Chapter 222: Outpatient with chest pain

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The next day, Zhang Reid, the director of the Department of Internal Medicine, brought an internship with him, and it quickly spread throughout the entire Department of Internal Medicine, and even other departments were heard. Many people were surprised and surprised because of this matter. Many people are extremely suspicious of this matter.
This is because trainees generally arrange for an attending doctor to teach at most, and the deputy chief physician can rarely teach.
As for the case where the head of the department brings trainees, I will say in Appendix I that something that has never happened, let alone the head of the department.
So after this incident came out, many people didn't believe it; but several doctors who were on duty yesterday in the internal medicine department vowed that Director Zhang did bring a trainee to the department to see the patient. And it is either a round of ward rounds, or simply taking the trainee to see the patient.
And these doctors all said mysteriously: "The reputation of this trainee is also very famous recently in Fuyi, the one who made a tracheotomy for the patient by himself..."
What doctors say is so lively, and there are doctors in several departments say that no one is unbelievable.
Therefore, those doctors and nurses are also curious. What kind of person is Xu Ze, who can be taught by Zhang Reid, the director of internal medicine who has always been above the eye, is really curious enough.
However, most of the people who knew the real situation of Xu Ze were the directors of various departments of internal medicine. The impact of the subject competition was still there. Regarding the face of this internal medicine, they naturally will not reveal Xu Ze's situation.
The director of the emergency department Qu and a few doctors are the only ones who know the real situation of Xu Ze except the internal medicine, but at the beginning Xu Ze was working in the emergency department under the brand of rotation doctor; but now Xu Ze 'S identity is an apprentice who has not yet graduated from Xingda University.
Who would dare to reveal the details of Xu Ze, otherwise, if it is revealed in the emergency department that an ungraded student should be listed as a rotation doctor, I am afraid that even Director Qu will be in trouble.
Therefore, Xu Ze’s student at Xingda is one of those medical staff who are extremely well-known. Many people would like to see who the surnamed Xu is, how sacred he is, so powerful, even It makes Zhang Reed, the director of the Department of Internal Medicine, so blue-eyed.
Even on the campus of Star University, those students who saw Xu Ze followed by one-on-one behind Zhang Reed with his own eyes were passed on.
This incident has caused quite a stir in the University of Clinic Medical School, especially these seniors who are also internship students, naturally know what treatment is given by the director of the Department of Internal Medicine at the University of Xingda. The admiration for Xu Ze increased even more.
This figure at the top of the list is really extraordinary, and it will be a very noticeable person no matter where he is...
Xu Ze, who is in the center of the storm, is naturally not very clear, because at this time, he is following Zhang Reed and sitting in the internal clinic of the outpatient building.
Zhang Reed, as the director of the Department of Internal Medicine at the First University of Xingda University, naturally his reputation is very famous in the Star City area. He sits in the expert outpatient department of cardiovascular medicine, and he will be in the outpatient clinic for two afternoons every week. And at this time, a long line will be lined up in front of his clinic, and hundreds of patients are waiting for him to see a doctor or return to the clinic every day...
Xu Ze, sitting at the side of Comrade Zhang Reed's expert, is helping to see the patient. Of course, sitting there is not just a helper, measuring blood pressure or something. These nurses at their own door are checked one by one. All he has to do is wait for Zhang Reed to show the patient after reading the medical record. Finished, and then he looked at it again. Beautiful name: learning...
Xu Ze was also very puzzled that Zhang Reed could see more than one hundred patients every afternoon, but he soon understood why Zhang Reed had such a speed.
Here comes a patient. After Zhang Reid briefly asked about the situation, he listened to it for a little more than ten seconds, and then he will open the relevant test sheet to the patient and let the patient go to do the examination. . I went to see the next patient myself, so such efficiency is naturally extremely high.
However, Xu Ze has come to study by name. Naturally, he would take a look seriously. Whenever a patient has an examination and takes the results, and Zhang Reed is examining another patient, Xu Ze will take a look first.
At this time, Xu Ze was holding a patient's examination report. He was frowning. This patient was a patient with chest pain. Chest pain had occurred for two days, and the chest pain was very severe when it broke out.
Zhang Reed has given the patient an electrocardiogram and chest radiography. The patient's examination reports show that the electrocardiogram has myocardial ischemia and coronary heart disease is considered; while the chest radiograph shows no abnormalities.
However, Xu Ze looked at the patient's situation, but always felt something was wrong. Although the patient had chest pain, much like angina caused by acute ischemia, the patient's chest pain was continuous, mild and severe, not Like simple myocardial ischemia.
Looking at the patient's blood pressure just now, it seems normal.
Looking at the patient's pale face, Xu Ze frowned, but after thinking about it, he was still uneasy. Then he took another blood pressure meter and measured the blood pressure for the patient.
The blood pressure of the patient's left arm is basically the same as the blood pressure recorded by the nurse on the medical record, both are mmhg, which is normal; but after the test, Xu Ze always felt wrong and then moved. Instead, the patient stretched out his right arm and measured it again.
At this time, the patient was always looking at Zhang Reed, waiting for Zhang Reed to see him, and was very impatient with Xu Ze's inspection here. However, the patient currently limited to Zhang Reed had not finished reading it, and it was not his turn. He had to be patient and let Xu Ze check it.
Helping the impatient patient to push up his sleeves, and then checked it again. Hearing his blood pressure this time, Xu Ze couldn't help raising his eyebrows, and it was not right... the blood pressure on the right arm of this patient turned out to be left The difference in arms is extremely large, the blood pressure in the right arm is only mmhg, and the pulse pressure difference is actually 20 millimeters of mercury.
Thinking of this pulse pressure difference, Xu Ze's heart flashed, and it seemed that there was a big problem in this middle, but he couldn't think of any signs of this disease, but it seemed to be light and heavy, but he was not sure. …
At this time, Zhang Reed had just finished seeing the patient he had on hand, and the patient Xu Ze was looking at had already been a little impatient, and it seemed that Zhang Reed had already dealt with the patient. It was my turn to grab the medical record and examination results in Xu Ze's hand, and sat on the side of Zhang Reed. He said enthusiastically: "Director Zhang... My results have come out. Please help me see..."
Xu Ze looked at the patient sitting on Zhang Reed's side and hesitated, because although he felt there was a problem, he didn't know where the patient was. So I had to watch Zhang Reed check the patient to see if he would see any problems.
Zhang Reed took the patient's medical record and test results, quickly turned over, and then listened to the patient again. Nodded and said: "You should be coronary heart disease, myocardial ischemia... there is still chest pain, so I suggest you be hospitalized..."
"It's really coronary heart disease..." After hearing this for a while, the patient said to Zhang Reed, "Director Zhang... It's really inconvenient to live here, I think you can prescribe it to me Some medicine, I will go back to our place for treatment, don’t you know?

Zhang Reid was not surprised at such requests from patients. After all, there were many patients who came to Xingda Fuyi from the field and several subordinate counties to see the doctor. After confirming the disease, nearly 50% or 60% of the patients did not want to be treated in Fuyi. But want to go back to the local.
Zhang Reed was very experienced and nodded at the moment: "Your disease is still quite serious. It is best to be treated in our hospital and to do some related examinations... Back to your local treatment, it is OK. , But relatively speaking, naturally it’s not that insurance..."
The patient thought for a while and continued to insist: "Director Zhang, I still want to go back to us for treatment. The people's hospital near us is more convenient. As long as the diagnosis is clear, go there for treatment, I think it should be no problem..."
"Okay...this is up to you..." For such patients, Zhang Reed will naturally not be reluctant. After writing a few strokes in the medical record book, he will hand it to the patient and let him leave Go to see the next patient.
The patient took the medical record book, thanked Zhang Reed for a few words, and then planned to leave. At this time, after Xu Ze thought for a long time, he finally remembered this patient's situation, which was very consistent with a certain extreme. The manifestation of serious illness. And Zhang Reid just looked at the blood pressure measured by the nurse on the medical record, and should not have noticed that the blood pressure of the patient's arms has this pulse pressure difference~EbookFREE.me~ Thinking of this, Xu Ze immediately hurriedly anxiously pointed at the station A patient who is about to leave. Tao: "You have to wait..."
The patient heard Xu Ze's cry, but he was shocked. He was first examined by Xu Ze for a long time, but he was impatient with Xu Ze. Now he was stopped by this kid, but he was very impatient. Looking at Xu Zedao: "Doctor, what are you doing?"
Seeing that the patient had stopped, Xu Ze hurried to Zhang Reid's ear and said: "Director Zhang, this patient has a pulse pressure difference in both hands... The blood pressure in the right arm is only mmhg, I think he may have other problems..."
"Twenty different?" Zhang Reid frowned, but then smiled: "Coronary heart patients, some people will have a little pulse pressure difference, this is normal..."
"But..." Hearing Zhang Reid's words, Xu Ze felt relieved a little bit, indeed there were such cases, but he was still a little uneasy. After thinking about it, he quickly hurried toward the station. The patient in front of his eyes looked at his heart, and at the same time commanded the automatic response system: "Color B-mode ultrasound is activated to perform a cardiac ultrasound examination..."
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