This miracle doctor just wants to be fired!

"Okay...okay, senior brother!"

The two then came to their senses, quickly responded, and turned to walk briskly toward the ward where the other patient was.

As they walked down the corridor to the hospital room, Chen Xi couldn't help but lower her voice and say to Li Yang beside her, "What should we do? Do we really have to handle this on our own? I'm a little nervous and afraid of making a mistake."

Li Yang took a deep breath: "Don't panic, my senior brother must think this patient's condition isn't serious, that's why he's letting us practice."

"Let's follow the previous procedure first, then take a medical consultation and then a physical examination, step by step. If there's anything you're unsure about, just write it down and ask your senior colleague later."

Even so, there was a clear hint of nervousness in his voice.

After all, this was the first time the two of them had faced an emergency patient on their own.

"Okay, that's the only way." Chen Xi nodded nervously.

The two walked into the ward.

A young man was lying on the hospital bed, leaning against the headboard, his hands covering his lower abdomen. Although he looked unwell, his spirits were still good.

Upon seeing the two enter, the young man looked up, his voice weak: "Doctor, my stomach hurts terribly, and I've had diarrhea several times before."

Chen Xi stepped forward first: "Don't worry, let us understand the specific situation first."

When did your abdominal pain and diarrhea start?

Perhaps due to nervousness, Chen Xi spoke faster than usual.

The young man frowned, didn't say much, thought for a moment, and then replied, "Around noon today, I ate some barbecue skewers from a roadside stall, then drank an iced cola, and it started not long after that."

Seeing this, Chen Xi continued to ask, "Where exactly is the abdominal pain located?"

Is the pain intermittent or continuous?

"Are there any ways to relieve the pain?"

"By the way, do you have any history of drug allergies?"

The patient, perhaps due to abdominal pain, sounded somewhat impatient with Chen Xi's numerous questions: "I don't have any history of drug allergies. The abdominal pain is around my navel, it comes in waves of cramping, and squatting down helps a little."

"I've had diarrhea five times already, all of it was watery. The ER doctor just said I'm almost dehydrated."

Chen Xi wrote down the key information the patient provided to avoid missing anything.

During the consultation, the two would occasionally pause, either forgetting to ask for key details or failing to take notes in a timely manner.

After finally getting the medical history done, the two began preparing for the physical examination.

Chen Xi was responsible for assessing the dehydration situation.

She gently pinched the skin on the patient's arm, and when she released it, the skin recovered much more slowly. She also checked the patient's lips, which were indeed dry and peeling, and the eye sockets were slightly sunken.

Li Yang was responsible for the abdominal examination.

When listening to bowel sounds, he was probably too nervous and put his ear too close, so he couldn't hear clearly for a while and had to readjust his position.

During the palpation, Li Yang's technique was too strong, causing the patient to groan in pain, which startled him so much that he quickly reduced the pressure.

After finally completing the physical examination, the two left the ward.

……

Back to the emergency room doctor's office.

Chen Xi recalled the treatment methods her mentor had used to handle similar patients.

"For moderate dehydration due to acute gastroenteritis, shouldn't we first administer saline and glucose solution, and also add potassium chloride to replenish electrolytes?"

Li Yang hesitated and asked, "What about the dosage? Should we calculate it based on weight? The patient looks to be around 60 kilograms."

The two studied the drug instructions and previous medical record templates repeatedly, and after much deliberation, they finally came up with a preliminary plan.

First, administer 500ml of normal saline + 500ml of 5% glucose injection + 1.5g of potassium chloride via intravenous drip.

Secondly, montmorillonite powder was prescribed to stop diarrhea, and bifidobacteria were prescribed to regulate the intestinal flora.

After drafting the patient's medical order, the two checked it over with each other, afraid that there might be some problems. Only after confirming that there were no obvious errors did they take the plan to report to Zhou Cheng.

……

At this point, Zhou Cheng had initially stabilized the pancreatitis patient's condition.

After treatment including fluid resuscitation, antispasmodics, and analgesics, the patient's abdominal pain symptoms were relieved, and the blood pressure rose to 110/70 mmHg. The patient no longer groaned in pain as before.

The abdominal CT scan results are also in, indicating acute edematous pancreatitis, ruling out the possibility of necrotizing pancreatitis, and surgery is not required for the time being.

Zhou Cheng was adjusting the follow-up treatment plan when he saw Chen Xi and Li Yang arrive. He asked, "How is the patient with gastroenteritis? Has the treatment plan been finalized?"

"Senior, we have completed the consultation and physical examination. This is the patient's medical history and preliminary fluid resuscitation plan."

Chen Xi handed over the patient's medical record book; she had just printed out a copy of all the patient's medical orders.

Zhou Cheng took it and started reading, nodding slightly as he read, occasionally frowning slightly.

After he finished reviewing all the medical records and doctor's orders, he looked up at the two of them and said, "The overall approach is correct, there are no fundamental errors, and it deserves recognition."

"But there are quite a few problems with the details."

He first pointed to the medical history record.

"During the consultation, you didn't ask the patient about the specific characteristics of their diarrhea, whether it was watery or pasty, and whether there was mucus or blood."

"This can help rule out other intestinal diseases."

"Also, the patient wasn't asked if they had tenesmus, which is a key point in the initial consultation for acute gastroenteritis."

Then, Zhou Cheng talked about the physical examination: "The physical examination record only mentioned abdominal tenderness, but did not mention the specific location of the tenderness, whether there was rebound tenderness or muscle guarding, and the frequency of bowel sounds was not recorded. For patients with gastroenteritis, hyperactive bowel sounds are a typical sign, and these details cannot be overlooked."

Finally, he looked at the fluid resuscitation plan: "The type of fluid resuscitation you chose is fine, but the dosage can be adjusted."

"The patient has mild to moderate dehydration and weighs 60 kg. The fluid replacement volume in the first 24 hours should be 2000-2500 ml. The 1000 ml you prescribed is a bit too little. It needs to be increased to 2000 ml and administered in two separate infusions."

"In addition, the dosage of potassium chloride is fine, but the infusion rate must be controlled and not too fast to avoid causing heart discomfort."

The two listened attentively and wrote down each of the problems Zhou Cheng pointed out in the medical record book.

"Okay, I'll go do the follow-up consultation and physical examination right away," Chen Xi said quickly.

Upon hearing this, Zhou Cheng smiled and nodded: "Go ahead, remember that in clinical diagnosis and treatment, we must not only focus on the key points, but also pay attention to the details. Every detail can affect the diagnosis and treatment results."

Zhou Cheng stood to the side, watching the two figures leave, a faint smile appearing on his lips.

These setbacks are an inevitable part of a young doctor's growth. Only by allowing them to practice independently can they master diagnostic and treatment skills more quickly.

However, he quickly snapped out of his thoughts and turned back to the ward for pancreatitis patients.

Patients with this type of pancreatitis need close monitoring. Even if their vital signs are temporarily stable, they may develop necrotizing pancreatitis if not carefully monitored.