This miracle doctor just wants to be fired!

Emergency room.

As soon as the door to the emergency room opened, Zhou Cheng could feel a heavy and tense atmosphere.

In stark contrast to the relatively quiet emergency room outside, every bed here is occupied by a patient with an acute or critical condition.

Zhou Cheng turned to Chen Xi and Li Yang behind him and instructed them, "You two stay by my side and observe carefully. Pay close attention to any changes in the patient's vital signs. Write down any questions you have and don't take any action on your own. I'll ask for your help if needed."

"Understood, senior brother!" Chen Xi and Li Yang nodded quickly.

They knew that the emergency room was different from the observation room and the ward.

In the observation room and wards, Zhou Cheng could boldly let go and even let Chen Xi and Li Yang practice, since although the patients there were also in the emergency room, most of them were not in the emergency room and their conditions were not that urgent.

However, the situation was different once they arrived at the emergency room.

Patients who are referred to the emergency room and triage desk but are still sent to the resuscitation room must be in very serious condition.

For these patients, every minute and every second is a matter of life and death.

Zhou Cheng's decision not to let them handle the cases alone was not only responsible for them, but also for the patients.

Although they have learned a lot from Zhou Cheng and their abilities have improved significantly, they still lack sufficient experience to handle critically ill patients independently. They can only learn from Zhou Cheng and accumulate practical experience.

Zhou Cheng said no more and took the lead to a bed by the window in the emergency room.

There lies an elderly heart failure patient who was admitted to the emergency room last night. After a night of treatment, his condition has temporarily stabilized, but he still needs close monitoring.

"This patient is 72 years old and has acute left heart failure complicated by pulmonary infection. When he was admitted to the hospital yesterday, he was experiencing difficulty breathing and orthopnea. After treatment with diuretics, vasodilators, and anti-infection drugs, his respiratory rate and heart rate have decreased. However, we still need to focus on monitoring changes in blood oxygen saturation and blood pressure, and pay attention to the presence of rales in his lungs."

As Zhou Cheng listened to the patient's lungs and heart sounds with a stethoscope, he spoke slowly.

"Chen Xi, go and measure the patient's blood pressure and heart rate, and record yesterday's intake and output. Li Yang, observe the patient's level of consciousness, and have the nurse repeat the blood gas analysis. Report any abnormalities immediately."

"Okay!" The two nodded and immediately got to work.

Chen Xi skillfully took out the blood pressure monitor and gently strapped it to the patient's arm.

Zhou Cheng stood to the side, his eyes scanning the various values ​​on the monitor, his mind quickly sorting out the patient's subsequent treatment plan.

Heart failure patients' conditions are highly variable, and even the slightest change in physical signs may indicate a worsening of the condition, so it is essential to remain vigilant at all times.

"Senior, the patient's blood pressure is 140/74 mmHg."

Just as Chen Xi announced the patient's blood pressure value, the door to the emergency room was suddenly pushed open, and a series of hurried footsteps accompanied by shouts from medical staff came through.

"Quickly! Make room in the emergency room! The patient suffered an electric shock and was unconscious. After regaining consciousness, the chest tightness and chest pain have not subsided!"

Zhou Cheng immediately turned his head and saw two medical staff from the emergency department rushing in with a stretcher.

A middle-aged male patient was lying on the stretcher.

He was pale, his brows were furrowed, and he was groaning in pain. His clothes also had obvious burn marks.

Especially on his right wrist, the skin was blackened and broken, clearly indicating an electric shock injury.

"Quick! Put it on bed 5!" Zhao Wenqi shouted hurriedly.

The medical staff in the emergency room and resuscitation room immediately transferred the patient to bed 5 in the resuscitation room.

The monitor was quickly connected.

The beeping of the instruments suddenly became rapid, disrupting the previously relatively calm rhythm of the emergency room.

The emergency room doctor saw Zhou Cheng and immediately stepped forward, saying, "Dr. Zhou, the patient is 45 years old. He was accidentally electrocuted while handling electrical wires at the construction site. He lost consciousness on the spot and fell to the ground for about 3 minutes before regaining consciousness. After regaining consciousness, he experienced chest tightness and chest pain, which was described as squeezing and did not subside. We immediately performed an emergency electrocardiogram, which showed ST segment elevation in leads V2-V6. His vital signs are temporarily stable, with blood pressure at 118/75 mmHg, heart rate at 92 beats/min, and oxygen saturation at 96%."

The emergency room doctor wiped the sweat from his face as he quickly reported Zhou Cheng's condition, handing him a crumpled electrocardiogram report.

"We're unsure whether it's an acute myocardial infarction or myocardial damage caused by an electric shock, so we didn't dare to handle it ourselves and brought it over immediately!"

Without the slightest hesitation, Zhou Cheng immediately walked quickly to the bedside.

He first checked the patient's level of consciousness, gently calling the patient's name, and the patient was able to respond weakly. He then examined the electric shock site on the patient's wrist.

"Let me see the electrocardiogram," Zhou Cheng said, looking at the emergency room doctor beside him.

"Here you go." He quickly handed it over.

Zhou Cheng quickly took the electrocardiogram report and scanned it rapidly with his eyes.

Indeed, the ST segment was significantly elevated in leads V2-V6, and there was also ST segment elevation in leads I, II, avF, and avL, while the ST segment was depressed in lead AVR.

Is this a typical manifestation of myocardial ischemia and necrosis, or an acute elevation myocardial infarction?

However, given the patient's clear history of electric shock injury, the possibility of myocardial damage caused by electric shock cannot be ruled out.

The two conditions present with similar clinical manifestations, but the treatment plans are completely different. If misdiagnosed and treatment is delayed, the consequences could be disastrous.

"Establish intravenous access first and quickly resuscitate fluids!" Zhou Cheng quickly issued the order while continuing to observe the patient's symptoms. "The patient's vital signs are currently stable, but there is significant ST-segment elevation, and the chest tightness and chest pain persist without relief. Acute myocardial infarction cannot be ruled out, and the myocardial damage caused by the electric shock cannot be ignored. The next step is to make a clear diagnosis as soon as possible in order to treat the symptoms accordingly."

The nurses immediately sprang into action, quickly establishing intravenous access, adjusting the monitors, and meticulously recording all the data, leaving no room for carelessness.

Zhou Cheng straightened up, quickly took out his phone, and dialed the number of Li Degang, the second-line doctor for today.

Electrical injury is a relatively rare type of patient.

Zhou Cheng had never seen a similar patient before, so reporting it to a second-line doctor was the safest approach.

"Teacher Li, this is Zhou Cheng. We've received a 45-year-old patient with an electric shock in the emergency room. He lost consciousness after the shock but has regained consciousness. He's experiencing chest tightness and pain that hasn't subsided. The ECG shows ST-segment elevation in leads V2-V6, and we can't determine whether it's a myocardial infarction or myocardial damage caused by the electric shock. Could you please come and take a look?"

"Okay, I'm in the ward, I'll be right there!"

After hanging up with Li Degang, Zhou Cheng didn't pause; he immediately contacted the cardiology department and the ICU for an emergency consultation.

As the saying goes, three cobblers are equal to one Zhuge Liang.

In the emergency department, if you have doubts about the diagnosis or are not very confident, it is better to ask for a consultation.