Rebirth of Medicine Practices the World

"Dr. Zi's report is very detailed. I have nothing special to add." Now, Zi Xuan is under Dong Huayu.

"Dr. Zi's report is good. It can be seen that he has put a lot of effort and made a lot of preparations. Before going to see the patient, I would like to ask a few questions."

"First, how is the pressure in the patient's ventricle currently?"

"Reporting to Director Lin, at present, the patient's drainage tube is still maintained at a height of 18 centimeters from the puncture point, but there is no cerebrospinal fluid flowing out." Dong Huayu immediately took over.

"How long has this been going on?"

"It's been more than a week." It's Dong Huayu again.

"If that's the case, why are you still using dehydrating agents?"

"We're always worried."

"What are you worried about?"

"Worried about high intracranial pressure."

"Okay, just now Dr. Zi said that he had taken blood tests many times. How are the patient's biochemical results?" After Lin Lin finished speaking, she looked at Zi Xuan.

"Uh... basically normal."

"It's basically normal, so there's something abnormal, right?"

"Uh, yes."

"What's wrong?"

"Well..." Zi Xuan couldn't answer, and neither could Dong Huayu.

"Doctor Zi just said that the patient's phlegm is not much, but it is quite thick. What method can be used to thicken it?" At this moment, everyone knew that Dean Lin had not missed every word of Zi Xuan.

"Wow, Dean Lin is so amazing, isn't he? How can he multi-task and be so precise?" The new doctors, graduate students and interns were very shocked.

"I would like to add that the patient's phlegm is very thick and the phlegm scab often blocks the inner opening of the tracheal tube, so we need to handle it carefully." Yu Ling interjected.

"Okay, the nurse's supplement is very good. Director Ding, it's best for nurse Yu to participate in your ward rounds in the future. They may be more aware of some nursing issues."

"Yes, next time, please nurse Yu to participate in my ward rounds." Ding Feng quickly picked up.

"Going back to the question I asked just now, the patient's blood test showed that the potassium and sodium ions in the blood were low, the blood sugar was high, and the transaminases were slightly elevated. The routine blood tests showed that in addition to the increase in white blood cells,

In fact, red blood cells and hemoglobin also increased slightly. As for why, we will discuss it later."

"Okay, let's go see the patient."

Arriving at the patient's bedside, Ding Feng introduced Lin Lin to the patient's family members as usual. The patient's family members were naturally very happy when they heard this. Lin Lin's name was very loud in Yingzhou.

Some family members of patients even said that if you go to the neurology department of an affiliated hospital to see a doctor, if you have not been seen by Director Lin, it means that you have not been to the affiliated hospital and you have not seen the neurology department of the affiliated hospital.

It can be seen how high Lin Lin's status is in the hearts of the patients' families.

Lin Lin first performed a systematic examination of the internal medicine system for the patient, including looking, touching, percussing, and listening to the heart and lungs. Especially for the auscultation of the lungs, Lin Lin was very patient and attentive.

Nervous system examination, because the patient had a tracheotomy and was unable to communicate. During the physical examination, Lin Lin found that the patient's right limb muscle strength was level 2, the muscle tone was low, and the tendon reflexes were absent, but the pyramidal tract sign was positive and the meningeal irritation sign was positive.

Negative.

Lin Lin loosened the drainage tube fixed on the bedside infusion pole and slowly lowered it to a level with the puncture point. She found that no cerebrospinal fluid flowed out of the drainage tube.

After re-fixing the drainage tube, Lin Lin removed the gauze covering the tracheostomy tube opening and found that the patient did not have much phlegm.

Lin Lin's inspection sequence is very particular. From sterile to sterile, from closed to open, this is what the aseptic operation must be, otherwise, iatrogenic infection may occur.

"Okay, let's go back and study the next treatment plan. Don't worry, we will do our best." Lin Lin said to the patient's wife.

Lin Lin washed her hands and returned to the office to sit down.

"Okay, let's start the discussion, starting with the doctor in charge." Lin Lin went straight to the topic.

"This patient's neurology diagnosis is clear.

Chu, the previous treatment method is also correct. The most puzzling question now is why the patient's body temperature never returns to normal."

"According to common sense, we have used various types of antibiotics, all bacteria should be killed, and the infection should be controlled, but why is the patient's body temperature still not normal?"

"At this point, I don't understand." Returning to clinical practice, Zi Xuan did not dare to be arrogant...c

"Dean Lin's question just now and the subsequent ward rounds, I feel that there are many things that we have not done carefully enough."

"First of all, the patient's cerebral pressure should be normal. We don't have enough guts to deal with it. Of course, one of our worries is whether the patient will have secondary ventricular infection."

"Also, we didn't pay enough attention to the patient's blood biochemistry results, and we didn't detect the patient's electrolyte imbalance in time, so we didn't make timely adjustments."

"Of course, I don't understand why the patient's body temperature rises so stubbornly, so I'd better ask Dean Lin for guidance." Dong Huayu is still young after all, and Lin Lin promoted him for the future, not the present.

"I agree with Director Dong's opinion. I don't understand either. I dare not pretend to understand in front of Dean Lin." Tan Xiaomin was very smart and spoke quickly.

Because this patient has been discussed many times in the department, Ding Feng, Ling Xiaoyun, and Zhuo Yiming did not have any new opinions.

"Let me share my incomplete opinion." Ye Xiu spoke.

"This patient's current problem is that his body temperature has never returned to normal levels. The cause of fever is a very common problem in the internal medicine system, and it is also a problem that is not easy to solve."

"Specifically for this patient, I came up with a few ideas based on Director Lin's interview and physical examination just now."

"First of all, is the patient's body temperature problem related to infection? If so, why have broad-spectrum and large amounts of antibiotics been used for such a long time without any effect? ​​If the body temperature does not go down, is there the possibility of secondary infection?"

"Secondly, the patient's lesion is in the cerebral hemisphere and affects the ventricles. Could the patient's increased body temperature be related to the central nervous system?"

"These are a few other issues I have considered. I would like to ask Dean Lin for guidance." Ye Xiu's considerations cannot be said to be unreasonable.

Seeing that everyone was silent, Lin Lin looked at Ling Xiaoyun.

"Hey, Dean Lin, don't look at me. You've been missing for so long and everyone misses you. We all need to see you more." Ling Xiaoyun's speaking style remained unchanged.

After hearing this, Lin Lin smiled slightly and said, "Yes, it's true that I haven't been back to discuss cases with you for a long time. In fact, I miss you all too."