The Enhanced Doctor

Chapter 1222: Chapter 1222: Young Hypertension Patient

(Thanks to mangmangliu and Yang Zhong for their monthly ticket support)

"Teacher Liu, there’s an epileptic seizure, I just gave some Valium, but I’m afraid it’s a delayed subdural hemorrhage."

Just running into the emergency room, Miao Rui hurriedly said.

"Open intravenous access, prepare for intubation, 20 units of Etomidate, 100 units of Succinylcholine." Liu Banxia said as he ripped open the intubation package.

"Teacher Liu, Valium seems to be ineffective." Miao Rui stated.

"200 milligrams of Phenobarbital, intramuscular, Mannitol." Liu Banxia responded.

His heart was equally anxious; in this situation, the patient needed to be quickly sedated to relax the muscles for intubation.

"It’s taking effect."

Pressing down the patient, Miao Rui shouted, quickly laying the patient flat.

Liu Banxia didn’t hesitate, forcefully opening the patient’s mouth and directly intubating.

Ding! Emergency task completed

Experience gained: 20 points

"How’s the situation?"

At this time, Xiao Jun, the neurosurgery attending physician, also rushed over.

"Walking and speaking were normal, and suddenly there was an epileptic seizure, suspecting delayed subdural hemorrhage." Miao Rui quickly explained.

"Damn, another case? Directly push to the operating room." Xiao Jun also seemed anxious.

It’s indeed perilous with subdural hemorrhage; even pushing to the operation room now, it’s uncertain if time will suffice.

Yesterday there was just one case, still lying in the ICU, and today another one without any warning.

The patient was pushed away, and Liu Banxia flexed his wrist a bit after the struggle during intubation.

Even with medication, the muscles were overly tense. But fortunately, the drugs were effective, which was better than nothing.

At least there was a chance for rescue; otherwise, with continuous seizures, intracranial pressure could directly send the patient away, making on-site craniotomy futile.

"What’s up with this guy, two cases in two days." Qi Wentai remarked.

"Oh... it’s been really distressing for me. But perhaps yesterday’s situation paved the way, so today’s Miao Rui shouldn’t be influenced." Liu Banxia said.

"Doctor Peng, are you busy now? If not, come over for a chat. We need to discuss some issues; things can’t go on like this."

"Is it related to the patient who was just pushed away?" asked Peng Bo as he approached.

Liu Banxia nodded, "Do you have any other methods to deal with delayed subdural hemorrhage? Standard procedures are somewhat time-consuming now. I’m just worried the patient can’t wait, so even somewhat risky methods might be worth trying."

"There’s no other way, unless for on-site craniotomy." Peng Bo said calmly.

"Plus, it also depends on the bleeding volume; if the bleeding is significant, there’s essentially no chance for rescue. Intracranial pressure is so high that during craniotomy, brain tissue might be forced out."

"Just like when you encounter massive organ bleeding in general surgery, no matter how fast, rescue is unlikely. The reasoning is similar; it’s not about speed but patient luck."

"We’re just doctors, and our procedures require time; unlike machines, you can’t just press a switch. How was your patient? Did ventricular fibrillation occur?"

Liu Banxia shook his head, "Quite lucky, I used Valium and Phenobarbital, then gave Etomidate and Succinylcholine; eventually got the seizures under control."

"Also administered Mannitol, hoping it’s timely. Otherwise, facing such patients, how about we directly hang Mannitol for prevention?"

"Regarding this matter, it depends on the approach." Peng Bo said with a bitter smile.

"In theory, it’s for the patient’s benefit, but these aren’t one or two cases; we encounter many daily. If we keep using Mannitol, what would others think?"

"Moreover, if the bleeding volume is significant, Mannitol is useless. If small, Mannitol works well and can buy us more surgical time."

"Your patient, I’d judge a high probability of successful rescue. If ventricular fibrillation occurred, it’d signify intracranial pressure at a terrifying level."

"You ponder over it; everyone fears delayed subdural hemorrhage, but over the years, any solutions devised?"

"Oh... truly distressing." Liu Banxia sighed.

He also understood the situation; delayed subdural hemorrhage is utterly unpredictable. By the time you notice it, the condition has already progressed significantly.

Rescue by doctors is only one aspect; successful rescue is dictated primarily by the patient’s bleeding circumstance.

Treatment methods are consistent, mature, and truly depend on patient luck.

Such extensive bleeding scenarios are rare, but encountering two in succession is certainly frustrating for everyone.

"This also shows that with the increase in intake at our emergency center, various emergencies also become more frequent." Qi Wentai mentioned.

"Regardless, yesterday’s patient rescues left a deep impression on me. Studying these details more could indeed be beneficial."

"Especially intubation not clear in view; mastering it might negate the need for cricothyrotomy, reducing patient harm."

"That primarily depends on the feel; using finer soft tubes for trials could work." Liu Banxia stated.

"But it’s not recommended for everyone to do it this way. If done well, it can save the patient. If not, you might end up being responsible, and then there will be many issues."

"Actually, thinking about it now, being a doctor is truly tiring." Peng Bo sighed.

He is an internist, which is relatively better.

Although he sometimes has to participate in emergencies, fortunately, it’s not often. Most of the time, the cases are referred to the catheterization lab, and such operations are quite easy.

But Liu Banxia and the others are different. They receive patients every day, constantly facing many tough situations, keeping their spirits tense at all times.

Just like the situations today and yesterday, these were events with very low probability, and yet there were two cases.

If they were indeed knocked unconscious, after the physical examination, they would be given an urgent head CT to check the situation.

But these two patients? They can both talk and walk, showing no abnormalities.

This is the terrifying aspect of delayed subdural hemorrhage.

But no matter how frightening it is, if you work in this field, you have to face it.

"Okay, don’t overthink it, there really are no shortcuts." Peng Bo reassured.

Liu Banxia nodded, "Looks like I’ll have to keep working hard, there’s no other way."

"Are you on duty this Spring Festival?" Peng Bo asked.

"Yes, what other choice is there? Actually, this year I really want to go home for the New Year." Liu Banxia replied.

"Last year, I was the hospital resident, and this year, I’m the deputy director and the head of the second department, making it hard to go home. After the holiday, I’ll have to give Xu Yino and the others some time off."

"Ever since joining the Second Hospital, it’s been continuously intense. They also need a break from. Balancing work and rest, otherwise, I worry they might get exhausted."

"During dinner yesterday, Chief Director Xu mentioned that the only relief this year is not allowing fireworks, which reduces the pressure of admitting such patients."

"Just like last year, the few kids were terribly injured by the explosions. It looks pretty and is fun to play with, but it’s too dangerous."

"Alright, if there’s nothing else, I’ll go back and organize the medical records." Peng Bo said.

They can’t just chat idly with Liu Banxia, as there’s still plenty of work on hand.

Liu Banxia thought for a moment and decided to call the operating room.

The feedback information was reassuring; nothing unexpected happened during the transfer, and intracranial pressure was managed.

The bleeding situation wasn’t as severe as everyone imagined.

That’s considered good news; barring any accidents, the patient’s life should be saved. There might be some sequelae, but they won’t be severe.

This is a successful treatment.

"Teacher Liu, please take a look at this patient; it’s a Colles’ fracture of the wrist."

At this moment, Huang Bo called out.

"How did it happen? Have you notified the parents?" Liu Banxia walked over and asked.

The patient isn’t very old, probably around sixteen or seventeen. This requires a guardian for bone setting, casting, and observation for a period.

"We went to the supermarket. While shopping, I couldn’t hold on and fell. No need to call the parents; we have enough money." The young man said gruffly.

Liu Banxia frowned slightly, it seemed this young man had a minor disagreement with his friends.

But what caught his attention was the young man’s complexion, which was somewhat flushed, indicative of being angry, often leading to elevated blood pressure at such moments.

Just as he was about to give a reminder, Huang Bo had already brought the sphygmomanometer and began measuring the patient’s blood pressure.

He was quite satisfied as it seemed they had just received the patient, noticed the fracture, and called him for manual reduction, saving trouble for the orthopedic doctors who were quite busy lately.

"I’ll take a look, but it might hurt a bit."

Liu Banxia said as he began a careful examination.

"My gosh, your blood pressure is high? Do you feel dizzy or have a headache? Did you hit your head when you fell?"

Before he finished examining, Huang Bo interjected.

"What’s the blood pressure?" Liu Banxia asked.

"150/90." Huang Bo quickly answered.

Liu Banxia frowned, if this blood pressure was observed in a slightly overweight adult, it would be considered normal. But this is a young man, even if he’s angry, the reading is abnormal.

"I fell against the shelf, feeling a bit dizzy, but it’s not serious."

The young man’s words made Liu Banxia’s heart skip a beat.

"Teacher Liu, shall we do a CT first? There’s time for the reduction." Huang Bo suggested.

Liu Banxia nodded, "Okay, go ahead and do it, and monitor his blood pressure."

He certainly didn’t want another case of subdural hemorrhage today.

Visit and read more novel to help us update chapter quickly. Thank you so much!