"The patient suddenly had a heart attack?!" Dr. Ma exclaid, "Impossible, the patient’s on cardiac monitoring, the electrocardiogram shows no significant abnormalities."
If it were really a heart attack, pulling up an electrocardiogram would reveal it, how could he, on duty, fail to notice it and seek Professor Fang’s guidance.
"No." Xie Wanying shook her head, "I’m saying that it probably isn’t the original illness of the patient that’s causing this, but rather a complication that has arisen after endoscopic treatnt."
"What complication are you talking about?" Fang Xueqing and Dr. Ma impatiently urged her to clarify.
This issue pertains to internal dicine’s technical problems, and it is indeed very serious. Moreover, endoscopic treatnt is far safer than surgical treatnt. The most terrifying complications from endoscopy should be significant bleeding or perforation, but currently, the patient’s symptoms and physical signs do not support the occurrence of these two severe complications.
Xie Wanying said, "It’s a pulmonary embolism."
Fang Xueqing and Dr. Ma stared at her blankly for a while before looking at each other with uncertainty. As internists, they had not heard of such a complication.
"There have been case reports on this in the literature," Xie Wanying inford them.
"Professor Fang?" Dr. Ma asked for guidance from Professor Fang, completely uncertain on his own. Pulmonary embolism is extrely rare in clinical practice, and as a young doctor who had never encountered it before, he could only ask Professor Fang if this patient’s symptoms could be suspected of pulmonary embolism.
Frowned brows crossed Fang Xueqing’s face; speaking of pulmonary embolism, she likewise had like no experience with it. She is a gastroenterologist, not a pulmonologist or a cardiothoracic surgeon.
The most important aspect is that extrely rare cases can be reported in the literature as special cases. But indeed, they are too rare to be generalized to clinical practice. They can only serve as a reminder, alerting clinicians to the possible existence of these special cases.
How to ascertain that what Xie Wanying is suggesting isn’t rely a wild guess stemming from reading an article? So dical students who are keen on research and disconnected from clinical practice are like that. Upon seeing a similar case in the clinic, they imdiately beco overly suspicious. These types of dical students, in the eyes of clinical educators, seem to be deliberately showing off their talent and flaunting their skills, which doesn’t endear them to their clinical supervisors.
Speculating is fine, but it requires evidence for support. Suspecting rare cases ans that the patient needs to undergo additional testing. The cost is entirely borne by the patient and their family. If the suspicion is wrong, this money is considered wasted, and in case of a dical dispute, the patient’s family could use this against the doctor. Now, with this patient, the family has already shown dissatisfaction, and to needlessly order more tests for the patient? Fang Xueqing’s brows were knotted in frustration. Dr. Ma was waiting for her decision, glancing outside occasionally where the family was visibly anxious.
"Doctor Song." Fang Xueqing once again sought the opinion of Song Xueling.
Song Xueling said, "Do as Dr. Xie suggests."
A hint of surprise flashed through Fang Xueqing’s eyes: "Do you support her opinion, Doctor Song?"
Dr. Ma was more anxious than anyone, urgently asking, "If we suspect a pulmonary embolism, what tests need to be done? Send for a CT scan imdiately?"
Clinically rare events can also easily cause doctors to suddenly forget less common knowledge points from textbooks.
"We could start with a blood gas analysis test," Xie Wanying suggested, "The cost isn’t high, and the results co out fast. In the case of acute pulmonary embolism, the patient’s body will be oxygen-deprived and feeling suffocated, and a typical blood gas analysis shows both carbon dioxide and oxygen in the blood to be low. Such test reports can rule out many diseases, serving as an important reference indicator. After having data to support it, we can consider further tests for definitive diagnosis."
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