Hearing Shi Lei’s call, Xu Hui also dashed towards the ICU. He didn’t wait for the elevator, choosing instead to take the stairs.
"The patient’s intracranial pressure has risen substantially; we can’t wait any longer. I just had blood drawn. However, even by visual inspection, the patient appears to be anemic," said Zhang Xiao, who was stationed in the ICU.
"What about body temperature and kidney function?" Liu Banxia asked.
"The body temperature hasn’t decreased, nor has it risen too much. It’s 0.5 degrees Celsius higher than when they ca out of surgery. The urine tests likely haven’t been done yet," Zhang Xiao responded.
"Arrange for a stat urine test, and in the blood tests, focus on kidney function," Liu Banxia instructed.
"I suspect the patient’s current condition is TTP. If we can confirm it, we can perform a plasma exchange. Once the platelet count has risen, we can proceed with the decompression surgery."
"TTP? Surely not? If that’s the case, I nearly killed the patient," Zhang Xiao exclaid, clearly taken aback.
"This isn’t the ti to discuss that. Let’s get the tests done first. If four symptoms of the Pentad match, we should be close enough, and we’ll need to start treatnt imdiately," Liu Banxia said.
Zhang Xiao nodded and imdiately began coordinating with the ICU staff.
The situation was critical. Suspected TTP, or Thrombotic Thrombocytopenic Purpura, has a very rapid progression and an extrely high mortality rate.
This wasn’t a question of whether to operate; it was a condition that directly threatened the patient’s life. While detailed diagnostic thods are cumberso, TTP is usually diagnosed clinically based on the "Pentad."
Reduced platelet count, elevated body temperature, anemia, acute renal failure, and neurological symptoms—these constitute the "Pentad" of TTP.
Since the patient was currently unconscious, assessing the central nervous system was difficult, but the other factors were relatively easy to determine. All that remained was to confirm anemia and acute kidney failure, after which the lab could perform a specific analysis.
The four of them waited anxiously for the results, making everyone in the lab tense.
"There are indeed signs of renal failure! We can proceed now, right?" the physician responsible for the tests exclaid excitedly when the results ca out.
DING! Diagnosis task completed.
Awarded 300 experience points, 200 diagnostic proficiency points, and 5 Glory Points.
"Perfect, thank you very much," Liu Banxia said. Then, forgetting to even grab the lab report, the four of them turned and ran.
The treatnt for TTP is straightforward: plasma exchange.
The thod involves drawing the patient’s whole blood, separating it into plasma and cellular components, discarding the patient’s plasma, and then transfusing fresh plasma, albumin solution, or other plasma substitutes back into the patient at an equivalent rate to replace the removed plasma.
This common thod is a well-established extracorporeal blood purification therapy.
Although it would take ti, for this patient, even the elevated intracranial pressure had to take a backseat. The TTP symptoms were the most urgent concern.
"President Liu, how did you figure it out?" Xu Hui asked curiously.
"A bit of educated guessing, I suppose. After all, TTP and DIC are often confused in clinical practice," Liu Banxia replied with a smile.
"You must have initially considered Disseminated Intravascular Coagulation, but then felt so symptoms didn’t align, so you could only continue to administer plasma and platelets to the patient."
I figured, since these two conditions are so easily confused, if we rule one out, could the other be the answer?
"The most critical factor, however, was the platelets. Initially, we considered that the decrease was due to so condition in the patient reducing platelet production. But platelets can also be destroyed, leading to a reduction. That’s when it occurred to ."
Shi Lei and the other two exchanged bitter smiles.
Looking back from the outco, everything seems so simple. However, diagnosing a condition is often like a magic trick; even if you’re separated by just a thin veil, you can’t see the whole picture.
The three of them had discussed it for so long, yet their combined efforts didn’t match the effectiveness of Liu Banxia mulling it over alone in his office.
What was the most crucial point? Liu Banxia had been trained by Shi Lei and was rely a resident who had recently completed his standardized residency training. The other three were all distinguished doctors from various departnts, senior attending physicians with years of experience.
"There’s nothing more for to do here, right? Once the patient’s platelet count rises, you can schedule the surgery. I’m heading back downstairs; I’ve got a busy day." With that, Liu Banxia casually walked away.
"Shi Lei, you’ve spent the most ti with President Liu. Do you have anything to say?" Xu Hui asked with a smile.
Shi Lei smiled bitterly and shook his head. "Not really. I don’t know what to say. Don’t you have anything to add? You’re an internist."
Xu Hui rolled his eyes. "We old waves have been completely crushed by the new wave, with no hope of recovery."
"Haha, that has nothing to do with . I’m just a neurosurgeon," Zhang Xiao said with a grin.
"What’s there to be happy about? This fellow could snatch your job at any mont," Xu Hui retorted.
"He already perford cardiac procedures in the old ergency departnt, and now at the Ergency Center, he’s taken over many orthopedic tasks. Who’s to say he won’t attempt an ergency craniotomy one day?"
Zhang Xiao grew troubled as well; this truly was an unpredictable situation.
A fundantal requirent for a neurosurgeon is a steady and quick hand. In this regard, Liu Banxia was not just qualified; he even surpassed Zhang Xiao.
You really couldn’t predict when Liu Banxia would showcase his skills. He was now smoothly handling internal dicine cases, and he excelled in general surgery and orthopedics too. Was there anything he couldn’t do?
"Oh, I just rembered sothing!" Zhang Xiao suddenly exclaid.
"Do you guys rember? There was a patient with progressive paralysis, and it was Director Xiao who personally perford the surgery and found the hematoma in the spinal cord?"
Shi Lei nodded. "How could we forget? That was when this kid was spouting off without understanding the gravity of the situation. Even Director Zhou was startled, thinking this kid’s audacity knew no bounds."
"Back then, Director Xiao returned to the office and said that Liu Banxia should actually join Neurosurgery. He observes very ticulously, which would be a great asset during neurosurgical procedures," Zhang Xiao said with a bitter smile.
"Sigh... what else can be said?" Xu Hui remarked helplessly.
"Vice Director Li of Cardiology, Director Zhou of General Surgery, Director Xiao of Neurosurgery, Director Xu of Orthopedics—these are our hospital’s crown jewels. It’s just that Director Zhou got to him first. He’s a real hot commodity."
"The key is that he’s so young; I truly admire him now. Our Second Hospital is really capable of nurturing such talent. But I wonder where his limits lie."
"Currently, there are only restrictions on his scope of practice. If there were no restrictions, do you think he’d try to register under every single departnt?"
Hearing Xu Hui’s words, everyone laughed, though behind their smiles lay a hint of envy.
Human energy is finite, but for Liu Banxia, that limit seed much less restrictive. The guy showed imnse talent in so many disciplines; he was truly incomparable.
Back on the first floor, Liu Banxia was in a good mood. Even if he hadn’t gained much experience from it, he had saved a life. It seems the system’s judgnt is quite fair, primarily testing one’s ticulousness, he thought.
After a big stretch, he still had to devise a training plan for the six interns. It was impossible to send them all for practical training simultaneously. With the increasing patient load, their help allowed everyone else to manage a bit more easily.
Moreover, working here provided them with more hands-on opportunities. He couldn’t ensure an entirely equitable distribution of resources. For now, their primary task was patient intake. Whoever admitted a patient would get the chance to participate in their surgery.
He also needed to sohow find the ti to gather everyone for case discussion etings.
Arranging suitable eting tis wasn’t easy. He couldn’t just summon everyone at once, as so staff had to remain on duty for patient admissions.
For the Ergency Center, scheduling had to be flexible for now. There was no set day or ti slot; they had to seize opportunities whenever the patient flow was lighter.
He felt sowhat ntally drained now. His forr self would never have imagined worrying about so many responsibilities. But for the sake of a better future, he had to persevere.
Just then, the sound of an ambulance siren ca from outside. However, no one rushed in to call him, indicating it wasn’t a major incident with many patients, so he could continue with his tasks in peace.
Although he was the Chief Resident, his presence wasn’t required for every ergency patient’s resuscitation. There were plenty of capable doctors available.
After finishing the task at hand, he stepped outside.
"President Liu, are you free during your break tomorrow?" Wang Chao approached him again.
"What’s up?" Liu Banxia asked curiously.
"If you’re free, I’d like to treat you to a al. To be precise, my parents want to invite you to dinner to thank you for looking after ," Wang Chao said.
"I really can’t make it tomorrow. I’ve promised Director Zhou I’d go to his place for dinner. It’s supposed to be a proper first visit, as I haven’t been there even once," Liu Banxia said.
"Seriously? You haven’t been there even once after all this ti?" Wang Chao asked in surprise.
Liu Banxia nodded. "It’s true, I’ve never been. I thought about visiting when I was suspended, but the Director was constantly on duty, so I didn’t dare bring it up."
"Alright then, that’s more important. Most people visit their ntor at least once a week after being accepted. You, on the other hand, are really treated like you’re free-range," Wang Chao said with a helpless sigh.
He was a bit envious. Liu Banxia had found such a good ntor. The systematic surgical observation opportunities Zhou Shuwen had arranged for Liu Banxia during this period were sothing many could only dream of.
Then again, Liu Banxia had the skills to back it up. Anyone else might not have been able to keep pace. Still, envy wouldn’t change anything, and the dinner invitation would have to wait.
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