Chapter 347: Rescue immediately, Dr. Luo panics
Cheng Dazhuang stood up and called Zhou Can, "Can, why don't we go over and take a look too."
"OK!"
Zhou Can agreed and stood up, subconsciously checking what book Doctor Luo Jian was reading.
103 cases of abdominal pain in general surgery.
Judging from the yellowed cover of the medical book, it must be quite old. It may be a medical book from 40 or 50 years ago.
Doctors like to refer to old books on case analysis.
Because the conditions were very difficult decades ago, most doctors studied medicine carefully. Their work attitude was also meticulous, and the medical records and medical records they wrote were extremely rigorous and of great value for reference and study.
In modern times, with the rapid economic development, the values of many doctors have been objectified.
Plagiarism is rampant in written papers, and there are even fewer good doctors willing to spend time writing medical records for future generations to learn from. Some doctors may have this intention, but their level is limited, and they are afraid of being scolded, so they dare not write.
A smile appeared in Zhou Can's eyes. It seemed that Doctor Luo had encountered a disease that he couldn't treat, so he had to cram in the office and read books, trying to find treatment experience that could be used as a reference.
It's almost the same in every hospital. When doctors encounter a case they can't handle, unless the patient is an emergency or critically ill, they usually look it up in books first. Only when they really can't handle it themselves will they ask their senior doctors for help.
This is especially true when on duty at night.
If you call your superior doctor for a trivial matter while on duty, the chief physician will have a very bad impression of you, even if he doesn't scold you to your face.
If anything good happens in the department in the future, people with a bad impression will naturally line up at the back.
If things go wrong, because of the bad impression, some of your minor ailments and mistakes will be magnified in the eyes of the chief physician, and then you will be scolded every other day.
Therefore, we must grasp the right measure in life.
Some young people ask their superiors everything, whether they are at work or resting at home, harassing them with phone calls at night and circling around the chief physician like a fly during the day. The most frightening thing is that these people are often unaware of this and think that asking questions frequently can leave a good impression on the chief physician that he is a studious person.
Little do you know that others have already blocked you in their hearts.
It's just that I can't say it out loud because of my face.
"A-chan, hurry up! I'm telling you, this case is quite difficult and it's a very good learning opportunity. You came at a really good time today."
Cheng Dazhuang urged in front with a little excitement.
It seems that he is not unmotivated, but lacks learning opportunities.
In addition, the overall working environment was not very good and everyone was lazy, so he also fell into depravity.
The two men came to the outside of a ward, and before they entered the door, they heard the patient groaning in pain.
Entering the ward, there were only two beds in the ward of at least 30 square meters, and all kinds of facilities were complete. The hospitalization environment of the County People's Hospital was quite good, even better than that of Tuya Hospital.
It is unimaginable that in Tuya Hospital, such a large ward has only two beds.
The nurse I had seen at the nurses' station before was also in the ward, nervously looking at the patient who was holding his stomach and crying in pain.
The patient looked to be a man in his forties, with wrinkles on his forehead.
Because of the pain, he clenched his teeth, his cheeks bulged high, and his facial expression showed extreme pain.
Zhou Can secretly observed the patient.
This is also the first reaction of doctors after seeing patients. Traditional Chinese medicine's visual diagnosis has been well "borrowed" by Western medicine.
"This patient was admitted at around 5pm this afternoon. He has abdominal pain for unknown reasons. And it's labor pain. He's in so much pain now, I guess it's a relapse."
Cheng Dazhuang was whispering about the patient's condition.
Luo Jian, the attending physician, is examining the patient at the bedside.
"Does this area hurt?"
He pressed the patient's abdomen and kept asking questions.
"Yes! Ouch, ouch...it hurts so much!"
The patient was in excruciating pain, his face turned pale, and sweat broke out on his forehead.
"Did your stomach ache start today?"
"Yes, yes, yes! Doctor, please think of a solution for me quickly. I can't stand the pain any more!"
The patient gasped, hoping that the doctor could quickly heal him and relieve his pain.
Almost all patients think so.
After they were admitted to the hospital, they thought they were saved and had a natural trust in the doctors and nurses.
In fact, sometimes doctors and nurses are also very panicked.
It would be fine if they encountered a disease they could cure, but if it was like the current situation, where they encountered a patient with abdominal pain of unknown cause, the doctors and nurses might be more panicked than the patient.
"Take his temperature and blood pressure!"
Doctor Luo frowned, thinking hard about the cause of the patient's abdominal pain.
Zhou Can walked to the bedside and picked up the patient's examinations and medical records to check.
I had an abdominal ultrasound and even a CT scan, as well as routine blood, stool and urine tests. However, because the specimens were submitted too late, the results of the blood test are not yet out.
The results of urine and stool examinations were basically normal, with no urine protein or occult blood in the stool.
The main focus of the doctor's examination may be common abdominal pain diseases such as acute appendicitis, acute cholecystitis, acute pancreatitis, acute enteritis, and gastric ulcer.
Unfortunately, after examination, no obvious lesions were found in the patient's abdomen.
"The medical history says that you have had stomach pain for more than ten hours? Did you come to the hospital after suffering from pain at home for a long time?"
Zhou Can originally didn't intend to meddle in other people's business.
Otherwise, people would think he was showing off on purpose.
But when he saw the patient's medical history, it said that he had been suffering from abdominal pain for more than ten hours. The patient had abdominal pain after working, not continuous abdominal pain, but labor pain.
After resting for a while, the stomach pain stopped.
But after a while the pain started again.
This situation is often a warning sign of danger.
"I've had stomachaches before, and they always went away after I went to the toilet or rested for a while. This time the pain was a little different. It came in waves, and it got worse and worse. I couldn't stand it anymore, so I came to see the doctor."
While the patient was explaining, his wife sat silently by the bed.
It can be seen that my wife probably doesn't have much status at home.
"Most ordinary people think the same as you do. They are afraid of spending money to go to the hospital! Is stomach pain a dull pain or a stabbing pain? A stabbing pain is like having needles piercing your stomach."
Zhou Can took the opportunity to start chatting with him.
"It seems to be a dull pain. Anyway, it hurts a lot, in waves, as if someone is pulling the flesh inside."
The patient answered truthfully.
"Breathe in slightly, I'll press your stomach to see if the pain eases."
Zhou Can asked the patient to inhale.
However, the patient seemed to be a little skeptical of his medical skills because he was young.
"This is the doctor from Tuya Hospital. You will be right if you do as he says." Cheng Dazhuang spoke up for his good friend.
Doctor Luo said nothing.
I guess he also doesn't think highly of Zhou Can's medical skills.
"Husband, just listen to the doctor!" the family member advised the patient.
He then cooperated by breathing in, and Zhou Can held his stomach.
"It hurts, my stomach still hurts, it doesn't get better at all! Little doctor, your method doesn't work, it doesn't work!" The patient was in severe pain and his temper was much more irritable than normal.
After following Zhou Can's method, it was of no use at all and he seemed quite annoyed.
Doctor Luo Jian raised his lips slightly, probably thinking that Tuya's doctor was just so-so.
"The appendix is fine, enteritis can be basically ruled out, and there is no obvious tumor in the abdominal cavity. It is recommended to take an electrocardiogram or do a cardiac color ultrasound." Zhou Can said in a very serious tone.
"Doctor, although I don't know much about medicine, my stomachache has nothing to do with my heart. You can't let us ordinary people waste money in vain." After hearing this, the patient retorted while enduring the pain.
"I've never heard of heart disease causing abdominal pain."
Doctor Luo Jian disagreed with Zhou Can's opinion.
It's basically equivalent to dismantling Zhou Can's stage.
But he had no idea how amazing this young intern was.
At Tuya Hospital, he is often invited by chief physicians to help diagnose difficult cases and participate in various consultations.
Cheng Dazhuang felt that Zhou Can’s arrival was just in time, as it would provide him with an extra opportunity to learn and practice.
They should actually be grateful that they met Zhou Can, a great doctor who went to the grassroots level.
"Just because Dr. Luo hasn't heard of it doesn't mean it doesn't exist. The patient's condition is not optimistic. I suggest you do an electrocardiogram or cardiac ultrasound right away. You can also report it to the chief physician right away and tell him that I said the patient might have a heart problem."
Zhou Can's tone was solemn and serious.
A life was rapidly disappearing before his eyes, and out of his sense of responsibility as a doctor, he felt that he had to fulfill his duty to remind the patient.
"It's not as serious as you say, right?"
Doctor Luo felt a little uneasy when he saw that he didn't seem to be joking.
"Acan, why don't you go to Dr. Luo's office and have a chat?" Cheng Dazhuang tried to smooth things over between the two.
Many things are difficult to say in front of family members and patients.
It is even worse if two doctors get into an argument.
The nurse who had taken the patient's blood pressure also looked at Zhou Can with a rather repulsive look. This young doctor was really ignorant. Even if he was from Tuya Hospital, so what? He was so young that he must be an intern or a regular trainee. He had only studied medicine for a few days, but he dared to speak to Dr. Luo in such a tone.
He is so ignorant of the immensity of heaven and earth.
"If Dr. Luo doesn't believe my diagnosis, there is a simple and direct way. Just measure the patient's left and right arm blood pressure."
Zhou Can ignored the female nurse's strange and hostile look, and didn't care about Dr. Luo's ugly expression.
What he has to do now is to get the patient treatment as quickly as possible.
"This nurse has already measured the blood pressure in the left arm. Just measure the right arm."
Zhou Can said to the nurse.
"Based on my more than four years of nursing experience, the blood pressure in the left and right arms is the same, and there is no need to measure it." The nurse is not as easy to talk to as you might think.
I don't buy Zhou Can's account at all.
This is normal. When facing doctors from other hospitals, the medical staff of our hospital will instinctively stand on one side and unite.
"It won't take you too long to measure it. Maybe you can learn some different clinical knowledge." Zhou Can said calmly.
His realm and level are there, so he would not bother with a little nurse.
“Tutu, just measure the blood pressure on your right arm and let us see if Tuya’s doctor is really different!”
Dr. Luo Jian spoke, and the nurse immediately measured the patient's blood pressure in his right arm.
Everyone was quietly waiting for her results to come out.
Gradually, the female nurse with a somewhat cold face began to show a surprised expression.
Shock and surprise gradually deepened on her face.
"Tutu, how's your blood pressure?"
When Doctor Luo Jian saw this situation, he immediately felt something was wrong.
But he was more worried about the patient's condition.
If what the doctor from Tuya said was true, the patient had been suffering from abdominal pain for more than ten hours. The situation was probably extremely dangerous.
Because under normal circumstances, chest pain that persists for more than forty minutes should be a cause for concern.
Why can patients with chest pain go to the hospital without waiting in line? They can go directly to the chest pain center and the green channel of sudden heart attack. This is because if it is a heart attack, the patient will die soon.
"What he said... turned out to be right. The blood pressure difference between the two arms was nearly 30. This is incredible. I have been a nurse for several years, but this is the first time I have encountered such a strange situation ."
The nurse's face felt hot.
There was more shock, a hint of shame, and even a hint of inferiority.
She didn't expect that there would be such a big gap between her and the doctors at Tuya Hospital.
It turned out that she was looking at the world from a narrow perspective.
"I suggest you send him to the emergency room for an ultrasound scan right away. What I'm most worried about now is that it's too late to find out and there's no chance of rescue!"
Zhou Can has worked in Tuya's emergency department, cardiothoracic surgery department, and critical care medicine department.
Their experience is simply not comparable to that of the attending physicians and nurses in these county-level people's hospitals. Some patients looked fine one second ago, but their condition deteriorated rapidly the next second. The medical staff tried their best to rescue them, but in the end they still failed to save the patients.
He has seen this kind of scene too many times.
"Send him to the emergency center immediately. Contact Director Wang from the cardiothoracic surgery department to come to the hospital quickly! Notify head nurse Liu Bin to come over! Cheng Dazhuang, help send the patient to the emergency room for emergency treatment!"
Doctor Luo Jian was already busy lifting the buckle of the bed, and then pushed the bed directly to the emergency department.
To be able to become an attending physician, you must have some experience.
After discovering that Zhou Can's diagnosis was true, he immediately became highly alert.
"Doctor, my husband just has a stomachache, is it really that dangerous?" The family members were obviously still a little hard to accept the result. They were even skeptical of the hospital.
"He seems to have a stomachache, but in fact he has a heart problem. You will know when the test results come out. Based on my clinical rescue experience, if there is really a problem with his heart, the prognosis will be very poor. Please hurry up and follow him. There will definitely be a lot of things that require your signature. Don't waste any more time."
That’s all Zhou Can could say.
Ask him to tell the family directly in an affirmative tone that your husband is in a critical condition and may not be able to be saved. He is not that stupid.
Afraid of being beaten by family members.
Zhou Can did not go to the emergency center with them. He was just a guest who came to chat with his childhood friend.
It would definitely be inappropriate to follow the doctors from the County People's Hospital to participate in emergency work.
Unless the other party invites him, that's another matter.
Otherwise, it is not showing off one's ability, but using the guest to pressure the host and meddling in other people's affairs.
He didn't go back to the doctor's office either. There was no one inside, and it would be inappropriate for him to stay there as an outsider.
When you are in a melon field or a plum garden, you have to be more careful about some things.
Self-cultivation is the self-awareness that requires no reminders.
Only a few lights were on in the corridor at night, making it quite dim. Only the nurses' station was bright, so Zhou Can sat down on a bench to rest and took out his phone to check messages.
"Um... Doctor Zhou, could you please go over and help rescue the patient just now?"
Less than thirty minutes later, the nurse came running over with an anxious look on her face.
