"Did the patient have a heart attack?!" Dr. Ma exclaimed in surprise, "That's impossible. The patient was under ECG monitoring and there was no obvious abnormality in the ECG."
If he really had a heart attack and found out through an electrocardiogram, how could the person on duty not see it and call the professor?
"No." Xie Wanying shook her head, "What I mean is, I'm afraid it's not the patient's original disease that caused this situation, but the complications after endoscopic treatment."
"What complication did you say?" Fang Xueqing and Dr. Ma anxiously asked her to explain clearly.
This is a technical issue related to internal medicine, which is very fatal. Besides, endoscopic treatment is much safer than surgical treatment. The most terrifying complication of endoscopic treatment should be massive bleeding or perforation, but now the symptoms of patients are as follows:
The physical signs do not support the occurrence of these two serious complications.
Xie Wanying said: "It's pulmonary embolism."
Fang Xueqing and Dr. Ma stared at her blankly for a while, and then looked at each other. As physicians, they had never heard of this complication.
"There are papers reporting such cases." Xie Wanying told them.
"Professor Fang?" Dr. Ma asked Professor Fang. He was completely unsure. Pulmonary embolism is extremely rare in clinical practice. As a young man, he had never seen it before, so he could only ask the professor if this patient's symptoms could be suspected of pulmonary embolism.
Fang Xueqing frowned. When it came to pulmonary embolism, she seemed to have never seen it before. She was a doctor in gastroenterology, not respiratory medicine or cardiothoracic surgery.
The most important thing is that there are extremely rare clinical cases that can be published as special case reports in journal papers. But they are indeed too rare and cannot be used to infer clinical practice. It can only be used as a reminder to remind clinicians that they may need to pay attention.
There are such special cases.
How to determine whether what Xie Wanying said is a guess based on random thoughts and associations from a paper? Some medical students who like to engage in research and research papers away from clinical practice are like this. They immediately become suspicious when they see similar cases in the clinic. This kind of medical students are in the eyes of clinical teachers
It was as if he was deliberately showing off his talents and showing off his skills, which the clinical teacher didn't like very much.
Guessing is okay, but it needs to be supported by evidence. Presuming that rare cases mean that patients need extra examinations. The expenses are all paid by the patient and the patient’s family. If the suspicion is wrong, the money is a waste. Once a medical dispute arises, the patient’s family will take it.
This is an attack on the doctor. Now that the patient and the patient’s family are already dissatisfied, are they going to perform random examinations on the patient? Fang Xueqing’s brows were so furrowed that she couldn’t untie them. Dr. Ma was waiting for her decision and sometimes looked at the family members outside.
Very anxious.
"Doctor Song." Fang Xueqing asked Song Xuelin's opinion again.
Song Xuelin said: "Do as Dr. Xie said."
Fang Xueqing's eyes flashed with surprise: "Do you support her opinion, Doctor Song?"
Dr. Ma was more anxious than anyone else and asked urgently: "If pulmonary embolism is suspected, what tests are needed? Should I be sent for CT immediately?"
It is too rare in clinical practice, and it is easy for doctors to suddenly forget the relatively remote knowledge points in textbooks.
"You can try taking a blood gas analysis first." Xie Wanying suggested, "The cost is not high, and the results are obtained quickly. In the case of acute pulmonary embolism, the patient's body is hypoxic and suffocated. The typical performance of blood gas analysis is that blood carbon dioxide and blood oxygen are evenly balanced.
Low. Such an examination report can be said to distinguish many diseases, and it is an important reference indicator. After there is data support, other examinations can be considered for further confirmation."