Even though Liu Banxia kept reminding himself to remain composed, the slightly upturned corners of his mouth betrayed his good mood.
Tis have changed.
In the past, he had to beg in the ergency departnt just for a sip of soup. But that sip wasn’t that easy to get.
Now? It’s almost like shoveling at into his mouth without thought.
All of this was thanks to the system. Without the system, he didn’t know what his life would have beco.
When he returned to the Ergency Center, he didn’t linger downstairs but went straight to the ICU ward upstairs.
"I have so good news for you. I just consulted with the Chief Director. Our fourth floor will soon be setting up the CCU. Even if it only has ten beds for now, it will greatly reduce your pressure here," Liu Banxia said.
"President Liu, is it true? You’re not just humoring , are you?" Su Hongbo was skeptical.
"Why would I humor you? It’s not like it’s going to increase my pay," Liu Banxia said with a smile.
"The CCU issue wasn’t just brought up by you; Doctor ng also ntioned it. Initially, no one expected our Ergency Center to be so popular, so we weren’t adequately prepared."
"Now that this issue has co to light, we can postpone constructing other departnts, but we can’t delay the CCU. The wards are ready, and the pipelines have already been reserved."
"Well... hearing that relieves so of my anxiety. Freeing up ten beds will give us a lot more room to maneuver here," Su Hongbo said with feeling.
"Otherwise, our nurses have to face questions from patients needing transfer to the general ward every day, and there’s nothing we can do. If we don’t free up beds, people really can’t get in."
"Things will gradually get better. The hospital takes our situation here very seriously," Liu Banxia said.
"I have to go down and help with debrident and suturing to shorten the patients’ waiting tis. It’s currently peak flu season, and with so many patients waiting, it’s really too risky."
Su Hongbo nodded. He didn’t have much free ti to chat either. Patients admitted to the ICU for post-operative observation were, paradoxically, often the least severe cases there.
Returning downstairs, Liu Banxia put on his gear again. His main task was still debrident and suturing.
The current interns had completed this phase of training and had all passed. Although there was still room for improvent, they also needed training in other areas.
For instance, seeing patients independently and communicating with their families are all essential skills for practicing dicine.
"Teacher Liu, let handle this for you," Huang Bo said, stepping in after Liu Banxia had been seeing patients for a while.
"What’s this? Trying to earn so points with ? Are you getting anxious seeing Su Wenhao and Xu Yino get their own special patients?" Liu Banxia asked.
Huang Bo shook his head. "Teacher Liu, I’d rather such patients co later, after I’ve had more ti to build up my skills."
"There are also quite a few patients outside. You want to give us opportunities to practice, and we can’t just watch you get bogged down here. Leave the rest to ; I can also use it to review my basic knowledge."
"Alright, then I’ll leave it to you. I think I heard more ergency cases arriving outside?" Liu Banxia asked.
"Yes, three ergency cases. One with an abdominal stab wound has already been taken to the operating room by Dr. Wei. Another has a severed tendon, and Miao Rui is suturing it," Huang Bo said.
"Good. You’ve all grown and can handle these situations now. You take the next patient; I’ll go outside and take a look," Liu Banxia nodded in approval.
Outside, there were still many patients. He glanced around; Liu Yiqing and Miao Rui weren’t there. They had probably gone to assist Wei Yuan in surgery.
Just then, paradics brought in a patient. Liu Banxia saw that everyone else was busy, so he went over to receive them.
"Thirty-three-year-old female, fell on a treadmill at the gym. Vital signs are stable, pain in the ankle, suspected fracture," the paradic said.
"Okay, leave her to ," Liu Banxia said.
"Did you hit your head when you fell?" Liu Banxia asked.
The patient shook her head. "No. I’m so unlucky. I hope it’s not a fracture, but it really hurts."
"Working out? Well, you shouldn’t push yourself too hard. Let take a look at you first," Liu Banxia comnted casually.
He rolled up her pant leg. There was severe swelling just above her left ankle. Seeing this, Liu Banxia decided against palpation.
"Let’s get an X-ray directly. The chances of a fracture or bone crack are high. But don’t worry too much; you’ll likely recover with a cast in about two months."
"Ah..." The patient sighed. "I was just starting to see so results from my weight loss. If I can’t move for two months, who knows how much weight I’ll put back on."
"Your health is what’s most important. You should aim for gradual progress. Don’t push yourself too hard, or your body can easily develop problems. Are you here by yourself?" Liu Banxia asked.
"My boyfriend is at work. It didn’t seem too serious, so I didn’t inform him," the patient said.
"Alright, I’ll arrange for a nurse to get a wheelchair and take you for the X-ray. There are quite a few patients right now, so you might have to wait a bit. Alternatively, you can have a bedside X-ray done here in the resuscitation room. The results are quicker, but the cost is a bit higher," Liu Banxia said.
"Then let’s do the bedside X-ray. I can hardly walk now; otherwise, I wouldn’t have called 120," the patient quickly replied.
Liu Banxia nodded. Although there was a price difference, it wasn’t too significant. Since there were no other patients needing imdiate resuscitation at that mont, this was a flexible use of resources.
The X-ray was done, clearly showing a distal fracture of the fibula.
"It’s not too severe, you might recover in a month and a half," Liu Banxia said with a smile.
"When you get to that point, physical rehabilitation will be like exercise. Just be patient and don’t rush it. Otherwise, if the fracture site is subjected to too much force, it could be affected."
The patient nodded.
However, just as Liu Banxia was about to call a nurse to prepare a cast, the patient’s eyes rolled back, and she suddenly had an epileptic seizure.
This startled Liu Banxia, who quickly turned the patient onto her side to prevent asphyxiation.
The seizure lasted for nearly a minute. Liu Banxia breathed a long sigh of relief once the patient stabilized.
"Connect her to a monitor, run a rapid blood panel, and schedule a head CT. Her airway is clear for now," Liu Banxia ordered.
"You just had a seizure. Are you alright now? Did you feel anything unusual before you fell? Think carefully, now: did you hit your head or neck when you fell?"
The patient shook her head; she was too weak to speak.
Liu Banxia nodded. "Don’t worry. Give our nurses your family’s contact information. We’ll get you a head CT scan right away. You’re in the hospital; you’re safe here."
The patient nodded with difficulty.
"President Liu, what’s the situation with this patient?" Wang Chao asked after the patient was taken for her CT scan.
"It’s still unclear. We’ll have to wait for the test results. Initially, I thought she fell due to exhaustion from overdoing her diet. Now, it seems there might be a problem with her brain, since she had a seizure," Liu Banxia said.
Just then, paradics wheeled in another patient. Liu Banxia gave Wang Chao a look: back to work.
"Fifty-seven-year-old male, fell at ho while mopping the floor and hit a coffee table. Vital signs are stable," the paradic reported.
"To an examination bed! Did he hit his head?" Wang Chao called out.
"I think so. I felt a bit dizzy before I fell. The next thing I knew, I was in the ambulance," the patient said.
"Doctor, please give my dad a thorough check-up," the accompanying son said.
"Let examine him first," Wang Chao said and began his auscultation.
"His lung and heart sounds are normal. I also looked at the injury on his back; it’s not very serious. Given that he felt dizzy before falling, let’s do a head CT scan first."
The patient’s son nodded and hurried off to pay for the scan.
"Teacher Liu, the blood test results for your patient are back," a nurse hurried over to report.
"Looks like we caught this batch just in ti," Liu Banxia comnted, taking the report.
He only glanced at it, but his brow furrowed. The patient’s blood ammonia level was very high; this was what had caused her seizure.
Hyperammonemia is not a common finding in dical tests. When it is detected, it’s often related to the patient’s urea tabolism. For this reason, it also has another na: Urea Cycle Disorder.
However, this condition is a recessive genetic disorder. It was unusual for the patient to develop symptoms at her age.
Another possibility is a liver problem, because urea synthesis requires the involvent of six enzys. If there’s an issue with any one of these six, it will affect the synthesis process.
It’s similar to how so people’s faces turn red after drinking even a little alcohol; their bodies lack the specific enzy to process alcohol.
"President Liu, make an educated guess. Is it a genetic disorder or a liver problem?" Wang Chao asked.
"The probability of a genetic disorder is higher, I think. But we still need to see the CT results," Liu Banxia said.
"Often, during an acute phase, patients with a urea cycle disorder will show signs of cerebral edema. The patient’s fall while running today might have been caused by such edema."
Because this condition is quite specific, Liu Banxia and Wang Chao could infer a great deal just from the hyperammonemia. Of course, a definitive diagnosis would still require detailed laboratory tests.
"President Liu, have you figured sothing out?" Wang Chao asked, feeling a bit uneasy when he suddenly saw a smile appear on Liu Banxia’s lips.
"It should be a Urea Cycle Disorder. The patient is dieting, rember? During a diet, if one loses control, they might consu a large amount of protein in a short period."
"So, even though the patient has this genetic disorder, it only manifested now. Mm, that should be it. It seems it’s not too severe; it should be manageable with proper control."
Wang Chao was stunned for a mont, then shook his head, genuinely unsure what to say.
It was pretty much a certainty, even if it was just Liu Banxia’s prediction.No wonder this guy was so brilliant at diagnostics. His mind was always processing so much information, able to connect all the different possibilities.
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