My Medical Skills Give Me Experience Points

Chapter 1416 - 564: Holding Down the Fort, A False Alarm (Part 2)

It’s undeniable that Vice Director Hee is indeed very capable, and his experience is extremely rich.

The pink sputum indicates hemorrhagic exudate in the lungs or actual bleeding.

Aside from Director Xue Yan, no one else actually knows exactly how the surgery was done at the time. But everyone still has quite a lot of confidence in Zhou Can’s surgical skills.

"I was the one who did the surgery, and I am indeed more familiar with the patient’s condition. You and the other directors calling me over to handle this is a very prudent move."

Zhou Can gave the other party a word of praise, then continued.

"I looked over the medications for the past three days just now, and there’s no particular problem. The patient’s sudden onset of pulmonary edema should be related to his left pneumonectomy. Put bluntly, this kind of postoperative complication is unavoidable. After the entire lung on one side is removed, the reduction in pulmonary vasculature leads to an increase in intravascular hydrostatic pressure, and capillary permeability also increases. A large amount of fluid seeps from the pulmonary capillaries into the alveoli, ultimately resulting in acute pulmonary edema."

Zhou Can laid out his pathophysiological analysis for the doctors and nurses present.

When everyone is resuscitating various critically ill patients, it is in itself a process of learning and progressing together.

Each person’s medical knowledge, clinical experience, clinical application of knowledge, and way of thinking are all different. Listening more to others’ views lets you learn from each other’s strengths and compensate for weaknesses. The next time you encounter a similar case, it can serve as a very useful reference.

Some doctors who are more outstanding can even directly offer different diagnostic and therapeutic opinions during the case, pooling collective wisdom.

This helps prevent missed diagnoses and misdiagnoses.

Sometimes, when a patient in one department has a problem, a dozen doctors and nurses will gather around. The family doesn’t understand and thinks they’re here to start a fight.

That’s really not the case.

In the hospital, when doctors sense danger, they definitely won’t have a dozen doctors standing together confronting the patient’s family.

Unless the family is already attacking and physically assaulting people, and the doctors have to stand shoulder to shoulder to protect the female doctors and nurses, to stop the family from continuing their violence.

When resuscitating critically ill patients, a large group of doctors and nurses rushing in is, on one hand, an expression of how seriously they take the patient’s life.

On the other hand, it’s also about gathering collective wisdom and strength to rescue a life together.

This also helps ensure a higher success rate for resuscitation.

"So what’s your plan now?"

Thinking about how she had almost gone ahead with ECMO just to keep the patient alive, Director Xue Yan couldn’t help feeling a slight flush of heat on her face.

When you panic, your thinking falls apart.

When your thinking falls apart, you lose clarity.

Just now, seeing the patient’s condition suddenly deteriorate into what looked like imminent respiratory collapse, she really had been scared.

The other attending physicians were equally anxious.

If this were a regular patient who didn’t respond to an oxygen mask, they could still consider putting them on a ventilator. But this patient’s situation was very特殊, and everyone agreed ECMO would be the safest option.

At least at that moment, that was how it looked.

Even now, if Zhou Can hadn’t calmly analyzed the patient’s condition for everyone and told them that there was no abnormal bleeding in the patient’s lungs or heart, that it was just acute pulmonary edema, they would probably still be as nervous and anxious as before.

Every doctor present had rich experience in emergency resuscitation.

They were acutely aware of how fragile a patient’s life can be.

Sometimes, one second you’re fine, and the next second you’re simply gone.

"I think the patient’s heart rate is still a bit too fast. Let’s give another 10 mg of morphine intramuscularly for sedation, and then use cardiotonic and diuretic drugs to control the acute pulmonary edema. Also, the infusion of crystalloids must be reduced; this is also somewhat related to the sudden onset of acute pulmonary edema in this patient."

As Zhou Can said this, he looked toward the head nurse.

The orders are written by doctors, but nurses have the responsibility and duty to review medications when administering them.

If, in the course of nursing care, they had observed this patient more meticulously and noticed early warning signs, and promptly reported to the attending physician, the acute pulmonary edema might not have erupted so abruptly.

Of course, you ultimately can’t pin the blame on the nurse.

This isn’t the kind of thing Zhou Can could say outright.

"Understood. In the upcoming nursing care, I’ll pay special attention to this patient."

She wouldn’t have become head nurse if she were foolish.

She immediately understood the implication behind Zhou Can’s words.

"We’ll have to trouble Mr. Chang a bit more then! Once this patient’s condition improves, I’ll treat the sisters at the nurses’ station to milk tea."

Zhou Can was very satisfied with the head nurse’s attitude.

What he wanted was precisely a correct and serious attitude.

There are only two head nurses in the monitoring ward; once one of them has spoken up, that’s as good as a guarantee.

"Director Hee, there’s one more thing that needs attention. When turning this patient, you have to be extra careful. After a pneumonectomy on one side, it’s very easy to get a progressive mediastinal shift. Especially with this patient’s pulmonary edema being so severe right now, the risk is even higher."

Zhou Can then gave further instructions to the ICU’s chief physician.

This Director Hee was newly promoted after the two former chief physicians of the monitoring ward jumped ship. His academic title is Associate Chief Physician, and he is currently the overall director of the Cardiothoracic Surgery monitoring ward.

He does his work with reasonable diligence and responsibility, but in terms of skill level, he’s not quite on par with the two directors who were poached.

Now that those two who jumped ship have returned, the position of overall director of the monitoring ward no longer belongs to them.

They’re adults; when you make a mistake, you have to pay the price.

After a pneumonectomy on one side, the lateral position is a delicate matter.

You can think of it this way: originally the two lungs fill the intrathoracic space just about completely. Once the lung on one side is removed, a cavity is left behind.

At that point, the remaining lung on the other side can shift medially, which can lead to mediastinal displacement.