My Medical Skills Give Me Experiences
Chapter 305: Turn around, watch out for small injuries to children
【My medical skills can add experience points】【】
It is said that women are the most careful human beings in the world, and my predecessors do not deceive me.
Zhou Can offended her to death, and now he wants to repair the relationship between the two and apologize to her, I'm afraid it will not be an easy task.
As the news was broadcast on the large advertising screen, some family members and patients discovered Zhou Can.
"Look, isn't that young doctor the same Dr. Zhou that was just reported on the news?"
"He seems to be quite free now! Husband, let's register our daughter quickly and go see a doctor with Dr. Zhou!"
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A well-dressed young couple left directly from Du Leng's waiting line after reading the news report.
Then he quickly ran to the registration window and registered Zhou Can's consultation number.
Anyway, it is free to register an expert account, and changing the account will not affect them at all.
"Is it true that the child's broken arm was easily healed without surgery or hospitalization?" An old man who took his grandson for treatment looked up at the big advertising screen, hesitating in his heart.
After ten seconds of fighting between heaven and man, he decisively carried his grandson to the window and hung up Zhou Can's number.
Zhou Can was originally ignored by no one, but under the aura of news reports, the situation changed immediately.
One after another, patients have begun to take the initiative to register his number and seek medical treatment from him.
Looking back and thinking about it, no one had registered with him before this, mainly because there was no clear field of medical expertise.
His personal introduction only wrote that he is good at emergency and miscellaneous disease treatment.
This introduction is very general, and it lacks a clear and clear identification for patients and family members seeking treatment. When there are better options, family members will definitely consider registering with other experts first.
For example, if a pregnant woman suffers from a severe stomachache after catching a cold, her illness is not only an emergency, but also an obstetrics and gynecology disease.
Then she went to Xinxiang Maternity and Children's Hospital to have a look. Among the experts attending the consultation, Director Zhang Bihua's introduction said that he was good at treating gynecological and obstetrical diseases.
The patient immediately thought that she was pregnant with a baby, which must be an obstetric disease.
She will subconsciously ignore that this is an emergency.
In addition, Director Zhang is nearly sixty years old, so he looks like an experienced old expert. Look at Zhou Can again, a young frizzy guy, this must be a novice doctor, don't even think about it.
So she immediately hung up Director Zhang's account decisively, even if she waited in a long line.
Being cold during the consultation forced Zhou Can to think about these issues.
He is still in the regular training stage now, and it will be over a year before the regular training is over and he will become a formal resident doctor. At that time, you will definitely need to face an independent consultation.
Having one or two areas of specialization helps him create a personal calling card.
"Hello, Doctor Zhou, can you please take a look at my daughter?"
"Please sit down! What's the matter with her?"
Seeing that a patient had finally arrived, Zhou Can hurriedly put up all his energy to deal with it.
"My daughter has been not very energetic since last week. Later, she developed a fever and was always shivering. She complained of leg pain and hand pain." The family member gave a general description of the girl's symptoms.
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【My medical skills can add experience points】【】
Looking at the little girl who is only two years old, her eyes are closed, her face is flushed, her breathing is heavy and short, and she looks sick.
Pediatrics are called dumb.
Because most children behave silently when they are sick, and they will not tell their symptoms and the course of the disease.
Basically, the doctor needs to guess by himself.
This will undoubtedly increase the difficulty of diagnosis for doctors.
"I got sick last week, and it has been several days now, why didn't I take her to the hospital for treatment in time?"
Judging from the couple's economic situation, it should not be bad.
It is too irresponsible to bring her to see a doctor when the child is so ill.
"We thought it was just a common cold at first. We read in parenting science books that children should not rush to take their children for injections and infusions if they have a common cold. This will cause the child to become dependent on drugs, and it will also cause the child to lose a boost of immunity. She had a cold before, and we fed her some brown sugar and **** juice, asked her to drink plenty of warm water, keep warm and rest, and she will get better soon."
"I didn't expect to be so sick this time. And her condition progressed very quickly. Two days ago, she only had a little fever. In the middle of the night, she suddenly cried out for cold, clenched her teeth, and shivered. We took her to the community health station overnight. I went to see a doctor. After the doctor saw it, he also said it was a cold, and prescribed a box of cold medicine for children."
"I went home and took medicine, but it still didn't improve after a day. We took the child to a big hospital for treatment. I happened to watch TV and said that Xinxiang Maternity and Children's Hospital launched a free consultation with experts, so I came here."
After listening to the family members' description, Zhou Can said nothing more.
Start to do some necessary checks for your child.
Ji You helped measure the child's body temperature, heart rate, blood pressure and other physical signs.
Zhou Can found that the little girl's hands and feet were extremely cold, and her face was slightly cyanotic. These most superficial symptoms all indicated that the child was suffering from an acute illness. It's no ordinary cold.
"What kind of medicine did you give the child?"
"Here, we brought it specially, it's this little Chai Gui antipyretic granule."
This medicine belongs to Chinese patent medicine and has less side effects.
The doctor at the community health station may want to help the patient get rid of the fever first.
In fact, the level of the hospital basically determines the level of the doctor. Just like hard-working and gifted children who can be admitted to key universities for further study, children who do not study hard or have poor talents fail in the high school entrance examination and college entrance examination, and are eventually shunted to vocational schools, junior colleges, third-rate universities, or even pheasant universities. .
Hospitals are more stringent in the selection of talents.
Those with poor education or mediocre medical skills will work in township health centers, community health service stations, and private clinics.
It's not that they don't want to work in big hospitals, it's that they can't.
The child's condition will worsen, and the doctor at the community health station is actually responsible. If it can be discovered in time that the child's disease is not a common cold, enough attention can be paid to it, and the child may be able to receive effective treatment in time.
At least the family members can be advised to take the child to a big hospital for examination and tests to find out the cause.
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【My medical skills can add experience points】【】
"Doctor Zhou, can children take this medicine?"
Family members obviously trust doctors in big hospitals more, and they worry that the medicines prescribed by doctors in community health stations will not work.
"Under normal circumstances, if it is this type of cold, you can take this medicine. But judging from your child's current symptoms, it is probably not a common cold."
Zhou Can's words shocked the family members' hearts.
The woman's face turned pale on the spot.
"Doctor, what disease is my daughter suffering from? Will it be all right?" She was very afraid that there might be some serious problem with her child.
"The specific cause of the disease needs to be further investigated. You can carefully look at her face and fingers. They all have a certain degree of cyanosis, which shows that the child is likely to have a certain degree of hypoxia."
Cyanosis of complexion and fingertips are usually the most direct manifestations of hypoxia.
When the blood oxygen concentration is lower than 90%, typical symptoms of hypoxia such as cyanosis of the face, lips, and nails will appear.
After being reminded by Zhou Can, the young couple stared at the child carefully, right?
The child's face and nails were indeed somewhat cyanotic.
They couldn't help but panic even more.
"Doctor, please save my child!" Women's psychological endurance is often worse than that of men, and the child's mother is already crying. She was so frightened that she lost her mind and panicked.
"Don't worry, she is only progressing towards a serious condition, and the situation has not reached a very bad level. As long as the cause is found out in time and the symptoms are treated, there will be no major problems."
While comforting the family members, Zhou Can continued to examine the child.
"Doctor Zhou, there seems to be induration and lumps in the child's armpits!" Ji You took the child's temperature and found abnormalities.
Children take their body temperature. Old doctors like to measure their **** body temperature.
It is not hygienic, and the child will feel a certain degree of discomfort. It is not easy to cooperate with the doctor's examination.
Today's pediatricians are smart enough to measure the body temperature of the child's armpits.
There is a lot of quantitative data, and there is not much difference between the medical reference significance and the direct measurement of the anus.
Due to the difficult conditions of the older generation of doctors, the inspection methods at that time were far less abundant and advanced than they are now, so the requirements are stricter. Measuring **** body temperature is more accurate.
Sometimes even a difference of only 0.1 degrees can have a great impact on the doctor's diagnosis.
Low heat and high heat are two completely different concepts.
Zhou Can reached out and touched it, then raised the child's arm for visual inspection.
"Her axillary lymph nodes are swollen."
Zhou Can gave a conclusion.
Faced with the signs of pathological changes that were detected one after another, the parents of the children became more panicked.
"High fever of 40.3 degrees."
Ji You read out the result of the child's temperature measurement.
In order to avoid errors, it is necessary to measure body temperature at least twice. Usually a responsible nurse or doctor will measure the body temperature three times.
It must be mentioned here that measuring the body temperature of the **** is not so troublesome, just one time is enough.
In fact, measuring oral temperature can also get very accurate results.
Just put the thermometer into the child's mouth, and the family members will reject it first. Definitely felt unhygienic. The doctor's thermometer is reused. After putting it in the mouth of one child, it is put in another child's mouth. Even if there is disinfection and cleaning in between, people still extremely reject this method of measuring body temperature.
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【My medical skills can add experience points】【】
Another point, if the child bites the thermometer, the mercury in it is poisonous.
The risk is too great.
Therefore, considering various factors, doctors and nurses now basically measure the child's armpit temperature uniformly.
I would rather work harder and measure twice more.
"Is the child's bowel movement normal in the past two days?" Zhou Can continued to ask for some key information.
"The stool seems to be relatively normal, but I haven't urinated much in the past two days. Especially today, the child hasn't urinated yet." The child's mother's answer made Zhou Can's face change.
This is an extremely bad signal.
In the intensive care unit, as long as a patient does not urinate for two days, the family members can basically be notified to prepare for the funeral.
"Give her a blood test first! The child's condition is serious, so hurry up!"
After Zhou Can inquired about some basic information, he ordered the most common inspection.
Unlike many novice doctors, as long as he can meet the above inspection items, he will not miss any of them, and he will prescribe them all for the patients.
It can not only generate income for hospitals and departments, but also avoid unnecessary troubles as much as possible.
To put it bluntly, it saves trouble and avoids many risks.
It is just the opposite when experts open inspection applications.
The higher the level of experts, the more streamlined the application for inspection. Very targeted.
In many cases, one or two items are checked first, and a new examination is prescribed after further diagnosis based on the results.
Starting from regular training, Zhou Can basically followed the chief physician, and he was the most senior chief physician in the department. In terms of applying for inspections, he has inherited the characteristics of chief physicians very well.
Never prescribe inspection items indiscriminately, make patients suffer as little as possible, save patients these unnecessary expenses, and shorten the time for patients to see a doctor to the greatest extent.
If a lot of examinations are prescribed to the patient in a lazy manner, it may take a day or two for the patient to do all the examinations.
This is really not an exaggeration.
Large hospitals do most of the examinations are queuing.
why? Because there are many patients seeking medical treatment, there are also many doctors who prescribe a lot of examinations indiscriminately.
"Doctor Zhou... Let me first declare that I am not questioning your level! Is my child just taking a blood test?" The family members saw that Zhou Can only prescribed one test, which was the simplest blood routine, and they felt very uncomfortable.
"Otherwise? Give her a lot of checks? Electrocardiogram, urination and bowel routine, chest and abdomen B-ultrasound... check all the checks that can last?"
Zhou Can raised his eyebrows.
"Ah...hehe, I'm just asking jokingly, please don't take offense." After hearing this, the child's father turned bitter, and quickly admitted his cowardice with a smiling face.
The two family members took their children to draw blood for examination.
"Doctor, my grandson's ankle is sprained, can it be cured?"
The grandfather who took his grandson to see a doctor also sat at Zhou Can's consultation table after registering.
"Let me see!"
Zhou Can stood up, walked in front of the child, squatted down and carefully inspected the child's feet.
The little boy's right ankle was swollen several times, with bruises and purple subcutaneous plaques. This is a hematoma.
"Go and take an X-ray first! If there is no serious fracture, the problem will not be serious. However, because he has subcutaneous hematoma and bleeding, the specific injury will not be known until the examination results come out. Now try to Maybe don't touch his injured part, let alone rub it."
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【My medical skills can add experience points】【】
While prescribing the examination for the child, Zhou Can told the precautions.
Many people don't understand medicine, and they heard from the older generation that if there is swelling anywhere, just massage for a while can quickly reduce the swelling.
This method is actually not desirable.
Ordinary hematoma massage can indeed activate the muscles and bones, help the hematoma part to accelerate blood circulation, so as to achieve the purpose of quickly reducing swelling and relieving pain.
But if there is a fracture in this kind of sprained foot, random massage at this time will aggravate the injury.
Originally, it was only a minor fracture, but after some vigorous massage, it directly caused a serious fracture, which was not worth the candle.
Also, if the hematoma occurs on the head, especially some children are particularly prone to bruises and injuries to the head because they are active and naughty. It is quite normal to have a big swelling on the head.
According to some folk methods, it is like to smear oil or white wine on the swelling, and then rub the swelling hard.
Doing so is very dangerous.
Children's blood vessels are very delicate, and the walls of the capillaries are also very thin.
In the case of a hematoma, massaging the area vigorously will further squeeze the congested blood vessels, which will only aggravate the bleeding. It even causes further rupture of the blood vessel wall, resulting in serious consequences of intracranial hemorrhage.
After applying for the child's examination, several patients came to Zhou Can's consultation table one after another.
It seems that the broadcast of the TV program has been of great help to him.
Especially when the news interview about him was broadcast on the big advertising screen in the outpatient hall, this kind of publicity was enough to push him to a high position.
Zhou Can diagnoses every patient seriously.
Today's luck is not bad. So far, a total of five patients have been treated, and the symptoms are relatively clear and not particularly complicated.
At this time, the first child who had a blood test came back with the results.
"Doctor Zhou, UU Kanshu www.uukanshu.com has finished the blood test, please take the trouble to take a look."
The brows of the family members are full of worry.
"White blood cells are elevated, the proportion of neutrophils is also elevated, but the number of platelets is decreasing... Has she been scratched by a rusty nail or metal recently?"
When Zhou Can saw the results of the routine blood test, he was also taken aback.
"No! The child has always been fine, and I have never heard of any injuries!" The child's mother shook her head and said.
"Who usually takes care of this child?"
Zhou Can asked.
He noticed that the child's mother said that she hadn't heard of the child's injury, not that she hadn't seen the child injured.
It means that she is definitely not the only one with children.
"My husband and I usually have to go to work. During the day, the child's grandma usually takes care of the child. After get off work, and on Saturdays and Sundays, we take care of the child."
Young people in cities are stressed and need to work hard to earn money.
It is indeed much better to have the elderly to help you with children.
The couple can work to earn money, thereby increasing the income of a family.
"Can you call and ask if the child has been pricked by a rusty object recently?"
Zhou Can has already begun to examine the child's extremities and other exposed parts.
Soon, he made a discovery.
There is a light red mark on the palm of the child's left hand. Young children have a strong healing ability and a strong vitality. Even with skin trauma, it can heal quickly.
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【My medical skills can add experience points】【】
This area is likely to have been injured.
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