Thereās no way, it canāt be seen. The doctor from the CT room of the Provincial Peopleās Hospital might add a sentence of suspicion based on the clinical doctorās belief that there is a thrombus in the atrium and the patient has pulmonary embolism, which is always right. After all, there were complaints from surgeons before about serious consequences caused by not detecting heart problems before surgery.
The difficulty of detecting a thrombus in the atrium, the detection rate of CT is only a few tens of percent.
As Boss Zhang said, Xiao Shugang was unlucky to encounter doctors with insufficient skills. This again illustrates that medicine requires interdisciplinary collaboration, and any department dropping the ball can lead to big problems. The skills of CT room doctors are equally important to patients.
If CT canāt detect it, what about other instruments, like ultrasound? Sorry, the detection rate of transthoracic echocardiography for atrial thrombus is even lower than CT. As for transesophageal echocardiography, the detection rate is similar to CT.
If the ultrasound room doctors at the Provincial Peopleās Hospital had very high skills, surpassing the CT room doctors, they could have covered the gaps and avoided subsequent problems. However, when Xiao Shugang was transferred to the Provincial Peopleās Hospital for emergency surgery, the pre-operative cardiac ultrasound wasnāt performed, this check wasnāt ordered. This means clinical doctors, based on the CT report, believed that only the lung had issues, not the heart. This mistake is due to insufficient caution, a responsibility clinical doctors have to bear.
As inferred by Zhang Huayao and the others, the problems during the treatment process were multi-faceted, and each department bore some responsibility.
The final issue was that the doctors in the ultrasound department of the Provincial Peopleās Hospital couldnāt perform beyond their usual ability, leading the final report to follow the CT roomās report and failing to completely determine whether there was a thrombus in the right atrium, possibly there was, possibly not. This is tantamount to not detecting the thrombus.
"They canāt detect it." Doctor Zhao was under great pressure, his head suddenly felt like it would explode.
Teacher Xu hadnāt discussed it with him before, he hadnāt expected the patientās problem to be so significant.
"Iāve always told you this." Doctor Xu took this opportunity to tell the student how important it is for a CT room doctor to hone their skills, one could say, now the hopes of the patient and clinical doctors are all here with them.
Xie Wanying was aware of this fact, so she managed to slip into the CT room under Teacher Qinās influence.
"Stay calm." Doctor Xu patted the studentās shoulder, using his strong presence to cool everyoneās minds.
The discussion continued. Doctors at the Provincial Peopleās Hospital believed the patient had a thrombus in the right atrium because the patient had pulmonary embolism. Pulmonary embolism is closely related to the right atrium.
"The focus is still on ruling out the right atrium, they havenāt detected it, we need to find out the problem with the right atrium." Doctor Zhao believed that even though the doctors at the Provincial Peopleās Hospital were somewhat embellishing, their speculation had some reason.
"What do you think?" Doctor Xu turned to ask Student Xieās opinion.
"I think the focus might need to be on the ventricles instead of the atrium." Xie Wanying said.
The thrombus in the atrium may not necessarily originate from the atrium, it might originate from the ventricles. The reason being, in case of cardiac trauma, the most commonly damaged is the right ventricle, this point has been mentioned before.
Clinical doctors, based on the patientās clinical symptoms, believe the patient might have a thrombus in the atrium. From the fact that the CT and ultrasound from the Provincial Peopleās Hospital couldnāt detect a thrombus in the right atrium, whether it is advisable to start from the potential source of atrial thrombus to further clarify the heartās problem.
"What youāre saying makes sense, but isnāt this even harder to investigate?" Doctor Zhao admitted her hypothesis was the correct direction, but said with a look of difficulty.