Chapter 310: Reading a lot doesn't necessarily mean you can be a doctor, Yang Chan is in glory
Pregnant women belong to a special group of patients, and what they fear most is infection.
Whether it is infection during pregnancy or postpartum, it is very fatal.
At 37 weeks of pregnancy, with only a month left before the birth, she developed a severe respiratory infection, which was difficult to treat.
After Director Zhang read the information, he passed it to other experts for review.
After everyone had read it, the information was returned to Professor Hu Wanjun.
"Dear experts from Tuya Hospital, do you have any good suggestions?"
Professor Hu Wanjun was the first to lose her patience and asked everyone.
"The patient now has a high fever and a severe cough. I think it is safer to use acetaminophen to lower her body temperature first, and then use antibacterial drugs to control the infection. It is also better to rely on her own immunity and slowly recover."
Director Luo from the Department of Obstetrics and Gynecology spoke first.
"Well, this treatment plan is good. But how to treat the fetus in the pregnant woman's belly? Also, the upper respiratory tract infection of the pregnant woman seems to be spreading to the lower respiratory tract."
Serious respiratory infections in pregnant women are just one example.
A weaker fetal heart rate is also a serious problem.
If you don't take it seriously, it can easily lead to stillbirth.
In addition, spread of infection to the lower respiratory tract is also very troublesome.
The lower respiratory tract mainly refers to the area below the larynx, including the trachea, bronchi, and lungs. The most serious of these is lung infection, which is often referred to as pneumonia in pregnant women.
In fact, the infection in this pregnant woman was so severe that lower respiratory tract involvement was inevitable.
The best proof is that pregnant women have severe coughing.
Pregnant women are very strict about medication. They need to consider not only the history of allergies, but also the safety of the fetus. Drugs that may cause fetal malformation, death, disability, etc. cannot be used.
"It would be best if we could first check the pregnant woman's condition and then develop a corresponding treatment plan." Zhang Bihua stopped Director Luo from continuing.
"The patient is in the ward. How about I take the experts over to take a look now?"
Professor Hu Wanjun was particularly positive about this matter, indicating that the patient's condition might be worse than imagined.
The group of people came to the ward in a mighty procession. It was nearly 6:40 in the evening. Usually, most of the doctors would have gone off work at this time.
Nearly twenty doctors entered the ward. The two pregnant women and their accompanying family members were all very surprised.
There are four beds in this ward, but only two pregnant women are hospitalized.
It also indirectly reflects that the operating conditions of Xinxiang Maternity and Child Health Hospital are very poor.
Half of the beds are vacant, which is unimaginable in Tuya Hospital. In Tuya, every department is in a desperate situation. The beds in the obstetrics department are even more severely limited.
Many pregnant women cannot be admitted to the hospital even when their cervix is five fingers dilated. They can only stay in a hotel near the hospital, or go home and wait until their cervix is ten fingers dilated before being sent to the hospital to give birth in the delivery room.
There's no way, beds are really tight.
There have been many cases where pregnant women falsely claimed to have high blood pressure or heart disease in order to be admitted to the hospital.
I wonder if he learned this trick from the doctor?
Doctors sometimes exaggerate the severity of the disease to scare the family members and patients. Pregnant women apply what they have learned to scare the doctors and nurses in return.
It doesn’t matter if you don’t admit me to the hospital. I’m telling you, I have high blood pressure. I’ll come to you if there is any problem.
Most women who have just given birth have slightly high blood pressure, so this trick does work at the beginning.
It almost always works.
Later, the obstetrics department held a special meeting on this matter, requiring pregnant women who claimed to have high blood pressure or heart disease to provide proof of their medical history. Eventually, this unhealthy trend was curbed.
Zhou Can had less experience, so he stood consciously near the ward door.
He just watched quietly as Director Zhang and others asked about the pregnant woman's condition and examined her.
Even from a distance of seven or eight meters, he could see that the skin on the pregnant woman's neck and abdomen was an abnormal color. It was hard to describe, but it was a dark brown color.
He couldn't go up and ask to check his armpits or groin.
However, the same situation was expected.
"Squad leader!"
Zhou Can turned his head and looked at Yang Chan who was also standing at the door.
"what?"
Her tone was a little bit fierce.
"Did you notice that the skin on the pregnant woman's neck was dark and brown?" Zhou Can said.
"Isn't it normal for pregnant women to become ugly due to changes in hormone levels in their bodies?" She didn't know what Zhou Can's intention was.
"You are a female comrade. Can you go to the bedside and check if there is any skin discoloration in her armpits and groin?" Zhou Can could only ask her for this favor.
"Why don't you go by yourself? You are an expert, and I'm just a second-line assistant doctor." She seemed a little dissatisfied that Zhou Can was doing better than her and had a higher status than her.
"I'm a man, and I ran up to check someone's groin and armpits. People thought I was a pervert." Zhou Can looked depressed. If it was something he could do himself, why would he ask her for help!
“Wait!”
She pushed forward.
This is considered an agreement.
In fact, as long as Zhou Can gave a legitimate reason, she would almost always agree to his request.
Du Leng, who was standing not far away, had been secretly watching Zhou Can. Seeing that Zhou Can was so interested in the changes in the skin of pregnant women's necks and groins, he secretly pondered the pathology.
Every time such difficult cases were diagnosed, Zhou Can would steal the limelight and make great contributions. Today, in front of doctors from the two hospitals, he, a returned overseas doctor, could not let down his reputation again.
"What is the use of this clue found by Mr. Zhou?"
Du Leng frowned and thought carefully.
But no matter how hard he racked his brains, he couldn't figure out what the connection was between the darkening of the skin on a pregnant woman's neck and her respiratory tract infection and weak fetal heart rate?
After all, a doctor is not as good as the one who reads more books.
Guangjian must put his knowledge into practice and have rich clinical diagnosis experience to ensure his level.
Yang Chan was Zhang Bihua's favorite disciple. Because of this relationship, when she squeezed in front of the bed, no one dared to say anything to her.
After whispering a few words to Director Zhang, she asked the patient for his opinion.
After obtaining consent, he pulled the curtain and examined the pregnant woman.
Soon, the bed curtains were drawn.
Director Zhang was very pleased with Yang Chan's positive attitude towards learning and gave her the greatest support.
She completed the task assigned by Zhou Can and returned.
"I just checked. The groin is darker. The armpits are darker than the neck."
"Okay, thank you for your hard work."
Zhou Can got a positive answer, and when he thought about some of the pregnant woman's symptoms, he already had some ideas for diagnosis.
"Have you made any discoveries? Please share your diagnostic ideas!"
The only symptom she could see was respiratory infection. The pregnant woman's temperature had been basically under control. It had dropped from a high fever to a low fever. This showed that Xinxiang Maternity and Child Hospital had already used medicine after admitting the patient.
It is undeniable that Zhou Can is indeed much better than her in diagnosis.
Zhou Can was about to share his diagnostic ideas with Yang Chan when he accidentally saw Du Leng standing in front of him eavesdropping with his ears perked up. He couldn't help but smile and pointed at Yang Chan's phone.
Then quickly enter text on the phone screen.
Du Leng, who was waiting to eavesdrop in front, suddenly heard no sound.
He felt something was amiss and subconsciously looked back.
After discovering that Zhou Can was communicating with Yang Chan via private messages on his mobile phone, he couldn't help but secretly scold Zhou Can for being stingy. Isn't it just a diagnostic idea? Is there any need to hide it?
"Doctor Du seems quite interested in our conversation! Do you want to join us?"
Yang Chan is also a very smart person.
As soon as she saw Du Leng's expression and thought about Zhou Can suddenly communicating with her on the phone, she immediately understood a little bit.
She couldn't help but laugh and tease Du Leng.
"Ahem... No, thank you!"
How could Du Leng, such a proud man, lower himself to have a 'discussion' with Zhou Can?
"Dr. Du is a top student from a prestigious overseas university. His diagnosis is much better than ours. He would rather not discuss with interns like us!"
Zhou Can used words to push Du Leng up a notch.
As long as there is a chance, he doesn't mind killing Du Leng's arrogance. If for no other reason, just because he is not happy with this Si.
Why do you act as proud as a rooster all day long with the title of an overseas PhD?
"No, no!"
Du Leng smiled awkwardly and turned his head back.
Zhou Can and Yang Chan smiled at each other. On this matter, their positions were surprisingly consistent.
At this time, Zhou Can had already input all his diagnostic ideas.
Send directly to Yang Chan.
"So mysterious. I want to see what your diagnostic ideas are." Yang Chan muttered while checking WeChat messages.
After reading it, she couldn't help but widen her eyes.
"Your... train of thought is too complicated! She had this test done when she was admitted to the hospital, and the result was normal!" Yang Chan said in disbelief.
Du Leng, who was standing in front, was a little absent-minded.
Because he found that the knowledge he had learned was completely useless, just like a three-year-old child who had a room full of hot weapons but could not use them to deal with the approaching wolf.
Du Leng eavesdropped on the conversation between Yang Chan and Zhou Can without missing a word.
Which items are checked upon admission?
Du Leng couldn't help but ponder.
Also, what was the diagnosis result that Zhou Can told Yang Chan?
The more confused he was, the more curious Du Leng became.
Zhou Can smiled confidently at Yang Chan and said, "You are the only one who has a say in front of Director Zhang. Please mention it to Director Zhang and have the patient tested again for this project. I believe there will be a major discovery."
"I'll trust you this time! But you have to promise me that you must teach me the diagnostic ideas ."
What she said was basically tantamount to admitting that Zhou Can was stronger than her.
"No problem. We are old classmates. We can discuss various cases on WeChat at any time if you want."
Zhou Can and Qiao Yu often discuss medical issues on WeChat, but rarely talk to his old classmate Yang Chan.
In Zhou Can's impression, she is rather aloof.
Unless it was something important, Zhou Can didn't dare to harass her.
So as to avoid being rejected by her.
But things are different now.
Zhou Can is now much stronger than her. When it is her turn to ask Zhou Can for advice, no matter what, her attitude will be much better than before.
Yang Chan squeezed to the front again and asked Zhang Bihua for inspection suggestions.
At this point, the chief physicians had almost finished their discussion.
However, no clear conclusion was reached.
When it comes to discussing obstetric cases, only a few experts such as Director Zhang Bihua and Director Luo can contribute on site.
People like Deputy Director Shi of the Department of Gastroenterology and Director Jiang of the Department of Neurology are really helpless in diagnosing obstetric diseases.
In other words, just follow along to broaden your horizons.
"Teacher, can you check the blood sugar of this patient?" Yang Chan found the right time to make a suggestion to Director Zhang.
"The patient's blood sugar was checked when he was admitted to the hospital, and it was normal! Do you have any new discoveries?" Zhang Bihua was very happy to see her beloved disciple actively participating in the consultation discussion.
"I suspect the patient may be suffering from diabetic ketoacidosis!"
Yang Chan boldly continued according to the diagnostic ideas provided by Zhou Can in the message.
"The patient has no history of diabetes!" Professor Hu Wanjun looked at Yang Chan with some confusion.
The other doctors had similar expressions.
"Didn't I just draw the curtain to examine the patient? Her armpits and groin have obvious skin color changes, dark brown. One of the symptoms of diabetes is skin color change. Also, when the patient took a cup to drink water not long ago, she scooped up nothing at first, which means that her eyesight is problematic. This is also a symptom of diabetes."
Yang Chan didn't know how Zhou Can's observation skills were more detailed than a woman's.
When the pregnant woman took the water cup just now, I believe someone must have noticed that she touched nothing for the first time. However, everyone thought that it was due to her serious illness and weak body.
Only Zhou Can keenly judged that the pregnant woman's vision was blurred.
"Can you read the words on this paper clearly?"
Zhang Bihua was obviously still a little unconvinced. She took a check report, placed it one meter away from the pregnant woman, and asked her to identify the words on it.
"I can't see clearly!"
The pregnant woman shook her head.
Director Zhang moved the paper closer, but the pregnant woman still shook her head.
"Those words and patterns look very blurry. I can't see them clearly."
"Have you ever been nearsighted?"
"No!"
This time, everyone finally believed that there was really something wrong with the pregnant woman's eyesight.
"If Dr. Yang Chan's diagnosis is correct, the baby in the patient's belly is in danger. Diabetic ketoacidosis not only endangers the patient's life, but also seriously endangers the life of the fetus. Her symptoms are not obvious yet, so it should not be too late. Check her blood sugar quickly."
Director Zhang Bihua has extensive clinical experience and immediately realized that the pregnant woman and fetus were in danger.
However, further investigation is needed to clarify.
Normally, diabetic ketoacidosis will cause nausea and vomiting. However, for pregnant women with severe respiratory infections like this, vomiting and nausea are easily ignored.
The nurse drew a blood sample from the pregnant woman on the spot.
"Come, give me the specimen. Human life is at stake, we must urge the laboratory to hurry up." Section Chief Tang took the specimen and ran this errand himself.
It can be seen that the senior management of Xinxiang Women's and Children's Hospital is also secretly paying attention to the consultation between the two hospitals.
Whenever necessary, we will immediately make every effort to mobilize all medical resources to treat patients.
Less than eight minutes later, Section Chief Tang called Professor Hu Wanjun's cell phone directly.
As soon as the call was connected, Hu Wanjun's face changed drastically after hearing a few words.
"News came from the laboratory that the patient's blood sugar is as high as 17.2mmol/L." When Professor Hu Wanjun said this, it was like a bolt from the blue, causing many doctors present to tremble with fear.
This is very bad news.
"My blood sugar level was normal when I was admitted to the hospital. How come it suddenly rose so quickly in just two days? It's so weird." Although Professor Hu Wanjun is only a gynecologist, she has also treated many obstetric cases.
She had never encountered such a thing before.
"It's a good thing that the problem has been found. If it hadn't been found, the patient's blood sugar would have been so high. I'm afraid after tonight, her fetus would probably not be saved. Even the adult's life would be in danger. I hope it's not too late now."
After hearing the blood sugar results, Zhang Bihua quickly calmed down from her initial shock and fear.
Every second counts and the patient's blood sugar must be corrected immediately.
The subsequent treatment became simple. Among the experts present was an endocrinologist, and correcting the blood sugar of the pregnant woman was just a piece of cake for them.
The most common treatment method is to fill the body with saline solution, and then add insulin to the saline for continuous intravenous drip to lower blood sugar.
"We just need to leave a few obstetricians and gynecologists and nurses here. You've worked hard all day and will need to see patients tomorrow. Go back to the hotel and rest first!"
Zhang Bihua looked at the other experts.
"Wait! Director Zhang, experts, we have a few more cases that we would like you to discuss. If possible, please go to the conference room and take a break. We will be there soon."
It takes some time for this pregnant woman's blood sugar to correct.
Hu Wanjun was worried and left immediately, estimating that she would see the effect after staying in the ward for about twenty minutes at most.
Intravenous infusion is a relatively fast-acting treatment method.
"Then you can go to the conference room and rest first!" Director Zhang said to everyone, and then his eyes turned to Yang Chan's beautiful and pure face. "Yang Chan, you did a good job! You really impressed me today!"
Seeing her beloved student perform so well, Director Zhang Bihua not only felt proud, but also felt extremely happy and relieved in her heart.
Teachers all hope that their students can achieve success.
Yang Chan's face immediately turned red when she was praised in public.
It is undeniable that she stole the show just now. Countless experts, doctors, nurses, and even family members and patients looked at her with admiration.
Because she discovered the patient's blood sugar problem, she saved two lives.
