I Can See Health

At this time, a woman about 40 years old, with an anxious look on her face, hurried into the emergency room.

"The patient is here."

Before the woman could say anything, Wang Xiaodong pointed to the drunk's bed.

"Thank you, doctor." The woman looked at where Wang Xiaodong pointed, her expression tensed, and she hurried over.

Wang Xiaodong sighed helplessly.

In the emergency department, he had seen a lot of such scenes.

To be drunk in such cold weather, lying on the street, life must have encountered great difficulties.

The woman ran to the bed and called softly, but there was no response.

"Doctor, what happened to my husband?"

"He was sent to the hospital by the police..." Wang Xiaodong briefly described the patient's condition, "He is still in a coma."

The woman's face was already covered with tears.

"It's all my fault. I shouldn't have quarreled with him at night."

"He was working well during the day, and he was scolded by his leader. I shouldn't have quarreled with him."

"Doctor, you must save him!"

As she said that, the woman was about to kneel down to Wang Xiaodong.

Wang Xiaodong saw this kind of thing happen more and more often, so he quickly supported the woman.

"We will try our best, but the patient is not in a stable condition now, so you still have to be mentally prepared."

"Thank you, thank you doctor." The woman wiped her tears and returned to the bedside.

...

Because the drunk's condition was special, Wang Xiaodong reported it to his superior doctor and the director of the emergency department, Lu Jianjun, in time.

"Xiaodong, you are the patient's bed doctor, what do you think?" Lu Jianjun asked after understanding the patient's condition.

"The cause of the coma is to be investigated, it may be caused by hypothermia, but the most important thing now is that his electrocardiogram is abnormal, and we haven't found any reason yet." Wang Xiaodong said.

"Well." Director Lu Jianjun nodded slowly, then looked at the other people in the office, "Do you have any other opinions?"

"Could it be cardiomyopathy? Congenital heart disease?" An attending physician in the emergency department said.

Wang Xiaodong immediately replied: "The cardiac ultrasound is normal, there are no abnormal changes, myocardial enzymes and BNP are normal."

"We also asked the patient's family, and the patient had no history of heart disease."

"Cardiomyopathy and congenital heart disease have been temporarily ruled out."

Wang Xiaodong ruled out several diagnoses in succession, and the doctors fell into deep thought.

At this time, a voice suddenly sounded from the corner of the office.

"I think, why don't we let the patient do a cardiac MRI?"

Everyone looked in the direction of the voice.

The one who proposed this suggestion was a doctor named Xu Yiwen who had just come to the emergency department.

He is currently studying for a doctorate, and his advantage lies in scientific research.

Xu Yiwen continued: "Cardiac ultrasound is not the gold standard for diagnosing cardiomyopathy, but cardiac magnetic resonance imaging is."

"Perhaps we recommend that patients undergo cardiac magnetic resonance imaging to further confirm or exclude it."

Hearing this, Lu Jianjun nodded slowly, "But the technology of cardiac magnetic resonance imaging is relatively new. Has our hospital started it?"

"Yes." Xu Yiwen smiled, "I have a recent project on cardiac magnetic resonance imaging. I have asked the hospital's CT room before. Their director has sent people to the superior hospital for further training. At present, they can independently complete the diagnosis and treatment process of cardiac magnetic resonance imaging."

Director Lu Jianjun of the emergency department is still very satisfied with this new doctor.

You know, it is quite difficult for a department like the emergency department to recruit a doctor.

Even for a provincial leading hospital like Jinghua Second Hospital.

If someone is doing scientific research, there will be a project.

If there is a project, there will be a fund.

"Okay, then follow your idea." Lu Jianjun nodded slightly.

"Okay." Xu Yiwen grinned and suddenly saw Lu Chen next to Wang Xiaodong, "By the way, Junior Brother Lu Chen seems to have not expressed his opinion yet."

Lu Chen is now in the limelight in Jinghua Second Hospital.

Gu 鏱

You may not know who the department director is, but everyone knows the name Lu Chen.

Even though Lu Chen is just a graduate student.

Wang Xiaodong and Lu Chen don't have much grudge, they just want to know what Lu Chen thinks about this patient.

Lu Jianjun also looked at Lu Chen with curiosity.

Two years ago, he knew about Lu Chen, a student.

Of course, there was an explosion in Jinghua, and Lu Chen was the first student to come to the emergency department for support.

The various skilled clinical skills left a deep impression on Lu Jianjun.

Seeing everyone looking at him, Lu Chen smiled and said, "I think your idea is very good. It can further diagnose cardiomyopathy. The current gold standard for cardiomyopathy is also the Lake Louise standard of cardiac magnetic resonance imaging. If the patient has the conditions, this examination can be improved."

Cardiac magnetic resonance imaging is good, but the cost is still quite expensive, costing several thousand yuan.

Xu Yiwen was very pleased to hear Lu Chen say this.

"But..."

Lu Chen's next words attracted everyone's attention.

"This patient is also my first visit. After the emergency rescue in the morning, the patient's vital signs have improved." Lu Chen said, "The patient will most likely wake up tomorrow."

"What treatment measures did you mainly use?" Xu Yiwen asked curiously.

"This is the point I want to make." Lu Chen smiled, "In addition to warming up and rehydrating, we did not give any other special treatment."

In the office, everyone was still a little bit unbelieving, and they all opened the patient's medical order sheet.

At a glance, there was indeed no other treatment except warming up and rehydration.

"So, I was just thinking that all these abnormal manifestations of the patient might be related to hypothermia."

As soon as the voice fell, everyone below remembered whispering.

Xu Yiwen frowned and said, "Can hypothermia make the patient's electrocardiogram look like a facelift?"

Lu Chen picked up the patient's electrocardiogram from the table and explained, "The principle of the electrocardiogram is cardiac electrical conduction, which is simply the current passing through the heart. If the hypothermia is severe, the flow of cellular ions slows down, which can produce electrocardiogram-like changes similar to hypokalemia, such as prolonged QT interval and obvious U waves."

Lu Chen marked several locations on the electrocardiogram, which just corresponded to the places he said.

"Looking at it this way, it seems to be true." Wang Xiaodong said in surprise.

However, Xu Yiwen frowned, "How can I confirm my idea there? What kind of examination should I do?"

Lu Chen smiled, "It's actually very simple."

Very simple?

Everyone's mouth twitched when they heard this.

They had no idea at all, but Lu Chen said something very simple...

Lu Chen continued, "Just wait until the patient's body temperature completely rises, and then recheck the electrocardiogram and other indicators."

"Compare the results before and after. If the electrocardiogram returns to normal, it can be basically confirmed that the patient's electrocardiogram abnormality is related to low body temperature!"

Before the answer was revealed, everyone was confused.

But once Lu Chen revealed the answer, everyone said "Oh", and then they suddenly realized it.

In fact, this is also a classic laboratory diagnosis method in clinical practice.

For example, some patients with undiagnosed pulmonary nodules often receive experimental anti-tuberculosis treatment without checking any pathogens.

If the patient's symptoms are alleviated, then it can be inferred that the patient is infected with tuberculosis.

"Lu Chen makes sense!" Lu Jianjun smiled with satisfaction.

He really wanted to keep such an excellent student by his side.

But it was just a thought...

Xu Yiwen did not continue to ask questions at this time, and bowed his head in silence.

It is obvious that compared with his cardiac MRI, Lu Chen's diagnosis and treatment method may be simpler.

"In fact, Brother Xu's idea is also very good." Lu Chen smiled and added, "Maybe because I am the patient's first doctor, I understand the patient's condition better. Otherwise, I also support the patient to undergo a cardiac MRI examination."

Hearing Lu Chen's words, Xu Yiwen felt better.

It's really not that I can't do it!

It's that Lu Chen is like a cheat...

.