My Medical Skills Give Me Experience Points Chapter 1416 - 564: Holding Down the Fort, A False Alarm (Part 2)

It cannot be denied that Vice Director Hee is exceptionally skilled and possesses a wealth of experience. The presence of pink sputum serves as an indicator of hemorrhagic exudate within the lungs or actual bleeding. Apart from Director Xue Yan, the precise details of the surgery performed previously remain unknown to everyone else. Nevertheless, a considerable degree of trust is placed in Zhou Can's surgical proficiency. "The surgery was performed by me, and I am indeed more familiar with the patient's condition. Your decision, along with that of the other directors, to summon me for this matter is a very prudent one." Zhou Can offered a word of praise to the other party before continuing. "I've reviewed the medications administered over the past three days, and there are no particular issues. The patient's sudden onset of pulmonary edema is likely linked to his left pneumonectomy. To put it plainly, this type of postoperative complication is difficult to avoid entirely. Following the removal of an entire lung on one side, the reduction in pulmonary vasculature leads to an elevated intravascular hydrostatic pressure, and the capillary permeability also increases. A significant volume of fluid then seeps from the pulmonary capillaries into the alveoli, ultimately resulting in acute pulmonary edema." Zhou Can presented his pathophysiological analysis to the assembled doctors and nurses. When everyone is engaged in resuscitating various critically ill patients, it is, in itself, a collective process of learning and advancement. Each individual's medical knowledge, clinical experience, practical application of knowledge, and thought processes are distinct. By actively listening to others' perspectives, one can learn from each other's strengths and compensate for their weaknesses. This acquired knowledge can then serve as a valuable reference when encountering similar cases in the future. Some physicians, who are particularly adept, may even offer differing diagnostic and therapeutic opinions during case discussions, thereby pooling collective wisdom. This practice aids in preventing both missed diagnoses and misdiagnoses. Occasionally, when a patient in one department experiences a critical issue, a dozen or so doctors and nurses might congregate. Families might misunderstand this gathering, assuming it signifies an impending confrontation. However, this is rarely the case. Within the hospital setting, when medical professionals perceive a dangerous situation, it is highly uncommon for a dozen doctors to stand together facing the patient's family. This typically only occurs if the family has already resorted to physical aggression, prompting the medical staff to unite and protect their female colleagues, thereby preventing the family from continuing their violent actions. In the context of resuscitating critically ill patients, a large assembly of doctors and nurses signifies, on one hand, the profound importance they place on the patient's life. On the other hand, it represents the convergence of collective wisdom and strength to jointly undertake the life-saving effort. This collaborative approach also contributes to a higher success rate in resuscitation. "So, what is your plan now?" Reflecting on how she had nearly proceeded with ECMO solely to sustain the patient's life, Director Xue Yan felt a slight warmth on her face. When one panics, their thinking becomes disorganized. When their thinking is disorganized, clarity is lost. Just moments ago, witnessing the patient's condition rapidly deteriorate towards apparent imminent respiratory collapse, she had been genuinely frightened. The other attending physicians shared her anxiety. If this had been a typical patient who did not respond to an oxygen mask, they might have considered mechanical ventilation. However, this patient's situation was highly unusual, and everyone concurred that ECMO would be the safest course of action. At least, that was the prevailing sentiment at that particular moment. Even now, had Zhou Can not calmly analyzed the patient's condition for them and confirmed the absence of abnormal bleeding in the lungs or heart, attributing the issue to acute pulmonary edema, they would likely still be as nervous and anxious as before. Every doctor present possessed extensive experience in emergency resuscitation. They were keenly aware of the precariousness of a patient's life. Sometimes, one moment you are stable, and the next, you are simply gone. "I believe the patient's heart rate is still slightly elevated. Let's administer another 10 mg of morphine intramuscularly for sedation, followed by the use of cardiotonic and diuretic medications to manage the acute pulmonary edema. Furthermore, the infusion rate of crystalloids must be reduced; this is also somewhat related to the patient's sudden onset of acute pulmonary edema." As Zhou Can stated this, he glanced towards the head nurse. While doctors write the orders, nurses bear the responsibility and duty to review medications during their administration. If, during the course of nursing care, they had observed this patient more diligently and recognized early warning signs, promptly reporting them to the attending physician, the acute pulmonary edema might not have manifested so abruptly. Of course, ultimately, one cannot place the entire blame on the nurse. This is not something Zhou Can could openly articulate.

"Understood. For the upcoming nursing care, I will give this patient special attention."

She would not have earned the position of head nurse if she were incompetent.

The implication behind Zhou Can's words was instantly grasped by her.

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

Zhou Can was quite pleased with the head nurse's reaction.

What he desired was precisely a proper and conscientious approach.

There are only two head nurses in the monitoring ward; once one of them has spoken up, it's essentially a done deal.

"Director Hee, there is another aspect that requires careful consideration. When repositioning this patient, extreme caution is necessary. Following a pneumonectomy on one side, a progressive mediastinal shift can easily occur. Given the severity of this patient's pulmonary edema at present, the risk is even greater," Zhou Can added, giving further directives to the ICU's chief physician.

This Director Hee had only recently been promoted after the previous two chief physicians of the monitoring ward had departed. His academic designation is Associate Chief Physician, and he currently holds the post of overall director for the Cardiothoracic Surgery monitoring ward.

While he executes his duties with a fair degree of diligence and responsibility, his skill level doesn't quite measure up to that of the two directors who were recruited away.

Now that those two who left have returned, the position of overall director for the monitoring ward is no longer theirs to hold.

They are adults; one must face the consequences of their mistakes.

The lateral positioning of a patient after a unilateral pneumonectomy is a critical procedure.

One can visualize it in this manner: initially, both lungs occupy nearly the entire space within the chest cavity. Upon removal of one lung, a void is created.

Subsequently, the remaining lung on the opposite side may drift towards the center, potentially causing the mediastinum to shift its position.