【My medical skills can add experience points】【】
"Probably not! The child's grandma never said this, and we see the child almost every day, and we have never seen the child get hurt." The man is still not convinced that the child was stabbed by a rusty sharp object Pass.
This is also out of trust in the elderly.
After all, it is his mother who takes care of the child at home.
"Husband, call Mom and ask Mom! The doctor will definitely not talk nonsense!"
The woman has already begun to persuade her husband.
The man believes in his mother, and the daughter-in-law is separated by a layer after all, and it is already very good to be able to get along well.
Now that this kind of thing happened, she dared to be suspicious of her mother-in-law.
After hesitating for a few seconds, the man met his wife's gaze and finally took out his mobile phone to make a call.
The child himself was already very ill.
Finding out early will help the doctor's diagnosis.
"Mom, you are at home!"
…
"We are in the hospital with Xiangxiang! I would like to ask you something, has Xiangxiang been hurt by anything recently? The doctor asked us to ask if the child has ever been hurt by a rusty object."
Afraid of causing the old man's displeasure, he explained again.
After hearing a few words, the man's face changed slightly.
"Ah... I was really hurt by a rusty angle iron! Okay, I know. I have to call the doctor here, so I won't tell you! We won't be back at noon, you don't have to wait Let's just eat by ourselves!"
It can be seen that the man is not very old, twenty-seven or eighteen years old, but he is very filial.
Zhou Can could already hear it clearly by the side, so there was no need for him to repeat it.
A second checklist was issued directly.
"I initially suspect that the child has sepsis, which is more dangerous. You should check the procalcitonin first. After the results come out, I will formulate a corresponding treatment plan for the child according to the situation."
Zhou Can saw that the child's mother's face was very ugly, and wanted to tell the family members to be more careful with the child in the future, and it is best to put nails, knives and other sharp objects away.
There are also some tranquilizers and blood pressure lowering drugs that adults take, and they should also be kept out of the reach of children.
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Children are full of curiosity and exploration about everything in the outside world.
The first sensory organ that babies use to explore the outside world is not the hands, but the tongue. For all animals, eating is an instinct from the moment of birth.
When babies eat, they first use their tongues to lick the taste of objects.
It's the taste they like, that's what **** and swallows.
Therefore, the tongue is the earliest organ used by humans to explore external things, not the hands.
Human hands and feet were originally organs used for crawling.
Even in adulthood, the main function of the hand is not to perceive things in the outside world, but to grasp objects.
Children under the age of three have almost no ability to distinguish, and they will instinctively stuff everything they think they can eat into their mouths. The little girl only scratched her hand with a sharp rusty object, which is luck among misfortunes.
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At least leave the chance of treatment to the doctor.
Seeing the little girl's parents anxiously holding the child for examination, Zhou Can was already thinking about the next treatment plan in his mind.
Let the patient do a second check, just to confirm the diagnosis.
In fact, based on his experience and medical knowledge, he was 80% sure that the child had sepsis.
"Dr. Zhou looked young, but he didn't expect that the level of diagnosis was so high! That little girl was stabbed by a rusty sharp object. Even his parents didn't know, but you just looked at the blood test results and inferred It’s really amazing! I’ve learned a lot today!”
A woman with a very bad complexion but an extremely obese body sat down at Zhou Can's consultation table.
When looking at Zhou Can, he was full of admiration.
Not only her, but also the family members and patients who watched the excitement just now admired Zhou Can very much.
He has the news of the interview to bless him, and his image of an 'expert' has gradually increased.
It's just that this kind of fame promotion has certain limitations, and the scope is very small.
Only the dozen or so patients and family members who were onlookers at the scene knew that he was capable.
It is really not easy to accumulate a famous doctor.
All beginnings are hard.
Other famous doctors are like him, accumulating popularity little by little, and eventually become very well-known medical experts.
In addition, in addition to relying on the way of treating patients to enhance their reputation, famous doctors have a certain bonus effect in publishing scientific research results and academic papers. Then there are senior honorary titles such as senior professional titles, excellent youths, outstanding youths, Changjiang Scholars, academicians, etc., which have a greater added effect.
As for the titles of professor and expert, in the eyes of industry insiders, they belong to bad street titles.
Chief physicians who do well can basically reach the professor level in medical schools.
"You have won the prize! Is there something wrong with your body?"
Zhou Can looked the obese woman up and down, and asked about her condition straight to the point.
Judging by her complexion, there must be something wrong with her body.
After she sat down, she conveniently placed the registration note in front of Zhou Can.
"I just feel a little heartburn, I can't eat, I keep vomiting, and it hurts when I eat!" The woman described her symptoms.
Zhou Can glanced at Deputy Director Shi at the desk next to him.
The symptoms described by this woman should belong to digestive tract diseases.
At this moment, Deputy Director Shi was reviewing the examination data of a patient repeatedly, frowning tightly. Looking at this situation, most of them have encountered difficult cases.
It's fine if he doesn't ask Zhou Can for help.
If Zhou Can pushes another patient over, it is estimated that Deputy Director Shi will definitely be angry.
Zhou Can regained his composure. He has been trained in the Department of Gastroenterology for more than two months, and he can easily deal with general digestive tract diseases. Even if it is a difficult digestive tract disease, as long as it doesn't happen to touch the short board of his knowledge, he can probably diagnose it.
"How long has this symptom lasted?"
"It's been almost a month!"
"Did it appear suddenly, or did it appear slowly?"
"It slowly emerged after I used a special weight loss method online."
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【My medical skills can add experience points】【】
She bowed her head in embarrassment and replied.
"What kind of special law?"
Zhou Can asked.
There are various ways to lose weight online, many of which are fabricated and packaged by unscrupulous businesses. Some of them are figured out by non-professionals. They may be effective for the parties concerned, but they are not suitable for everyone.
There are also some methods that can only be written by the magic sticks after they have become obsessed.
For example, do not eat whole grains, and only eat a little water and low-calorie food to maintain basic life.
Others are even more exaggerated, talking about bigu, the food eaten is gradually reduced day by day, and finally reaches the so-called Qi therapy. This set was learned from a Taoist priest, swallowing purple qi in the morning and swallowing xia in the evening.
Normal people certainly don't believe this.
However, there are some obese people who go to the doctor in a hurry, and they really believe what they say.
After a lot of tossing, he almost killed himself, and was finally carried by his family to the hospital for emergency treatment.
Zhou Can has received similar cases in both gastroenterology and surgery.
What kind of weight loss method did this woman use?
Seeing her weak and seriously ill, I'm afraid she must have been tossing a lot.
"Me, I used a special medical weight-loss device called fairy tube to lose weight. When I bought fairy tube online, the seller's service was very good. I also invited a special medical expert to give lectures, teach us how to operate, and tell us In this way, you don’t have to worry about all kinds of side effects after taking diet pills to lose weight.”
I saw the woman hesitated and took out a plastic bag from her satchel, which contained a transparent plastic tube with an astonishing diameter.
Its length is at least half a meter or more by visual inspection.
The inner diameter of the pipe wall should be no smaller than a penny.
How to lose weight with such a thick tube?
"How do you usually operate? You don't need to demonstrate, just explain it."
"After about half an hour after eating the food, extend the tube from the mouth into the esophagus, push it all the way in, until it reaches the stomach, and then lean over to **** out the food in the stomach."
She even explained it with gestures.
After listening, Zhou Can couldn't help stroking his forehead with one hand. What kind of people dare to be called medical experts these days.
Doctors perform gastroscopy on patients, are they absolute professionals? All patients have to be fasted in advance, make adequate preparations, and be more careful during the gastroscopy process, and all kinds of protective measures are in place.
I can't imagine that the patient directly pokes such a thick plastic tube into the stomach, which is simply too scary.
Aren't those unscrupulous merchants afraid of killing people?
For money, criminals really dare to do anything. As long as you eat food that won't kill you, they will dare to sell it, regardless of whether you have excessive pesticide residues or the risk of cancer if the food deteriorates, anyway, that is the consumer's own business.
"How many times have you used this tube?"
"I can't remember exactly, but it should have happened twenty or thirty times!"
"Now, from the standpoint of a professional doctor, I am very responsible to tell you that this method of weight loss should never be used in the future. It is very easy to damage the esophageal mucosa and your stomach wall during the operation. It may also cause Bacterial infection can cause tracheitis and bronchitis. In more serious cases, food that causes regurgitation enters the trachea, and suffocation and death may occur.”
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"Using this extreme method to spit out food is also very harmful to the body. The contents of the stomach contain a lot of gastric acid, which will severely burn the esophagus, trachea, throat, vocal cords, etc. when regurgitated."
Zhou Can could only persuade her earnestly.
As for people not listening, there is no way.
Doctors have no way to limit patients' thoughts and behaviors, they can only fulfill their duty of persuasion.
"Let's prescribe two tests for you to see the specific situation in the esophagus and stomach! Judging from your symptoms, the esophagus and stomach may have been damaged to a certain extent. And hearing your voice is rough and hoarse, I'm afraid the vocal cords were also injured."
Zhou Can applied for an examination for her and asked her to make an appointment for a gastroscopy examination first.
"I really don't understand, since you care so much about your figure, why don't you control your diet and exercise more?" Ji You looked at the back of the obese woman leaving, and sighed deeply.
"In the final analysis, there are two reasons. I want to be greedy for my tongue, and I want to eat delicious food when I see it. I don't want to exercise and exercise more. At the same time, I want to have a slender body. How can there be such three people in the world? All good things?"
Zhou Can can see clearly.
The unscrupulous merchants just seized on the patient's desire for pleasure and the idea of having a beautiful body.
At this time, the little boy with a sprained foot came back after taking the X-ray film.
"Doctor Zhou, this is the picture just taken, please take a look."
The little boy's grandfather sat down with the child in his arms.
After receiving the film, Zhou Can found that the child's right navicular bone had an obvious fracture line, and the fracture line could not be seen on the front or side of the talus.
The boy suffered only minor fractures.
Hematoma in the ankle area, this is not a problem. There will be some pain for a while, but it will disappear after a couple of days.
The self-healing ability of the human body, as well as the absorption ability of this local hematoma, are very powerful.
"His sprained ankle is quite serious! Look, the navicular bone has been fractured."
Zhou Can showed the film to his family members.
Theoretically speaking, the scaphoid, talus, first and second cuneiform bones are all prone to fracture during sprains.
However, the navicular bone is the most prone to fracture.
related to its location.
It is an important link connecting the heel to the toe. When sprained, often this part bears the most violent external force.
Moreover, the vast majority of sprained feet are sprained to the outside.
When the foot hits the ground, the center of gravity is unstable, and the foot skims toward the outside of the foot. In this case, the body's own body weight plus the superposition of the unbalanced force can easily exceed the bearing range of the bones.
resulting in a fracture.
Zhou Can has seen the most serious, direct comminuted fracture.
There is no way for external fixation and reduction at all, and the only option is surgery.
And even with surgery, it is difficult for patients to return to their previous athletic ability.
"Then, what should we do? His father and mother have left, and his father is working outside. His grandma and I are bringing our grandson. Doctor, you need to help us find a way!"
Grandpa didn't expect his grandson to be injured so badly, so he became anxious when he heard it.
The first reaction of many family members at this time is to cry miserably.
Zhou Can is also used to it.
"Don't worry, I'll try to put a plaster cast on him and perform external fixation and reduction treatment. But you must follow the doctor's advice, and you must not let the child's temper. If the recovery is not good, causing walking disabilities, then it's okay It's easy."
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There is a certain amount of scaring in these words.
Zhou Can also had good intentions, his face was black, but his heart was red.
The little boy's parents are divorced, his father is not at home, and his grandparents live with him. Under normal circumstances, it is difficult for grandparents to control their grandchildren. All kinds of pampering since childhood are the most true portrayal.
Zhou Can is now performing external fixation on the fracture of the little boy, but the little boy is naughty and took it apart within two days.
Then the therapeutic effect of correction cannot be achieved.
It's really possible to be disabled.
After recovery, you can walk. But will limp.
"All right, all right, we will definitely listen to you!" Grandpa couldn't help but use the honorific address for Zhou Can. As soon as he lowered his head, he glared at his grandson again and said fiercely, "Boy, did you hear what the doctor said? If you don't obey this time, your legs will be disabled."
The mouth is fierce, but the eyes are full of kindness.
"Yeah! I'm obedient!"
The little boy promised very simply, but it is not clear whether he can really do it.
Zhou Can performed external fixation of the fracture on the little boy.
To put it bluntly, it is a plaster cast.
When he was done, he checked it carefully. After observing for more than ten minutes, I didn't find that the bandage was too tight to block the blood flow, so I was relieved.
Applying plaster seems to be a very simple matter, but novice doctors often tie the bandage too tightly or too loosely because of nervousness.
If it is too loose, the ideal fixing effect cannot be achieved.
If it is too tight, it is easy to cause ischemic necrosis of the patient's lower limbs.
This kind of thing has never happened in a big hospital like Tuya, but he heard it from his colleagues in the orthopedic surgery department. Some patients were treated with plaster in small clinics because of foot fractures, greedy for cheap. Later, because the bandage was wrapped too tightly, the blood supply of the lower limbs was blocked, which directly led to necrosis of the lower limbs.
When she was sent to Tuya Hospital, her limbs had to be amputated to save her life.
Many seemingly simple operations in large hospitals often lead to medical accidents and even fatalities in small hospitals or clinics.
This is because large hospitals have inheritance and a three-level responsibility mechanism.
Many blood lessons have been passed down from generation to generation. Therefore, the probability of accidents in large hospitals is much lower.
Zhou Can gave some precautions~www.mtlnovel.com~ and sent the grandfather and grandson away.
There are very few patients looking for him to see a doctor.
There were also people who came to him with the results after the examination.
After more than an hour, the little girl whose palm was scratched by the rusty angle iron came back after checking the procalcitonin. Sure enough, as Zhou Can expected, the test result was abnormally high.
Now the patient has basically been diagnosed as sepsis.
Since the patient reported anuria and oliguria, Zhou Can deduced that there must be something wrong with the patient's renal function.
Now that the cause of the disease has been diagnosed, it is the process of admission to the hospital.
Before that, kidney function must be checked.
The urine test is one of the important tests. The patient had no oliguria, so he could only ask the child to drink more water. In the end, he just squeezed out a urine sample and sent it for testing.
In addition to this method, doctors have other methods for patients who are really anuric.
Like inserting a catheter.
If it fails, it means that there is no urine in the bladder, and the situation is serious. At this time, CT, ultrasound and other examinations can be done to further clarify the condition of the kidneys.
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【My medical skills can add experience points】【】
Some patients with kidney failure may even experience severe atrophy of the kidneys, and the kidneys can hardly be seen on imaging examinations.
The little girl clearly hadn't made it that far.
After a series of examinations, the little girl was finally diagnosed with sepsis and acute renal failure. Zhou Can admitted her to the hospital for emergency treatment.
It was also the first patient he admitted to the hospital alone.