My Medical Skills Give Me Experience Points Chapter 1243 - 490: Drastically Different Fates, Touching the Threshold of Top-tier Diagnosis (Part 2)

After assessing the patient’s clinical signs, Ali provided an update to Zhou Can.

Clinical expertise cannot be measured by a doctor’s age; seniority does not guarantee superior capability.

The moment Zhou Can arrived at the scene, she deferred to him as the primary authority.

"His blood pressure is clearly bottoming out. Has the blood sample been collected? As soon as the blood type is confirmed, we must have the bank get plasma ready. I suspect he will require both a transfusion and fluid resuscitation," Zhou Can remarked while maintaining his physical examination of the patient.

A physician’s true proficiency is often reflected in their grasp of minute details.

During a physical assessment, some might perform a superficial routine.

Conversely, a truly seasoned doctor can synthesize a diagnostic assessment through the patient’s general appearance, mental state, demeanor, body habitus, chest percussion, and more.

A healthy blood pressure reading is usually near 120/80mmHg.

With the patient’s systolic pressure plummeting to 90, the situation has become critical.

Once the lab results arrive, Zhou Can will be able to calculate the approximate volume of blood loss by checking the hemoglobin levels.

The immediate priority is to locate the source of the hemorrhage and secure it.

Failing to stop the bleeding renders any transfusion strategy futile.

"Blood has been drawn and is currently undergoing analysis!"

As a veteran doctor, Ali displayed far greater composure than the junior Dr. Xie.

Zhou Can gave a nod and proceeded to palpate the patient’s torso.

Since the stomach and intestines are contained within the abdominal cavity, any gastrointestinal bleeding warrants a focused exam of that region.

The patient’s abdomen felt soft to the touch, and there was no guarding upon pressure.

Palpation revealed no abnormal masses.

However, the patient exhibited active bowel sounds.

A sharp groan escaped the patient when Zhou Can applied pressure just beneath the xiphoid process.

"Teacher Lu, I need a disposable glove for a digital examination."

While issuing the request, Zhou Can took hold of the patient’s hands to inspect them closely.

"Dr. Zhou, what specific signs are you checking for by examining his hands?" inquired a young female doctor standing near Ali. She didn't appear to be more than twenty-three or twenty-four years of age.

She was a fresh intern assigned to the Emergency Department.

Due to the frequent rotation of interns, Zhou Can often failed to memorize their names.

This junior doctor possessed the courage to pose questions even in such a tense environment.

"I am checking for signs like hepatic palms, spider angiomas, and digital clubbing, as well as checking for inflammation or swelling in the finger and wrist joints. If you don't understand the pathological correlation of these signs, study your textbooks thoroughly after your shift. In an emergency, we don't have the luxury of consulting references."

Zhou Can explained the diagnostic reasoning behind his hand examination in a calm voice.

Given the urgency of the patient's condition, an elaborate lecture was not feasible.

Novice doctors simply must make a habit of reviewing their textbooks to solidify their foundational knowledge.

Aspiring physicians have a vast amount of information to master; learning early in their journey is beneficial, as they will eventually integrate these details into daily practice.

A nurse provided a thin glove, and Zhou Can donned it for the digital exam.

He then lowered the patient’s trousers to perform a rectal assessment.

While privacy is typically prioritized for female patients, such conventional standards are often bypassed for males in dire situations.

When a life hangs in the balance, etiquette is secondary.

The entirety of a doctor’s focus must remain dedicated to the patient’s survival.

The exam showed that the patient’s sphincter was tight, and while no hemorrhoids—internal or external—were found, the glove was marked with traces of dark red blood.

This outcome effectively excluded lower gastrointestinal bleeding.

Had it been an active rectal hemorrhage, the residue on the glove would have been bright red.

"Doctor Ai, should we proceed with an emergency chest X-ray and abdominal ultrasound?"

"I completely concur!"

Ali consistently demonstrated unwavering support for Zhou Can in the presence of relatives.

"I suspect an upper gastrointestinal bleed. We will clear the chest and abdomen first, then weigh the necessity of an emergency gastroscopy. Even though he presented in shock, certain indicators suggest the bleeding has slowed. Provided we have the plasma ready, the prognosis should be relatively stable."

Zhou Can opted not to offer any guarantees.

With his Hemostasis Skill reaching Level 6, he possessed a distinct diagnostic edge.

Through various physical indicators, he could form a reasonably accurate mental picture of the internal bleeding.

His series of physical exams allowed him to approximate the site, rate, and volume of the bleeding, though an exact measurement remained impossible.

The patient was swiftly transported to diagnostics.

The inquisitive intern accompanied them.

Because the patient was in shock, there was no time for standard queues; critical cases are given priority for all diagnostics and therapies.

The primary mission of the Emergency Department is the preservation of life.

Ali pulled Zhou Can aside and murmured, "Dr. Zhou, I feel quite uneasy about this case. Would you mind delaying your other tasks? Once this patient reaches a stable state, you can head to the theater, would that be acceptable?"

She was aware that Zhou Can often remained in the operating room until well past lunchtime, occasionally staying for the entire day if the workload was heavy.

"That is fine," Zhou Can readily agreed.

Refusing a request from a veteran colleague out of professional courtesy would have been improper.

The laboratory results arrived shortly thereafter.