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Chen Cang stumbled his way to the Cardiothoracic Surgery Departnt at Dongda First Hospital.
He wanted to be admitted as a patient.
But he thought it over and couldn’t decide which departnt to go to!
Chen Cang really wanted to ask the Pain Managent Departnt if they treated butt pain, but when it ca to explaining the cause of his pain, he wasn’t sure how to answer.
Should he say... he got his glutes punched in Jeet Kune Do?
Sigh...
He was ntally exhausted!
Qin Xiaotian, oh Qin Xiaotian, why did you have to run away so fast!
This is your own father, and you didn’t even try to stop.
Chen Cang felt extrely anxious.
By the ti he reached the departnt, it was already six-thirty. As soon as he entered, he saw San Bo imdiately stand up!
"Chen Cang is here!"
Suddenly, Ge Huai pushed Chen Cang down into a chair, "Xiao Chen, aweso job snagging the first place in your group, representing Dongyang in the competition. Any thoughts on that?"
Chen Cang abruptly stood up!
Thoughts?
My damn ass hurts!
Scholar Two, Zhang Dai, pushed Chen Cang back down into the chair: "Xiao Chen, you’re really sothing. We didn’t even notice how amazing you were. Sit down quickly, we have prepared three surgeries for tonight, and you’ll have to teach us properly."
Chen Cang imdiately stood up again, this ti he glanced at Scholar Three, moved the chair aside, and said indifferently,
"It’s all good, I’d rather not sit... been sitting all day."
Just then, ng Xi walked in and said with a smile, "You’re here."
Chen Cang smiled, "Hello, Teacher ng!"
ng Xi nodded, "Sit down first. Dr. Ge, go and get the discharge notice for bed 12 ready. Also, the discharge certificate—family mbers of the patient will co early tomorrow to go through the procedures."
Chen Cang smiled, "I’d rather stay standing. Dr. Ge, let handle the discharge certificate for you."
Ge Huai nodded, "Thanks, Xiao Chen."
After writing the discharge certificate, ng Xi signed it, setting the date for the following day.
In Cardiothoracic Surgery, Chief Zhou did his major ward rounds on Tuesdays. On Tuesdays and Fridays, based on the conditions of the patients, major dication prescriptions had to be made.
This brings us to the dication prescribing practices in various hospital departnts—generally, it’s customary to do major dication prescriptions twice a week.
"Major dication prescribing" ans that if you’re going to prescribe dicine on Tuesday, you prescribe all the way through Friday, issuing three days’ worth of dication, along with long-term dical orders.
Temporary dical order modifications are also convenient; they can be changed out promptly if necessary.
This way, it’s easier for both the nurses dispensing dication and the doctors giving orders.
If you prescribe dication today and they prescribe more tomorrow, it disrupts the order of the departnt.
And... never think that nurses are subordinate to doctors.
When nurses don’t cooperate, it can cause a lot of trouble for doctors.
Thus, cooperation between dical staff is essential.
It even directly affects every aspect of dical work.
Tuesday mornings are busy, so most things are done the night before whenever possible; never think that you can just do your own thing during the chief’s major round...
After finishing a series of tasks, everyone was about to head to the operating room.
Suddenly, a nurse ran in hurriedly, "Director ng! Dr. Ge, it’s not good, the patient in bed 12 just fainted."
Upon hearing this, ng Xi dashed towards bed 12!
Chen Cang also followed closely, and Ge Huai stood up, turned back, and grabbed the dical chart.
Bed 12 was the patient of Ge Huai and ng Xi; any issues were their responsibility.
They had just entered the ward when they suddenly found the patient lying on the floor—a young man in his mid-thirties, while his wife and child stood by, panicked and overwheld.
"Doctor! How could he just faint all of a sudden?"
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ng Xi’s expression was solemn as he said to the woman, "Don’t be nervous, calm down."
"Cardiac monitor, blood oxygen saturation, urgently check the blood sugar!"
"Chen Cang, lift the patient onto the bed!"
"Yang, ECG machine!"
"Nurse station, page the ergency departnt for an urgent consultation!"
...
ng Xi instantly issued several dical orders.
When a cardiothoracic surgery patient collapses, the first consideration is still potential cardiac sequelae.
After all, surgery can result in a variety of postoperative complications, so of which can cause arrhythmias and so on.
Of course, there are many reasons for fainting, and they cannot be generalized; however, the priority in ergency situations like this is to rule out cardiac issues for cardiothoracic patients.
At this ti, Ge Huai had already rushed in holding the dical record.
All the nurses were busy in an orderly manner.
While observing the patient, ng Xi helped Chen Cang lift the patient onto the bed and undress them.
He asked Ge Huai about the patient’s condition.
"Does the patient have any dical history? Any hypertension, diabetes, hyperlipidemia..."
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Ge Huai shook his head: "Nothing! The admission tests were all normal, and the patient’s previous physical examination was fine. This ti it was an aortic aneurysm excision, with no discovery of hepatitis, tuberculosis, etc."
After hearing this, ng Xi said to the nurse testing the blood sugar, "What’s the urgent blood sugar result?"
Upon seeing the result, the nurse imdiately said, "Blood sugar 9.8!"
Normal!
ng Xi turned and asked Ge Huai, "Did they do a cerebral vascular MRI when the patient arrived?"
Ge Huai was startled!
Who would do that?
We’re in cardiothoracic surgery, not neurology or neurosurgery.
However, ng Xi’s consideration was correct; with sudden syncope, one should consider cerebral vascular issues. Even without hypertension, if the patient had cerebral vascular malformation or existing intracranial arterial aneurysm, a ruptured aneurysm could lead to unconsciousness!
This possibility could not be excluded!
After all, so people have aneurysms in more than one place.
Taking a deep breath, Ge Huai shook his head: "No, the patient had a head CT, which showed no abnormalities."
He also knew that a head CT could only give a rough idea and miss many details.
If a CT could be perford now, it would show if there was any cerebral hemorrhage, but at this mont, with the patient’s life hanging by a thread, there was no chance to transfer them to the CT room.
Moreover, the probability of intracranial aneurysm rupture was too low!
Just then,
Chen Cang said, "Both pupils are equal and round, no dilation found, and the reaction to light is normal... I don’t think it looks like a cerebral hemorrhage!"
Chen Cang’s words made ng Xi’s eyes light up. Right... The most basic physical examination and neurological assessnt had been overlooked.
Although it couldn’t completely rule out a cerebral hemorrhage, it was very close to certainty.
Sotis, diagnosis is really a process of elimination, especially when the cause is unknown. To quickly establish a diagnosis, the process of elimination is one of the best thods.
The entire process seed prolonged, but it actually took less than a minute!
And at that mont, the ECG machine had already been connected!
But before the ECG machine had ti to print out the results, a nurse suddenly said, "Director ng! It’s ventricular fibrillation!"
At those words, everyone’s complexion changed instantly!
ng Xi was startled and quickly said, "Contact the ergency departnt, get the defibrillator, hurry!"
This was serious trouble now!
The patient had just undergone an aortic aneurysm excision, and now they were suddenly experiencing ventricular fibrillation—a dangerous situation that drastically increased the risk factor.
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