This miracle doctor just wants to be fired!

Zhou Cheng glanced at Feng hope and said in a serious tone, "The worst thing you can do in the emergency department is to make assumptions. You can't just look at the surface symptoms."

"This patient has symptoms of blurred vision, and while his blood pressure is low, his pulse, although regular in rhythm, is weak and somewhat rapid. This cannot be explained by low blood pressure alone."

"If we administer intravenous fluids directly, any underlying problems might mask the illness or even worsen the symptoms."

Feng hope lowered his head and stopped talking.

However, he was somewhat unconvinced and felt that Zhou Cheng was making a mountain out of a molehill.

Zhou Cheng ignored Feng hope's emotions and continued to communicate with the patient's family to persuade them to agree to the blood test.

The family members were getting annoyed with Zhou Cheng's stubbornness.

"Honey, let's forget about it. Why don't we go back, or go to the clinic next door for the injection..."

Before she could finish speaking, her face turned even paler, her lips turned bluish-purple, and her breathing became rapid.

"Doctor, I feel some chest tightness, and my dizziness is getting worse; my vision is also going black."

The middle-aged man panicked immediately and rushed forward, asking, "What happened? Everything was fine just now, how did it suddenly turn into this?"

The two graduate students standing nearby, Feng hope and Li Dongyu, also tensed up instantly.

The relaxation on their faces vanished instantly, and they looked at Zhou Cheng helplessly, not knowing what to do.

Zhou Cheng didn't say much. He immediately supported the patient's head, keeping her lying flat, and instructed, "Feng Xi, quick, check her blood pressure and pulse again! Li Dongyu, go get the defibrillator and emergency medications, and also notify the cardiologist for an urgent consultation!"

The two immediately got to work.

Feng hope held up the blood pressure monitor, and the reading made his expression change: "Teacher Zhou, your blood pressure has dropped to 70/40, and your pulse has become faster, 120 beats per minute, and it's a bit irregular!"

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Zhou Cheng's heart sank; it seemed his vigilance was justified.

This patient's condition is far more serious than it appears.

"Give the patient oxygen first!"

Upon hearing this, the nurse immediately brought oxygen equipment and a nasal cannula.

Zhou Cheng picked up the stethoscope again and listened to the patient's heart and lungs.

This time, he heard slight moist rales in the patient's lungs, and the heart sounds also became somewhat weak.

"Acute heart failure cannot be ruled out! Establish intravenous access first, and quickly administer fluids!"

"Let's take another route to the kidneys and raise the blood pressure first!"

Zhou Cheng issued instructions while observing the patient's level of consciousness.

At this point, Feng hope dared not be careless anymore and quickly began to move according to Zhou Cheng's instructions.

Li Dongyu also brought a defibrillator and emergency medications, and stood by, ready to deal with any emergencies.

The middle-aged man paced anxiously nearby, repeatedly saying, "Doctor, we agree to have our blood drawn! Quickly, hurry up!"

Zhou Cheng reassured the middle-aged man, "Don't worry, we are doing our best to save him. The most important thing now is to find out the cause so that we can treat him accordingly."

He kept thinking about it.

The patient had no underlying medical history and no typical symptoms of chest tightness or chest pain.

At first, I only had dizziness, nausea, and low blood pressure. How could I suddenly develop acute heart failure?

On the other side, after the patient's family gave their consent, the nurse immediately drew blood from the patient.

……

After fluid resuscitation and norepinephrine infusion, the patient's blood pressure rose slightly, but only reached 85/50 mmHg.

This made Zhou Cheng's expression somewhat serious.

Hypotensive shock commonly has three causes: hypovolemic shock, cardiogenic shock, and distributive shock, as well as the less common obstructive shock.

The first three types of shock can all be treated by resuscitation or by raising blood pressure with vasopressors.

However, even after using norepinephrine, this patient still had great difficulty maintaining his blood pressure!

Just then, the lab called.

As Feng Xi approached the nurses' station, he answered the phone. After listening to the call, his expression turned even more grim. He quickly said to Zhou Cheng, "Teacher Zhou, the blood test results are in. D-dimer is significantly elevated, exceeding the normal range by ten times. Troponin is also slightly elevated, but other indicators are normal."

"D-dimer levels are significantly elevated?"

Zhou Cheng frowned and immediately turned on his computer to check the more detailed test results.

Besides a significant increase in D-dimer, troponin was slightly elevated...

"Could it be an acute pulmonary embolism!"

Zhou Cheng immediately made a judgment.

The typical symptoms of pulmonary embolism are shortness of breath, chest pain, and hemoptysis.

However, many patients have atypical symptoms, such as dizziness, low blood pressure, and nausea, which are easily mistaken for common low blood pressure or a cold.

The mortality rate is very high if treatment is delayed.

At this time, the cardiologists who were consulting also arrived.

Zhou Cheng immediately explained the patient's condition, test results, and his own judgment to the cardiologist.

The cardiologist carefully examined the patient's condition, reviewed the electrocardiogram and blood test reports, and agreed with Zhou Cheng's judgment.

"Acute pulmonary embolism is indeed highly suspected. A pulmonary CTA is needed immediately to determine the location and extent of the embolism, followed by thrombolytic therapy. Otherwise, the patient's life will be in danger at any time."

Zhou Cheng immediately arranged for Feng hope and Li Dongyu to accompany the patient to undergo a lung CTA examination, and at the same time contacted the radiology department to prioritize the examination and strive to get the results as soon as possible.

The middle-aged man followed behind Feng hope and Li Dongyu, his face pale.

……

About ten minutes later, Feng hope's voice came through the phone: "Professor Zhou, the CTA results are in. It confirms acute pulmonary embolism. There's an embolism in the main right pulmonary artery, and multiple smaller embolisms in its branches!"

"Okay, I understand!" Zhou Cheng's expression was extremely serious.

Main trunk embolism, that can be fatal at any moment!

He immediately notified the cardiologist to develop a thrombolytic therapy plan, and instructed the nurses to prepare the thrombolytic drugs and strictly adhere to the dosage.

"The dosage of thrombolytic drugs must be accurate, the infusion rate must be strictly controlled, and the patient's blood pressure, heart rate, and bleeding must be closely monitored. If any abnormality occurs, the infusion must be stopped immediately and hemostasis treatment must be performed."

Zhou Cheng repeatedly gave instructions to the nurses and graduate students.

While thrombolytic therapy is effective for pulmonary embolism, it also carries significant risks, including a high risk of complications such as bleeding, requiring extreme caution.

Thrombolytic therapy was initiated immediately after the patient was returned to the observation room.

Zhou Cheng stayed by the patient's bedside the whole time, never leaving him for a moment, and checked the patient's blood pressure and heart rate every few minutes, as well as the patient's level of consciousness and breathing.

Feng hope and Li Dongyu also helped out from the side, not daring to slack off in the slightest.

The resentment I felt earlier has long since vanished.

……

After an hour of thrombolytic therapy, the patient's symptoms gradually improved.

Most importantly, her blood pressure gradually rose to 90/60, her pulse returned to normal, her complexion improved, and she regained consciousness.

"How's the tightness in your chest now?" Zhou Cheng asked.

"I feel much better. I'm not as dizzy anymore, and the chest tightness has eased," the woman said weakly. Although her voice was faint, her condition was clearly different from before.

The middle-aged man gripped Zhou Cheng's hand tightly, his eyes red-rimmed: "Doctor, thank you so much, thank you for saving my wife's life. If the IV had masked the symptoms..."