My Medical Skills Give Me Experience Points

Chapter 1375 546: Asymptomatic Is Most Dangerous, Diagnosis Like Dispersing Clouds to See the Sun

When various critically ill patients are brought to the hospital, the situation often looks particularly frightening.

At least when Zhou Can first started his internship in the Emergency Department, five critically ill patients in near-death status were admitted in just one day.

"I remember your name is Xie Yu, right?" Zhou Can talked with the young nurse as they walked towards the emergency hall.

"I didn't expect you to remember my name, I'm so touched!" The young nurse was somewhat flattered.

Now, everyone in the Emergency Department knows that Zhou Can is a key figure in the department. He has strength, status, and a bright future. Though not everyone worships him, at least they have reached a consensus to treat Zhou Can as a heavyweight in the department.

"Let me tell you, patients who seem to have severe conditions like this aren't actually scary. What truly needs vigilance are those patients who don't seem so serious. For instance, pulmonary embolism, its onset is very quick, and death can occur within one or two minutes."

Zhou Can was advising the newcomer.

In the hospital, medical staff form a community of shared interests. Especially members of the same department; if one person gets into trouble, it could potentially drag down the entire department. So, even those doctors or nurses with reclusive personalities will take the opportunity to offer guidance to newcomers.

The reason why medicine can be perpetuated is precisely because of this spirit of being eager to teach others.

"Dr. Zhou isn't exaggerating at all. I still remember in my first year as a nurse, I was examining a patient under observation in the ward. The patient was very cheerful and talkative, actively chatting with me. His children were also by the bedside. I had just measured his blood pressure and found it was dropping. Obviously, the patient could still talk and laugh, showing no symptoms, so why was his blood pressure so low? I prepared to switch arms for another measurement. Suddenly, the patient convulsed, collapsed on the bed, his eyes rolled upwards, and he died quickly. We discovered later that there was an aortic dissection in his body, which ruptured."

Jiang Wei also shared her own growth experience alongside.

An aortic dissection, during its formation process, generally causes varying degrees of pain.

But some patients have a high tolerance for pain and don't care about the mild pains, making them easy to ignore.

Then there's the most terrifying kind of aortic dissection.

The time from formation to rupture is extremely short, with a near 100% mortality rate.

Unless it can be detected in advance and intervened, like placing a vascular stent to seal off the torn part of the vessel wall, not even a divine doctor could save them.

"I've been taught, and I will definitely be cautious in the future! I truly didn't realize asymptomatic patients could be the most dangerous ones."

The young nurse deeply agreed with what these two seniors said.

By this time, the three had arrived in front of the triage desk, where they saw a man of about thirty-four or five, lying pale on a stretcher.

It was clear he had been brought back by an ambulance as an emergency patient.

The patient was clutching his chest tightly, his face deathly pale, sweat had already formed on his forehead, and his hair was wet.

His expression was one of extreme pain.

Breathing seemed to be quite difficult.

Seeing Zhou Can approach, the on-duty doctor felt like he'd found a savior and quickly stepped aside to let Zhou Can examine the patient.

"Where do you feel pain?"

Zhou Can first checked the patient's carotid artery.

Encountering such patients with suspected chest pain, or patients who suddenly faint and fall, checking the carotid artery can yield a lot of diagnostic information.

For instance, the strength or absence of the carotid artery pulse can roughly infer the working status of the heart.

Some patients may also exhibit neck stiffness, which can have diagnostic significance for conditions like meningitis or neurological disorders.

"Here, the pain is severe! It also seems like the left shoulder and back are aching intermittently."

The patient's voice sounded weak, like he could expire at any moment.

Upon hearing this, Zhou Can tried pressing the indicated area on the patient's chest.

The patient merely groaned twice, with no significant reaction to the pressure.

Some patients have become numb to pain, so they don't even know where it hurts. They only know that a large area is very painful.

At this time, it requires a doctor to use their experience and medical knowledge to discern and finally pinpoint the real pain location.

Everyone knows that pain is actually a form of protection for the body.

Wherever it hurts indicates that the organ or body tissue in that area is undergoing severe pathological changes. The more intense the pain, theoretically, the more severe the pathological changes.

Moreover, if initially, there's only a bit of pain, and it continues for a long time with gradually intensifying pain, or if it's intermittent, this can generally indicate a chronic condition.

Only when the pain starts mild and quickly becomes unbearable, progressing swiftly from mild to severe pain, one should be wary.

These are typically acute pathological changes, often with a high degree of danger.

There's no need to mention chest pain or tightness, but even acute severe abdominal pain or headaches require special attention.

Such as common cases of cerebral infarction, cerebral hemorrhage, acute appendicitis, acute bowel perforation, etc., if not treated in time, it's easy to miss precious golden rescue time, ultimately leading to death or disability.

After pressing the patient's chest, finding no significant reaction to the pressure, Zhou Can had some reassurance in his heart.

It's very likely not cardiac pathology.

The on-duty doctor may have been a bit panicked after hearing about the patient's chest pain and vomiting.

Since the pain area isn't in the chest, it means the chest pain might be referred pain.