My Medical Skills Give Me Experiences Chapter 289

As the number one expert and the general manager of the expert group, it is impossible for her to accompany the patient for the examination.

But she was worried about sending someone else.

Only by sending Zhou Can to accompany the pregnant woman for an examination can she feel more at ease.

With Zhou Can's excellent rescue ability, if a pregnant woman is really in danger, she can be rescued immediately.

"Can I go with you?"

The female reporter Mu Tie seemed to have sensed the smell and followed her.

"Non-medical personnel, it's best not to go, because it may interfere with the normal rescue work. If you want to interview, you can do it afterwards."

Section Chief Tang said it politely, but in fact he told the female reporter explicitly that he couldn't do it.

The situation of this pregnant woman is scary to look at. If she dies, God knows how these media reporters will report.

As the chief of the Propaganda and Traditional Warfare Section, he must guard against potential propaganda risks.

"Oh well!"

Even though Mu Ge was unwilling, she had no choice but to give up.

Pregnant women's inspections are expedited throughout the process, and they take the green channel.

She is already like this, and no one dares to let her line up for examination like ordinary patients.

After the X-ray was taken, the pregnant woman kept crying that she couldn't breathe, which was very uncomfortable.

Fortunately, the chest X-rays and femoral head x-rays have been checked.

However, it will take a while for the X-ray inspection results to be printed out on the self-service printer.

"Let's inhale oxygen through one nose first! The concentration is 28%, and the oxygen flow rate is 1.6l/min!" Zhou Can saw that the blood oxygen of the pregnant woman has been very low.

Give the pregnant woman oxygen through one nose first, keep it up for a while, wait until the X-ray examination results come out, and then consult Director Zhang Bihua for diagnosis.

While waiting for the results, he took the patient's chest X-ray to check.

There were diffuse infiltrating shadows in both lungs of the patient, but no obvious lesions were found in other parts.

Usually, when a diffuse infiltrating shadow is detected in the lung, the first consideration is infection.

such as bacterial and fungal infections.

The pregnant woman had difficulty breathing the day after the fall. There may be an infection, but it is relatively small.

Tumors can also cause diffuse infiltrating shadows in the lungs, such as patients with advanced lung cancer.

Zhou Can's experience is limited, and after watching the film, he can't give an accurate answer.

Because there are too many causes that can cause diffuse infiltrates in both lungs.

Lung infections caused by viruses, fungi, and bacteria, lung tumors, cancerous lymphangitis, diffuse lung injury... What is the specific cause, not to mention Zhou Can, even the experienced director Zhang Bihua may not be able to diagnosed.

Now it is only determined that there is a problem with the lungs. What is the cause of the lung lesions needs to be further checked.

After waiting for more than ten minutes, the X-ray examination results were finally printed out.

The right femoral head fracture was obvious.

This is consistent with Director Zhang's prediction. No wonder the patient can no longer stand and walk, the femoral head has been broken, how can he stand and walk?

I really admire this pregnant woman, who actually resisted at home all night after the fall.

"Go get the blood test results for this patient and send them directly to Director Zhang Bihua."

Zhou Can said to a nurse accompanying him.

"OK!"

The nurses that Tuya brought over could be regarded as her own family.

Zhou Can's orders were well executed.

"Doctor Zhou, what are you going to do next?"

Chief Tang asked.

"I'm going to push it directly to the outpatient hall to ask Director Zhang to diagnose her cause."

Zhou Can would never dare to diagnose such a high-risk pregnant woman by himself.

He doesn't have the ability, and he can't afford the responsibility.

"I'm just a little worried that pushing her over will affect the normal order of diagnosis and treatment in the consultation hall."

Section Chief Tang is obviously not willing to push pregnant women to the outpatient hall.

Zhou Can understands his worries.

"If you think it is better to push her directly to the emergency room, I have no objection. However, I think that pushing her directly to Director Zhang can make a rapid diagnosis of her with the experience of many experts in our Tuya Hospital. This is the most economical way of time."

What Zhou Can considers is the safety of the patients, but Section Chief Tang considers the prevention of the negative impact of the hospital.

He was afraid that patients would have accidents in the outpatient hall.

I am even more worried that the cause of the disease will not be found out, and many Tuya experts have become nothing in front of the media.

The best way is to send the patient to the emergency room.

It's just that the cause of the disease is unknown now, and sending it directly to the emergency room will undoubtedly make pregnant women wait for a long time before they can get a diagnosis. Because she looks scary now, but her physical condition is still stable.

The on-site experts discussed it yesterday, and the crisis team will handle any crisis situations.

It is absolutely impossible for the experts to stop their work and run to the emergency room to diagnose the pregnant woman.

"The doctors in the emergency room can actually make a diagnosis." Section Chief Tang was still deadlocked.

Zhou Can couldn't refute him face to face, so he looked at the patient's husband and father-in-law, and winked quietly.

Although the husband of the pregnant woman is a barbarian, he is not stupid, and has a bit of cunning and cleverness unique to farmers. During the War of Resistance Against Japan, the peasant brothers made the Japanese army suffer a lot.

There are many brave farmers who act as good citizens on the surface, but secretly drug and stab the Japanese soldiers stationed in the town.

"Can a general doctor be the same as an expert? My daughter-in-law has an expert account, so I must let an expert treat her disease!"

Saying that, the husband of the pregnant woman pushed the flatbed cart to the outpatient hall.

Section Chief Tang was able to 'discuss' with Zhou Can, but he had nothing to do with the family members.

I can only watch helplessly as the patient is pushed into the outpatient hall.

At this time, the nurse Ji You had already received the patient's blood test report and arrived.

"Director Zhang, the femoral head of this pregnant woman was broken as you expected. The chest X-ray showed diffuse infiltrates in both lungs."

Afraid of delaying the patient's condition, Zhou Can hurriedly reported to Director Zhang.

"Is the heart okay?"

After hearing this, Director Zhang immediately took over the inspection report and checked it.

"My level is still low, and I haven't found any problems for the time being." After Zhou Can answered, he took the opportunity to look at the blood test report. There were no abnormal white blood cells, indicating that the possibility of lung infection with bacteria and viruses is relatively low.

This shows that the patient's lung disease is likely to be related to the fall.

He wondered to himself, could it be that the pregnant woman already had lung cancer, and this fall just showed up?

This is true in clinical practice.

Some patients have very strong tolerance, even if they feel unwell, they still endure silently.

I didn't think about going to the hospital until I was completely overwhelmed by other diseases such as a cold or a fall, and I couldn't afford it.

"Have you ever had trouble breathing or trouble with your lungs before?"

Zhou Can asked the patient.

As the deputy leader of the crisis management team, he must play his due role.

Help the attending experts to find the cause of the patient together, and try to avoid the tragedy as much as possible.

"No... yes! I feel the baby is moving constantly, is it okay?"

Abnormal fetal movement occurs after the pregnant woman inhales oxygen.

Usually, you can feel the obvious fetal movement at three months of pregnancy, and at five months, the fetal movement is already quite obvious.

"Yang Chan, measure her fetal heart rate!"

Director Zhang was still frowning and thinking about the reason for the diffuse infiltrate in the lungs.

This is the main cause of breathing difficulties in pregnant women.

Only by finding the cause of the lung disease can it be solved.

Zhou Can stood by and watched.

When Yang Chan lifted the pregnant woman's clothes, Zhou Can found that there were bruises everywhere on the pregnant woman's abdomen. Not just in one place, but everywhere.

At first, he thought that the pregnant woman had suffered domestic violence and was beaten like this.

After careful inspection, it was found that these ecchymosis were irregular in size and shape.

And spread all over the upper body.

"Let me see if there is any abnormality in your back!"

After Zhou Can explained, she pulled up the collar of her clothes to check the patient's back.

The result was the same as the chest and abdomen, with ecchymosis everywhere.

Seeing this situation, he was immediately on high alert.

At this moment, Yang Chan had already measured the fetal heart rate.

"The fetal heart rate is generally quite normal."

Her words also made everyone a little relieved.

The child is fine.

The fetus in the womb is actually not as fragile as we imagined. Sometimes, even if the abdomen of a pregnant woman is accidentally hit or other accidents occur, the fetus will be safe and sound.

There was even a pregnant woman who was hit by a car accident and was knocked five or six meters away.

By the time the paramedics arrived, the pregnant woman was seriously injured. He was pulled back to the hospital for emergency treatment, but failed to be rescued. The doctor detected that the fetal heart rate of the pregnant woman was still there, but it was a little weak, so he quickly performed a cesarean section.

A premature baby was taken out, and after examination, everything was normal.

After living in the incubator for nearly a month, the baby survived smoothly.

It can be seen from this that the fetus is actually very safe in the mother's womb.

With the cushion of the mother's abdominal fat layer and the protection of amniotic fluid, the fetus can be like wearing two thick cotton coats.

"Squad leader, check her armpits and chest to see if there are bruises like this!"

It is inconvenient for Zhou Can to check it directly, so he can only ask Yang Chan to do it for him.

After looking at it, she confirmed, "There are bruises in both places. Especially the underarms."

"OK!"

Zhou Can's discovery has also attracted Zhang Bihua's attention, and she also went to the patient to examine it carefully.

At this time, the condition of the pregnant woman is deteriorating.

Even though the single-nasal oxygen supply has been implemented, her breathing is still as heavy as a bellows.

It looks very worrying.

To put it bluntly, in this situation, as long as you can't breathe, it is very likely that you will die.

"Come on, open your mouth and let me see the oral mucosa."

Zhou Can put on the mask and asked the pregnant woman to open her mouth.

Her reaction was a little sluggish, and Zhou Can said it several times before she slowly opened her mouth.

Because the mouth was not wide enough, Zhou Can could only shine a small flashlight into the mouth to check the situation inside.

"The oral mucosa also has similar ecchymosis."

Zhou Can reported to Director Zhang.

Suddenly thinking of something, he subconsciously looked at the patient's eyelids.

"There are also bruises on the conjunctiva."

There is no external injury in these places, and it is certainly not caused by domestic violence.

Then her ecchymosis is a major diagnostic direction.

"Could it be aspiration pneumonia?" Yang Chan offered her own diagnosis opinion.

"It's possible. But her consciousness seems to be a little blurry. This is a very bad sign. It shows that the disease is progressing extremely rapidly. If the cause cannot be found as soon as possible, the person may die in an instant."

Director Zhang's expression was particularly dignified.

Deputy Director Shi, the leader of the crisis management team, has also come over to help with the diagnosis.

He is only good at diseases in the field of gastroenterology, and he is a little helpless about the pregnant woman's illness.

After diagnosing the patient in hand, two more experts joined the consultation camp.

Experts from Tuya Hospital carry out expert outpatient activities here, and everyone is prosperous and all is hurt.

When you meet a patient whose cause cannot be found by an expert, let's go together side by side.

Unity is very important at this moment.

"Director Zhang, just give the patient a chest X-ray, isn't that too little?"

Deputy Director Shi saw that the patient was already taking in more air than exhaling less, and he was as anxious as an ant on a hot pan.

The leader of this crisis management team is not so easy to be.

Maybe, on the first day of taking office, a patient will die in his hands.

"Lung x-rays show blizzard-like changes in the lungs. This must be vigilant, and it can easily lead to death."

Another expert commented.

"There are so many bruises on the body, which means that the subcutaneous spotting is serious."

An expert in obstetrics and gynecology is not to be outdone.

At this time, Director Jiang leaned forward and focused on checking the patient's consciousness and head, and then looked at all the checks.

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"Her head was not obviously injured, but she had some neurological symptoms such as chest tightness and palpitation. The direction of diagnosis should focus on the heart and lungs. The possibility of brain problems is extremely low."

Director Jiang is a doctor of neurology, and he has certain authority in the diagnosis of neurology.

A number of experts gathered together, discussing what you said and what you said.

A few reporters, like flies smelling the smell, all gathered together, taking pictures and so on.

Section Chief Tang's face darkened for a while, and he had already said that patients should not be brought to the outpatient hall. If something happened now, how would it end?

While the experts were anxiously making a joint diagnosis, Zhou Can picked up the patient's blood test report to check again.

The white blood cell count is normal, but the blood test results show that there are many abnormal indicators.

Now there is subcutaneous spotting, and the blood picture is also an important reference.

"Her blood test results indicated that the platelets were reduced, which may be related to subcutaneous spotting and bruises on the upper body. I checked her legs and there were no bruises. It is likely to be mainly concentrated on the upper body."

Zhou Can, the deputy team leader, is also working hard to contribute his strength.

"In addition, the patient's serum lipase was significantly elevated. I think blood free fat should be checked. It is best to do a urine test to check urine fat."

At this time, Zhou Can obviously had a major diagnostic breakthrough.

He has the diagnostic bonus of the special medical skill of emergency life wisdom, which is especially useful when rescuing some critically ill patients.

It can make his brain extremely clear, and his thinking is unprecedentedly flexible.

"Doctor Zhou suspects what is the cause of the patient?"

Director Zhang's eyes brightened slightly after listening to Zhou Can's diagnosis opinion.

"Judging from the patient's various symptoms and the current examination data, I am personally more inclined to the disease of fat embolism syndrome. When I was in orthopedic training, I was fortunate to hear a superior doctor once said that traumatic fractures should be especially vigilant about this disease. .The patient happened to have a femoral head fracture due to a fall, and the onset time was within 48 hours."

"In general, the likelihood of developing fat embolism syndrome is highest within 72 hours after a traumatic fracture occurs."

Every time Zhou Can enters a department, he can learn from one or more chief physicians, and perform consultations and operations together.

And he can be appreciated by those chief physicians and teach him everything.

This gave him a practical knowledge that ordinary doctors can hardly match.

To put it bluntly, these are valuable clinical experiences summed up by predecessors.

"Immediately give the patient a blood free fat test! Then draw urine for emergency testing."

The current situation of pregnant women is that they are no longer able to urinate independently.

Consciousness almost fell into a coma.

Take off her pants here ~www.mtlnovel.com~ and get a catheter, the family members will be the first to agree. It is impossible for a doctor to do such a thing that disregards the patient's privacy.

"Send her to the emergency room first, insert a catheter to take a urine sample and send it for testing immediately. Tell the laboratory to give priority to urine fat inspection."

In fact, the current examinations are all analyzed by highly intelligent automated instruments, and the results of urine tests and blood tests can be released quickly.

It's just that there are often many patients queuing up for the examination, so it feels that the time is very long.

"Director Zhang, is it a bit hasty to confirm that the patient has fat embolism syndrome?"

Du Leng didn't know what the wind was.

He also enthusiastically ran over to help with the diagnosis.

It's a pity that I couldn't make it work.

He had two quarrels with his family members yesterday, and he was obviously affected a lot during his consultation today. Although the new patient today did not know that he was a silver-like wax gun head, he was afraid of being slapped in the face again during the consultation process. As long as there were cases that were slightly difficult to diagnose, he would immediately push them to other doctors.

The consequence of this is that fewer and fewer patients seek him for medical treatment.

Everyone is not stupid, standing there waiting in line, watching Du Leng diagnose and treat the patients in front. This can't be cured, and that can't be found out either. They immediately understood in their hearts that the returnee doctor was just like that.

In addition to gimmicks, the ability to diagnose diseases is far worse than other real experts.

As a result, some patients who had originally signed up for Du Leng's clinic quietly changed to other specialists' clinic numbers.

Anyway, registration is free.

They don't want to put their lives in the hands of a pompous returnee doctor. For patients and their families, titles such as doctors and professors are very attractive, but what they really need is someone who can cure them.

This is the most important.

Chapter end