time for this because there were fewer patients downstairs at the moment. He mainly checked on the hemophiliac patient, the Klebsiella pneumoniae patient, and the patient who had one testicle removed. This patient was now showing some signs of depression. At the time, he just wanted to get better quickly, but now, after all, he was missing a testicle. Liu Banxia could only offer a certain degree of comfort for this, but it wouldn’t have much actual effect. That was a job for a psychiatrist, which the Second Hospital currently didn’t have.
Just as he returned downstairs, he saw Liang Xiaolin rushing out.
"What’s wrong? Shouldn’t the surgery have started by now?" Liu Banxia asked in surprise.
"The patient is allergic to the anesthetic; general anesthesia is impossible. He’s been resuscitated, and the reaction wasn’t too severe," Liang Xiaolin said with a wry smile.
Liu Banxia was stunned. The anesthetics currently used were very safe. It was just that occasionally, a patient might have an allergic reaction; he hadn’t expected to encounter one today.
"Then what treatment plan is Dr. Chen considering?" Liu Banxia asked with a frown, a dreadful idea forming in his mind.
"High epidural anesthesia, but the patient will remain conscious," Liang Xiaolin said.
Liu Banxia sighed inwardly. That was exactly what he had just thought of. But this is major heart surgery! It’s not like an anal fistula operation that’s over with a bit of poking around. How strong must the patient’s willpower be to endure this surgery while wide awake? If it were him, he doubted he’d have such courage.
"Have you communicated with the patient? The surgical risk is very high," Liu Banxia said.
Liang Xiaolin shook her head. "We haven’t told the patient yet. My brother asked me to consult you on its feasibility."
Liu Banxia was dumbfounded. So it was just an idea they were considering, and now they were consulting him. But he couldn’t make the decision on something like this. It depended on the patient’s wishes, and all the associated risks had to be clearly explained. This was a huge undertaking.
