The Enhanced Doctor-Chapter 583 is not asthma

"The young woman was just a bit anxious; she likely didn’t have any malicious intent," Zhang Zhiyuan said.

"Our top priority is to figure out what’s going on. Shall we review the situation?" Liu Banxia asked.

"Considering Doctor Xu’s description, is the possibility of asthma quite low? Should we do an allergen screening?" Zhang Zhiyuan asked.

Liu Banxia furrowed his brow. "An allergy is impossible. The patient’s skin is clear, with no rash. Moreover, he only displayed respiratory distress during the onset. I believe the problem lies with the lungs."

Many things could cause acute respiratory distress, including lung inflammation, embolism, asthma, foreign objects, hemorrhagic shock, serious trauma, and blunt contusions; any of these could be the reason.

However, considering the patient’s current state, Liu Banxia felt confident that he could rule out both allergy and asthma. 𝐟𝗿𝐞𝚎𝚠𝐞𝚋𝕟𝐨𝚟𝐞𝕝.𝕔𝕠𝚖

If the patient had asthma, medication would have relieved the symptoms very quickly. The patient has been on medication for a considerable time, since yesterday.

In fact, he had even considered cardiac asthma. He had helped with a consultation for a young patient with that condition.

But for cardiac asthma, the medical history would typically be quite long because it’s usually a congenital disease. What about this patient’s condition? He has only started showing symptoms within the past month, and they suddenly worsened this morning.

He had previously treated patients with severe allergy-induced respiratory distress. However, allergic patients usually exhibit various other symptoms. If it were an allergy, this sudden severity would be unlikely; it would have manifested in his daily life.

According to the patient’s daughter, the patient’s day-to-day life at home was perfectly normal, with coughing being the only issue, which only worsened with exposure to irritating odors.

DING! Task issued: Mysterious Patient with Respiratory Distress

Open-ended task: As the patient’s condition cannot currently be determined, an accurate diagnosis and appropriate treatment cannot be given. The host needs to investigate further. Rewards will be based on the diagnosis.

Looking at the suddenly issued task, Liu Banxia felt a headache coming on.

With this current case, he felt he was at a dead end, with no ideas.

"How are the patient’s vital signs?" Xu Hui returned at that moment.

"They have returned to normal, with oxygen saturation up to 98%. Judging from the current situation, it appears to be a simple case of respiratory distress, but what exactly is causing it?" Zhang Zhiyuan asked.

Xu Hui looked at Liu Banxia again.

Liu Banxia shook his head. "I can’t make a diagnosis right now. Inflammation is certainly present, but could such mild inflammation paralyze the patient’s lung function?"

"Besides, the blood test results don’t support this. Although the white blood cell count is a bit high, it’s only slightly elevated, which is quite normal. When we catch a common cold, it’s about the same, right?"

"What’s going on? Why is Doctor Xu in such a hurry?" Xu Guosheng from Cardiology walked in from outside just then.

Liu Banxia handed over the blood test results and chest X-ray. "Sudden acute respiratory distress. Oxygen saturation once dropped to 85%, requiring intubation. Take a look and tell us what illness this might be. Give us your initial assessment."

"What game are you guys playing?" Xu Guosheng asked, half-joking, half-exasperated.

Seeing that the three of them remained silent, looking at him earnestly, he had no choice but to examine the results carefully.

"The blood test data is mostly normal. The inflammation in the lower right lung isn’t severe. Was this X-ray taken yesterday? Have you taken a new one?" Xu Guosheng asked after looking them over.

"It was taken last night. It wasn’t this severe during rounds this morning. It worsened shortly after," Xu Hui said.

"Did he choke on something he ate? No, if that were the case, you would have seen it during intubation. Besides an acute asthma attack, I can’t see what else it could be," Xu Guosheng said.

"Sigh... We initially thought so too. However, the patient’s condition didn’t improve even after administering bronchodilators since yesterday," Liu Banxia said.

"Then today, he experienced acute respiratory distress again. We were considering whether to do a plain CT scan plus a contrast-enhanced one. The patient’s daughter was quite agitated just now, so we need to be cautious."

Xu Guosheng furrowed his brows. "Let me check the patient first. Something doesn’t feel right."

Zhang Zhiyuan quickly led Xu Guosheng to the patient’s bedside.

"Banxia, thanks a lot. It’s nothing much, really. I was just a bit anxious seeing the patient’s oxygen saturation so low," Xu Hui said.

"Why are you being so polite with me? Your diagnosis and medication were perfectly fine; don’t feel burdened. Leave it to us. Rest for a few minutes, then continue your rounds. Don’t expect me to cover for you," Liu Banxia joked.

"Sigh... I really do want to follow up on this patient, but I’ll listen to you. Let me know immediately if there are any updates; otherwise, it’ll keep weighing on my mind," Xu Hui said.

Liu Banxia nodded and patted him on the shoulder.

Xu Hui had seemed a bit off. It wasn’t about being questioned by the patient’s daughter, but rather his demeanor after bringing the patient over. In the past, Liu Banxia wouldn’t have bothered with such things. Xu Hui was an experienced doctor; he should be able to manage his own emotions. But after Xu Chengjun’s advice yesterday, he felt he needed to do something. Letting Xu Hui regulate himself would take longer. Xu Guosheng’s initial assessment after seeing the test reports could alleviate a large part of Xu Hui’s anxiety. The patient just now was in critical condition. Even if he didn’t suffocate and die from respiratory distress, he might have ended up needing a cricothyroidotomy. It developed too rapidly; it flared up suddenly, and his blood oxygen dropped so much.

"This case is a bit complicated. There’s no visible rash on the skin, so it’s probably not an allergy. We can probably rule out asthma as well, right? Let’s do a CT scan; there are no other options. His vital signs are stable now, so let’s proceed directly," Xu Guosheng said after his observation.

"Alright, I’ll arrange it from my end; it’ll be easier. I’m just worried it might be a pulmonary embolism. If it is, Old Xu, you’ll take charge then, right?" Zhang Zhiyuan said.

Xu Guosheng nodded. "Sure, I’m not too busy today anyway."

"You two, please keep thinking. What if it’s not a pulmonary embolism?" Liu Banxia said.

"The patient’s daughter is emotional. If we still can’t get a confirmed diagnosis after these two tests, subsequent tests will be difficult to perform."

"If it wasn’t because the situation was urgent and we were still in the ward, I wouldn’t have pushed for transferring him to the ICU. As things stand, if we don’t have a diagnosis before noon, the patient’s daughter will be even more upset."

"I’m thick-skinned, so it’s nothing to me, but I’m afraid Brother Hui will feel burdened. He was a bit down just now, so we really need to try harder."

Xu Guosheng nodded. "Don’t worry. At worst, you can just call more people for a consultation."

Liu Banxia gave him a helpless look. "It would be best if we can resolve this internally. We have to push ourselves. I’m heading downstairs first. Don’t forget to tell me when the CT results are out. Right, how’s that patient with diffuse peritonitis?"

"He’ll have to stay here for a couple more days. He developed a postoperative infection, but his condition has improved a lot after medication," Zhang Zhiyuan said.

"Okay, thanks for your hard work. You’re our last line of defense; hold strong," Liu Banxia said.

"Wait, don’t go yet! Didn’t you say you were sending interns over? Why haven’t they arrived?" Zhang Zhiyuan asked.

"Tomorrow, they’ll be here tomorrow. Actually, I’m a bit reluctant. But as they say, ’nothing ventured, nothing gained,’ they also need to experience these things," Liu Banxia said and quickly slipped away.

"Seriously, our President Liu is truly busy every day," Xu Guosheng said with a smile, watching Liu Banxia’s retreating figure.

"He tricked me too, saying he’d add people here for me. Now I’m just hoping he’ll send the interns over for training. One person per week, with six people, that’s a month and a half, isn’t it?" Zhang Zhiyuan said.

"Don’t worry, he’ll definitely be willing to send them over. But don’t expect to poach any of them. Those six interns are already completely devoted to him," Xu Guosheng said with a laugh.

"He was off yesterday but was called to Jinshui District to perform a guest surgery. He came back today and brought a local griddle-cooked specialty from there, which made those interns incredibly happy."

"He dared to go?" Zhang Zhiyuan asked in surprise.

"It was through official channels. It’s hard work and doesn’t pay much. But he has a good relationship with them; anyone else would have found it difficult," Xu Guosheng said.

"Doctor Xu, isn’t it said that President Liu can be promoted to deputy director after he steps down from his current role? Will he make it?" Zhang Zhiyuan asked.

"That’s hard to say. It depends on the future staffing of our emergency center," Xu Guosheng said.

"From my perspective, if there’s only one deputy director position, it’ll be fine as long as Chen Xuehai from Cardiothoracic Surgery doesn’t compete with him. If there are two positions, then it’s even less of a problem."

"Of course, this is just within our emergency center. Hospital-level and external factors also need to be considered, so it’s quite uncertain."

"However, I believe that if the opinions of our emergency center staff were sought, no one would have any objections. With him around, there’s a lot of joy, and many matters can just be thrown his way, so we don’t have to worry so much."

Zhang Zhiyuan nodded. "That does seem to be the case. It’s been established for so long, yet the deputy director position hasn’t been filled."

"And our emergency center is doing very well right now. My feeling is that we’re not short of patients, but short of doctors. I heard that many doctors have reported for duty at the hospital’s inpatient department these past few days, so things might get a bit easier for us here."

"Let’s hope so," Xu Guosheng said. "But even though the pay and benefits are better here in the emergency center, everyone knows it’s exhausting, so not many are willing to come."

This is also a very realistic problem. If doctors were all willing to work in emergency, pediatrics, or the ICU, things wouldn’t be like this now.