Chapter 479: Strange pregnant woman, with fetal heartbeat but no image
"Doctor Zhou, does my brother need open-heart surgery?"
The patient's sister could only half understand what was said and was worried about her brother's treatment.
Her family was not well off to begin with, and she was interning at a company right after graduation.
Even before the probation period is over, the monthly salary is pitifully low. Nowadays, most unscrupulous bosses set a probation period of more than three months. The longest can even be more than a year.
It is basically a consensus that interns do not receive any bonuses and only receive the minimum basic salary every month.
Because the labor cost is much lower than that of formal employees, both hospitals and other units are particularly fond of having a very long internship period.
The worst place should be the hospital, where you can do a year of internship and work for free.
You may even have to pay money to the hospital.
During the next three years of regular training, there is only the minimum basic salary.
A large number of undergraduates and postgraduates were used as cheap labor for more than four years.
"Judging from the patient's current postoperative performance, the outlook should still be relatively optimistic. However, no one can predict what the final result will be." The answer Zhou Can gave was basically a doctor's standard rhetoric.
First give the patient and his family hope, and then tell the family and the patient that the final outcome is unknown.
…
After seeing the patient in the cardiothoracic surgery department, I returned to the emergency department. As soon as I reached the lobby, I was stopped by Dr. Xie at the triage desk.
"Doctor Zhou, Doctor Zhou, this pregnant woman was unfortunately involved in a car accident and was seriously injured. Please help me see what to do!"
Zhou Can looked over and found that during his visit to the cardiothoracic surgery department, several car accident victims were sent in. Medical staff kept running in and out of the emergency room, and the seriously injured patients had probably been sent in first for rescue.
Injuries to pregnant women are very troublesome.
The pregnant woman seemed to be seriously injured, with blood all over her body and a bulging belly. The baby must be at least eight or nine months old.
Zhou Can is not good at obstetrics.
Whether it is necessary to deliver the baby by cesarean section first must be evaluated by a gynecologist.
"Have you checked your basic vital signs?"
"We measured her temperature, blood pressure, heart rate, and breathing. Her blood pressure was a little high, her heart rate was a little fast, and her breathing was short, but everything else was normal. After a preliminary examination, it was found that her right leg was probably broken, there was bleeding in her lower body, and there were varying degrees of abrasions on her back, right shoulder, and right arm. There was an obvious bruise and hematoma on her forehead."
Dr. Xie only performed the most basic examination.
This is a common problem among many novice doctors, who only follow the procedures in the textbook.
An experienced doctor will be very targeted when asking patients questions and performing various examinations.
"Have you measured the fetal heart rate?"
"No! But I listened with a stethoscope and it seemed normal."
Dr. Xie said after hesitating for a few seconds.
"Let's do an abdominal ultrasound first! Now let's test her blood! The right leg definitely needs an X-ray. If there is dizziness, headache, or loss of consciousness, it would be best to do a head CT scan."
Zhou Can gave Dr. Xie some guidance.
"Her lower body is bleeding, should we just ignore it?"
When Dr. Xie asked this, he was worried about the baby in the pregnant woman's belly.
"We must first do a B-ultrasound to clarify the situation in the abdominal cavity before we can proceed to the next step of diagnosis and treatment. We must do a blood test as soon as possible. When we see this type of patient in the future, the first thing we should do is to do a blood test. If it is Xiaomei or someone like her, we can find out in time. In addition, if the injured person is bleeding and needs a blood transfusion, we can also know her blood type in time."
The Xiaomei that Zhou Can mentioned refers to syphilis.
What frontline clinical nurses fear most is probably people infected with syphilis or AIDS.
In front of patients, medical staff sometimes speak in code.
The main purpose is to avoid causing resentment among patients and avoid medical disputes.
"By the way, please ask a gynecologist to come for a consultation."
After saying that, Zhou Can walked directly to the operating room.
With his director-level hemostasis skills, he was able to basically conclude that the bleeding was not as severe as he had imagined when observing the patient just now. He should not be in danger of death in the short term.
There was another thing that particularly puzzled him.
When looking at the face of this pregnant woman, she does not have a pregnancy look. Usually, after a woman becomes pregnant, she will be affected by the estrogen in her body and her face will become ugly. This will give her a unique look during pregnancy.
But this female patient did not have this characteristic.
Also, he asked Dr. Xie to check the pregnant woman's blood routine first because he felt that the patient was not an ordinary patient based on his director-level hemostasis skills and level-five pathological diagnosis skills.
Various special patients are often encountered in clinical practice.
Among them, syphilis and AIDS patients are the most common.
Even for these people who are professional medical staff, it is sometimes difficult to tell from their appearance that they are suffering from infectious diseases.
…
In the operating room, Zhou Can had just finished three operations. Dr. Xie came over and told Ma Xiaolan to tell Zhou Can that after examination, the pregnant woman was found to be a carrier of both syphilis and AIDS.
Among the injured people who were sent in with the pregnant woman, three were later found to be infected with the two viruses.
The medical staff in the emergency room were so scared that they broke out in cold sweats.
Because one of the injured people they rescued was one of these three people.
Blood transmission is one of the most dangerous routes of infection.
When rescuing the patient, the medical staff did not think too much. At that time, various emergency operations inevitably came into contact with the patient's blood. No one wore any protective equipment, not even a pair of simple rubber gloves.
The other three infected people are all men, namely the pregnant woman’s boss, current boyfriend, and male colleague.
It is said that the pregnant woman's current boyfriend's face turned green when he heard the news.
He was not angry because he was infected with syphilis and AIDS, but because his boss and male colleagues were also infected. You know, syphilis and AIDS can't be transmitted through ordinary physical contact.
Infection is often only likely to occur when the patient comes into contact with the patient's body fluids.
Moreover, when the skin on the surface of the body such as the hands comes into contact with the patient's body fluids, as long as the skin is not broken, infection will not occur. The skin is the first line of defense in our human immune system, and it is much more powerful than you think.
Almost 99.9% of bacteria and viruses can be blocked outside the body by this barrier.
Therefore, it is absolutely impossible for it to be a coincidence that the pregnant woman's boss and another male colleague were also infected with syphilis and AIDS. They must have been infected by the pregnant woman.
Anyone who is not a fool will understand how the infection is caused.
After a few minutes, word came in from outside, asking Zhou Can to go out and help with the consultation.
Zhou Can quickly cleaned the wound and stopped the bleeding for the surgical patient on the table, and then handed it over to medical assistant Yang Zhi to suture the patient.
In many operations, he would deliberately leave some surgical training opportunities for Yang Zhi.
Sometimes he would also point out Yang Zhi's shortcomings and operational errors during the operation. Of course, such words are usually said by the patient after he leaves the operating room.
Yang Zhi did not disappoint his high expectations and grew very fast. In addition, he already had good surgical skills and could now help Zhou Can in many situations.
After Zhou Can handed the patient over to Yang Zhi, he went outside to help consult with the patient with peace of mind.
"Where is the patient? What is his condition?"
As he walked, he asked the nurse who came to ask for him.
"It's the pregnant woman who infected Xiaomei and Xiaoai. Her abdominal ultrasound showed abnormalities. Dr. Yang from the obstetrics and gynecology department would like to ask you to help with the consultation."
As they were talking, the two had already arrived at the emergency room.
Zhou Can saw a pretty figure standing there, it was none other than his college classmate Yang Chan.
Like Zhou Can, she is now a full-time resident doctor.
"Hello, squad leader!"
Zhou Can stepped forward and said hello.
He was actually a little afraid to see Yang Chan now, because the look in her eyes when she looked at Zhou Can was very fiery.
This is not a good thing.
If Zhou Can didn’t have a girlfriend, that would be fine.
Yang Chan is beautiful and has outstanding medical skills. I heard that she has passed the postgraduate entrance examination and is currently a working graduate student.
In terms of academic advancement, she has already surpassed Zhou Can.
"Zhou Can, this pregnant woman's B-ultrasound is very strange. Can you please help me with some advice?"
She basically calls Zhou Can by his name.
Compared to others calling him Dr. Zhou, calling him by his name makes the relationship seem closer.
After taking the patient's examination form, Zhou Can was stunned.
The ultrasound report only showed a vague large gestational sac, but no fetus. Logically, with such a large belly, even the worst ultrasound equipment should be able to detect the fetus and show its specific appearance.
When Zhou Can saw the pregnant woman for the first time, he felt that she did not look pregnant.
However, obvious stretch marks can be seen on her belly.
As for whether there were stretch marks on the thighs and groin, Zhou Can did not check.
Be especially careful when examining female patients.
If you look around without permission, you may be beaten by family members.
"Can you hear me?"
Zhou Can asked the pregnant woman.
"able!"
A pregnant woman's voice is sweet and soft, and it can really touch a man's heart.
Zhou Can thought to herself, no wonder her boss and male colleagues were fooled. If it weren't for a man with strong willpower, who had more contact with her at work and she was more casual, few people would be able to keep themselves clean.
"How long have you been pregnant?"
"Uh... probably more than eight months!"
"It should be nine months and two days." A middle-aged man with an angry expression was lying on a flat bed next to him. It seemed that he had injured his lumbar spine and was unable to move.
"Who are you to her?"
"Boy friend!"
It turns out that this man is the pregnant woman’s boyfriend.
"You remember it clearly! Your lumbar spine looks badly injured. We need to get someone to send you to an orthopedic surgeon for treatment."
Zhou Can felt quite sympathetic towards this man.
The fact that he could clearly remember the pregnant woman's pregnancy period showed that he cared very much about the relationship between the two.
But at this moment, with the green sky above my head, I am afraid I must feel uncomfortable.
"We have contacted the orthopedic surgery department for him, but he refused to go there and wanted to stay here with his girlfriend," the nurse explained.
"You have to treat your lumbar spine injury as soon as possible. What if you delay it for too long and become paralyzed?"
Zhou Can advised this wronged man.
"I have to see that she and the baby in her belly are safe before I go to the orthopedic department for treatment. Don't worry about me, please help her get treatment as soon as possible!"
The man is a lovesick person.
Zhou Can stopped persuading her and turned his gaze back to the pregnant woman.
"Squad leader, have you measured her fetal heart rate?"
Zhou Can asked Yang Chan.
Although Dr. Xie had measured the patient's fetal heart rate, he was not professional.
Zhou Can was not confident about the novice doctor.
In particular, the situation of this pregnant woman was extremely strange. A large gestational sac could be seen, but the fetus could not be seen.
"This is exactly what puzzles me the most. The fetal heart rate is clear and normal."
This was probably the first time that Yang Chan encountered such a weird thing.
Zhou Can's hair stood on end. He was an atheist. Such a bizarre thing was enough to make him doubt whether "ghost fetuses" really existed in this world?
The fetus of Nezha appeared in ancient mythological novels.
B-ultrasound cannot see the fetus, but it can measure the fetal heart rate, and the pregnant woman's belly is no different from that of an eight or nine-month pregnant woman.
"Mr. Lu, give me a pair of rubber gloves."
"Give!"
It's already prepared nearby.
After all, everyone already knows that this pregnant woman is infected with syphilis and AIDS, so we must be on guard.
To be honest, if a person is infected with one of the two viruses alone, it is possible that the patient was unfortunately infected by his or her partner, or was infected while having an affair.
Being infected with two viruses at the same time, this woman must have a bad lifestyle.
No one can control the messy private lives of adults, but for men and women who don't love themselves, syphilis and AIDS are definitely their nightmares.
Zhou Can put on rubber gloves and lifted up the pregnant woman's shirt, revealing her round belly.
Then touch your abdomen with your hands.
There are two purposes for doing this: to see if the fetus can be felt and to detect whether there is fetal movement.
“Hmm…”
When he tried to touch the pregnant woman's abdomen for further examination, he actually felt a clear fetal canal, as if a mouse was swimming under his palm.
There were fetal movements and heartbeats, but the fetus could not be seen on B-ultrasound.
Could it be that there is a problem with B?
This possibility cannot be ruled out.
However, Tuya's ultrasound examination department has a strict inspection system. If there was really a problem with the ultrasound machine, it would have been discovered when examining other patients.
What exactly is the problem?
Zhou Can didn't know how to judge for a moment.
When you press lightly on a pregnant woman's belly, it's quite soft and there's no sign of the fetus at all.
The belly in the late pregnancy feels very firm, and you can even feel the outline of the fetus.
"What's the fetal heart rate?"
He asked Yang Chan.
"109 times per minute."
Zhou Can was slightly stunned when he heard the result, and then took the patient's medical record. When Dr. Xie saw the pregnant woman, the heart rate he measured was 110 beats per minute. Now the fetus' heart rate is about the same.
Is it a coincidence or is there a close connection between the two?
The normal heart rate of an adult should be between 60 and 100 beats per minute. Some monks and Taoists who have been meditating for a long time have a much slower heart rate than ordinary people.
The pregnant woman's heart rate reached 110 beats per minute, which was obviously too fast.
The normal heart rate of a fetus is generally between 110 and 160 beats per minute. This pregnant woman's fetal heart rate was 109, which was barely acceptable.
"Monitor, measure her fetal heart rate again, and I'll measure the pregnant woman's heart rate! We'll do it at the same time. Teacher Lu, please help us yell start."
"Ah... ok, ok, no problem."
Nurse Lu was stunned for a moment, then agreed.
Yang Chan didn't understand Zhou Can's intention at first, but she agreed instinctively.
"start!"
After the two were ready, Nurse Lu waved her hand and gave orders.
People who don’t know the situation might think a competition is being held here.
While measuring the fetal heart rate, Yang Chan was thinking about Zhou Can's intention. Then her eyes lit up and she seemed to understand a little.
Soon, the measurement was over.
The pregnant woman's fetal heart rate is 112 beats/minute. The fetal heart rate is also 112 beats/minute.
When they saw the result, the medical staff present were all shocked.
