Free Web NovelChapter 1041: Chapter 1041: Concurrent Pulmonary Embolism?
(Thanks for the rural guardian’s monthly ticket encouragement)
"I have to say, the food in your cafeteria is much better than ours," Shen Xinhao said with a smile.
"The price is also higher. What’s your cafeteria’s price, what’s our cafeteria’s price, money can’t be spent for nothing," Liu Banxia said.
"You really have to be careful later, I really don’t think that guy is anything good, he’s pretty ruthless. Last time there was a commotion in his home too, but fortunately, it didn’t succeed."
"Don’t worry, the infringement is so severe, he can’t escape criminal responsibility. As long as the girl can persevere, it’s just a matter of going through the procedures later," Shen Xinhao said.
"In the past, there weren’t many cases like this in our country, which might have something to do with the broader social environment. But that’s not the case now, everyone is very concerned about women’s rights protection."
"Liu Yiqing, so just eat happily. I really can’t let you go beat him up, if you do, both of us will get in trouble later."
"Ah, Captain Shen, it’s okay. I just feel that girl is quite pitiful, how did she encounter such a scoundrel," Liu Yiqing quickly said.
"Did she say, like last time, that I’m very powerful and have connections?" Liu Banxia asked.
"I didn’t say that, she just knew it herself, otherwise, she wouldn’t have come over. She just can’t figure out the relationship between emotions and hurt, so I tried to talk to her while doing the CT," Liu Yiqing said.
"You’re still single, yet you can be an emotional coach for others. Focus more on research and proficiency in your procedures, that’s the real deal," Liu Banxia said.
"Sigh... Sometimes I really wonder if we are also victims of workplace PUA," Liu Yiqing said seriously.
"Go ahead, report me," Liu Banxia didn’t care in the slightest.
"Dr. Liu, you really can tell me, I have the reason to take Director Liu for a tea chat," Shen Xinhao said happily.
"Sigh... I can’t really report. Although Teacher Liu is usually tough, after his ’torment,’ you really can learn things," Liu Yiqing said with a bitter face.
Liu Banxia rolled his eyes, "You really plan to report an issue, Captain Shen said drinking tea is just drinking tea."
"Eh? Really? Hahaha, on TV, they only take you for tea when you’ve done something wrong," Liu Yiqing said, laughing.
Shen Xinhao was amused, "I’ve realized, your place must be happy all the time."
"Finding joy in hardship, work is so busy and stressful every day. If we don’t find a way to relieve it, we’ll all break down over time," Liu Banxia said.
"By the way, we have so many good girls and excellent guys in our hospital, maybe you can help matchmake over your side too."
"That’s definitely not a problem, we have many singles in our team. However, many people don’t like our work. Always away from home, I haven’t been home for two days," Shen Xinhao said with a wry smile.
"We’re just a bit better than you guys, but it’s still more hectic than the inpatient department," Liu Banxia said.
"But it doesn’t matter, that’s just how fate works. Later, I’ll make a list, maybe we can really pair some up. Then we’ll let Ma Limin work her magic, it might work."
At this time, Liu Banxia’s phone rang. It was Xu Yino calling, and he quickly answered, "Is there new progress with that patient?"
"Yes, Teacher Liu, difficulty breathing, blood oxygen dropped to 92 and is trending downward," Xu Yino quickly said.
"Okay, I’m heading to the ward," Liu Banxia said and hung up the phone. freēwebnovel.com
"Captain Shen, I have to go, the patient is in trouble. Liu Yiqing, please keep Captain Shen company. Reheat my meal later and bring it back."
"Director Liu, you go handle your work first, it’s important. I’ll take care of that girl’s issue today, I’ll make sure it’s arranged properly," Shen Xinhao said quickly.
"Alright, I won’t be polite. If it’s not enough, order more, Manager Zhou here is also a good brother," Liu Banxia said and ran back.
"Dr. Liu, do you guys do this often?" Shen Xinhao asked curiously.
"We’re not as busy, but doctors like Teacher Liu are quite busy," Liu Yiqing said.
"This time, the patient being observed is in trouble, sometimes we have emergency patients coming in that need surgery. Manager Zhou, can you get me two boxes later, Teacher Liu left without finishing his meal."
"Sure, don’t worry about it," Zhou Qiang responded.
"Captain Shen, we can’t let that scoundrel get away, right?" Liu Yiqing asked again.
Shen Xinhao nodded with a smile, "Such a person is hated by gods and ghosts alike, rest assured."
It can also be confirmed, just like Liu Banxia said, this Dr. Liu is quite sincere. The communication with Liu Banxia was clear, but this girl didn’t get it.
As for Liu Banxia, he went straight to the ward.
The rapid drop in blood oxygen levels is extremely dangerous. It could potentially lead to respiratory distress syndrome, a condition with a high mortality rate.
"Teacher Liu, we’ve already given oxygen through a mask, and the blood oxygen level has returned to 94, but it’s still not very optimistic," Xu Yino said. fɾeeweɓnѳveɭ.com
"The blood pressure is a bit high as well. This might really be affecting the lungs," Liu Banxia said with a frown.
"Your husband’s current condition requires airway protection in advance. The current value is 94, but that’s the level after oxygen delivery and breathing assistance."
"When the value drops to 90, there’s a certain level of danger, indicating that the oxygen-carrying capacity in the blood is inadequate, affecting bodily functions."
"What we do for airway protection is non-invasive intubation, then connect him to a ventilator to supply oxygen directly to the lungs. If we wait until respiratory distress threatens his life, non-invasive intubation might be too late."
"Intubation, intubation, doctor, do whatever you can to save him," the patient’s wife said hastily.
Liu Banxia nodded to Xu Yino, suggesting they go ahead with intubation, focusing on managing the immediate issues and then addressing the respiratory distress later.
Xu Yino did not delay, administering succinylcholine and etomidate to the patient, then proceeded with intubation and hooked him to a ventilator.
There was some effect, as the patient’s blood oxygen level increased by 2, reaching 96.
Still, Liu Banxia couldn’t find much joy, as he listened to the patient’s lungs with a stethoscope, his frown deepening.
With the ventilator in use, the blood oxygen concentration was only this high, clearly indicating less than ideal lung condition.
"Doctor, is it still not okay? Didn’t the number just go up?" The patient’s wife, seeing his expression, also became worried.
"Although the value has improved, we haven’t resolved his underlying issue," Liu Banxia said.
"I suspect his pancreas has damaged other organs. We have two options for treatment right now: wait and see how his blood oxygen level changes—whether it continues to drop."
"If it keeps dropping, we’ll need to perform angiography on him. I listened to his breathing and didn’t detect signs of pneumothorax; based on his current presentation, it tends to resemble pulmonary embolism."
"However, in previous cases, acute pancreatitis concurrent with pulmonary embolism is not commonly seen. Let’s observe for a while; enhanced CT requires injecting contrast agent into the blood vessels, which is an invasive test."
Actually, he wished he could perform the enhanced CT on the patient immediately, but the current indications are not quite sufficient.
A plain scan chest CT could be done first, but Liu Banxia worried it might not reveal anything.
The patient’s current symptoms suggest acute respiratory distress syndrome; if there were pneumothorax or empyema, unilateral or bilateral pulmonary collapse, he could detect that through auscultation.
As for pulmonary embolism, judging this condition is complex; its manifestations vary based on the extent of embolism and the affected blood vessels.
Pulmonary embolism is indeed a major culprit in acute respiratory distress syndrome.
Right now, the patient’s vital signs are still stable, so Liu Banxia decided to observe a bit longer.
However, such situations demand communication with the patient’s wife in advance. Waiting for an emergency to discuss things leaves little time to respond effectively.
He also knew that given the patient’s current condition, it warranted sending him to the ICU.
The blood oxygen content is crucial; if it drops further and the cause remains unidentified, extracorporeal membrane lung might be necessary. It’s expensive, and Liu Banxia was trying to save the patient money wherever possible.
After observing for a few more minutes, with the patient’s blood oxygen levels remaining at 96, Liu Banxia felt somewhat relieved.
If he had failed to detect anything during auscultation and the patient indeed had pneumothorax or pulmonary collapse, failing to perform intubation and drainage but instead using the ventilator to keep forcing air would make the patient’s situation very dangerous.
Even though the true cause has yet to be identified, at least these two possibilities can be eliminated.
"Teacher Liu, should we go ahead and book an operating room? The patient seems to be in some pain," Xu Yino commented after observing for a bit longer.
"Let’s observe for one more minute," Liu Banxia said while scrutinizing the patient’s face.
The patient’s expression certainly was not ideal, but presently his blood oxygen level hadn’t dropped.
"Teacher Liu, blood oxygen is at 95 now," Cui Jia called out.
"Prepare to proceed, the ventilator hasn’t greatly improved his condition. Let’s perform an urgent enhanced CT; given the patient’s current blood pressure, we have room for maneuver," Liu Banxia affirmed.
He couldn’t persist any longer; the descending blood oxygen reading was an indication. Even though it had only dropped by one, it might fall quickly afterward.
If it truly was pulmonary embolism, one possibility is that blood clots in the patient’s pulmonary vessels are increasing.
Due to Liu Banxia’s prior discussion with the patient’s wife, obtaining her signature for consent was straightforward. After all, invasive examinations require the patient’s family’s consent.
