Chapter 327 Different Diagnoses, the Sorrow of the Lower Class
It doesn't look like asthma.
Zhou Can frowned and thought, for a moment he really couldn't diagnose what disease the old lady had. Could it be a cerebral hemorrhage?
But the patient's blood pressure was quite normal. Logically speaking, even if there was a brain aneurysm, it shouldn't have ruptured with just a little stimulation! Besides, the human body is not as fragile as imagined.
At this time, other pediatric doctors and nurses came to provide support.
When a patient needs emergency treatment, the medical staff are usually very united. This is true regardless of which department they are in.
There is only one exception.
There are great risks in rescuing patients.
For example, there is a possibility of blackmail by family members, or the patient may behave in a difficult manner, or even engage in some shameless behavior before rescue is needed.
Doctors and nurses are also human beings. They know that proactively providing rescue services may cause big trouble, so they will definitely avoid danger and act according to the circumstances.
It is too much to kidnap medical staff using the standards of saints.
"Doctor Zhou, do you know what disease she has?"
"I just don't know! Before she fainted, she said she had high blood pressure, but she took her medicine on time. I measured her blood pressure and it was normal. Her heart rate was a little fast, but she was still in good condition. She felt unwell after hearing that her granddaughter's condition was serious. She said she felt weak all over, had a headache, and had chest tightness. Oh, and she was sweating before she fainted."
Zhou Can couldn't find out the cause of the woman's illness for a while, so he described the patient's symptoms and the course of her illness.
"Director Yan is here, let Director Yan take a look!"
In situations like this where patients are in urgent need of rescue, the weight and prestige of top experts carry even more weight.
Because we can't find the cause of the patient's illness in a very short time, we can't treat it accordingly. For many fatal diseases, even if we treat them just one second in advance, we can save the patient.
Director Yan came forward, leaned over to listen to the patient's breathing, observed the patient's mouth and nose, and finally lifted the patient's eyelids to take a look.
"Her breathing looked scary, but she wasn't life-threatening. I felt her forehead was a little hot, did you take her temperature?"
Top experts are indeed extraordinary.
This move, with its powerful aura and composure, was enough to stabilize the situation and make the medical staff present feel at ease.
"I haven't taken your temperature yet!"
At that time, Zhou Can was only thinking about ruling out high blood pressure and heart disease, the two diseases with the highest risks, and did not think about taking the temperature.
A nurse was quick enough to insert the thermometer into the patient's armpit.
During this period, Director Yan began to ask Zhou Can about the patient's illness in detail.
After listening, she said calmly, "It shouldn't be too dangerous. I noticed that her eyes were a little red and swollen, as if she had cried many times. It's possible that she was overworked, and she was too old, and she was worried about her granddaughter's condition. When she learned that her granddaughter was seriously ill, she was stimulated, which triggered abnormal nerve discharges and eventually fainted."
After hearing Director Yan's reasoning, the other doctors nodded repeatedly.
This explanation is indeed very close to reality and consistent with medical logic.
In addition, Director Yan has always been highly respected in pediatrics, and his medical skills are extremely superb, not to mention his experience in diagnosis and treatment.
"Did you take your temperature?"
Director Yan looked at the nurse who was measuring the temperature.
She was already accustomed to all the admiring looks and people agreeing with her diagnosis.
So there wasn't much change in expression.
"37.3, seems to be a low-grade fever." The nurse replied after checking the temperature.
37.1 degrees is considered a low fever, which is only 0.2 degrees higher. In clinical practice, doctors will make a judgment based on the patient's comprehensive symptoms and in most cases will consider it a normal temperature.
"It should be similar to my judgment. It's just that the nerves were stimulated and discharged abnormally. It's normal for the heart rate to be fast after being frightened. Let the patient rest for a while, and he should be able to recover soon."
After Director Yan learned about the patient's body temperature, he made a diagnosis.
"Maybe... this old lady is also sick."
Zhou Can kept frowning and thinking hard. He seemed to have grasped something, but he was not too sure.
It wasn't until the nurse read the patient's temperature that he realized that the patient's temperature was most likely a true low-grade fever.
"Why do you think so, Dr. Zhou?"
Director Yan had just made a conclusion when her opinion was overturned by Zhou Can. Isn't this a slap in her face?
But she wasn't angry.
Instead, he wanted to hear the basis for Zhou Can's rebuttal.
"Because the old lady's granddaughter also had symptoms such as fever and chest tightness. The two of them lived together and their symptoms were very similar. I thought it was probably an infectious disease."
Zhou Can's diagnostic ideas became clearer and clearer.
"Yes, that must be the case! Grandma and granddaughter may have the same disease."
After hearing Zhou Can's diagnosis, a doctor rushed to ask, "Headache and fever, these types of infectious diseases are not common. Could it be a cold?"
"A cold can basically be ruled out! This little girl's symptoms are highly similar to those of a cold, but the results of her blood and urine tests both indicate that it is not a cold." Zhou Can has his own judgment.
If the disease were so easy to diagnose, he would have diagnosed it long ago.
"The white blood cell and platelet counts are so low? And her urine protein is 4+. Could it be nephrotic syndrome?" After Director Yan took the girl's test results and looked at them, the first thing he suspected was that the girl had kidney disease.
These similar symptoms often appear as precursors to uremia.
In fact, the little girl's symptoms are consistent with leukemia, but the urine test results of leukemia are generally increased uric acid concentration and uric acid excretion in urine.
She showed symptoms of protein in her urine, so leukemia can basically be ruled out.
The probability of kidney disease is high.
Director Yan has extensive experience in diagnosis and treatment, and there is a reason why he thought of this disease first.
Based on his intuition, Zhou Can felt that the patient's illness was probably not kidney disease.
"I am more inclined to another diagnosis, which is kidney failure and disease caused by some serious disease. It may even lead to whole-body organ failure."
Zhou Can expressed his own judgment.
Director Yan's diagnosis was challenged again, and when other doctors looked at Zhou Can, there was something strange in their eyes.
They felt that the young man was too arrogant and self-righteous.
"What Doctor Zhou said is a real possibility. The old lady is not in any danger of death. She does not need emergency treatment and can be sent to the observation area to recover on her own. However, we still need to pay close attention to changes in her vital signs to avoid accidents."
Director Yan gave guidance.
Her status was the highest at the scene, and no one had any objection to her taking command.
"I'll leave the diagnosis of this little girl to Dr. Zhou! If it can't be resolved, we can leave it for discussion at tomorrow's morning meeting. I have a lot of patients waiting to be seen, so I'll go over first."
She was somewhat unhappy because her diagnosis was rejected twice in a row.
It's just that at her level, she is broad-minded and won't be too fussy about Zhou Can. She came here mainly to help rescue the old lady, and now that she has dealt with it, she will naturally stop meddling in other people's business.
The hospital has always implemented the first-visit system, where the patient will be taken care of by the first doctor who sees the patient.
She had the old lady taken to the observation area, and she obviously did not agree with Zhou Can's diagnosis that the old lady and the little girl had an infectious disease.
"Uncle, please save my grandma, please!"
The little girl wiped her tears and pleaded with Zhou Can.
Maybe she had been in contact with Zhou Can for a long time, and she also went to the hospital to see Zhou Can. Now that her grandmother was in trouble, she instinctively had a certain trust and dependence on Zhou Can.
"Don't cry, don't cry! This is the most capable doctor among all . She just diagnosed your grandmother and she's not in danger of death. Don't worry, your uncle is a doctor and he will definitely not ignore you."
While Zhou Can was comforting the little girl, he watched the nurse and other doctors work together to get the old lady onto the flat bed that was pushed over.
This flatbed cart is a common tool used in hospitals to transport unconscious patients.
"Director Yan, I'm still a little worried that the patient has an infectious disease. The observation area is full of children, even newborn babies, and mothers accompanying their children. These are all susceptible groups. For safety reasons, do you think it is possible to arrange this old lady and her granddaughter in a relatively closed environment?"
Zhou Can has a strong sense of safety.
It mainly comes down to the doctor’s caring heart!
If these two people really have an infectious disease that can be transmitted through the air, saliva droplets, etc., the consequences would be disastrous .
After hearing Zhou Can emphasize twice that the patient might have an infectious disease, the doctor and nurse who had just carried the old lady were somewhat worried. Doctors and nurses are both high-risk professions, and it is common for them to be infected with various diseases.
Everyone is afraid of being infected.
"Doctor Zhou's concerns are not without reason. Let's arrange them to Ward 0 first! We can make further arrangements after the specific cause of the patient's illness is found out."
Although it was the first time Director Yan dealt with Zhou Can, he had heard some stories about Zhou Can.
I know this young man has extraordinary abilities.
She didn't dare to underestimate Zhou Can's diagnosis.
Ward 0, some large hospitals have this special ward. Some hospitals also call it an isolation ward.
For example, AIDS patients, hepatitis B patients, potential rabies patients, etc., if they need to be hospitalized for observation, in order to avoid threatening the safety of other patients and their families, they often enjoy special treatment of living in Ward 0.
Some hospitals will directly stipulate that patients with infectious diseases will be transferred to the infectious disease ward for treatment.
Regulations vary from hospital to hospital.
Tuya Hospital was originally founded by foreign friends, and Ward 0 has always existed.
It is not a specific ward, the department will be temporarily changed according to actual needs.
"Little girl, you stay by your grandmother's side, okay? I will arrange for a nurse to collect a blood sample from you and send it for a biochemical test so that we can find out the cause of your and your grandmother's illness as soon as possible."
Zhou Can spoke gently to the little girl.
After saying that, he looked at the nurse who was measuring the old lady's temperature.
"Beautiful lady, could you please collect a blood sample for her? Her illness is actually quite serious, and her grandmother doesn't know when she will wake up. I'll apply for the test and take her blood sample for testing. The results will probably be out around 2:00 p.m. at the latest."
It was almost noon at this moment, and Zhou Can was very worried that the little girl's illness would be delayed.
She had been ill for two days and looked very weak.
This little girl is very sensible and makes people feel sympathetic.
As long as he could help, Zhou Can would deliberately do his best to help the grandparents.
"Of course!"
The female nurse agreed readily.
Many female nurses are very kind-hearted and sympathize with the weak.
Zhou Can opened an application form for the examination, and after the nurse brought tools to collect blood samples from the little girl, he, as a doctor, personally ran errands for the patient. First, he took the form to the window to pay.
There was no way. The old lady was unconscious and it was impossible to search her bag for her ID card.
Paying at the window is the only quick way.
Pay the fee and then send it for inspection.
The outpatient department is closed at noon.
Go to work at one o'clock in the afternoon.
The doctor's meal time is about half an hour, and he can also rest for half an hour.
…
When he went to work in the afternoon, Zhou Can was worried about the little girl's test results, so he went to check, but the results of the biochemical test were not out yet.
There are too many patients undergoing biochemical tests at Tuya Hospital. Even though the laboratory has a lot of staff and the testing speed is fast, it still takes an hour or two to get the results.
Some biochemical testing projects are themselves time-consuming.
He had just entered outpatient room No. 17 and hadn't even sat down when the gambling addict mother came in with her son.
"Doctor Zhou, I called everywhere but couldn't borrow any money. Can you prescribe some medicine for my son?" Her eyes were a little red, and traces of crying could still be seen on her eyelashes.
It seemed that she couldn't borrow money by phone, which made her a little overwhelmed and she cried.
It is a very sad thing if a person does not have a certain level of credit when he reaches middle age.
Not to mention anything else, when you encounter problems, no one is willing to believe you when you want to borrow money.
This woman must have deeply experienced what it means to be helpless.
The feeling of being abandoned must be unpleasant.
"Please register your and your child's name, address and other information first! Our hospital will also help you think of a solution." Zhou Can did not tell her directly that he would contact the street office.
Because if I say that, she will be so scared that she won't cooperate with the registration.
After registering, he specifically asked for the woman's ID card and checked it carefully.
After looking at the ID card, I realized that this woman was already 38 years old.
She felt sad.
The most pitiful one is her son.
He is just over three years old and no one cares about him even though he is so sick.
"Is the child's father still unwilling to pay for his medical treatment?"
"I called him and he said he lost money. He then scolded my son and me. I don't dare to call him anymore. The father of my child has a bad temper. If I bother him about this matter again, he will probably hit me."
The woman seemed very afraid of the child's father.
"Okay, our hospital will find a way to deal with this matter. You take the child home first."
Zhou Can sent the mother and son away.
The woman hesitated for a moment, but finally left with the child.
She may want to ask how the hospital can help her solve the problem.
