When the Doctor Uses A Hack

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Chen Cang stumbled his way to the Cardiothoracic Surgery Department at Dongda First Hospital.

He wanted to be admitted as a patient.

But he thought it over and couldn’t decide which department to go to!

Chen Cang really wanted to ask the Pain Management Department if they treated butt pain, but when it came 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 mentally 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 extremely anxious.

By the time he reached the department, it was already six-thirty. As soon as he entered, he saw San Bo immediately stand up!

"Chen Cang is here!"

Suddenly, Ge Huai pushed Chen Cang down into a chair, "Xiao Chen, awesome 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 something. 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 immediately stood up again, this time 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, Meng Xi walked in and said with a smile, "You’re here."

Chen Cang smiled, "Hello, Teacher Meng!"

Meng Xi nodded, "Sit down first. Dr. Ge, go and get the discharge notice for bed 12 ready. Also, the discharge certificate—family members of the patient will come early tomorrow to go through the procedures." @@novelbin@@

Chen Cang smiled, "I’d rather stay standing. Dr. Ge, let me handle the discharge certificate for you."

Ge Huai nodded, "Thanks, Xiao Chen."

After writing the discharge certificate, Meng 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 medication prescriptions had to be made.

This brings us to the medication prescribing practices in various hospital departments—generally, it’s customary to do major medication prescriptions twice a week.

"Major medication prescribing" means that if you’re going to prescribe medicine on Tuesday, you prescribe all the way through Friday, issuing three days’ worth of medication, along with long-term medical orders.

Temporary medical order modifications are also convenient; they can be changed out promptly if necessary.

This way, it’s easier for both the nurses dispensing medication and the doctors giving orders.

If you prescribe medication today and they prescribe more tomorrow, it disrupts the order of the department.

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 medical staff is essential.

It even directly affects every aspect of medical 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 Meng! Dr. Ge, it’s not good, the patient in bed 12 just fainted."

Upon hearing this, Meng Xi dashed towards bed 12!

Chen Cang also followed closely, and Ge Huai stood up, turned back, and grabbed the medical chart.

Bed 12 was the patient of Ge Huai and Meng 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 overwhelmed.

"Doctor! How could he just faint all of a sudden?"

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Meng 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 emergency department for an urgent consultation!"

...

Meng Xi instantly issued several medical 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, some 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 emergency situations like this is to rule out cardiac issues for cardiothoracic patients.

At this time, Ge Huai had already rushed in holding the medical record.

All the nurses were busy in an orderly manner.

While observing the patient, Meng 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 medical 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 time it was an aortic aneurysm excision, with no discovery of hepatitis, tuberculosis, etc."

After hearing this, Meng Xi said to the nurse testing the blood sugar, "What’s the urgent blood sugar result?"

Upon seeing the result, the nurse immediately said, "Blood sugar 9.8!"

Normal!

Meng 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, Meng 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, some 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 performed now, it would show if there was any cerebral hemorrhage, but at this moment, 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 Meng Xi’s eyes light up. Right... The most basic physical examination and neurological assessment had been overlooked.

Although it couldn’t completely rule out a cerebral hemorrhage, it was very close to certainty.

Sometimes, 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 methods.

The entire process seemed prolonged, but it actually took less than a minute!

And at that moment, the ECG machine had already been connected!

But before the ECG machine had time to print out the results, a nurse suddenly said, "Director Meng! It’s ventricular fibrillation!"

At those words, everyone’s complexion changed instantly!

Meng Xi was startled and quickly said, "Contact the emergency department, 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.