Chapter 1492: Basic skills

The two exchanged two sentences in a small voice and did not continue.
Surrounded by the mess, who knows whether there are patients or family members. And it is said that the 120 emergency doctor said that there is no way to judge the specific situation at that time.
It’s all speculation, it’s not counted. But to be self-righteous, a publicity, heard by the patient's family, the following doctors are afraid that there will be trouble.
Don't bother people, this is the most basic.
Fortunately, the patient has already woken up, and there is nothing to worry about.
Zhou Litao called the patient's family to ask the situation. The question was very careful. Zheng Ren listened for 2 minutes and then went over and asked: "What medicine did the patient take last night?"
"Oh..." The family of the patient was stunned and tried hard.
"Zheng boss, what do you doubt?"
When Zheng Renjian went to the baggage to find a pill box, he whispered: "The patients with hyperthyroidism generally have a fast heart rate and oral propranolol lowering heart rate. It is recommended in all major guidelines to inhibit the conversion of T4 to T3. It is the first choice.
However, high-dose beta blockers can attenuate the action of catecholamines, inhibit the breakdown of hepatic glycogen, reduce hepatic sugar output and gluconeogenesis, inhibit fatty acids, lower blood glucagon levels, and reduce blood glucose production.

That is to say, if the drug is eaten too much, it will lead to a decrease in blood sugar.
"I know." Zhou Litao said immediately.
In fact, Zheng Rengang started to take the lead, Zhou Litao thought of this.
After all, it is not an endocrine doctor. Zhou Litao is not very familiar with the fact that β-blockers can cause hypoglycemia.
But if Zheng Ren is not there, he estimates that he will not miss it. Zheng Ren is here, reminding the direction and speeding up the process of asking about medical history.
Sure enough, the family came over with the propranolol pill.
Because the patient is not seriously ill and the activity is normal, there is no family member to accompany him. People who listened to the clinic this morning said that the patient's heart rate was fast last night, and there was no significant relief after 30 minutes of oral administration.
This is a trouble, Zhou Litao sees that the patient has nothing to do, let the emergency physician open a list, emergency hospital for observation.
Let's observe for a while.
Just a hyperthyroidism, there is no way to get a hospital.
When he was busy, Zhou Litao called Zheng Ren to his duty room.
"Zheng boss, the eyes are really bright, have you done endocrine?" Zhou Litao took out a box of purple clouds and was despised by Su Yun.
"No, I met a similar patient in Xiangjiang a while ago, but it was not a hyperthyroidism." Zheng Ren casually perfunctory.
Su Yun took a look at Zheng Ren, and this answer is too serious.
Hypoglycemia refers to the reduction of the concentration of glucose in the blood, which ultimately leads to symptoms and signs of impaired brain function.
Clinical manifestations range from behavioral changes, fatigue, confusion to epilepsy and loss of consciousness, namely functional brain failure.
Therefore, many patients with hypoglycemia are often misdiagnosed as epilepsy and even depression and mania.
Qin Lan’s illness, madness or something, is related to hypoglycemia, but at the time he seemed to be able to see it at a glance.
This goods, sneaky, watching is really not pleasing to the eye.
It’s a pity that I can’t catch up with him. I really want to find an opportunity, so I can slap him once, Su Yun smokes, and I think of it.
"To Zhou Zong, how do you judge low blood sugar?" Zheng Ren asked.
"When the patient comes, I feel that something is wrong." Zhou Litao said with a smile: "To sleep with the nurse on duty, the sister is not brought directly in front of the ward in front of others, there must be problems."
"Well, it is awkward." Su Yun said: "I have encountered a patient, a car accident, bilateral rib fractures, bilateral blood pneumothorax, lung rupture, traumatic wet lung, head trauma. Postoperative ICU, Plugged in the tube ventilator for 3 days. Later extubation, the first sentence you guess what?"
Zheng Ren smiled and didn't speak.
Zhou Litao skeptically asked: "It will not be related to nurses."
"He took the hand of the ICU head nurse and said that he would go to drink wine together at night." Su Yun laughed.
"Later?" Zhou Litao's gossip has a lot of thoughts.
When you are in the emergency department, you can go to the hospital and listen to the gossip.
"After the condition was a little stable, I was taken out of the ICU." Su Yun laughed.
The condition is different and the symptoms are similar.
"Zheng boss, what do you say about the patients in Xiangjiang?"
"The pancreas has a plaque in the feeding artery, and the intermittent flow rate changes lead to abnormal insulin secretion. He is a higher-end than these two patients, not a nonsense, but a thing he has experienced in his own virtual." Zheng Ren briefly said Qin Lu The disease.
"Hey." Zhou Litao secretly remembered the case that Zheng Ren said.
Although you may not be able to encounter similar patients in your life, if you encounter it, you will have a shadow and a little impression in your heart. At the very least, you will reduce the chance of misdiagnosis and missed diagnosis.
"Zhou, if the patient is not low blood sugar, what are you going to check?" Zheng Ren continued to ask.
"Peoplestroke patients have psychiatric symptoms, which may be electrolyte disorders, hyperthyroidism, hypoglycemia, or autoimmune encephalitis. It is most convenient to check blood sugar, and the symptoms of patients sleeping well. If not, just check it."
Zhou Litao's foundation is solid, and Zheng Ren just finished asking this question, he said casually.
Zheng Ren thought, 912 is profound. The total hospitalization of an emergency department is so powerful.
These things in hyperthyroidism, except for the departments of gland surgery and endocrinology, it is difficult for doctors in this department to know the details. EbookFREE.me~ The role of the specialist is here, but there are disadvantages in the good things, the more It is to study a certain direction, and the diseases of other departments will be understood very little.
"Zheng boss, you are really all-powerful." Zhou Litao said with a smile, "Do I have any attention to this patient?"
"Nothing, you look at the rule." Zheng Ren smiled. "When you observe two days, let you go to the specialist clinic. You have an emergency department to solve a hypoglycemia. Yes, tell the patient that the medicine can not be eaten casually."

"Yeah, how much you want to eat is really terrible." Zhou Litao said, "Zheng Bo, a patient with Gaucher's disease, when are you going to have a live surgery?"
"I don't know, if there is no problem, the sooner the better." Zheng Rendao.
"I have seen your live surgery, it is very good." Zhou Litao is somewhat envious.
Can go to surgery, as a surgeon, who is not willing to be in the emergency department.
However, when he lost his age and hatred, he was young and ignorant, he was deceived to the emergency department.
Nowadays, there is not much more than a good person who is engaged in the medical industry after graduation. Let alone the emergency department.
Zhou Litao thinks more and more that he feels that his future is gray.
How good it can be like Zheng Bo.
These can still be tolerated, the key is that Zheng boss is a high level, and a girlfriend!
If you have a girlfriend, you can give it to him when you have surgery.
Uh... Zhou Litao sighed.
Zheng Ren and Su Yungang were leaving, and suddenly they heard a series of hurried footsteps in the corridor.
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