Chapter 305: Turning Point, Beware of Minor Injuries to Children
It is said that women are the most petty human creatures in the world, and my predecessors were right.
Zhou Can had offended her so much that it would probably not be easy for him to repair their relationship and apologize to her.
As the news was broadcast on the large advertising screen, some family members and patients discovered Zhou Can.
"Look , isn't that the young doctor the Dr. Zhou that was just reported on the news?"
"He seems to be quite free now! Husband, let's quickly make an appointment for our daughter to see Dr. Zhou!"
A well-dressed young couple left Du Leng's waiting line directly after reading the news report.
Then he quickly ran to the registration window and got Zhou Can's consultation number.
Anyway, it’s free to make an appointment with an expert, so changing the number has no impact on them at all.
"Is it true that the child's broken arm can be cured easily without surgery or hospitalization?" An old man who was taking his grandson for treatment looked up at the big advertising screen, hesitating.
After struggling with his conscience for more than ten seconds, he decisively carried his grandson to the window and called Zhou Can.
No one paid attention to Zhou Can at first, but with the halo of news reports, the situation immediately changed.
More and more patients have started to make appointments with him and seek medical treatment from him.
Thinking back carefully, not many people had made appointments with him before, mainly because he did not have a clear medical specialty.
His personal introduction only wrote that he was good at treating emergencies and miscellaneous diseases.
This introduction is very general and lacks clear and distinct identification for patients and their families. If there are better options, the family members will definitely consider making an appointment with other experts first.
For example, if a pregnant woman suffers from severe stomach pain after catching a cold, her condition may be classified as both an emergency and a gynecological disease.
Then she ran to Xinxiang Women's and Children's Hospital and saw that among the experts on duty, Director Zhang Bihua's introduction said she was good at treating gynecological and obstetric diseases.
The patient will immediately think that she is carrying a baby in her belly, and it must be an obstetric disease.
She would subconsciously ignore that this was an emergency.
In addition, Director Zhang is nearly 60 years old, and he is obviously an experienced old expert. Looking at Zhou Can, a young and impetuous guy, he must be a novice doctor, without a doubt.
So she would immediately and decisively make an appointment with Director Zhang, even if she had to wait in a long line.
The cold reception during his consultation forced Zhou Can to think about these issues.
He is still in the training stage, and will complete the training in about a year and become a formal resident physician. At that time, he will definitely have to face the challenge of seeing patients independently.
Having one or two areas of specialization would help him create a personal calling card.
"Hello, Doctor Zhou, can you please help my daughter?"
"Please take a seat! What's wrong with her?"
Seeing that a patient had finally arrived, Zhou Can immediately put his full attention into dealing with him.
"My daughter has been looking a bit listless since last week. She later developed a fever and was shivering all the time. She complained of leg pain and then hand pain." The family member gave a brief description of the girl's symptoms.
The little girl looked to be about two years old. Her eyes were blind, her face was flushed, her breathing was heavy and rapid, and she looked sick.
Pediatrics is known as a dumb subject.
Because most children remain silent when they are sick and will not describe their symptoms or how the disease progressed.
Basically, doctors have to guess.
This will undoubtedly increase the difficulty of diagnosis for doctors.
"She fell ill last week and it's been several days now. Why didn't you take her to the hospital for treatment in time?"
Judging from the couple's financial situation, they should be pretty good.
The child is so sick, and it is so irresponsible to take her to see a doctor only now.
"We thought it was just a common cold at first. We read in a parenting book that if a child has a common cold, don't rush to take the child for injections and infusions, as this will cause the child to become dependent on the drugs and will also deprive the child of an opportunity to enhance immunity. She had caught a cold before, and we always fed her some brown sugar ginger juice, asked her to drink more warm water, and keep warm and rest, and she recovered quickly."
"I didn't expect her illness to be so serious this time. Her condition progressed very quickly. Two days ago, she just had a slight fever, but in the middle of the night, she suddenly cried out that she was cold, clenched her teeth, and shivered. We took her to the community health center to see a doctor that night. After examining her, the doctor also said that she had a cold and prescribed a box of children's cold medicine."
"I went home and took medicine, but there was still no improvement after a day. We took the child to a large hospital for treatment. I happened to see on TV that Xinxiang Women's and Children's Hospital was holding a free consultation activity by experts, so I came here."
After listening to the family members' description, Zhou Can said nothing more.
Start doing some necessary examinations for your child.
Ji You helped measure the child's body temperature, heart rate, blood pressure and other vital signs.
Zhou Can found that the little girl's hands and feet were cold and her face was slightly cyanotic. These superficial symptoms showed that the child had an acute and serious illness. It was definitely not an ordinary cold.
"What medicine was given to the child?"
"Here, we brought it specially. It's this Chaigui Antipyretic Granules for Children."
This drug is a traditional Chinese medicine with relatively few side effects.
The doctor at the community health center may want to help the patient reduce the fever first.
In fact, the level of the hospital basically determines the level of the doctors. Just like hardworking and talented children can be admitted to key universities for further studies, children who are not hardworking or have poor talents will fail in the junior high school entrance examination and the college entrance examination, and eventually be diverted to vocational schools or junior colleges, third-rate universities, or even fake universities.
The hospital is more stringent in its talent screening.
Many people with poor academic qualifications or mediocre medical skills will work in township health centers, community health service stations, and private clinics.
It’s not that they don’t want to work in big hospitals, but that they can’t.
The child's condition will get worse, and the doctor at the community health center actually has some responsibility. If he had discovered in time that the child's illness was not a common cold and paid enough attention to it, the child might have received effective treatment in time.
At least we can advise the family to take the child to a large hospital for examination and tests to find out the cause of the disease.
"Doctor Zhou, can children take this medicine?"
Family members obviously trust doctors in large hospitals more; they are worried that the medicines prescribed by doctors in community health centers are not effective.
"Normally, if it's this type of cold, you can take this medicine. But judging from your child's current symptoms, it's probably not a common cold."
Zhou Can’s words frightened the family members.
The woman's face turned pale with fright .
"Doctor, what disease does my daughter have? Is she going to be okay?" She was very afraid that her child might have some serious problem.
"The specific cause of the disease needs further investigation. You can take a closer look at her face and fingers. There is a certain degree of cyanosis, which means that the child is likely to begin to suffer from a certain degree of hypoxia."
Cyanosis of the face and fingertips is usually the most direct manifestation of hypoxia.
When the blood oxygen concentration is lower than 90%, typical symptoms of hypoxia such as cyanosis of the face, lips, and nails will appear.
After Zhou Can’s reminder, the young couple stared at the child carefully, that’s right!
The child's face and nails were indeed a little cyanotic.
They couldn't help but panic even more.
"Doctor, please save my child!" Women's psychological endurance is often worse than men's, and the child's mother was already crying. She was so scared that she was at a loss and panicked.
"Don't worry, she is only developing a serious condition now, and the situation is not very bad. As long as the cause is found out in time and the appropriate treatment is given, there won't be any big problems."
While comforting the family, Zhou Can continued to examine the child.
"Doctor Zhou, there seem to be nodules and lumps in the child's armpits!" Ji You took the child's temperature and found something abnormal.
When taking children's temperature, old doctors liked to measure the temperature of the rectum.
It is not only unhygienic, but also makes the child feel uncomfortable to a certain extent and it is not easy for him to cooperate with the doctor's examination.
Today's pediatricians have learned to be smart and will measure children's armpit temperature whenever possible.
There is more data on the quantity, and its medical reference significance is actually not much different from directly measuring the anus.
The older generation of doctors had more stringent requirements because the conditions were difficult and the examination methods at that time were far less abundant and advanced than they are now. Measuring the temperature of the anus is more accurate.
Sometimes even a difference of 0.1 degree can have a great impact on the doctor's diagnosis.
Low fever and high fever are two completely different concepts.
Zhou Can reached out and touched it, then lifted the child's arm and examined it with his eyes.
"She has swollen lymph nodes in her armpits."
Zhou Can gave the conclusion.
The child's parents became more panicked as they faced the signs of disease revealed one after another in examinations.
"High fever 40.3 degrees."
Jiyou read out the child's temperature measurement.
In order to avoid errors, body temperature should be measured at least twice. Usually, responsible nurses or doctors will measure body temperature three times.
It must be mentioned here that measuring the temperature of the rectum is not so troublesome and only needs to be done once.
In fact, measuring oral temperature can also get very accurate results.
The first thing that family members will reject is just putting the thermometer in the child's mouth. It must be considered unhygienic. Doctors reuse thermometers, putting them in one child's mouth and then in another child's mouth. Even if they are disinfected and cleaned in between, people still strongly reject this method of measuring body temperature.
Another thing is, if a child bites the thermometer into pieces, the mercury inside will be poisonous.
The risk is too great.
Therefore , doctors and nurses take various factors into consideration and now basically measure the child's armpit temperature in a unified manner.
I would rather work harder and measure twice.
"Have the child's urination and defecation been normal in the past two days?" Zhou Can continued to ask for some key information.
"The bowel movement seems to be normal, but the child has not urinated much in the past two days. Especially today, the child has not urinated yet." The child's mother's answer made Zhou Can's face change.
This is an extremely bad signal.
In the intensive care unit, if a patient does not urinate for two days, the family can basically be notified to prepare for the funeral.
"Let's do a blood test first! The child's condition is serious, do it urgently!"
After Zhou Can asked for some basic information, he prescribed the most common examination.
He was not like many novice doctors who would prescribe all the examination items listed above to the patients without missing any.
It can not only generate income for hospitals and departments, but also avoid unnecessary trouble as much as possible.
To put it bluntly, it saves trouble and avoids many risks.
When an expert issues an application for inspection, the opposite is true.
The higher the level of the expert, the more concise the inspection application will be. It is very targeted.
Many times, one or two tests are done first, and then new tests are prescribed after further diagnosis based on the results.
Zhou Can started his training as a regular physician, and he basically followed chief physicians, who were the most senior chief physicians in the department. In terms of issuing examination applications, he inherited the characteristics of the chief physicians very well.
We will never prescribe random examination items, try our best to reduce the suffering of patients, save them unnecessary expenses, and shorten the time they spend on medical treatment to the greatest extent possible.
If a patient is prescribed a bunch of tests, it may take one or two days for the patient to complete each test.
This really is not an exaggeration.
Most examinations at large hospitals require long queues.
Why? Because there are many patients seeking medical treatment, and many doctors prescribe a lot of tests.
"Doctor Zhou... Let me first make it clear that I am not questioning your ability! Is my child just going to have a blood test?" The family members felt uncomfortable when they saw that Zhou Can only ordered one test, and it was the simplest blood test.
"What else? Give her a bunch of tests? Electrocardiogram, urine and stool routine, chest and abdominal B-ultrasound... all the tests that can be done?"
Zhou Can raised his eyebrows.
"Ah...haha, I was just asking jokingly, please don't mind." After hearing this, the child's father's face turned bitter, and he quickly put on a smile and admitted his mistake.
The two family members took the child to have blood drawn for examination.
"Doctor, my grandson's ankle is sprained. Can it be cured?"
The grandfather who took his grandson to see the doctor also sat down at Zhou Can's desk after registering.
"Let me see!"
Zhou Can stood up, walked to the child, squatted down and carefully examined the child's feet.
The little boy's right ankle was swollen and had bruises and purple subcutaneous patches. This was a hematoma.
"Let's take an X-ray first! If there's no serious fracture, then it won't be a big problem. But because he has subcutaneous hematoma and bleeding, the specific extent of his injury will have to wait until the test results come out. Now try not to touch his injured area, and don't rub it."
While Zhou Can was examining the child, he also reminded him of the precautions.
Many people do not understand medicine, and they hear the older generation say that if there is any swelling, massaging it for a while will quickly reduce the swelling.
This approach is actually not advisable.
Massage can indeed help activate the muscles and bones of ordinary hematomas, and help accelerate blood circulation in the hematoma area, thereby achieving the purpose of quickly reducing swelling and relieving pain.
However, if this type of foot sprain occurs and a fracture occurs, indiscriminate massage will only aggravate the injury.
It was originally just a minor fracture, but after a vigorous massage it turned into a serious fracture, which is not worth it.
Also, if the hematoma occurs on the head, especially for some children who are active and naughty, it is very easy to hit the head and fall. It is normal for a big swelling on the head.
According to some folk methods, people like to apply oil or white wine on the swelling, and then rub it vigorously to loosen it.
Doing this is very dangerous.
Children's blood vessels are very delicate and the walls of the capillaries are very thin.
If you massage this area vigorously when a hematoma occurs, the congested blood vessels will be squeezed further, which will only aggravate the bleeding and even cause the blood vessel wall to rupture further, resulting in serious consequences such as intracranial hemorrhage.
After applying for an examination for the child, several more patients came to Zhou Can's desk for treatment.
It seems that the broadcast of the TV program was of great help to him.
In particular, news interviews about him were broadcast on the large advertising screen in the outpatient hall. This kind of publicity was enough to push him to a high position.
Zhou Can carefully diagnoses every patient he sees.
My luck today is pretty good. So far, I have seen five patients in total. All of them had relatively clear symptoms and were not particularly complicated.
At this time, the first child who had a routine blood test got the results back.
"Doctor Zhou, we have finished the blood test. Please take a look."
The family members' brows were filled with worry.
"The white blood cell count is elevated, the neutrophil ratio is also elevated, but the platelet count is decreasing...Has she been scratched by a rusty nail or metal recently?"
Zhou Can was also shocked when he saw the results of the routine blood test.
"No! The child has been fine. I haven't heard that he has been injured!" said the child's mother, shaking her head.
"Who usually takes care of this child?"
Zhou Can asked.
He noticed that the child's mother said she had not heard of the child being injured, not that she had not seen the child being injured.
This means that she is definitely not the only one taking care of the child.
"My husband and I both have to go to work during the weekdays, so the child's grandmother usually takes care of him during the day. After get off work, and on Saturdays and Sundays, we take care of the child."
Young people in cities are under a lot of pressure and need to work hard to make money.
When it comes to taking care of children, it would indeed be much better if there were help from the elderly.
The couple can go to work and earn money, thus adding another hand to the family income.
"Can you call and ask if the kids have been stabbed by rusty objects recently?"
Zhou Can has already begun examining the child's limbs and other exposed parts of the body.
Soon, he made a discovery.
There is a light red mark on the palm of the child's left hand. Children have strong healing ability and vigorous vitality. Even if they suffer skin injuries, they can heal quickly.
This area is likely to have been injured.
