My Medical Skills Give Me Experience Points

Chapter 1376 546: The Most Dangerous Are Those Without Symptoms—Fog-Clearing Diagnosis (Part 2)

When the pain is severe, it can continuously spread to a certain region around and even radiate to a distant area.

For instance, like the example of treating a headache by focusing on the foot, it might be possible that a foot ailment is causing head pain.

Zhou Can started to press the patient's abdomen.

"Ow... pain, pain..."

When Zhou Can's fingers pressed the middle upper abdomen, slightly above the navel, there was initially no major reaction. Upon slightly increasing the pressure, the patient suddenly let out a distorted scream, his body tensed suddenly, and the veins on his neck bulged.

"It seems the real pain area is right here. Not in the superficial middle upper abdomen, but deeper in the abdomen. This is where the stomach and pancreas are located. The stomach is in the more superficial upper abdomen, while the neighboring pancreas is located deeper towards the back. Analyzing his symptoms, it seems more likely that the pancreas has an issue."

While analyzing the patient's condition, Zhou Can turned to the on-duty Dr. Xie.

"Has the patient's temperature and blood pressure been measured?"

During a physical examination, blood pressure and temperature are two very important reference points.

"Yes, temperature is 37.8 degrees, blood pressure is somewhat low, with a systolic pressure of around 80."

Dr. Xie had worked in the emergency department for more than a year, showing significant improvement compared to when he first started. At least after admitting a patient, he managed such details relatively well.

However, he belongs to the type of doctors who are dull and rigid during disease diagnosis, with a belly full of medical knowledge but unable to apply it flexibly.

The patient's temperature is mildly high.

Systolic pressure is lower than 80 mmHg, no wonder Dr. Xie seemed quite anxious.

Chest pain combined with low blood pressure, which immediately makes one think of aortic dissection.

The normal range of systolic pressure is between 90 and 140 mmHg, below this value is clinically considered low pressure. Above this value, it is called hypertension.

Relatively speaking, there are many reasons why low blood pressure may appear clinically.

For example, long-term malnutrition, thyroid hypofunction, or taking antihypertensive drugs, etc.

Low blood pressure combined with chest pain is particularly alarming, as nearly all emergency doctors would first suspect aortic dissection rupture, and internal bleeding.

Zhou Can possesses Level 6 Hemostasis Skill and Level 6 Pathological Diagnosis, offering certain advantages in diagnosing various forms of internal bleeding.

Through preliminary diagnosis, he believed that the possibility of massive internal bleeding was relatively low.

Many symptoms of aortic dissection rupture highly overlap with this patient, but that doesn't necessarily mean it's aortic dissection.

Clinically, there are numerous diseases with overlapping symptoms.

Assessing a doctor's diagnostic level depends on whether they can swiftly and accurately integrate numerous symptoms, conducting targeted examinations step by step for a patient, then filtering out those suspect diseases with high symptom overlap, eventually diagnosing the true cause of the condition.

It sounds simple, but achieving this is extremely difficult.

Almost all doctors spend their lives striving towards this direction, continuously learning, accumulating diagnostic experience. Ultimately, those who reach a high level are fewer than one in ten.

Benefiting from system advantages, Zhou Can can achieve in one or two years what would take others twenty or thirty years, or even longer, to reach, which is currently his greatest advantage.

Many doctors, after spending twenty or thirty years, may only raise their Hemostasis Skill to Level 6, but can't simultaneously elevate multiple other medical skills to that level.

This results in a certain bias in their diagnosis.

This inevitably leads to a narrow scope of knowledge.

Zhou Can, however, breaks this convention, simultaneously elevating multiple medical skills to Level 6 and beyond. It's equivalent to combining multiple chief physicians with over thirty years of diagnostic level, which is quite terrifying.

It's not just a simple one plus one equals two.

In fact, recently, he has been nearly invincible in emergency, pediatrics, and the Cardiothoracic Surgery Department, solving many difficult cases that were unresolved even after consultation by chief physicians. This illustrates how proficiently he handles multiple Level 6 medical skills.

Learning has no limits.

He hasn't stagnated because of this.

On the contrary, he's still striving to elevate various medical skills further, aiming to push them to Level 7.

At that time, though not claiming to be the world's top, domestically it would be hard to find an expert comparable to him.

Dr. Xie observed Zhou Can examining the patient but dared not urge him, only secretly anxious.

Good heavens, the patient's situation is already so urgent, and the symptoms highly overlap with aortic dissection rupture, yet Dr. Zhou is still pondering?

He truly is not anxious!

Neither Dr. Xie nor the nearby nurses dared to urge Zhou Can.

Without a chief physician present, Zhou Can is the absolute leader.

He is the highest-ranked doctor on-site.

Even if a resident physician is present, it remains the same.

"Feverish temperature, low blood pressure, severe pain deep in the middle upper abdomen..." Zhou Can frowned deeply, needing to quickly clear away the fog to find the true cause.

At least he needs a clear diagnostic direction.

If it's not aortic dissection rupture, but being checked as such would undoubtedly waste precious rescue time.

As everyone's patience gradually depleted, the family members eventually erupted.

"The patient is almost gone, can you get a more experienced doctor to treat them? Young doctors lack experience, dilly-dallying, and no results have come out, just wasting time. You're not anxious, but we, the patient's relatives, are anxious!"

Family members were very emotional.

"A bun's meat isn't in the folds. Just because a doctor is young doesn't necessarily mean lacking experience or skill. Dr. Zhou is one of the exceptionally skilled doctors in our department, currently focused on diagnosing your relative's condition. Please do not disturb him. Otherwise, delaying the patient's treatment isn't the result you'd want to see."

Jiang Wei stepped out again to defend Zhou Can.

She, like a shield, blocked the attacks and dissatisfaction from the family.

"Our chief is currently in the ICU rescuing a critically ill patient, as soon as the situation stabilizes a bit, he will rush over. Though Dr. Zhou appears young, he is no less skilled than the chief. Please have a bit more patience."

Dr. Xie also spoke up, supporting Zhou Can's image and status.

No one teaches such matters.

It's an automatically evolved skill through academic titles. Those who master it and apply it well can quickly attain promotion and heavy use, advancing step by step. Blockheads may remain at the bottom throughout their careers.

After soothing by the two, the family's emotions stabilized significantly.

While Zhou Can continued focusing on pondering the patient's true cause, he ignored the family's curse.

"Do you feel thirsty?"

He suddenly asked the patient.

"Hmm, I really want to drink water!"

The patient replied laboriously.

At this point, the patient's breathing became much faster, very heavy, causing deeper worry.

"When did you start feeling unwell?"

"I think I started feeling not quite right from when I woke up the morning before yesterday."

"Did you urinate today?"

"Not yet."

"Do you currently feel any urge to urinate?"

"Seems like no!"

After hearing the patient's answers, Zhou Can nodded.

"His pulse is thin, heart rate fast, mild fever, low blood pressure, severe pain deep in the upper abdomen long-lasting and worsening, even radiating to the back and shoulders. Accompanied by thirst and diminished urine, this suggests his pancreas faces a severe issue. Initial suspicion is acute pancreatitis, quickly perform a blood test for complete blood count, and also test fasting blood glucose. Then, promptly send him for an ultrasound to check an abdominal B-ultrasound."

With a diagnosis, Zhou Can issued a stream of orders like a commanding officer.

He quickly facilitated a series of laboratory and ultrasonic examinations for the patient.

"Turns out it's not aortic dissection!"

Dr. Xie listened and was utterly surprised!

Indeed, he hadn't anticipated Zhou Can's initial diagnostic conclusion to be acute pancreatitis.

Dr. Xie deeply felt the gap between himself and Zhou Can.

"If everything is set, proceed with examinations immediately, do not delay. You take the patient for these tests, once the results are in, immediately seek me or the on-duty chief physician."

Zhou Can is well aware of the considerably high mortality rate of acute pancreatitis and dares not be negligent.