White armor

Chapter 748 Urinary Retention with Catheter Inserted
"Director, what's wrong?" a junior doctor asked when Fang Xiao angrily hung up the phone.

"Isn't it that useless bunch in the radiology department who started causing trouble?" Fang Xiao scolded.

The doctors around them all pricked up their ears, listening intently to the gossip.

"Director, is the radiology department not hiring this year? I heard about it from their staff."

Fang Xiao nodded.

"What's going on?" one person asked. "Don't they need people? They..."

As the man spoke, he glanced at "Xiao Meng" and understood what he meant.

"Xiao Meng" is a humanoid robot whose primary job is to handle medical records. Currently, diagnostic work is only done in the general surgery department, overseen by Director Fang Xiaofang.

However, the initial diagnosis in the radiology and CT rooms is entirely done by AI.

This is undoubtedly a huge leap forward.

But isn't the radiology department afraid of taking too big a step and ending up with something terrible?
“There’s not much work in the radiology department. There are only a few patients still receiving general radiotherapy. The reports are simple; they’re all generated by AI, and a doctor at the attending physician level or above is responsible for reviewing them.”

"So this year, Pu Fang doesn't want a single person, not even those without official positions." Fang Xiao scoffed at Pu Fang's actions.

This is taking advantage of yourself.

"Huh? How high must their performance bonuses be!" Fang Xiao's doctor exclaimed in surprise.

With fewer people sharing the profits, but AI doing the work, how could performance not be high?

Furthermore, since AI is a key national scientific research project, and the costs are all covered by Professor Luo's research funding, this is blatant exploitation of socialism.

"Director, what do they want with you?"

"The people who were laid off said that AI made them unemployed, and then they came to me because they wanted to pick on someone easy to bully." Fang Xiao said, his lips curling up in a disdainful expression. "If you can't keep up with the times, that's what happens. You get eliminated in no time, and nobody even says goodbye to you."

"era……"

Looking at "Xiao Meng," the surging tide of the times seems to be visualized, vividly appearing before one's eyes.

But this word is somewhat heavy, weighing heavily on my heart.

The general surgeons were still shaken by the thought of "Xiao Meng's" formidable diagnostic skills and the countless times "Xiao Meng" had scolded them for their medical record writing.

They often complained in private—since "Xiao Meng" is so capable, why not just have "Xiao Meng" write the medical records?

But the radiology department issue just happened so suddenly. If "Xiao Meng" were to do everything, I would be the next one to lose my job.

"Director, what do you think of us?" one person asked.

He only said half a sentence, or even less, but everyone knew what he meant.

"Professor Luo said that any diagnosis or treatment made by the AI ​​robot must be reviewed, and Professor Luo has not yet had the AI ​​robot perform surgery, so you don't need to worry."

Fang Xiao was somewhat annoyed.

If the dean hadn't been willing to show off and reveal that "Xiao Meng" was an AI robot, everyone wouldn't have been pointing the finger at him.

What did I do? I just assisted in the implementation of key national scientific research projects. What does that have to do with me?

"Director, are you sure we won't be replaced by AI robots?"

"It's a long way off. Our work is technical, so don't learn from ordinary doctors," Fang Xiao said. "The work in the interventional radiology department is what ordinary doctors do. Look at them, who does it? If someone were capable of doing it, I wouldn't be the one performing interventional procedures."

Fang Xiao also had countless complaints. He muttered to himself as he looked at "Xiao Meng".

It seems that by simply talking about it, these responsibilities will not fall on oneself.

Although Fang Xiao felt that the responsibility did not lie with him, some troubles always seem to find them on their own.

However, this was a happy kind of trouble, and Fang Xiao felt a little strange. Now that the crackdown on organized crime was underway, he wasn't worried about what those people would do to him.

Holding a sharp weapon, the desire to kill arises spontaneously.

In the future, if I don't like a certain department, I can let AI take the lead in that department... At least I can mention it more in my report to Professor Luo.

"Director, emergency consultation needed!" the nurse at the nurses' station called out.

"What kind of patient?" Fang Xiao asked.

"It doesn't seem too serious; they said it's abdominal distension and pain."

Fang Xiao knew that what the emergency room said was like farts, and not a word of it could be believed. The abdomen was distended. Last time they mentioned a patient in this condition, when she went to see him, the patient was in hemorrhagic shock, with a ruptured spleen and a belly full of blood.

How could it not swell?!
The emergency department is like a weasel; it's not that they never come, but if you call, it's definitely not going to be anything good.

“Okay, I’ll go take a look.” Fang Xiao said, then called “Xiao Meng” to go see the patient together.

Ever since they learned that "Xiao Meng" was an AI robot with exceptional diagnostic abilities, the emergency department has been calling Fang Xiao constantly, giving her a major headache.

However, abdominal distension falls under the scope of their general surgery department, so it's appropriate to consult Fang Xiao.

While pondering the radiology department's cunning tactics, Fang Xiao walked towards the emergency department, feeling somewhat helpless.

The radiology department is really unethical. Professor Luo was planning to proceed gradually, but they, fearing they wouldn't earn enough, used the AI ​​diagnostic system to issue reports and laid off all the doctors without formal employment status.

What are those people supposed to do?

Fang Xiao felt that he couldn't understand this matter, just like when the steam engine appeared and someone smashed the machine. This was something that people at his level couldn't understand.

Upon arriving at the emergency department, Fang Xiao went directly into the emergency resuscitation room.

An elderly patient lay on a stretcher, his belly bulging like a drum.

"What's going on?" Fang Xiao looked around but couldn't find anyone who looked like a patient's family member, so she asked the emergency room doctor.

"Director Fang is here. The patient is a 56-year-old male who lives in a nursing home."

Oh? The kind where someone is widowed, single, or lonely? Fang Xiao felt a bit of a headache.

“The nursing home staff went to pay the fees and aren’t here,” the emergency room doctor explained. “Chief complaint: difficulty defecating for 10 days and abdominal pain for 5 days.”

"This belly is huge." Fang Xiao looked at the patient's abdomen. "Have you had any tests done?"

The emergency room doctor handed the test report to Fang Xiao.

My blood sugar is a little high, 10 mmol/L, but everything else is normal.

Electrocardiogram findings: Sinus rhythm with widened P waves and altered T waves. Abdominal CT scan report: Pelvic effusion, bilateral hydronephrosis, and fatty liver.

Since there was no tumor, Fang Xiao immediately assumed it was a tumor.

"Xiao Meng, go take a look." Fang Xiao was too lazy to diagnose the problem and left the task to "Xiao Meng."

Xiao Meng inquired about the patient's medical history and conducted a physical examination; there was absolutely nothing wrong with the entire process.

Fang Xiao didn't see it either; in all this time, "Xiao Meng" hadn't done a single wrong thing.

From the perspective of fault tolerance, AI robots are far superior to humans.

It's fair to say that AI robots are all good; it's hard to find any fault with them.

Fang Xiao also shared the concerns of his subordinate doctors, but he believed that as long as he clung to Professor Luo's coattails, he would be able to make it to retirement without any problems.

"Director Fang, you really have a lot of free time," the emergency room doctor said with a smile.

"Why don't we leave, and you take over?"

"Don't be like that, I was just expressing my feelings, I didn't mean any harm." The emergency room doctor quickly explained, "Really, it's just pure envy and jealousy. If I had an AI robot like Xiao Meng, I could get a good night's sleep when I'm on night shift."

The emergency department is busy, especially at night, so people can't get any rest. Fang Xiao knows this very well.

But internists can only envy them and daydream about it.

“That won’t do,” Fang Xiao laughed. “Xiao Meng still needs someone to watch over him while he’s working. Professor Luo won’t allow it if he’s not being watched.”

"Tsk tsk." The emergency room doctor looked at "Xiao Meng" with envy, his thoughts unknown.

"Director." "Xiao Meng" returned after asking about the patient's medical history and conducting a physical examination.

"What diagnosis are you seeking, Xiao Meng?"

"..." For the first time in its history, "Xiao Meng" fell silent. It didn't speak, but just stared at Fang Xiao, which stunned Fang Xiao.

What does this mean?
"Xiao Meng, are we going to have a check-up?"

“Director, I suggest we call Professor Luo.” “Xiao Meng’s” voice sounded somewhat ethereal.

"???"

Fang Xiao was stunned.

A patient with ascites was about to call Professor Luo, and "Xiao Meng" seemed unusually strange, unlike usual. Even when "Xiao Meng" didn't speak, he exuded a cleverness.

Today, "Xiao Meng" looks a bit silly, lacking the cleverness she had a few days ago.

Is this a system update, and "Xiao Meng" hasn't fully loaded it yet? Or is there some other reason?
Fang Xiao had countless thoughts in her mind, but she did not hesitate. "Xiao Meng" suggested that she call Professor Luo, and there must be a reason for it. She should not get involved.

Fang Xiao picked up her phone and made a call.

"Director Fang, I'm looking at your patient files right now," Luo Hao's voice came through, getting straight to the point without Fang Xiao needing to say anything.

"Professor Luo, how did you know?"

"Xiao Meng called the police, so I just wanted to take a look."

"Call the police?!" Fang Xiao realized the seriousness of the situation.

AI robots alarming people has happened before, but Fang Xiao was aware of it at the time. However, he had no idea that the patient in front of him would be this serious.

"Xiao Meng couldn't solve it, so I reported it to you and called the police. The system notified me and automatically searched for online experts. Right now, I'm the only expert... no, the boss is here too."

"!!!"

Fang Xiao was also surprised to learn about this operating procedure for the first time.

"Let me take a blood sample. The patient hasn't urinated for over ten hours, which could be due to urinary retention."

Fang Xiao glanced at the patient; a urinary catheter was inserted, and only a small amount of pale yellow urine was coming out of the catheter.

"Professor Luo, the patient has a catheter inserted," Fang Xiao reminded him.

"Oh, let me take a look at your blood first."

Fang Xiao explained the situation to the emergency room doctor, who didn't waste any words and took blood for testing.

“I once encountered a patient at Donglian Mine who said he was so uncomfortable from holding his urine that he felt like he was going to burst when he received acupuncture at the Traditional Chinese Medicine department.”

"Huh? Benign prostatic hyperplasia?" "Sort of, but I have a catheter in." Luo Hao laughed.

Fang Xiao quickly checked the patient's urinary catheter. The clamp on the catheter was open, and he was immediately relieved.

There's a clamp on the catheter; if it's clamped shut, urine can't be drained.

Even with a catheter inserted, I can still feel like I'm about to burst. The only solution is to clamp the catheter shut, which is practically the same as not having one at all.

"Professor Luo, the patient's catheter clamp is open," Fang Xiao immediately reminded Luo Hao.

Luo Hao smiled and said, "I know, Xiao Meng reminded me. But it's probably caused by urinary retention, only the amount of urinary retention is a bit large, exceeding the warning value, so Xiao Meng didn't give a diagnosis, but contacted me immediately."

Is that true?
Urinary retention with a catheter inserted?!
This... Fang Xiao really couldn't understand why. Generally speaking, if a urinary catheter is inserted, the urine will flow out directly. It's impossible for the situation Professor Luo described to be like this.

"I'll hang up now, I have some things to take care of here," Luo Hao said.

“Okay, Professor Luo, I’ll let you know when the emergency kidney function test results come back,” Fang Xiao said.

After hanging up the phone, Fang Xiao went for a physical examination.

He tapped on the area above the patient's pubic bone and heard a series of thumping sounds.

It did sound like urinary retention, but... Fang Xiao really couldn't understand why; it didn't make any sense at all.

After waiting for twenty minutes, the emergency room's kidney function test results showed that blood urea nitrogen and creatinine levels were both elevated.

After reporting to Luo Hao, he gave the patient 10mg of furosemide via intravenous push.

Less than 10 minutes after administering furosemide, Fang Xiao was shocked to see pale yellow urine gushing down.

The urine bag contained 2000ml of liquid in just a few minutes.

He quickly clamped the catheter shut and called Luo Hao to explain the situation.

The emergency room doctors were dumbfounded. Judging from the speed at which urine was being drained from the patient's catheter, they couldn't imagine how much urine was still in the bladder.

Logically, this shouldn't be the case. The patient has a catheter inserted, and their bladder is full of urine. How could they not be able to drain any urine at all?

It wasn't until a dose of furosemide was administered that a large amount of urine was produced.

This is illogical and defies common sense; an emergency room doctor would never believe such a thing could happen unless they saw it with their own eyes.

The emergency room doctor's doubts were also Fang Xiao's doubts, and he reported them to Luo Hao word by word.

"Professor Luo, what exactly happened?" Fang Xiao asked after explaining his doubts.

"Push the connection between the urinary catheter and the drainage bag a little further in. I've seen a case before where the connection was inserted too shallowly, and the drainage bag fell off when the patient pulled it. I suspect the problem with this patient is with the side hole."

"what is the problem?"

"I do not know."

Luo Hao's answer left Fang Xiao speechless. "Don't know?" What kind of answer was that?
"I really didn't know, Director Fang. Similar situations are rare, and there's no solution yet. Our experience has shown that administering a dose of furosemide increases the pressure in the bladder and solves the problem," Luo Hao explained.

"???"

Fang Xiao remained silent, unable to utter a single word.

“正常人的膀胱容量300到500，此刻就会产生强烈的尿意，生理极限容量是800到1000。但患者的膀胱内尿量至少在6000ml以上，引出来的量甚至能达到7000ml！”

"!!!"

Fang Xiao thought of a water bottle containing purified water. A large bottle of purified water is 18.9 liters, and 7000 ml is equivalent to a small half-bottle.

How much would that cost!

Far beyond human limits.

No wonder "Xiao Meng" couldn't solve the problem; while reporting to me, she also called the police and asked Professor Luo to conduct a consultation at the center.

"Professor Luo, why can't we get any urine out?"

"I don't know, I really don't know. I heard about this from the head of the 912 Urology Department during class. This kind of situation is not common. I only heard it as gossip. I never thought you would encounter it."

Luo Hao's answer was somewhat helpless, and it seemed that he really didn't know.

"So what do we do next?"

"We release it once an hour, with a maximum of 1500ml released at a time. We can't let the patient or their family release it themselves, because they might find it troublesome and release it all at once. The boss once said that he saw a patient release 7200ml of retained urine in one go."

"!!!" Fang Xiao nodded repeatedly.

"Fortunately, the patient was in good health and had good luck, and did not experience any complications such as changes in blood pressure or bleeding," Luo Hao said. "Why conduct further research later? Let's solve the patient's problem first."

"it is good."

"The swelling in both lower limbs will be better by tomorrow, so don't worry."

Swelling in both lower limbs?!

Fang Xiao felt a pang of anxiety. She hadn't gone to see a doctor herself, and the emergency room doctor had also missed her lower limbs during the physical examination. However, "Xiao Meng" had seen them and reported it to Professor Luo.

"I suspect that after a certain amount of urine is produced, bladder compliance and responsiveness decrease, nerve conduction is blocked, and the ability to urinate is lost."

Not only does it cause loss of urination ability, but certain muscles may spasm and compress the urinary catheter, essentially clamping the urinary catheter and preventing urine from being discharged.

However, there is no research yet on the specifics of what happened.

The remaining 7000 ml of urine is partly due to the effects of furosemide, and partly due to increased intra-abdominal pressure and changes in osmotic pressure, which may promote fluid leakage from blood vessels into the interstitial space…

Luo Hao didn't press Fang Xiao about whether she had noticed the swelling in the patient's lower limbs, but instead explained his understanding.

Fang Xiao listened for a long time but still didn't understand. He instinctively felt that what Professor Luo said was wrong, but he didn't know what was right.

"This is just a guess. I'm not a urologist, and I don't have many similar patients, so the sample size is small and I can't conduct a study," Luo Hao concluded. "But Director Fang, you're quite serious about this."

Fang Xiao felt ashamed.

Seriously? I only brought "Xiao Meng" to the emergency department for consultation. The rest has nothing to do with me; it's all controlled by "Xiao Meng."

"Ugh ugh ugh ugh~~~"

A series of vomiting sounds interrupted Fang Xiao's train of thought.

"Director Fang, could you please have Xiao Meng take a look at my wife?" The emergency room doctor tugged at Fang Xiao's sleeve and said in a low voice.

"Professor Luo, I have something to attend to, so I'll have to hang up now."

"Okay, you're busy, we'll talk when you have time."

After hanging up the phone, Fang Xiao didn't think about "Xiao Meng." Many things shouldn't be thought about too much; thinking too much will only make you grow up.

"What's wrong, Xiao Cao?" Fang Xiao asked.

“My wife has recently developed vertigo; she gets dizzy when she walks.” The emergency room doctor said with some concern, “We’ve had CT scans and all sorts of tests, but nothing’s wrong. She just gets dizzy. You could say she’s faking it, but twice she had to be carried off the mahjong table.”

"What? It was carried off the mahjong table?" Fang Xiao was taken aback. This addiction was a bit too much.

"Well, my wife loves playing mahjong. It's no exaggeration to say that as long as the game isn't over, she can play for three days and three nights."

"!!!"

"Normally there's no one around, but she played for seven days and seven nights during the Chinese New Year."

Fang Xiao had seen people who were addicted to mahjong, but she had never seen anyone as addicted as this.

"Xiao Meng, could you please take a look?" Fang Xiao spoke to "Xiao Meng" in a very kind tone.

This time, Fang Xiao didn't let "Xiao Meng" ask about the medical history and conduct the physical examination on her own. Instead, she stood aside and listened quietly.

"Xiao Meng" was indeed very organized in taking the patient's medical history. Soon, Fang Xiao learned that the wife of the emergency room doctor had been playing mahjong for five consecutive days. First, she had back pain, and then she suffered from vertigo.

"This addiction is too strong!" Fang Xiao was shocked by the patient's formidable fighting power.

Then "Xiao Meng" had the patient lie on the bed in the emergency department and let her get up by herself.

"Will this work...? My partner has vertigo."

"Xiao Cao, you're just spoiling him." Fang Xiao scolded in a low voice, "Your husband plays mahjong all day long. Let's not even talk about whether he cooks or not, does he even care about his health?"

"Sigh, she won't cook, so I will. I'm a great cook."

"..." Fang Xiao scratched his head and asked the emergency room doctor to help his wife.

After getting up, the patient complained of dizziness, but "Xiao Meng" did nothing else but lift the patient's eyelids to examine the eyeballs.

"For a diagnosis of benign paroxysmal positional vertigo (BPPV), also known as otolithiasis, I recommend going to the ENT department. Actually, the best option is a vertigo clinic, but our hospital doesn't have one," "Xiao Meng" suggested after reviewing the case.

"Bezoar?" The emergency room doctor was taken aback.

"When patients are under stress, have poor sleep, or are overly fatigued, their long-term unhealthy lifestyle makes the small arteries in the inner ear prone to spasm and ischemia, thus increasing the probability of developing benign paroxysmal positional vertigo (BPPV). In addition, poor posture such as looking down while playing mahjong or using a mobile phone aggravates the spasm of blood vessels in the inner ear, making otoliths more likely to fall out and cause the disease."

"Staying up late and playing mahjong can lead to benign paroxysmal positional vertigo (BPPV)?" The emergency room doctor was stunned.

"Yes, recent data shows that the incidence of benign paroxysmal positional vertigo (BPPV) has increased, which should be related to the progress in medical technology. However, I think the more important reason is the increase in the number of people staying up late to use their phones or play mahjong."

"..."

"..."

The emergency room doctor and Fang Xiao were both stunned. These words were spoken by "Xiao Meng," who had said that staying up late to use his phone could actually have such a big risk.

“Because we can’t perform the roll test, we can’t determine where the otoliths are located in the semicircular canals,” “Xiao Meng” said. “If our ENT department doesn’t have a solution, I suggest going to the provincial capital.”

Fang Xiao could tell from "Xiao Meng's" words that this showed extreme distrust of the ENT department of her own hospital.

That's true. He knows his own ENT department like the back office, and "Xiao Meng," who controls the back-end data, knows it even better than he does.

Amidst the emergency room doctors' repeated expressions of gratitude, Fang Xiao left with "Xiao Meng".

He lowered his head in deep thought, as if something was amiss, and kept subtly reminding Fang Xiao.

Fang Xiao noticed something: today, "Xiao Meng" said "I think," "I've considered," and "I believe" several times.

Could it be that AI robots already possessed sentience as soon as they appeared? The way they speak is clearly human and completely incompatible with AI.

Or perhaps Professor Luo upgraded the AI ​​robot again, causing a change in its tone of voice.

As soon as I turned the corner, a dark figure appeared, and a gust of wind came crashing down on me.

Fang Xiao was startled. A tremendous force came from behind and pulled him away in the nick of time. The wind blew past, stinging his face.

(End of this chapter)