Great doctor starts with adding points

Qianjiang is a county-level city directly under the Hubei Province. Wu Xie used to go to the provincial capital Hanshi to study, for example, passing by.

Although I don't know where the Qianjiang Central Hospital is, it must be a third-class hospital, and its level may be better than that of Enzhou People's Hospital!

Jin Yinshan really took Jinping to a good hospital.

Jiang Yun's tone on the other end of the phone was not particularly kind, and he asked what was going on when he came up.

How else can I manage what happens after he leaves the hospital?

When Wu Xie heard the words, she had no choice but to respond in an official tone: "I wrote all of Jinping's treatment process in our hospital in the discharge record?"

"Before I was discharged from the hospital, the wound had improved slightly. I have taken pictures of the wound every day."

The wounds of infected patients must be photographed and recorded every day, so that we can observe whether the wounds are getting better or not. This is what every surgeon must do.

The other party was silent for about half a minute, and then said with a slightly stiff tone: "The family members said that the discharge medical records have been lost. Can I trouble Dr. Wu to repeat it?"

"I have an electronic file here, and he can come back and print it at any time." Jinping chose to leave the hospital at that time, and discarded the discharge medical records at the gate of the hospital. That was his freedom.

Asking Wu Xie to memorize the medical records again is not the business scope of the doctor to provide.

If Jinping really accidentally lost it, Wu Xie might really recount it roughly.

It seems that Jinyinshan is also on the opposite side, and now the mood is not stable, and it is noisy: "If I have time to come back and print, why should I bother?"

"I said you're a gangster in a town hospital, what's there to be so embarrassing about?"

"I can't say that your grandfather is an old man, but you still dragged him up?"

Jiang Yun is also a medical staff, and immediately began to appease Jinping when he heard this, and after more than ten seconds, Jiang Yun said: "Dr. me?"

"The current condition of Jinping's wound has become slightly worse."

This is normal communication and request!

However, for things like discharge medical records, except for the patient himself and his family members, the doctor in charge of the bed does not provide photos in principle.

But it doesn't matter, Wu Xie didn't change them.

"Wait a minute, add me on WeChat, and I'll send you the discharge medical records directly." Wu Xie still took a step back.

Even if Wu Xie refused the request and insisted that Jinping come back and print it himself, it made sense in principle, but it's not good to cause such an embarrassment.

The fact that grandpa went to find Jinping really stimulated Jinyinshan.

It was a landline phone, so Liu Song couldn't hear what Jinyinshan was angry about, so after hanging up the phone, Liu Song smiled curiously and said, "The doctor from Qianjiang Central Hospital also came to ask you about Jinping?"

"Tsk tsk, you are amazing, little crab."

Those who can bear the name Central Hospital are at least tertiary hospitals! And it is a medical institution only at the city level.

Wu Xie didn't explain, but smiled back: "Brother Liu, I'm going back to work first."

...

When Wu Xie arrived at the department, he squarely took a picture of the discharge record stamped with the department's seal in the discharge medical record that had not yet been filed, and then sent it to Jiang Yun.

Attached a sentence: "Doctor Jiang, this is the whole process of Jinping's hospitalization in our hospital and the medication process."

About two or three minutes after Wu Xie sent the discharge record, Jiang Yun made a voice call directly: "Hello, Doctor Wu, how did you think that when you were finally discharged from the hospital, you chose to use gentamicin?"

"Is there any drug sensitivity result? It's not reflected in the discharge record?"

Jiang Yun found it strange that when Jinping came with Jinyinshan, the wound healed well, but there was no medical document, so when he was admitted to the hospital, he just said that he should be treated, and he believed in the level of Qianjiang Central Hospital.

So Jiang Yun and the chief physician who led the team had no doubts. Seeing that the wound was fine, they had the right to treat it as an ordinary infection, and they were prescribed cefdinir.

I thought it was just a matter of staying for a few days, but who would have thought that the wound that was healed soon began to deteriorate again, and then Jiang Yun and others became anxious and started various checks.

Even after asking Jinping what kind of medicine he used, Jinping remembered to use Qingda.

When it was changed to Qingda, it still didn't work. I don't know why.

For Wu Xie, this question is not difficult at all: "Dr. Jiang, you have also seen that when Jinping was hospitalized in our hospital, he took cefuroxime for the first month and half a month, and cefuroxime for the second half month. Levofloxacin."

"Quinolones and cephalosporins have been used, so we thought about switching to aminoglycosamines, and it really works!"

"As for the results of drug susceptibility, our township hospital has limited conditions and cannot do bacterial culture and drug susceptibility. It can only be treated empirically."

It is impossible for Wu Xie to tell Jiang Yun about the speculative diagnosis of Rickettsia, because it is an empirical judgment, and in the eyes of outsiders, the current Wu Xie is inexperienced.

If you can't explain it clearly, you can only explain it from other aspects.

When Jiang Yun saw this information, his expression fluctuated. Co-authoring that there is no drug susceptibility test in your town hospital, it was almost done, and then it broke when he came to us, right?

Then he asked again: "There are many aminoglycosamine antibiotics, Dr. Wu, how did you think you would use Qingda's antibiotics?"

Wu Xie continued to explain: "The most commonly used aminoglycosamine antibiotics in our hospital are gentamicin and tetracycline. Gentamicin is more common. Although tetracycline is cheaper, after all, kidney toxicity is higher, and gentamicin is not much more expensive. can be reimbursed."

"So, when you chose gentamicin, it was only because it was cheap and easy to obtain, and there was no objective evidence for other aspects?" Jiang Yun breathed a sigh of relief, and then asked back.

This question is a bit more acute.

Wu Xie frowned slightly, without smiling, and speaking politely: "What does Doctor Jiang want to hear?"

It was strongly demanded by his family members that Jinping left here. As long as his life safety is not affected, the family members' right to freely choose a hospital for diagnosis and treatment is protected by law.

He left our hospital and went to your place. How to treat him is your freedom. Why do you ask me so much?

"No, Dr. Wu, you misunderstood me, I just want to know your general diagnosis and treatment ideas." Jiang Yun hurriedly replied in an apologetic tone——

Wu Xie sped up his tone a little: "Cefuroxime is the third-generation cephalosporin antibiotic!"

"Its antibacterial spectrum mainly includes Gram-positive bacteria: methicillin-resistant Staphylococcus aureus, Staphylococcus vulgaris, hemolytic streptococcus, Streptococcus pneumoniae, etc. Gram-negative bacteria: Klebsiella pneumoniae, Escherichia coli bacteria, Phosphobacterium, Enterococcus faecium, Pseudomonas aeruginosa, Isoclonus, Pseudomonas aeruginosa, carbapenemase-producing bacteria, etc.

"And Legionella pneumophila, Moraclaisia, etc."

"The use of moxifloxacin, a rather broad-spectrum quinolone antibiotic, is mainly considered to cover Salmonella (including Salmonella typhi, Salmonella paratyphi, etc.), Escherichia coli, Proteus, ParaEscherichia coli, Vibrio, Phosphobacterium, Spirochetes, etc."

"Or Mycoplasma..."

"The antimicrobial spectrum of aminoglycosamine antibiotics is..."

"Are these considered ideas for diagnosis and treatment? Dr. Jiang?" Wu Xie spoke for six minutes in one breath, probably approaching a thousand words before giving up, and then asked a rhetorical question.

It is a kind of taboo to ask people about their treatment plan and not think about other people's diagnosis and treatment ideas!

Even when the higher-level hospitals know that the lower-level hospitals may not consider the diagnosis and treatment carefully, they will see the other side's qualifications and conditions are limited, and will not hold them accountable.

After all, it's hard for a clever woman to cook without rice!

This Jiang Yun is really interesting.

"Enough, enough..." Jiang Yun was directly confused by Wu Xie's output, and he hesitated to say this until Wu Xie asked back.

Jiang Yun was stunned, so he blurted out a question: "Doctor Wu, where did you graduate from?"