(Thanks to kongxu jimoleng671112 for the reward and monthly ticket encouragement, and to cjxf200123, taiheiyang yelang, tianshi le, nanren xian, dandan, yutian, cizhe shen du ri de fanren, shuyou20170131164337395, JC1008, shuyou20191008201906592, speed and passion, kukude lang, xinyousuo wen, yuwo for the monthly ticket encouragement)

"Connect him to the heart monitor," Liu Banxia said.

Even though Xu Yino didn't know why Liu Banxia was so concerned about this intoxicated patient, she got to work.

In fact, this was an instinctive reaction developed from studying with Liu Banxia over time — to act slightly faster than think, moving immediately upon hearing instructions.

Liu Banxia didn't sit idly by either, and started examining the patient's limbs.

The drinking buddies who came along with this patient looked on curiously, not knowing what Liu Banxia and the others were doing.

"Teacher Liu, the examination shows the heart rate and blood pressure are a bit high, and the temperature is slightly low," Xu Yino said after connecting the heart monitor.

"Their blood test results aren't out yet?" Liu Banxia asked the nurse nearby.

"Dr. Liu, it'll take a moment longer," the nurse said.

"Notify the lab to expedite the results," Liu Banxia directed.

The nurse quickly ran to the lab, knowing that something might be up.

"Are you two his friends? Is he usually like this after he drinks?" Liu Banxia asked the two companions nearby, who, despite not being intoxicated, also smelled strongly of alcohol.

"We don't really know him. Xu Gang over there is our friend, and he knows the guy lying on the other bed. They just ended up drinking together," one of them said.

Liu Banxia felt a bit of a headache coming on. While not hoping for much, this was still much less helpful information than expected. There'd be no point expecting more information from patients. They'd have to diagnose blindly again.

Oftentimes it's like this; the information a patient provides during examination is extremely important. Yet for many emergency patients, it's a rushed diagnosis.

"This patient shows obvious signs of intoxication, but I noticed earlier he seems to have some level of convulsive response," Liu Banxia said.

"I did a quick examination, and the results are high heart rate, high blood pressure, and limb weakness. An additional symptom is he's complaining of 'pain'. Based on these, what do you guys think?"

"Teacher Liu, could it just be the patient shouting nonsense while intoxicated?" Xu Yino asked.

"Increased heart rate and blood pressure are also normal responses after heavy drinking, as alcohol stimulates blood flow. Limb weakness also aligns with intoxication, similar to other intoxicated patients I've seen before."

"Hmm... the only difference would be the shouting of 'pain'. Some do shout randomly, though it's often hard to tell what they're saying."

"Anyone else?" Liu Banxia continued asking.

"Teacher Liu, I agree with Xu Yino," Huang Bo said.

"Pain..."

At this moment, the patient shouted again. Although the voice wasn't loud, it was clear, and the patient's body twisted slightly.

"Oh, something's not right."

Xu Yino exclaimed.

"The patient might truly be in pain. It's just that his nerves might be reacting slowly, so only after shouting did his body respond," she said.

Liu Banxia nodded, "That seems about right. We can't quite identify where he hurts, but it's a symptom to note. Next, what examination should we do?"

"We still need a thorough checkup," Miao Rui said.

Liu Banxia moved aside to give Miao Rui space.

Miao Rui didn't hesitate, as this was a standard procedure. Having trained in the emergency center for so long, if he couldn't perform well now, that'd really be in vain.

The other four interns then realized this was Liu Banxia's on-the-spot teaching. Quickly, they took out their notebooks and started taking notes.

Liu Banxia was quite satisfied with their response, at least better than his own during his training days when he wasn't as quick to react.

"Teacher Liu, after a hands-on examination, I found the patient's liver is somewhat enlarged, and a liver and cardiac ultrasound is needed," Miao Rui said after the inspection.

Liu Banxia nodded, "Proceed directly with the examination."

"Can anyone say why Miao Rui also wants to perform a cardiac ultrasound?" Liu Banxia questioned the four interns.

"Teacher Liu, is it related to the pain? It might be pain from the liver, or it could be cardiac pain," Chen Dongmei replied.

Liu Banxia nodded, "You should have more confidence in yourself, answer with affirmation."

"From the actual situation of this patient, some things can actually be inferred. For example, his drinking history. Even when going out for some skewers, he could share a table with others. While this is normal behavior, getting drunk often indicates frequent drinking."

"People with limited alcohol tolerance usually set a small goal for themselves to avoid embarrassment from getting drunk. Long-term drinkers, however, tend to have some liver problems."

"Just now, after Miao Rui's hand examination, liver enlargement was detected, so an ultrasound was directly scheduled. From the current images, it's likely fatty liver."

"The patient's blood pressure increased, and his heart rate accelerated. We currently can't determine whether the hypertension symptoms are a reaction to alcohol or if he already had a history of hypertension."

"Moreover, even when drunk, he occasionally complains of pain, which should alert us. Heart-related diseases that cause pain are very dangerous, so a cardiac ultrasound is necessary."

"Teacher Liu, the patient's heart is also somewhat enlarged, and there is myocardial hypertrophy. Based on the patient's current condition, another electrocardiogram and a quick check for myocardial infarction should be added," Miao Rui said after scanning the liver.

"Go ahead and arrange it," Liu Banxia nodded.

"You two saw it too, right? It seems your new drinking buddy might be a frequent drinker. Even if he's not, this time's intoxication might trigger a lot of issues."

"Myocardial hypertrophy naturally leads to high blood pressure. A little more alcohol makes the blood pressure even higher. It's lucky the cardiac ultrasound hasn't found other diseases, or else it could be very dangerous."

The two guys were somewhat at a loss, having also drunk, their reactions were slower now.

"Basically, these are the post-consultation precautions for the patient," Liu Banxia then looked at the four interns.

"Many conditions manifest only after some delay, so after admissions, we need to observe carefully. Especially for patients like this one who are intoxicated, alcohol can often cause symptoms to be confusing."

"Even now, I can't ascertain whether his muscle weakness is a symptom of a disease or simply a result of being drunk. But we can't just start a muscle electromyography or biopsy because of this; we could be accused of over-medicalization."

"Teacher Liu, based on the current electrocardiogram readings, the patient is normal," Miao Rui reported after finishing the ECG.

"Alright, let's wait for the blood test results then," Liu Banxia said.

After a few more minutes, a nurse came running over with the lab sheet.

Liu Banxia took it, glanced, then furrowed his brow.

"Blood potassium is a bit low, and the creatine kinase levels are quite high at 3900. Electrolyte imbalances are already evident. What's the medication plan?" Liu Banxia asked.

"We can start with 10 ml of potassium magnesium aspartate, but the patient's creatine kinase level is really quite high. I recommend doing another biochemical blood test in half an hour to reassess the patient's indicators," Liu Yiqing suggested.

"Alright, Liu Yiqing and Miao Rui, you follow up with this patient," Liu Banxia instructed.

The four interns watched with admiration—it was a very detailed diagnostic process, and Liu Banxia was guiding them step by step to explore the patient's symptoms.

To them, even Li Tianyang, the senior among them, could not yet match Xu Yino and the others' level.

This is the difference. It may not seem significant, but when reflected on the patient, it magnifies tremendously.

Creatine kinase is a crucial indicator, a biomarker for diagnosing rhabdomyolysis. Currently, though the patient's creatine kinase is elevated, it hasn't reached the threshold for diagnosing rhabdomyolysis.

The quick myocardial infarction test is similar—the patient's current pain cannot be confirmed as either cardiac or hepatic, so both are possible.

Based on these, Liu Yiqing concluded that rechecking the indices after half an hour was a prudent decision.

This is a patient-centric testing policy and doesn't constitute over-medicalization.

"Actually, when admitting intoxicated patients, the biggest fear is hidden diseases," Liu Banxia remarked.

"Afterward, patients can't articulate, their reactions slow, possibly masking fatal symptoms. Then unexpected issues arise, leading to complaints from the patient's family."

"It all boils down to one thing: take admissions seriously. Even if the patient is uncooperative, we need to keep asking questions."

"Because patients unconsciously tell 'lies,' or they selectively forget significant symptoms. Without our level of professional knowledge, they can't make those judgments."

"In the past, I've had patients who wanted to test the doctors too. The longer you do admissions, the more unexpected scenarios you'll encounter."

"Hmm... another batch came in. You all take care of it. It seems the intoxicated army is arriving en masse today, comrades, prepare for battle."

The four interns, who had been listening intently, were momentarily stunned. Such a serious matter, how did it end on a playful note?

"You'll get used to it; our Teacher Liu's thought process sometimes jumps around," even the normally reserved Su Wenhao couldn't help but quip.

Liu Banxia gave him a sideways glance, "Night shifts are tough. We need to lighten up a bit, especially with us. I'd rather see trauma cases; they don't puke all over us."

Xu Yino and the others didn't pay attention to his complaints. They were already used to dealing with intoxicated patients, it was standard procedure. They knew Liu Banxia said this to let them give the new interns some practice.