When the Doctor Uses A Hack - Chapter 313:
Chapter 313: Chapter 314: Chain Quests
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As the system notification sounded, Chen Cang eagerly yet discreetly accepted the task, giving Meng Xi a calm look.
“Not bad.”
Meng Xi’s eyebrows lifted as he handed over the electrocardiogram, “Here, you analyze the patient’s condition.”
The First Hospital of Dongyang Medical University is not at the same level as the Second Provincial Hospital; it has many students, both interns and resident trainees, all abound!
And the emergency department is a special required rotation, which is why several curious onlookers were watching Chen Cang at the moment.
Chen Cang took the electrocardiogram and glanced at it once, just once, and then walked straight over to the patient, placed the stethoscope from around his neck to the patient’s chest and listened for a while before asking the patient, “Uncle, how long have you felt tightness and suffocation in your chest?”
The man cooperated, relieved it wasn’t a heart attack.
“Three days now, it felt odd out of nowhere, just after I attended a colleague’s son’s wedding. I caught a cold when I got back, had a bit of a fever, took some medicine, and the next day I felt a vague discomfort in my chest, a little chest pain. Still a bit feverish, I thought it was a cold from tiredness, so I didn’t pay much attention.”
“But… today, it suddenly got worse. I was worried it was a heart attack, so I came in. It’s chest pain, tightness, and now even breathing feels a bit labored.”
After listening, Chen Cang said, “Lie down, I’ll percuss you.”
The man cooperated and lay on the bed while Chen Cang started to percuss, asking if it hurt as he went along.
Two minutes later, Chen Cang finished percussing the precordial area and instructed, “Take a deep breath… yes, inhale… exhale…”
Suddenly, the man cried out in pain, “Ouch, ouch, it hurts!”
After a short pause, he slowly said, “I can’t, I can’t, it hurts when I inhale!”
Chen Cang asked the interns nearby, “Where are the lab results, the complete blood count, the cardiac enzymes?”
The resident trainee hesitated for a moment but then looked at Chen Cang with the same respect one would have for a teacher and quickly handed them over.
“Here, teacher!”
Chen Cang, not focusing on these details, opened them and looked carefully.
After looking at the chest x-ray, he seemed to understand everything at a glance.
As a doctor, the most important task is diagnosis, and now Chen Cang’s interpretation of chest images was perfect, electrocardiography perfect, clinical reading of physiological and biochemical test indicators perfect!
At that moment, probably no one knew the patient’s condition better than Chen Cang.
Chen Cang stated decisively, “The patient has an acute onset, accompanied by fever, chills, chest pain, breathing difficulties, and a clear pericardial friction rub. The complete blood count shows an increased white blood cell count with a left shift. The ECG shows significant changes in the ST segment and T waves. I looked at the chest x-ray, and the x-ray results show the heart’s normal outline disappeared, and the pulsations are faint.”
“So, I am ninety percent certain the patient has acute bacterial pericarditis, and there might even be purulent fluid in the heart. I felt this when I was percussing, due to the change in the dullness area.”
“The rapid heartbeat, difficulty breathing, these are signs of cardiac tamponade!”
His words left everyone stunned!
Logical and well-founded!
Every sentence made perfect sense!
And most importantly, every student present could understand. Chen Cang’s explanations were simple and easy to grasp, and each conclusion was substantiated.
Listening felt like unraveling a mystery, with each clue pointing to a reason that led to a certain outcome.
Surrounded by the group of medical students, one couldn’t help wanting to applaud!
So awesome!
Big boss is a pro!
A group of medical students really felt their blood surge with excitement.
Is Meng Xi awesome?
“`
Absolutely awesome!
He figured out it was acute pericarditis in just a few moments.
But everyone would just think it’s badass.
However, Chen Cang is different. He explains everything so thoroughly that students can actually learn something.
Clinical knowledge is just like that.
In fact, what this group of students didn’t know was that Meng Xi had done this on purpose.
After Chen Cang finished speaking, Ge Huai was also slightly taken aback. He could also tell it was pericarditis, but… perhaps not as clearly diagnosed as by Chen Cang.
But!
Ge Huai felt that Chen Cang could do this because Meng Xi had already mentioned it was pericarditis, and since Chen Cang was a student with a strong memory of book knowledge, he could articulate it well. It was the same as with suturing; he was a bit faster than Ge Huai, but… not as tight in his stitching.
Meng Xi was very satisfied with Chen Cang’s performance just now. Chen Cang had used all the diagnostic methods for acute pericarditis flawlessly, not missing a single one!
He even mentioned the possibility of cardioc tamponade in bacterial acute pericarditis.
The surrounding students looked at Chen Cang with eyes full of admiration!
However, Meng Xi suddenly asked, “What do you think should be done to treat the patient now?”
Chen Cang had been cramming basic knowledge recently and was very solid in theoretical knowledge.
“Firstly, the first step is to relieve the cardiac tamponade. The patient now has a lot of fluid in the pericardial cavity; the first thing to do should be a pericardial puncture to drain the fluid.”
“At the same time, test the nature of the pericardial effusion and conduct blood cultures to find the pathogen, then use antibiotics sensitive to the pathogen.”
“Finally, if relief is not possible, perform pericardiotomy!”
Meng Xi didn’t shower Chen Cang with excessive praise but simply asked, “Do you think you’d succeed if you did the puncture?”
Chen Cang’s eyes lit up. So, it was a sequential task. What would the final part be?
“I can do it!”
At this moment, the emergency department doctor Wu Peng returned, accompanied by the ultrasound department doctor pushing a cart inside.
“Director Meng, here we come!” Wu Peng said hurriedly.
The ultrasound doctor, often dealing with the cardiology department and having a good relationship with Meng Xi, knew Meng Xi’s personality.
So upon seeing Meng Xi, he didn’t dawdle but nodded and asked, “Director Meng, what’s the situation with the patient?”
Meng Xi replied, “I suspect bacterial acute pericarditis, and the patient shows signs of cardiac tamponade.”
The ultrasound doctor’s expression changed slightly upon hearing that. Cardiac tamponade?
This condition was no joke!
With this in mind, he quickly began the procedure.
The ultrasound was indeed very effective for this examination.
Soon enough, the results were in!
There was a significant amount of fluid in the pericardial cavity, already compressing the lungs and bronchi, causing a certain impact on breathing, and there was some compression on the heart as well.
Under echocardiography, the heart’s ejection fraction was already starting to drop.
The ultrasound doctor frowned. “Director Meng, we need to puncture as soon as possible!”
Meng Xi nodded: “Chen, you go ahead!”
