Chapter 1441: Decreased Instead of Increased Leukocytes

Chapter 1441: Chapter 1441: Decreased Instead of Increased Leukocytes

"Teacher Liu, Teacher Liu, that patient can be diagnosed now; there really is a frontal lobe tumor, and it’s quite large."

Liu Yiqing ran back.

"The indicators were too obvious; the likelihood of a diagnostic error in such a situation is very low," Liu Banxia said.

"So, this serves as a reminder not to let preconceived notions cloud our judgment. What we see and hear may not always be the true situation; we must observe carefully and form our own judgments."

Liu Yiqing nodded, acknowledging that there were indeed some preconceived notions regarding this patient.

People judged him as a lecher, a hateful, unremorseful lecher. So, they treated his symptoms as inherent expressions of a lecher.

If from the outset we had approached the patient objectively and considered his behavior as symptoms, the subsequent issues wouldn’t have occurred.

"Thinking too much again?"

Noticing Liu Yiqing’s thoughtful expression, Liu Banxia smiled and said.

"We’re ordinary human beings, so we naturally get influenced by normal thinking. I bet only a very few extremely calm people could directly diagnose the symptoms of today’s patient; anyway, I didn’t have that confidence."

"Teacher Liu, but you did diagnose it," Liu Yiqing said.

"That’s different. I noticed his subsequent actions and expressions, and then started considering this possibility," Liu Banxia said.

"So, don’t think I’m exceptionally skilled. It’s merely my experience of seeing more cases and pondering more, which allowed me to be slightly ahead."

"As for this patient, after he returns home today, his girlfriend will notice his abnormality and will take him back to the hospital."

"By that time, the admitting doctor will understand his symptoms, making diagnosis much easier."

"It’s just that our Liu Mingyue suffered needlessly this time; there’s no helping it. Next time you see her, you can offer some appropriate consolation."

"Remember, it’s appropriate consolation, not excessive comfort. Otherwise, she might feel even worse inside."

"Hehe, Teacher Liu, rest assured, I know the limits on this matter," Liu Yiqing said with a smile.

"By diagnosing the patient’s symptoms, she has made a great contribution; this has nothing to do with being bullied. Leave it to me, just a drizzle."

Liu Banxia laughed; everyone has their strengths. Liu Yiqing is indeed skilled in this area, and leaving it to her is genuinely reassuring.

"President Qi, there seem to be more patients today than usual."

Liu Banxia approached Qi Wentai.

"It’s the change of season, and people are dressing inappropriately, resulting in more cold patients," Qi Wentai said.

"The outpatient department is quite overwhelmed, so they’re all being directed to our emergency center. I feel the outpatient department should thank us; we’ve helped them by streamlining many patients."

"Ah..., this kind of situation is most common during season changes. Even the two little ones at my home are restless now, kicking blankets while sleeping, and they’re so young," Liu Banxia remarked.

"The fluctuating climate really harms people easily. Especially with the current unpredictable climate that feels erratic rather than gradual—either suddenly hot or cold."

"Exactly, even while on duty at the hospital during nights, it feels somewhat chilly," Qi Wentai said.

"Teacher Liu, are you busy now?"

At this time, Xu Yino walked over.

"What’s up?" Liu Banxia asked.

"I want to ask for your guidance with a patient I just admitted; I suspect they have signs of sepsis," Xu Yino said.

"What’s the specific situation?" Liu Banxia asked.

"A 32-year-old female patient voluntarily seeking medical attention, experiencing high fever, chills, aching limbs, cough, fatigue, dizziness; she self-diagnosed as having a cold and had taken antipyretics and cold medicine at home with temporary improvement," Xu Yino explained.

"Now her body temperature is 38.7°C, which is quite high. So, I did a complete blood count, blood biochemistry, blood cultures, and scheduled a chest CT to check for significant lung inflammation."

Liu Banxia nodded, "Considering the situation of this patient, your approach is correct. However, with coughing symptoms, generally, there’s also some upper respiratory tract inflammation."

"Has she had a history of medication, trauma, or chronic illness? In terms of the causes of sepsis, is there anything that can aid our auxiliary judgment?"

Xu Yino shook her head, "It started acutely, lasting only three days. From her current symptoms, I don’t think it’s a cold; it should be another disease, not excluding sepsis."

"Very good, you considered it quite comprehensively. Call me when the CT results are out; let’s first examine the lung condition," Liu Banxia praised.

"But I’m just viewing this; you all need to learn how to diagnose independently. Soon, you’ll have to truly take charge on your own, so keep working hard."

"Teacher Liu, I just feel a bit uncertain inside. And if it really is sepsis, the adjustment will be quite challenging," Xu Yino admitted.

"If the sepsis is caused by post-traumatic infection, it’s somewhat easier to trace. The real challenge is when mucosal damage allows bacteria into the bloodstream."

"Alright, just take the consultation boldly; I’ll be watching from the side," Liu Banxia said.

Even though he said this, he wouldn’t talk much during the upcoming consultation.

Xu Yino called him over merely to have some ’insurance’ during this consultation. However, as far as he’s concerned, the assurance might not be significant.

Seeing him agree, Xu Yino felt much more at ease. Although Liu Banxia might not value himself greatly, Xu Yino certainly does.

"Ah... truly as Wang Chao said, it won’t be long before we get washed away on the beach," Qi Wentai lamented.

"Before, when encountering a patient like this, I might have only considered severe pneumonia, without considering the possibility of sepsis."

"Things are different now; back then we dealt with so few patients, and now we meet so many in the emergency center every day," Liu Banxia said with a smile.

"I’ve encountered many conditions only after coming to the emergency center. If it were back when the emergency center had just been established, spotting a suspected sepsis patient would have made us very tense."

Qi Wentai also laughed; back then they indeed would be very nervous.

Now, however, they had become quite knowledgeable, having participated in many intense emergency rescues and witnessed a variety of critical conditions.

The medical profession truly requires ’courage.’ Particularly for emergency doctors, who nearly face life and death daily.

Without some courage, a person might collapse after one or two months.

Concerning Xu Yino’s recent handling, Liu Banxia also agreed wholeheartedly.

Although doing a blood culture might seem early, once you have a judgmental inclination, it’s not too early at all.

Moreover, the blood culture was conducted before administering medication. If done after antibiotics, the results wouldn’t be as effective.

This explains why some patients, clearly uncomfortable, aren’t given pain-relief medication. It’s due to the concern that medication might lead to misjudgment regarding their condition.

If this patient merely had ordinary fever symptoms, it would align with pneumonia. But upon reaching high fever levels, vigilance is required.

After waiting a bit longer, Xu Yino gestured to Liu Banxia.

"Are the results out?" Liu Banxia asked.

"The CT’s not ready yet, but the blood test results are out, and they’re a bit alarming. The white blood cell count is 2.7; is it truly dangerous?" Xu Yino said.

Liu Banxia furrowed his brow, "Let me take a look."

Xu Yino quickly stood aside to let Liu Banxia examine the results.

Normally, if the body has inflammation, the white blood cell count would rise. But for this patient, it’s the opposite; it’s falling instead.

What does this imply? It suggests the patient’s infection could be severe—severe enough to suppress her immune function, hence the decreased white blood cell count.

Given these circumstances, the patient’s pneumonia might already be severe, with a risk of respiratory failure at any moment.

"Aside from pneumonia, do you have any other considerations?" Liu Banxia asked suddenly.

"Besides pneumonia, sepsis and diseases of the blood and lymphatic system," Xu Yino quickly replied.

"Currently, this white blood cell count requires our attention. If there are issues in the patient’s blood and lymphatic systems, it could also lead to this situation."

"What tests should be done next?" Liu Banxia continued.

"Rheumatological immune tests should be supplemented, and, depending on the CT result, consider administering antibiotics," Xu Yino said.

Liu Banxia nodded, "Very good, I would arrange it the same way."

Xu Yino took a deep breath; she anticipated Liu Banxia would have targeted questions, so she was well-prepared, having considered potential avenues thoroughly.

Regarding this patient’s consultation, Liu Banxia felt gratified.

Xu Yino’s only shortfall was slight lack of confidence. If he were to consult, he indeed would arrange it similarly.

The current lowered immune level might be influenced by pneumonia or potentially by some special disease that just happened to overlap with the pneumonia outbreak.

Identical symptoms could correspond to numerous diseases, so during diagnosis, the elimination method is necessary. If no exclusion is possible, all possibilities must be considered.

From his perspective, although some time remains, the six protégés genuinely possess the capability for independent consultations.

In the future, peace of mind could be expected; just a bit more endurance is needed.