My Medical Skills Give Me Experience Points

Chapter 1243: Chapter 490: Drastically Different Fates, Touching the Threshold of Top-tier Diagnosis (Part 2)

Ali, after checking the patient’s vital signs, informed Zhou Can.

A doctor’s skill level isn’t necessarily linked to age; older doesn’t always mean better.

Once Zhou Can arrived, she clearly treated him as a guiding force.

"His blood pressure is evidently low. Has blood been drawn for testing? Once we know the blood type, we should have the blood bank prepare plasma. I suspect he will definitely need a blood transfusion and fluid replacement." Zhou Can spoke while continuing the physical examination of the patient.

A doctor’s skill level often manifests in attention to detail.

In conducting a physical examination, some might just run through the motions.

But a masterful doctor can diagnose and assess comprehensively through the patient’s complexion, spirit, demeanor, physical build, chest percussion, and more.

Normal blood pressure is typically around 120/80mmHg.

The patient’s systolic pressure has dropped to 90, which is extremely dangerous.

If a blood test is done, Zhou Can could even estimate the patient’s approximate blood loss based on hemoglobin levels.

The urgency now is to identify the source of the patient’s bleeding and find a way to stop it.

Otherwise, uncontrolled bleeding renders any blood transfusion futile.

"Blood has already been drawn and sent for testing!"

Ali, being an experienced doctor, is noticeably steadier than the younger Dr. Xie.

Zhou Can nodded and attempted to palpate the patient’s abdomen.

Bleeding of the digestive organs requires focused examination of the abdomen.

As the intestines and stomach are mostly situated within the abdominal cavity.

The patient’s abdomen was relatively soft, with no reaction when palpated.

No palpable lumps were detected in the patient’s abdomen.

However, active bowel sounds were audible.

As Zhou Can pressed below the patient’s xiphoid process, the patient immediately groaned in pain.

"Teacher Lu, please give me a disposable glove for a digital examination."

While speaking, Zhou Can picked up the patient’s hands and conducted a careful examination.

"Dr. Zhou, what specific aspects are you looking at when examining the patient’s hands?" asked a young female doctor standing beside Ali, who appeared to be just twenty-three or twenty-four years old, quite young.

This was a new intern recruited by the Emergency Department.

Due to interns frequently changing rotations, Zhou Can sometimes doesn’t bother remembering their names.

This young doctor was bold enough to ask questions in such a setting.

"Primarily looking for liver palms, spider angiomas, and clubbing of fingers, also checking for redness or swelling of finger joints and wrist joints. If you’re unsure what these signs correlate to, review your books after work and memorize them well. In clinical emergencies, there’s no time to look up information or consult books."

Zhou Can explained the purpose of examining the patient’s hands in a gentle tone.

Patients need urgent care now, so a detailed explanation isn’t possible at the moment.

New doctors will just need to frequently review textbooks and memorize information.

Medical students have tons of knowledge points to memorize; learning more while young will be beneficial. Later in their careers, they can apply these in practice and gradually retain them firmly.

A nurse handed a thin glove for digital examination to Zhou Can.

With it on, Zhou Can pulled down the patient’s trousers and performed a direct rectal examination.

For female patients, privacy might be considered, and the examination might be conducted in a different place. Male patients generally don’t receive such considerations.

When a life needs saving, there’s no room for modesty.

Everything a doctor does is aimed at saving the patient’s life.

Upon examination, Zhou Can discovered the patient’s sphincter was tense, with no internal or external hemorrhoids; the glove showed traces of dark red blood stains.

This basically rules out rectal bleeding.

If rectal bleeding were present, the stains on the glove would be bright red.

"Doctor Ai, should we first conduct an emergency chest X-ray and abdominal ultrasound for the patient?"

"I completely agree!"

Ali always shows strong support for Zhou Can in front of the family.

"I suspect the patient might have upper digestive tract bleeding. We’ll eliminate chest and abdominal cavity considerations first, then consider an emergency gastroscopy. Although he’s practically in shock now, judging by certain symptoms, the bleeding should have decreased. As long as plasma is ready, it should be relatively safe."

Zhou Can wouldn’t make unequivocal guarantees.

His Hemostasis Skill is now at Level 6, providing him significant diagnostic advantages.

He can somewhat understand the patient’s internal bleeding situation through various indicators.

He just conducted multiple physical exams to determine the approximate bleeding site, current bleeding rate, and volume. Precise evaluation isn’t possible, only rough estimation.

The patient was swiftly taken for examinations.

Accompanied by the intern who questioned Zhou Can.

The patient is already in shock, definitely not suitable for slow queueing. Such critically ill patients receive priority in all examinations and treatments.

The purpose of the Emergency Department is to save patients’ lives.

Ali took Zhou Can aside and whispered, "Dr. Zhou, I really have no confidence with this patient. Could we delay your time a bit? Once the patient’s condition stabilizes, you can head to the operating room, is that okay?"

She knows Zhou Can tends to stay in the operating room until after noon meals, sometimes not emerging for an entire day if extremely busy.

"Sure."

Zhou Can readily agreed.

Out of respect for an experienced colleague, denying her request would be inappropriate.

The blood test results quickly came back.