Since 1981 Health School

When Chen Qi resolutely said the word "yes", Li Huacheng was stunned for a moment, and the pen in his hand was suddenly broken.

You must know that the rich man in the United States is not only demanding compensation, but also that the attending doctor should go to jail for manslaughter.

If the responsibility lies with his emergency department, then Director Li, who is respected today, will be 9527 in the detention center tomorrow. This is a consequence that Li Huacheng cannot bear.

Zuo Yongxin, director of the gastroenterology department, had a happy face, wishing he could stand up on the spot and shake his fist.

Sure enough, Li Huacheng was in a hurry, he didn't even give face to the director of his own hospital, and dared to tear the face of his colleagues, let alone a foreign monk.

"President Chen, I know that you are the director of the Society of Gastroenterology, so you must stand on the side of gastroenterology. It is understandable to help gastroenterologists, but today is a big deal, you have to Keep a neutral position, don't bite people indiscriminately!"

Under the tremendous pressure, Li Huacheng lost his mind and even uttered swear words.

The scene was quiet, and everyone was wise and safe. Whoever speaks now will be burned on his own head.

Look at this Dean Chen Qi from Haidong Province, he got a hand full of shit when he first came here.

As soon as he heard Li Huacheng directly scolding him for "biting people indiscriminately", Chen Qi's anger also rose in his heart. He was calm just now, but now he has cooled down.

"Director Li, right? Let's talk about the first question first. Look at the information sent by Mifang. It clearly states that the deceased suffered from high blood pressure and diabetes, right? But I'm looking at the emergency department. In the original medical records, it is not reflected at all, I want to ask Director Li, did you ask for a doctor at that time?"

Li Huacheng was also unconvinced:

"The first thing we need to do in the emergency department is to save lives. It's understandable that we don't go into details during the consultation. If we need to be hospitalized or kept on observation later, we can ask the doctor in detail. There is no emergency department in a small place like Yuezhong. So it’s normal not to understand the process.”

Chen Qi sneered:

"Who told you that there is no emergency department in Yuezhong? I founded the emergency department of Yuezhong City People's Hospital, and all the rescue equipment is imported from the United States. Do you think I understand the process?"

Li Chenghua was stunned for a moment, but continued to argue:

"Even if you understand the emergency procedures, what is the direct relationship between the cause of death and the details of the consultation?"

"How can it be okay? On the contrary, it is directly related. Your emergency rescue at Ziguang Hospital is so casual?"

From Chen Qi's point of view, there is a big problem with the procedures of the emergency department of Ziguang Hospital. It is no wonder that there are not many hospitals in China that have emergency departments at this time, and everyone is making progress while groping.

Chen Qi was obviously not allowed to let Li Huacheng go:

"If you know in advance that the patient has hypertension and diabetes, then you should know that the cardiovascular and cerebrovascular arteriosclerosis of these patients with chronic diseases is very serious and hidden. How can it be called an equivalent risk disease?

I just rescued a patient in Yuezhong who came to the emergency department with the main complaint of abdominal pain. He was suffering from acute myocardial infarction, coronary artery ischemia, hypoxia, and complications caused by myocardial necrosis.

So let's look back now, what if this foreigner has a heart attack? Then, is there a possibility that when he was undergoing gastroscopy, the pressure increased due to severe vomiting, which led to the occurrence of myocardial infarction, and finally died of myocardial infarction.

I would like to ask Director Li, did you consider myocardial infarction at that time? You prescribe a gastroscopy without asking whether the patient has high blood pressure or diabetes. Do you think this is a mistake? "

Li Huacheng's face was flushed, he opened his mouth, but had nothing to say.

Chen Qi continued:

"In the same way, when a patient has hypertension, diabetes, and atherosclerosis, is there a possibility of a cerebrovascular accident? Director Li, tell me about this careful consultation, avoiding possible risks, and death. Is there an inevitable connection?"

As soon as Chen Qi finished speaking, the doctors at the scene whispered to each other.

The people present were all experts, professors and doctors. Chen Qi's words were like a piece of paper pasted on a window, including Li Huacheng.

Chen Qi obviously hadn't dissipated his anger, so he continued to shout and ask:

"There is another one. Among the common causes of gastroscopy death is aortic dissection. Everyone knows the danger of this disease. Then I would like to ask Director Li. If you know that the patient has a history of high blood pressure, severe abdominal pain or heartache, would you Think of a disease like aortic dissection?"

Li Huacheng replied weakly: "I, of course I thought of it..."

"Okay, you have thought that there may be aortic dissection, so let me ask Director Li, have you carefully auscultated the heart or lung sounds?"

"me……"

Li Huacheng couldn't continue talking, and the doctors in the conference room were all in an uproar.

When aortic dissection occurs, when the hematoma involves the aortic valve annulus or affects the support of the valve leaflets, aortic insufficiency will occur. At this time, a diastolic blowing murmur can be heard in the aortic valve area.

If you hear wet rales at the lung bases on both sides at this time, coupled with clinical symptoms, you should suspect heart failure.

The combination of so many symptoms can easily lead to the critical illness of "aortic dissection".

Li Huacheng was already sweating profusely at this time, his lips were trembling and he didn't know how to defend himself.

Dean Bian took a look at this subordinate and shook his head slightly. Obviously, in the emergency department, there are loopholes everywhere. Missing one important node after another is a kind of fault.

Chen Qi glanced at Zuo Yongxin, the director of Gastrointestinal Medicine who was gloating across the street, and asked:

"Director Zuo, right? You were the one who performed the gastroscopy at that time, and the patient also died in the endoscopy room. Please tell me about the process of the gastroscopy in detail."

Zuo Yongxin was relieved at this time, thinking that it was all the responsibility of the emergency department, so he began to report the gastroscopy process with great agreement.

"When the patient was sent in, there was no detailed medical history on the gastroscopy application form. It just said that he was admitted to the hospital with abdominal pain for 1 hour, with mild abdominal tenderness and no rebound pain, so I performed a routine gastroscopy... Then the patient suddenly developed an epileptic seizure. Trembling... Our endoscopy room will immediately carry out rescue..."

Director Zuo said it easily, but Chen Qi frowned the more he listened:

"Director Zuo, you are an old expert in gastroenterology, and you are also one of the most professional doctors in gastroscopy in China. You should understand the precautions and contraindications of gastroscopy, right? The first question I want to ask, you clearly know emergency medicine. The medical history is incomplete, why didn't I ask clearly?"

Zuo Yongxin was taken aback for a moment, his heart skipped a beat, and he thought again, why did this guy come at me?

"Well, at that time, I thought that the emergency department was urgent, so I didn't ask the doctor carefully..."

Chen Qi looked at his notebook, and continued to ask:

"You said that the patient had a very strong reaction during the gastroscopy. I also have a description from the secretary of the deceased. She said that the deceased was vomiting violently, his face was flushed, and he seemed to be asphyxiated. She asked to stop the gastroscopy. No such thing?"

When Li Huacheng, who was still dejected just now, his eyes lit up instantly.

Now it's Zuo Yongxin's turn to tremble with lips and hands, and his head is buzzing:

"I, um, um, it's not uncommon for patients to vomit during a gastroscopy. If we stop the gastroscopy because the patient is vomiting, then the gastroscopy work will not be able to be carried out at all."

When everyone heard this, they all felt that this made sense, and there were very few people who did not vomit during the gastroscopy.

Chen Qi obviously disagrees with this point of view:

"If it's just ordinary vomiting and nausea, gastroscopy can of course continue, but if the patient has severe vomiting and even his face has changed, two situations may occur at this time, one is rapid tracheal spasm, which may lead to suffocation of the patient .

Second, strong vomiting, gastric acid will rush up from the stomach, coupled with the presence of vomitus, and a gastroscope tube inserted, it is very easy to aspiration or suffocation to death.

Therefore, when our doctor is doing gastroscopy, when the patient starts to vomit violently, it is often necessary to stop the gastroscopy immediately and pull out the gastroscope tube instead of continuing the gastroscopy forcibly. Based on this, Director Zuo's handling at that time was problematic. "

Boom~~~ There was another uproar in the conference room.

At this time, a doctor also stood up and agreed with Chen Qi's point of view:

"What Dr. Chen said, our hospital has just encountered a case. The patient was an elderly male who died suddenly during a gastroscopy. Later, after an autopsy, it was discovered that the patient died of suffocation caused by severe vomiting."

When Zuo Yongxin heard this, his heart was already beating like a drum, completely flustered.

He was the person involved, and what happened during the gastroscopy that day was vividly witnessed. In addition, he himself is an expert in gastroenterology, and he is no stranger to suffocation death caused by gastroscopy.

So Zuo Yongxin was completely panicked, thinking that this could not be the real cause of death, right?

At that time, people were skeptical, not to mention other experts in the conference room, and everyone felt that they should have found the answer.

Only Li Huacheng looked like a survivor at this time. If the foreigner died at the hands of an endoscopy doctor, it would have little to do with him as an emergency doctor.

Even if you want to talk, the big deal is to be disciplined, at least you don't have to be fired and go to jail, and your family is ruined, right?

As for whether Zuo Yongxin will die or not, uh, anyway, it’s fine if he doesn’t die himself.

At this time, Professor Cheng Bangwu raised a question:

"Principal Chen, have you noticed in the medical history that the patient had epileptic convulsions before he died? What do you think is the reason for this? Is it possible to identify the cause of death?"

Everyone is an expert and has their own guesses about the possible cause of the convulsions, but everyone obviously wants to hear the analysis of the young dean.

Chen Qi glanced at his notebook, and then said:

"I have also noticed the details that Professor Cheng noticed. Just now I said that suffocation and aspiration are the most likely causes of death, but it is not the cause of death of this foreigner. It is not yet easy to judge.

The convulsions mentioned by Professor Cheng are also well explained in terms of physiology and pathology. The patient's sudden and severe vomiting during gastroscopy will lead to excitation of the vagus nerve, which in turn will lead to a slowdown of the heart rate and a drop in blood pressure.

When the patient's vagus nerve is suddenly excited, the worst consequence is nausea and arrhythmia, such as cardiac arrest, ventricular fibrillation, etc. At this time, the effective ejection of the heart is almost zero, resulting in tissue ischemia and hypoxia , resulting in convulsions. "

oh~~~~

There was another exclamation at the scene. It seemed that Chen Qi's analysis was closer to the truth of the patient's death, which was a heart problem.

At this moment, Zuo Yongxin's heart was ashamed, and he was completely dumbfounded.

After watching this for a long time, the biggest scapegoat fell on me. Thinking that I would soon be expelled from prison and ruined, this 50-year-old chief professor actually felt incontinent.

Dean Bian also heaved a long sigh after hearing this, thinking that this is the end, the whole diagnosis and treatment process is a disaster, one after another, all loopholes.

Originally, in Dean Bian's mind, Ziguang Hospital was regarded as the best hospital in Shenzhen and the hospital with the most advanced equipment in the country.

Looking at it now, the level of Ziguang Hospital is not much better than that of county-level hospitals.

So in the conference room, the people on the Ziguang Hospital side were silent, while the expert groups formed by the major hospitals on the other side were talking a lot.

The big leader who had been sitting in the first seat without saying a word smacked his lips, and looked at Chen Qi with complicated eyes:

"Comrade Chen Qi is really good under his reputation. After analyzing so many reasons, I hear it makes sense, but now there is a very troublesome place. If the responsibility really lies with Ziguang Hospital, in our Hua Fang, we will definitely lose this lawsuit.

If we are wrong, we will have no way to refute the smears by foreign forces, and we will not be able to maintain the image of the country. Similarly, the family members want us to pay 100 million US dollars in compensation, even if it is a discount in the final negotiation, 50 million US dollars, this is something we cannot afford.

So I think... please forgive my fluke mentality, is there a possibility that the real cause of death of this patient is not suffocation, malignant arrhythmia caused by gastroscope, or misjudgment caused by our failure to check carefully beforehand? .

What I mean is... Is there another reason for the death of foreign businessmen, and this reason is unforeseeable, at least our hospital does not have to bear any responsibility, we can talk about some ugly things behind closed doors up.

Now there is a lot of pressure up and down, and I will not hide it from Dean Chen. We invited you here. One is to find out the real cause of the patient's death, and the other is to find a way to escape. The other is justified to the family members. cause of death. "

Chen Qi was not some old pedant who never changed his mind, so he immediately understood the meaning of the big leader.

In fact, the meaning is very simple, to find a way to "exonerate" oneself, as long as it is not put to death by us.

Then the possibility that the death was not caused by Ziguang Hospital does not exist. Chen Qi looked at his densely recorded notebook, and then saw a diagnosis:

"There is really a possibility that we are not putting to death." (End of this chapter)