Is there no limit to this doctor's skills?

Chapter 196 Unsolvable Talent!

The beds in the emergency room have gradually become more evenly spaced.

Many of the beds have been reduced, and the previously haphazardly arranged beds have been returned to a parallel layout.

Therefore, Guo Ziyuan was able to travel quickly.

When the patient was yelling earlier, Professor Ning Sanlong moved closer to him.

Before he could even get close to Guo Ziyuan, Guo Ziyuan dropped his water cup and ran away, which made Ning Sanlong instinctively quicken his pace.

Based on Ning Sanlong's understanding, Guo Ziyuan was a very cautious person, and his sudden departure must not be for a trivial matter.

Guo Ziyuan quickly walked to a hospital bedside and then carefully touched her neck with his hand!

A nurse was nearly knocked over by Guo Ziyuan's sudden intrusion. She twisted her body to avoid him and then wiggled her hips to straighten herself.

"Dr. Guo, what's wrong?"

Guo Ziyuan was among the top-tier doctors and nurses in the emergency room.

The older nurses judged Guo Ziyuan by his abilities, while the younger nurses judged him by his appearance.

And he's still single.

Such surgeons are highly sought after by nurses.

The patient was a woman in her forties, of medium build!

She was startled by Guo Ziyuan's sudden movement: "Doctor..."

"Don't speak yet, let me examine you." Guo Ziyuan's voice was deep.

"Give me the stethoscope." Guo Ziyuan asked the nearest internist for the stethoscope.

Guo Ziyuan is a trauma orthopedic surgeon!

Trauma orthopedic surgeons never use the term "stethoscope"...

Xie Lili is an attending physician in the emergency internal medicine department and is 29 years old this year.

She pointed to herself in confusion.

"Dr. Xie, may I borrow your stethoscope? Excuse me." Guo Ziyuan nodded to Xie Lili again.

Xie Lili then removed her stethoscope; she was reviewing the patient's examination report.

Continue to focus on the examination report, with your hand outstretched to the side.

In fact, Xie Lili's thoughts were somewhat scattered at this moment.

She would steal a glance at Guo Ziyuan, and her speed in reading the medical report slowed down.

However, Xie Lili's looks are average, and she knows that Liu Lingli is pursuing Guo Ziyuan.

Xie Lili thought to herself, comparing herself to Liu Lingli.

She has no advantage in terms of looks, family background, or age.

Therefore, Xie Lili usually doesn't dare to joke about Guo Ziyuan.

No one would know that she actually has feelings for people; she's not the kind of girl who passively waits for blind dates.

Of course, none of this matters.

Treating patients is the most important thing.

Physical examination includes visual and tactile stimulation and visual and auditory percussion.

Visual palpation is a physical examination method used in orthopedics, while visual and auditory percussion are routine physical examination methods used in medicine.

Guo Ziyuan did not choose the standard order. After taking the stethoscope, he pulled up the bed curtain with one hand to cover everything.

Guo Ziyuan explained cautiously, "Auntie, I need to perform a heart and lung auscultation on you."

"It's urgent."

The woman's lips were a normal color, and her breathing and heartbeat were normal. She nodded and said, "Dr. Guo, it's nothing."

What's wrong with me?

Guo Ziyuan: "Please let me finish listening to the auscultation first, thank you."

"I'll tell you later."

"Oh, okay." This auntie has a gentle temperament and is not the anxious type.

He could see the respect others had for Guo Ziyuan, so he naturally chose to believe in Guo Ziyuan.

Guo Ziyuan then began to probe the patient's body surface extensively with the stethoscope.

In fact, what Guo Ziyuan just saw was a distended jugular vein.

Of course, the degree of jugular vein distension was not that extreme, which means that this aunt's symptoms had not reached a particularly extreme level.

Therefore, at this time, a simple examination can be used to locate the actual lesion!

If the lesion can be found before things like right heart failure or complete pulmonary embolism actually occur.

It is possible to successfully reverse a person's symptoms without going through a life-or-death race.

Unlike patients who develop symptoms and are searching for lesions, Guo Ziyuan began searching for lesions only after observing signs, without any symptoms appearing.

Ning Sanlong approached, and Guo Ziyuan simply pointed at the patient's jugular vein!

Ning Sanlong understood everything instantly and immediately began giving medical orders: "ECG monitoring, oxygen administration, monitor blood oxygen levels."

"Indwelling intravenous line, for future use."

"Bedside ECG, prepare for venipuncture!"

"Director Liu, thank you for coming over."

Liu Yuenan is currently explaining to Liu Yifan, the associate chief physician of internal medicine, how to determine the specific level of lactate...

She only got halfway through her sentence before dropping the order she was holding.

Guo Ziyuan was having a physical examination when she saw it.

"What's wrong... Professor Ning?" Liu Yuenan asked.

Ning Sanlong picked up his phone and pointed a finger at the middle-aged woman's neck.

He didn't reply to Director Liu Yuenan, but instead said to the middle-aged woman, "Sister, I have a favor to ask."

"Your symptoms of early-stage jugular vein distension are quite obvious. Could I take a picture to use as teaching material?"

"Don't worry, there won't be any images of your private parts or your face."

"Right here, I'm just filming here!"

The middle-aged woman was actually a little angry.

What's wrong with me? You're taking pictures of me while you're examining me.

But she saw Professor Ning Sanlong's sincere, even pleading, longing gaze and nodded mechanically.

"Professor Ning, go ahead and take the picture."

"Don't scare me, what's wrong with me?" the woman asked.

Ning Sanlong wasn't frowning or in a great hurry, and Guo Ziyuan wasn't running around like before.

Her panic subsided slightly.

Ning Sanlong lowered his head and carefully adjusted the camera position: "We are still investigating. There are many reasons for jugular vein distension."

At that moment, Liu Yuenan, the director of the internal medicine department, approached.

Guo Ziyuan had just finished listening to the patient's right lung.

After that, Guo Ziyuan did not listen to her heart again.

A true expert in performing physical examinations does not need to strictly and cautiously follow the order of heart and lung examinations.

While examining the right lung, Guo Ziyuan also listened to the heart!

This is not a heart problem.

Guo Ziyuan returned the stethoscope to Xie Lili and looked at Ning Sanlong: "Professor Ning, the lung sounds of this patient are very rare and typical."

"This is the thrombosis stage."

"She likely has atherosclerotic stenosis of the pulmonary artery; it's not completely blocked, but it has significantly affected blood flow!"

"Therefore, obstruction of right ventricular pumping is equivalent to a decrease in the amount of blood returning to the heart and an increase in the amount of blood in the circulation."

"Distended jugular veins, in an atypical phase."

"Furthermore, I discovered something else."

"The patient had external trauma, which activated the coagulation system."

"Her clotting system in her lungs is in a state of disorder, so her breath sounds are very uneven in different parts of her body."

"Check your blood clotting function immediately!"

After Guo Ziyuan finished speaking, he pointed to the patient's limbs: "The patient's limbs don't look special, but her current condition is definitely one of clotting more than hemolysis."

"And because she was lying flat, there was a 100% chance of blood clots in the deep veins of both lower limbs! Even though she had only been lying down for a day."

"My suggestion is to immediately begin high-efficiency anticoagulation therapy!"

Liu Yuenan is an internist. When she sees an external wound while administering anticoagulation, she instinctively feels some resistance.

"But the patient suffered external injuries!"

Guo Ziyuan: "It's okay to have an external injury. In our orthopedic surgery, we routinely administer anticoagulation after the surgery."

"She suffered a blunt force injury to the abdomen. The CT scan results are in, and there is no obvious organ damage."

"There are signs of edema in the abdominal soft tissue and abdominal wall, but it is quite uniform."

"The bleeding and trauma in the thigh area will not have a significant impact."

"I just reviewed her chief complaint again, and she said she had experienced transient difficulty breathing."

"I think it's possible that at some point, she experienced a blockage in a blood vessel in her lung, but then it cleared up again."

"Therefore, she was in the early stages of a pulmonary embolism."

"This is a very rare teaching case."

Upon hearing Guo Ziyuan's words, Director Liu Yuenan also came forward to begin auscultation.

She listened for a while, then suddenly asked, "Dr. Guo, you mentioned uneven breathing sounds? Which area exactly?"

"They're mostly uneven, aren't they?"

"Our stethoscope can only detect regional breath sounds, and the intensity of her breath sounds varies in each region, right?"

Liu Yuenan frowned deeply: "Isn't it the same?"

Liu Yuenan thought she had misheard.

She then looked at Professor Ning Sanlong.

Ning Sanlong only listened to the upper part of the patient's lungs before removing the stethoscope.

"Director Liu, I'm not an internal medicine specialist. I usually do auscultation, so I can't hear such subtle things."

Liu Yuenan looked at Guo Ziyuan with a puzzled expression.

Guo Ziyuan suddenly realized something and quickly shut his mouth.

"Professor Ning, Director Liu, then this patient is in your care. Please intervene and treat him as soon as possible."

"Since it's not yet tied up, I think it's a good time to intervene."

"I'll go get another glass of water."

Liu Yuenan stared at Guo Ziyuan: "Dr. Guo..."

"Director Liu, let's chat another time later. It's not appropriate to discuss such details today."

"I simply stated what I heard."

Guo Ziyuan looked at the physical examination technique (national champion)!

Similar to film viewing skills, what defines a master is a skill that can deliver a devastating blow to most people.

There's a joke circulating online.

Ordinary mathematicians solve problems by first finding the solution and then setting up equations.

Ramanujan's solution to the equation is: The solution is readily apparent.

Regardless of whether it's pieced together or not, I've pieced it together, and I have indeed discovered a special pattern, so it has to be correct!

Isn't that strange?

If it's true that film reading techniques are difficult to explain...

In fact, physical examinations are even more difficult to explain.

Auscultation during a physical examination requires not only general procedures but also the physician's own sensory perception.

This is even more abstract than art!

It's like this: I hear four different sounds from one sound, but you only hear one.

This isn't music, and I can't explain how it's performed to you.

The sounds within the human body are naturally formed and cannot be pieced together!

Therefore, Guo Ziyuan needs to think carefully about how to comfort and "deal with" Director Liu Yuenan.

Liu Yuenan is indeed a woman.

But listen to her name.

Liu Yuenan.

Listen to her professional title again?

Thirty-nine years old, chief physician at a prefecture-level city hospital.

These things combined are truly worthy of being called "Extinction Master"!

Of course, Liu Yuenan didn't get all of this through personal connections; she fought tooth and nail with the Grim Reaper in the emergency room.

……

Guo Ziyuan's explanation was correct, and Liu Yuenan glanced at the number of patients in the emergency room and stopped worrying about it.

A short while later, the patient's rapid blood test results came back.

There's definitely something wrong with the blood clotting function.

Embolism is a problem with the blood clotting function.

It's the early warning stage!

Therefore, it's quite simple to handle.

Even though it wasn't visually appealing, after the patient was taken care of, both Professor Ning Sanlong and Chief Physician Liu Yuenan moved closer to where Guo Ziyuan was.

Their idea was that after the patient screening results were completed, they could meet up with Guo Ziyuan.

We must catch Guo Ziyuan's "chicken feet".

Patients in the emergency room are not undergoing critical resuscitation procedures all the time.

In reality, most of the time, we're just waiting.

The patient will not receive much treatment; the doctor must rely on his own theories and experience.

We strive to make a clear diagnosis, rack our brains for solutions, and use the available medications and appropriate treatments to save the patient's life.

The race against time isn't as exaggerated as it's portrayed in the movies.

Because it really is very fast!

It was so fast that you weren't the director, you didn't have a script, and you didn't even have time to react.

It's quite possible that if a doctor goes to take a dump, the patient's electrocardiogram will be flat when he comes out.

Even if you manage to save someone, it won't have that grand, impressive visual impact.

Because no one is focusing on you...

Tiredness and monotony are the eternal labels of all medical professions.

Finally, half an hour later.

Director Liu Yuenan caught up with Guo Ziyuan: "Dr. Guo?"

"That bed 21? How did you figure that out?"

The patient has definitely already had a CT scan and a CTA, and the results are in.

Vein stenosis, but no embolism.

Moreover, the patient's symptoms did not worsen after the medication was administered.

The jugular vein remains distended; we await the medication to take effect, gradually eliminating the narrowing and achieving complete unobstructed flow...

Quantitative changes lead to qualitative changes, completely eliminating the typical precursor symptoms of jugular venous distension.

Guo Ziyuan: "Director Liu, I've thought about it for a long time, and I can only give you one answer: you can tell from what I hear."

"Hearing ability, like intelligence, is very abstract."

"Timbre, tone quality, pitch, and the blending of sounds are all things I can't explain clearly."

"So... I'm sorry."

Technology is difficult to learn and difficult for others to copy.

The fundamental reason is that many technologies are really quite abstract.

Moreover, all technologies will be imprinted with an individual's DNA.

Different people have different experiences with a particular technology.

There are thousands of ways to make tofu all over China!

Why should I, Guo Ziyuan, be able to explain the auscultation during a physical examination clearly?

This step can only be taken by talent!

Or it could be a matter of chance, or a sudden enlightenment.

Guo Ziyuan was very certain.

In my previous life, I must have been my teacher who unintentionally gained a profound understanding of something powerful.

It must be at least at the national level for him to rise again in the provincial hospital.

However, Guo Ziyuan used to be quite curious and expectant.

After all, this is a special opportunity given to our master, and it would be a pity to lose it.

Now, Guo Ziyuan also feels that if it's lost, it's lost.

After all, he's my own master, so I'll give him a share.

Guo Ziyuan still didn't believe that he couldn't develop a national-level skill from his master in his lifetime.

Liu Yuenan gently raised her head and looked at the ceiling.

He laughed: "I finally understand the love-hate relationship that Director Zhou and the others have with you."

"You're the kind of person who's truly despicable."

Liu Yuenan is a person with a gentle exterior but a strong inner character: "Of course, I don't mean to say you're bad."

"I just personally think that people like you are hateful."

Talent, there's no solution!

If Heaven does not grant it, there is no solution.