(Thanks to Shui Mi, mochax2, mangmangliu, Crushed Sorrow, Wolf Sky W, and Lazy Lost Bug for the monthly ticket encouragent)
"Pay attention, everyone. It’s been a long ti since we’ve had a formal morning eting. We’re not that busy today, so we should have a little chat."
Early the next morning, before making rounds, Liu Banxia gathered everyone.
"This is also to remind everyone: you must be extrely cautious when admitting patients with acute abdominal pain or chest pain," Liu Banxia continued.
"Among the patients admitted yesterday, one of our colleagues had a near miss. This isn’t about naming and shaming; this place is small enough that everyone knows what happened."
"I spoke with Dr. Shi about this yesterday. Right now, you still have the chance to make mistakes. But once you officially beco resident doctors, we won’t have as much ti to keep an eye on you."
"This topic is endless; if you’re interested, you can ask Dr. Shi for more information later. Now, back to our cases. Besides the unpredictable ergency patients with collision and fall injuries, there were two other cases yesterday."
"One was the patient who coughed so hard he damaged his lungs. He should be able to have follow-up tests today to determine if it’s asthma. The other was the young lady who loves bubble tea, diagnosed with hyperlipidemic severe acute pancreatitis."
"Just from its na, laden with qualifiers, you can tell this disease can be life-threatening. If Liu Yiqing hadn’t been more thorough yesterday and ordered blood chemistry tests for the patient, instead of just a simple CBC, can you imagine what might have happened?"
"If it were up to , I would still provide symptomatic ergency treatnt. Then the patient’s abdominal pain wouldn’t be relieved, the acute pancreatitis would worsen, and eventually, it would affect the surrounding organs."
"At that point, realizing sothing was gravely wrong, we would have transferred the patient to the ICU. Only after a comprehensive examination in the ICU would we discover what was really going on."
"I’m not saying you should run blood chemistry on every patient with abdominal pain. You must use your clinical judgnt and make appropriate choices based on each patient’s specific condition."
"I’ll say it again: be extra vigilant with patients complaining of acute abdominal pain or chest pain. The faster we diagnose, the more ti we can buy for our patients."
"Alright, that will be all for today. The Director will be back at work today. Don’t worry, I’ll be sure to praise all of you when I report on our work."
Seeing his gleaming white teeth, all the interns shivered in unison. One couldn’t take this arch-fiend’s words at face value. Who knew when he might be speaking ironically? He was a capricious arch-fiend; if you took him seriously, you’d lose.
It had indeed been quite so ti since they had a morning eting like this, as there were far too many patients coming and going in the ergency center.
Liu Banxia’s usual approach was to utilize any spare mont—perhaps during a lull in consultations or while eating—to have everyone discuss newly admitted cases.
Moreover, all doctors and interns in the ergency center were currently on duty, prepared for any major ergencies, which actually made patient handovers smoother.
Of course, this was only temporary. The interns were focused on learning, so sacrificing rest wasn’t an issue for now. People like Wei Yuan were also invested in the ergency center; after all, it was tied to everyone’s future livelihood.
This intense approach was manageable short-term, but if they continued this way indefinitely, everyone would eventually burn out.
People aren’t machines, where better oil ans less wear and tear. Even machines need maintenance and rest, don’t they?
After the morning eting, Liu Banxia leisurely strolled upstairs to Tang Feifei’s ward.
When he entered, Tang Feifei had already changed into the clothes she was wearing when she first ca for treatnt.
"Looks like you can’t wait to leave. Congratulations on overcoming your illness. Go ho and have a peaceful New Year. Is anyone picking you up?" Liu Banxia asked.
"Yes, Qiaoqiao is coming to get . Hehe, I don’t need to be formal with Qiaoqiao," Tang Feifei said happily.
"You two are really incredible. You’ve only known each other for such a short ti, yet you’re as close as if you’ve known each other for years. Whatever, I won’t ddle. Just have Qiaoqiao handle your discharge procedures," Liu Banxia said.
"Do you guys have ti to visit Beijing? Co find when you’re there," Tang Feifei asked.
"I can’t even think about taking ti off, let alone having so quality ti with Qiaoqiao at ho. I probably won’t get a decent break until the ergency center is truly running smoothly," Liu Banxia sighed, shaking his head.
"When you go back, please be mindful; don’t let my words go in one ear and out the other. I don’t want to go through the trouble of diagnosing you all over again."
"Well, if I feel unwell next ti, I’ll still co to you. You’re so skilled; you really should consider developing your career in Beijing," Tang Feifei said.
"I have several senior classmates in Beijing; it’s not all that different. No matter where you are, the work is the sa," Liu Banxia said.
"Alright, I’m going to take off now; you wait here. My parents are coming, and Qiaoqiao might not be able to get away early. Don’t forget the dical advice I gave you; it’s important."
Tang Feifei stuck her tongue out, understanding what Liu Banxia ant. She was torn now; she really wanted that role—it was an award-winning part!
Liu Banxia didn’t press further. There were too many non-compliant patients. While in the hospital, they took the doctor’s words seriously, but once they felt better, many tended to let the advice go in one ear and out the other.
"Oh, Director, you’re here! Any instructions?"
As soon as he returned to the first floor, he saw Zhou Shuwen’s office door open and hurried in.
"What instructions could there be? Do you only feel happy when I praise you?" Zhou Shuwen asked, smiling.
"Not at all!" Liu Banxia said quickly.
"Now that you’re back, I can finally relax a bit. I was losing sleep every night, worried we might encounter a major crisis. Xu Yino, Liu Yiqing, and Su Wenhao have already agreed to stay with us in the ergency center."
Zhou Shuwen nodded. "That’s good news. We need to focus more on their training. You’ve heard about my promotion to Deputy Chief Director, right? It will be publicly announced after the New Year."
"Hehe, I heard about it, though it’s a bit late; I only heard about this yesterday," Liu Banxia said, grinning.
"Alright, go back to work. You’ve done really well recently. After the New Year, our hospital should be able to bring in a new batch of doctors, which will also help support our ergency center," Zhou Shuwen said.
"So you went out to recruit people?" Liu Banxia asked, pleasantly surprised.
Zhou Shuwen shot him an exasperated look. "What else would I be doing out there for so long? These exchanges are also opportunities to discover and attract talent."
"Stop pestering and get to work. I can’t be bothered with these trivial matters. I’m quite tired from running around these past few days, so you’ll need to take on more responsibility."
"Then I’ll head out first. Call if you need anything. Actually, there aren’t that many patients now, so everyone can relax a little," Liu Banxia said, then sauntered out.
In his office, Zhou Shuwen shook his head helplessly. He hadn’t told Liu Banxia about his promotion to Deputy Chief Director earlier because he was worried Liu Banxia might beco too ostentatious. He couldn’t quite figure Liu Banxia out. He was a clever apprentice, but also a very troubleso one.
Just as Liu Banxia stepped out, he saw Wang Huan waving at him and happily went over.
"Given your expertise in internal dicine, help with a consult," Wang Huan said.
"The patient ca in this morning due to dyspnea. I perford an auscultation and a brief physical examination. I had just ordered a chest X-ray for the patient when he suddenly exhibited severe respiratory distress."
"I’ve taken blood samples for a CBC and blood chemistry, and I’ve also ordered a chest CT scan for a more accurate assessnt."
"What baffles is that communication with the patient during the physical exam was smooth, but then his condition suddenly deteriorated."
"If it were simple inflammation, it shouldn’t have progressed like this. I almost intubated him on the spot. Fortunately, using an Ambu bag significantly improved his condition, so he could proceed to the CT scan."
"This case is indeed challenging. He ca in for a routine visit and nearly beca an ergency intubation... but..."
BEEP. BEEP. BEEP.
The ergency center’s alarm suddenly blared, interrupting Wang Huan.
This alarm indicated a patient was in critical condition with no doctors imdiately available to assist.
Liu Banxia checked. The alarm had been triggered in the CT scan room, which startled him. He grabbed a pair of disposable gloves, pulling them on as he ran.
When he reached the CT room, he saw a male patient lying there while Xu Yino perford an auscultation.
"What’s the situation?" Liu Banxia asked.
"Teacher Liu, the patient is pale, with a rapid heart rate, muffled heart sounds, distended jugular veins, and difficulty breathing. I suspect cardiac tamponade," Xu Yino reported hastily.
Liu Banxia’s brow furrowed. "Get a large-gauge syringe and needle. We need to perform an on-site pericardiocentesis."
Xu Yino was montarily stunned but still ran to the ergency cart, found a large-gauge syringe and needle, and handed them to Liu Banxia.
Normally, pericardiocentesis must be perford under sterile conditions. Furthermore, imaging studies are typically required beforehand to determine the heart’s position and size.
However, Liu Banxia currently had no diagnostic data to rely on; he could only go by feel.
Moreover, due to the cardiac tamponade, the patient’s heartbeat had already slowed significantly, making it extrely difficult to palpate accurately.
The slightest misjudgnt could puncture the heart. Even if perford as an ergency life-saving asure, it would still constitute a dical incident, though his culpability might be lessened.
It wasn’t just Xu Yino who was tense; the surrounding patients and their families were also on edge, watching as the long needle was positioned over the patient’s chest. If he thrusts it in like that, wouldn’t it kill the man outright?
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