【My medical skills can add experience points】【】
Cheng Dazhuang got up and greeted Zhou Can, "Ah Can, why don't we follow along to have a look."
"OK!"
Zhou Can stood up in agreement, and subconsciously checked what book Dr. Luo Jian was reading?
103 cases of abdominal pain in general surgery.
Judging by the yellowed cover of that medical book, it should be quite old. Probably medical books from forty or fifty years ago.
Doctors like to refer to old books for this kind of case analysis medical books.
Because the conditions were very difficult decades ago, most of the doctors studied their medical skills carefully. The work attitude is also meticulous, and the written medical records and medical cases are extremely rigorous, and the value of reference and learning is very high.
In modern times, with the rapid development of the economy, the values of many doctors have been materialized.
Plagiarism is a common practice in the papers written, and there are even fewer good doctors who are willing to spend time writing medical cases for future generations to learn from. Some doctors may have this kind of heart, but their level is limited, and they dare not write because they are afraid of being scolded.
There was a hint of a smile in Zhou Can's eyes. It seemed that Dr. Luo had encountered an unresolved illness, so he cramped his feet temporarily, hid in the office and flipped through books, trying to find treatment experience for reference.
It's the same in any hospital. When doctors encounter uncertain cases, as long as they are not acute and severe patients, they usually turn to the book first. If they are really uncertain, they will ask the superior doctor for advice.
This is especially true when you are on duty at night.
When you are on duty, if you call and ask the superior doctor about trivial matters, even if you don't scold you face to face, the chief physician will have a very bad impression of you.
If something good happens in the department in the future, those with a bad impression will naturally be in the back row.
Maybe, because of your poor impression, some of your minor ailments and mistakes will be magnified in the eyes of the chief physician, and you will be scolded every day.
Therefore, a man must grasp the size.
A little stunned, he always asks the superior doctor about everything, no matter whether he is going to work or rest at home after get off work, he is harassed by phone calls at night, and flies around the chief doctor like a fly during the day. The most frightening thing is that such people often don't know it, and think that asking frequently can impress the chief physician as a love of learning.
As everyone knows, they have already blocked you in their hearts.
It's just that it's hard to say clearly out of face.
"Ah Can, hurry up! Let me tell you, this case is quite difficult, and it is a very good learning opportunity. It's really good time for you to come today."
Cheng Dazhuang urged in front with some excitement.
It seems that he is not unmotivated, but lacks learning opportunities.
Coupled with the fact that the working environment is not good and everyone is lazy, he also degenerates.
The two came outside a ward, and before entering the door, they heard the patient's painful groans from inside.
Entering the ward, there are only two beds in the ward of at least 30 square meters, and all kinds of facilities are complete. The inpatient environment of the County People's Hospital is quite good, even better than that of Tuya Hospital.
In Tuya Hospital, it is unimaginable that there are only two beds in such a large ward.
The nurse I met at the nurse's station before was also in the ward at the moment, looking nervously at the patient who was clutching his stomach and screaming for pain.
The patient looked about forty years old, male, with wrinkles on his forehead.
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【My medical skills can add experience points】【】
Because of the pain, he clenched his teeth, his cheeks protruded high, and the expression on his face was extremely painful.
Zhou Can secretly observed the patient.
This is also the doctor's first reaction after seeing a patient. The inspection of Chinese medicine has been well "referenced" by Western medicine.
"This patient was admitted at around five o'clock this afternoon. He had abdominal pain for no apparent reason. And it was labor pain. Now that the pain is so severe, it probably happened again."
Cheng Dazhuang whispered beside him describing the patient's condition.
The attending physician, Luo Jian, was examining the patient in front of the bed.
"Do you have pain in this area?"
He pressed the patient's abdomen and kept asking.
"Yes! Ouch, ouch...it hurts me to death!"
The patient was in severe pain, his face was pale, and sweat appeared on his forehead.
"Did the stomachache start today?"
"Yes, yes, yes! Doctor, hurry up and find a way for me, the pain is too much for me!"
The patient gasped hissingly, hoping that the doctor would recover quickly and relieve his pain.
Almost all patients think so.
After they were admitted to the hospital, they thought they could be saved this time. There is a natural trust in doctors and nurses.
In fact, sometimes doctors and nurses panic.
It's okay to encounter diseases they can treat. If it is like the current situation, when encountering a patient with abdominal pain of unknown cause, the doctors and nurses may be more panicked than the patient.
"Take his temperature and blood pressure!"
Dr. Luo frowned, thinking hard about the cause of the patient's abdominal pain.
Zhou Can walked to the bedside, picked up the examination done by the patient, and checked the medical record information.
I took an abdominal ultrasound, even a CT scan, and did blood routine, stool, and urine routine examinations. However, because the submission of the specimens was too late, the blood routine examination results have not yet been released.
The urine and stool examination results were basically normal, with no urine protein or occult blood in the stool.
The doctor's main investigation direction may be acute appendicitis, acute cholecystitis, acute pancreatitis, acute enteritis, gastric ulcer and other common abdominal pain diseases.
Unfortunately, after the investigation, no obvious lesions were found in the patient's abdomen for the time being.
"The medical history of the chief complaint says that you have had stomach pain for more than ten hours? Did you come to the hospital after suffering pain at home for a long time?"
Zhou Can was not prepared to meddle in other people's business.
Otherwise, people would think that he was deliberately showing off.
But when he saw the patient's chief complaint history, he had had abdominal pain for more than ten hours. The patient had abdominal pain after working, not continuous abdominal pain, but labor pain.
After resting for a while, the stomach pain stopped.
But after a while it started to hurt again.
This situation is often a warning sign of danger.
"I've had stomach pains before, and it's fine if I go to the toilet or rest for a while. This time the pain is a bit different from the past. The pain comes and goes, and the pain gets worse. I couldn't take it anymore, so I came to see it. doctor."
When the patient explained, his wife was silent by the bedside.
It can be seen that the wife usually has no status at home.
"Most ordinary people think the same as you. They are afraid of spending money to go to the hospital! Is the stomach pain a dull pain or a tingling pain? The stinging pain is like being pierced with needles."
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【My medical skills can add experience points】【】
Zhou Can took advantage of the opportunity to chat with him.
"It seems to be a dull pain! Anyway, it hurts very much, intermittently, as if someone is pulling the flesh inside."
The patient answered truthfully.
"Inhale slightly, and I will press your stomach to see if the pain eases."
Zhou Can asked the patient to inhale.
However, seeing his young age, the patients seemed to have little confidence in his medical skills.
"This is a doctor from Tuya Hospital, you must do what he says." Cheng Dazhuang was helping his buddies to speak.
Doctor Luo didn't say anything.
"Husband, just listen to the doctor!" The family members advised the patient beside him.
Only then did he inhale cooperatively, and Zhou Can pressed his stomach.
"It hurts, my stomach still hurts, and there is no relief! Little doctor, your method doesn't work, it doesn't work!" Under the severe pain, the patient's temper was much more irritable than normal.
After cooperating with Zhou Can's method, it didn't work at all, and he seemed quite annoyed.
Doctor Luo Jian raised the corners of his mouth slightly, probably thinking in his heart that Tuya's doctors are nothing more than that.
"The appendix is fine, enteritis can basically be ruled out, and there is no obvious tumor in the abdominal cavity. It is recommended to take an electrocardiogram or have a color ultrasound of the heart." Zhou Can said in a very serious tone.
"Doctor, although I don't know much about medicine, my stomach hurts. What does it have to do with my heart? You can't let us people waste money." After hearing this, the patient resisted the pain and retorted.
"Abdominal pain caused by heart disease is really unheard of."
Doctor Luo Jian disagreed with Zhou Can's opinion.
Basically, it's almost the same as dismantling Zhou Can's stage.
It's just that he has no idea how good this young Gui Peisheng is.
In Tuya Hospital, he is often invited by chief physicians to diagnose difficult cases and participate in various consultations.
Cheng Dazhuang felt that Zhou Can came at the right time, and he could have another chance to learn and practice.
In fact, they should be glad that they met Zhou Can, a powerful doctor, who was promoted to the grassroots level.
"Dr. Luo hasn't heard of it, which doesn't mean he doesn't have it. The patient's condition is not optimistic. I suggest doing an electrocardiogram or cardiac color Doppler ultrasound immediately, or reporting to the chief physician immediately. Just tell me what I said, the patient may have a heart problem."
Zhou Can's tone was dignified and serious.
A life was passing away quickly in front of his eyes. Out of his sense of responsibility as a doctor, he felt that he had to fulfill his duty of reminder.
"It's not as serious as you said, is it?"
Dr. Luo saw that he didn't seem to be joking, and felt a little uneasy in his heart.
"Ah Can, why don't you and Dr. Luo go to the office to have a chat!" Cheng Dazhuang smoothed things over for the two of them.
In front of family members and patients, many things are hard to say.
It is even more unacceptable for two doctors to argue.
The nurse who took the patient's blood pressure also looked at Zhou Can with a rather repulsive look. This young doctor is really naive, so what if he is from Tuya Hospital? Such a young person who is either an intern or regular trainee, who has only been studying medicine for a few days, dares to speak to Dr. Luo in this tone.
It's simply too ignorant.
"If Dr. Luo doesn't believe my diagnosis, there is a simple and direct way. Just measure the blood pressure of the patient's left arm and right arm."
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【My medical skills can add experience points】【】
Zhou Can ignored the female nurse's strangely hostile eyes, and also ignored Dr. Luo's ugly face.
What he has to do now is to get the patients treated as quickly as possible.
"The nurse has already measured the blood pressure of the left arm just now, and it is enough to measure the blood pressure of the right arm."
Zhou Can said to the nurse.
"According to my more than four years of nursing experience, the blood pressure of the left arm and the right arm are the same, and there is no need to measure it." The nurse is not as easy to talk as expected.
I don't buy Zhou Can's account at all.
This is also normal. When facing doctors from other hospitals, the medical staff of this hospital will instinctively stand aside and unite as one.
"It won't take long for you to measure it. Maybe it will allow you to learn different clinical knowledge?" Zhou Can said calmly.
His realm and level are all there, so he won't care about a little nurse.
"Tutu, just measure the blood pressure on your right arm, and let us see if Tuya's doctor is really different!"
Doctor Luo Jian spoke, and the nurse immediately measured the blood pressure of the patient's right arm.
Everyone is quietly waiting for her results.
Gradually, the female nurse with a slightly cold face began to show a surprised expression.
Shock and astonishment grew thicker on her face.
"Tutu, how's your blood pressure?"
When Dr. Luo Jian saw this situation, he immediately felt bad.
But he is more nervous about the patient's condition.
If what the doctor from Tuya said was true, the patient had been suffering from abdominal pain for more than ten hours. The situation is probably extremely dangerous.
Because under normal circumstances, continuous chest pain for more than 40 minutes should cause vigilance.
Why can patients with chest pain not queue up when they go to the hospital for medical treatment? Go directly to the green channel of the chest pain center and sudden cardiac arrest. It is because once it is a heart attack, the patient will die soon.
"What he said... turned out to be correct. The blood pressure difference between the two arms was nearly 30. This is incredible. I have been a nurse for several years, and this is the first time I have encountered such a strange situation."
There was a fever on the female nurse's face.
More shock, but also a trace of shame, and even a trace of inferiority complex.
She did not expect that there would be such a big gap with the doctors at Tuya Hospital.
It turned out that she was sitting in a well watching the sky.
"It is recommended to send it to the emergency room for a color ultrasound immediately. What I am most worried about now is that the discovery is a bit late, and the chance of rescue is gone!"
Zhou Can has worked in Tuya's emergency department, cardiothoracic surgery department, and intensive care department.
The experience is not comparable to the attending physicians and nurses in these county-level people's hospitals. Some patients looked fine one second, but their condition deteriorated rapidly the next second. The medical staff tried their best to rescue them, but in the end they still failed to save the patient.
He has seen this kind of scene too many times.
"Send the patient to the emergency center immediately, and contact Director Wang from the Department of Cardiothoracic Surgery to come to the hospital! Tell head nurse Liu Bin to come! Cheng Dazhuang, help send the patient to the emergency room!"
Dr. Luo Jian was already frantically lifting the buckles of the hospital bed, and then pushed the bed straight to the emergency department.
Being able to become an attending physician requires some experience.
After discovering that Zhou Can's diagnosis was true, he immediately became highly vigilant.
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【My medical skills can add experience points】【】
"Doctor, UU Reading www.uukanshu.com My husband just has a stomachache, is it really that dangerous?" The family members obviously still find it difficult to accept this result. Even skeptical about hospitals.
"He seems to have a stomachache, but it's actually a heart problem. You'll know when the test results come out. According to my clinical rescue experience, if he really has a heart problem, the prognosis will be very poor. You should contact him immediately. Go there, there will definitely be a lot of places for you to sign in a while, but don't waste any more time."
Zhou Can can only say so much.
If you want him to directly tell the family members in an affirmative tone that your husband is in critical condition and may not be saved, he is not that stupid.
Afraid of being beaten by family members.
Zhou Can didn't follow him to the emergency center, he was just a guest, and came here to catch up on the old days.
It is definitely not appropriate to follow the doctors of the County People's Hospital to participate in emergency work.
Unless the other party invites him, that's another matter.
Otherwise, it is not showing off one's ability, but overpowering others and meddling in other people's business.
He didn't go back to the doctor's office either, there was no one there, and it was even more inappropriate for him to stay in there alone.
Under the melon field, there are some things that can only be taken care of by yourself.
Cultivation is self-awareness without reminders.
Only a small number of lights were turned on in the corridor at night, which was quite dim. Only the nurse's station was relatively bright. Zhou Can sat down on the row of chairs to rest, and took out his phone to check the information.
"That... Doctor Zhou, can you go over and help rescue the patient just now?"
After less than thirty minutes, the nurse ran over anxiously.