Chapter 313: Bystander clear

If you have more contact with Mr. Cao, you will know that Mr. Cao still lacks clinical experience. He graduated as a graduate student and soon became an attending physician when he came to the hospital, but he mainly stayed in the laboratory during the graduate level. Lack of clinical experience. In many cases, there is a lack of experience in the treatment of diseases. When encountering a patient, it is often necessary to consult certain information before formulating a corresponding treatment plan. A few days after I came here, during the daily routine rounds, Director Shi Tingbang asked about the treatment of a few common cases on the spot, but Teacher Cao couldn't answer, and Director Shi was very angry. I was too unlucky to fall into his hands. Fortunately, I am different from the average intern.
Zhou Huaifang didn't know when he slipped over, "Huang Jingyang, why are you still in the department at this time?"
"What's wrong? A big patient came from the department. Teacher Cao didn't dare to leave, so naturally I couldn't go." I thought Zhou Huaifang said I didn't go back.
"I'm not talking about this. I mean there is such an important patient in the internal medicine department. Why can you still stay in the department? Why don't you go to the expert consultation? Expert consultation is a very rare learning opportunity. Go, let's also Go in and listen." Zhou Huaifang said.
"Ms. Cao didn't have a chance to get in, how can I get in?" I shook my head.
"What are you afraid of? We are not the same as their official doctors. We are interns anyway, even if they offend people, they can't really deal with us. Besides, we just go over and listen. As long as we don't talk too much, it must be It's okay. By the way, Dong Fu has already mixed in Chengdu. It was the text message he sent me just now. Go, let's go together." Zhou Huaifang said.
I couldn't help Zhou Huaifang's strong invitation, and went to the consultation room with him.
The patient complained of cough, suffocation with dizziness, and chest pain for nine days. And once fainted.
Internal medicine expert Li Shun has a serious face and a special patient status, so he naturally dare not neglect. "From the current examination results, the pharynx is slightly congested. Breath sounds in both lungs are rough, X-ray fluoroscopy is normal, and the electrocardiogram is generally normal. The patient has taken compound antihypertensive tablets and other drugs, but the symptoms have not been relieved. This morning the patient urinates Shi suddenly fainted and turned his eyes up. One minute later he was awake and dizzy and chest tightness was diagnosed in the hospital. In addition, the patient suffered from high blood pressure six years ago. According to the current examination results, the cause of coughing and fainting cannot be confirmed."
"Now it is not for you to talk about the condition, but to determine what disease the patient is suffering from. If the cause is not found out, a comprehensive examination will be carried out immediately, and the true cause of the patient must be found out as soon as possible. Is there anything else you want to add?" Zhang Zhenyuan was very irritable. After investigating for so long, the cause was not found. Looking at Li Sun very annoyed. Li Sun is an expert in internal medicine, but at this critical time, who can not show the value of an expert, can he be regarded as an expert?
Zhang Zhenyuan quickly turned to Lu Maozhu Road again, "Director Lu, when Ms. Lei entered the hospital. I had already applied for expert assistance from Yanjing Union Hospital. Now the expert is on the way to the East China Sea. It is estimated that I will be able to arrive soon. I The expert invited is Shi Weiming, an authoritative expert in internal medicine of Xiehe Hospital."
Lv Maozhu is a high-ranking official in the health system, so he has naturally heard of Shi Weiming, an authoritative expert. But I was still a little annoyed because I was worried about my wife's situation. "You talk about your Ruihua Hospital, which is also a well-known hospital in Donghai. I often say good things about your Ruihua Hospital outside. If there are any funding needs, I will try my best to lean towards you. How come you will be dropped when it is critical What about the chain? I told you that Donghai is an international-level city and it must have an international-level hospital to be able to match. Each department must find a way to equip heavyweight experts. You have no shortage of funds, no bad conditions, why can't you Have a group of high-level medical experts?"
Lu Maozhu's remarks were obviously dissatisfied with Dean Zhang Zhenyuan.
Zhang Zhenyuan looked at a group of experts in the conference room with a ferocious expression, and saw that these experts were silent. The interns standing around were also suppressed by this atmosphere. There is a shivering feeling.
The dean’s secretary hurried in and said something softly in Zhang Zhenyuan’s ear. Zhang Zhenyuan's expression immediately shocked. Hurriedly said to Lu Maozhu, "Director Lu. Expert Shi Weiming is here. I will go out to meet him."
"I'll go with you." Lu Maozhu was overjoyed when he heard that Shi Weiming had come.
Zhou Huaifang pulled me gently, "Today can be an eye-opener. This Shi Weiming is a real authority. He is very powerful in internal medicine, and his name can be seen in many internal medicine textbooks."
"Where is the patient?" I asked.
"At this time, it must be in the intensive care unit. Ask Dong Fucheng, he must know." Zhou Huaifang said.
Zhou Huaifang crept to Dong Fucheng's side and gave Dong Fucheng a little lightly.
"What are you doing? Don't mess around here. Otherwise, you won't be able to eat." Dong Fucheng was startled.
Zhou Huai winked at Dong Fucheng, and the two walked outside together.
"What are you doing?" Dong Fucheng asked.
"Huang Jingyang asked you where is this patient?" Zhou Huaifang asked.
"What do you want to do? This patient is not an ordinary person. Don't mess around." Dong Fucheng said nervously.
"We don't know anything here. What's the use of listening to these experts? It's better to see the patient's condition." I said.
"In the intensive care unit. It's useless if we go there. There is someone to guard there, so I can't get in." Dong Fucheng shook his head.
"Go, take a look." I took Zhou Huaifang to the intensive care unit.
"You two are really in the past? Don't mess around, there will be a major event." Dong Fucheng quickly reminded again.
"Don't worry. We are not stupid, how can we be in the limelight? Just go and take a look." I laughed.
When Zhou Huaifang and I arrived in the intensive care unit, we saw that the atmosphere in the intensive care unit seemed to be heavier than usual. A hospital security guard stands guard at the door. Through the glass, you can see that there are doctors on duty, especially one of the beds. There are two or three doctors guarding them. Without even thinking about it, the big man who came here today must be lying on this bed.
"Hey, you two interns. Don't come here to make trouble." The hospital security smiled at us.
"What are we messing up? Just take a look outside here." I said with a smile, and through the glass I could see the situation of the patient lying on the bed. I actually saw the undetectable black energy on her body began to escape from her body, it seems. Her condition is very bad. If you can't get effective treatment, I'm afraid it won't last too long. But the situation of the consultation. Ruihua Hospital has not found the true cause of the patient at all, and the current treatment of the patient is simply not symptomatic. If this continues, the consequences are really serious. I don't know if there will be any improvement after the experts come.
I stood with Zhou Huaifang for a while and saw a large group of people walking towards the intensive care unit.
The security eldest brother said to us quickly: "Go fast, the leader is here. Let them see it, and I will be unlucky."
Zhou Huaifang and I quickly stepped aside.
"Old Shi, please come here. As soon as Ms. Lei enters Ruihua Hospital, she will be admitted to the intensive care unit. The hospital has arranged several experienced doctors to monitor and pay attention to the changes of Ms. Lei's condition at any time." Zhang Zhenyuan's posture at this time Very low.
Shi Weiming was surrounded by everyone, watching the patient's examination report while walking. Frowning, from these examination reports, he could not confirm the patient's condition.
"Is there a possibility of cerebral thrombosis? Has the brain CT been done? Has the chest X-ray been done? Is the heart normal?" Shi Weiming asked many questions along the way.
"CT has been done, there is no bleeding in the brain, and there seems to be no problem with the chest X-ray reaction in both lungs. Percussion of both lungs is clear, and X-ray fluoroscopy is normal. Aspartate aminotransferase and alanine aminotransferase indicators All are normal, and the possibility of myocardial infarction can be ruled out. The bedside X-ray shows no obvious abnormalities in the heart, lungs and diaphragm." Li Shun said quickly.
Shi Weiming frowned, from the results of these inspections. He could not determine the cause of the disease. However, the patient's cough, suffocation, dizziness, and chest pain must be extremely related to the cause, but some of the conditions he thought of were excluded one by one.
When Shi Weiming entered the intensive care unit, the patient lying in the bed suddenly vomited. Breathing becomes rapid. And there are symptoms of convulsions.
"Quick, give low-molecular-weight L-glycan, 5% glucose salt solution." Shi Weiming said.
However, the patient's condition has not improved, but has been getting worse. The patient's condition did not improve. Instead, the extremities began to become cold, the skin of the back of the foot appeared purple mesh patterns, and the consciousness began to become blurred. The heart circle expanded slightly to the left. Occasionally there is a fine wet rale at the bottom of both lungs.
I saw that the patient's black air seemed to escape faster, and the situation became more and more critical.
Zhang Zhenyuan naturally knew that the situation was not good, and the sweat on his forehead rolled down like rain.
This Zhang Zhenyuan is a student of Teacher Qi, plus I can come here for an internship. It is also thanks to him. He was kind to me, so this time. I cannot stand idly by.
"Dean Zhang, since the patient has cough, suffocation, dizziness, chest pain and other symptoms. Why not consider pulmonary thrombosis? The pulmonary blood pressure can be found by using a bedside minimally invasive hemodynamic monitor. I know that our hospital has it. Minimally invasive hemodynamic monitor." I walked to Zhang Zhenyuan and said quickly.
Originally, Zhang Zhenyuan had just left the intensive care unit and was blocked by an intern. He was very angry, but after hearing what I said, his expression changed.
"Time is running out, if the best treatment time is delayed, it will be hard to save the gods!" I quickly warned.
Zhang Zhenyuan hurriedly returned to the intensive care unit. This kind of equipment was originally available in the intensive care unit, but since the possibility of myocardial infarction was ruled out before, this kind of equipment was not used at all.
"Quick! Get on the minimally invasive hemodynamic monitor! Focus on pulmonary thrombosis!" Zhang Zhenyuan shouted to the doctor in the intensive care unit.
Misdiagnosis is often one misleading with another misleading. In fact, all doctors are misled by the results of the examination. Because the pulmonary thrombosis has been directly eliminated before, there is an electrocardiogram, a fluoroscopy result, and a percussion result. It seems that the pulmonary thrombosis can be eliminated. Everyone began to ignore this and think about more complicated symptoms. Shi Weiming was also misled. He did not consider pulmonary thrombosis in the beginning. But now that Zhang Zhenyuan drank it so aggressively, everyone suddenly woke up.
In fact, it is very simple. A normal electrocardiogram cannot rule out pulmonary thrombosis, and the fluoroscopy results cannot fully tell people the true condition of the lungs.
Although there are common symptoms of pulmonary thrombosis such as cough, chest pain, and syncope, no one suspects pulmonary thrombosis. If it weren't for my special abilities, I'm afraid no one would want to think about the patient's condition from the beginning. Maybe they would have to wait for the autopsy to wake up.
The results of the minimally invasive hemodynamic monitor really showed pulmonary hypertension and pulmonary capillary pressure was normal or low. This is obviously the strongest proof of pulmonary thrombosis.
"Quick! Intubation! Urokinase 264000iu plus ns100ml intravenous infusion or intravenous injection for 10 minutes, followed by 132000iu/h for 12 hours." Shi Weiming said quickly. After taking symptomatic treatment, the patient's condition quickly turned from danger to peace.
"Lao Shi, this time I really thank you." By this time, Lu Maozhu's expression also improved a lot. He can clearly see that his wife's illness has been diagnosed and has improved.
Shi Weiming is not greedy for merit. After all, everyone at the scene saw it. The turning point of the treatment was because Zhang Zhenyuan suddenly advocated focusing on pulmonary thrombosis. "This time, thanks to Dean Zhang, he thought of pulmonary thrombosis. There were many signs to rule out pulmonary thrombosis. But it is true. It is the excluded pulmonary thrombosis that causes the patient's condition to become more and more serious.
"Ashamed~EbookFREE.me~ is not what I thought of. My teacher, Professor Qi Binhua, recommended me a clinical intern. He just reminded me to consider patients with pulmonary thrombosis." Zhang Zhenyuan wanted to take credit for this. Greed, but the scene at the door just now was seen by many people. He was simply aboveboard and did not covet Huang Jingyang's credit.
"Oh, where is this classmate? It seems to be a bystander, a fan in the play. Sometimes, we will be deceived by equipment. So we must be cautious when we are doctors. Patients entrust their lives to us, and we must be cautious, walking on thin ice. "Shi Weiming exclaimed.
"I'm going to call him in." Zhang Zhenyuan had forgotten my name a long time ago. For him, how could a small person like me get his way?
Zhang Zhenyuan strode out of the intensive care unit and called me when I was about to leave, "Hey, wait a minute."
"I know I can't escape. I had to turn my head. Dean Zhang, did you call me?" I said helplessly.
"Yes, yes, thanks to your reminder just now. Experts from Yanjing want to see you. And Director Lu wants to see you too." Zhang Zhenyuan thought I should be flattered. But my performance was very calm, which surprised him very much. (To be continued.)