This Doctor is Great

Zhou Mo didn't expect that he just published the paper, and then the paper micro-business came to his door.

Many doctors have to buy papers in order to be evaluated as attending and deputy directors, but their own strength is not enough.

Is this also a 'hidden rule'?

As for the people in the department, do they know that he bought the paper?

If the papers you buy are not related to your major, or if you fish and speculate in stocks all day long, but the papers are constantly rated as attending and deputy directors, then the possibility is high.

Although Zhou Mo is greedy for the price and income in this area, but after thinking about it, he should be safer and not be greedy for money in this area.

"Little Mo..."

At this moment, Mr. Huang Li walked into the duty room quickly.

"Teacher, what's the matter?"

"There is a consultation in the emergency department, are you interested?"

Have a consultation? If you say that, I won't be sleepy!

"Of course I'm interested, thank you teacher!" Zhou Mo said hastily.

"Teacher, I want to go too." Huang Yiming next to him looked at Teacher Huang Li shyly, looking forward to it.

Huang Li was also satisfied with Huang Yiming's recent performance, and waved his hand: "Okay, you too."

"okay!"

Huang Yiming jumped up happily.

The three quickly left the duty room, leaving behind five envious drooling medical students.

The emergency department pretends to be... ah no, consultation, I want to go too!

...

Emergency Department.

After Huang Li and Zhou Mo stepped into the emergency department, there was an uproar.

There were queue jumping, cursing, and children crying...

"We are from the Department of Cardiology, and we have just been notified to come for a consultation!"

"emergency room."

The nurse at the nurse station said quickly.

The three hurried to the emergency room.

Huang Yiming is excited, I must perform well later, and amaze everyone!

I, Huang Yiming, will never lose to anyone in my life (except Brother Mo)·jpg

Into the emergency room,

There are many beds in the emergency room, and several patients are lying there.

"Consultation from the Cardiology Department!" Zhou Mo yelled.

"Here..." shouted the doctor in one of the beds.

Huang Li and Zhou Mo walked over quickly.

Zhou Mo walked while observing the patient on the bed.

about sixty or seventy years old,

female,

There are many wrinkles, white hair and age spots.

The old man was unconscious and intubated by a ventilator, but his face was pale.

Zhou Mo glanced at the ECG monitor beside the bed.

Blood oxygen 68.

160/90mmHg.

Heart rate 132 beats/min.

"???"

With intubation ventilation, only 68?

Blood pressure and heart rate are working hard, why is blood oxygen so low?

Heart problems?

wrong,

It's not the heart, it should be a problem with the itching and closing of the lungs!

Zhou Mo suddenly had a judgment in his mind.

"Mr. Huang!" The emergency doctor greeted Mr. Huang Li, and then couldn't help but glance at Zhou Mo and Huang Yiming.

Zhou Mo took a look, isn't this emergency doctor the senior brother who sent Mr. Liu to the emergency room this morning? What a coincidence.

Teacher Huang Li observed the patient and asked, "What's the patient's condition now?"

The emergency brother rubbed his hands and said quickly: "The thing is like this. The patient suddenly felt a little difficult to breathe and chest tightness two days ago. The outpatient department of the respiratory department finally came to the emergency department."

"When the patient came in, her lips were cyanotic, her hands and feet were cold, and her face was pale. It was a sign of hypoxia, so she was given non-invasive breathing."

"But just when I wanted to examine her, the old man suddenly collapsed..."

"I can't wake up no matter how I scream, my heart is in sudden arrest!"

"Then we rescued him, cardiopulmonary resuscitation, ventilator and endotracheal intubation..."

"Finally, at 15 minutes, the rescue came back."

This emergency brother is more inkblot.

After listening patiently, Mr. Huang Li asked, "Have you asked about the medical history?"

Emergency brother: "I asked, no high blood pressure, no diabetes, no hyperlipidemia, I felt short of breath and suffocated 3 days ago."

Zhou Mo listened carefully.

Short of breath 3 days ago?

This shows that the condition has been more than 3 days.

There are many causes of shortness of breath, heart problems, lung problems, muscle weakness, etc...

Zhou Mo happened to be beside the bed, and couldn't help but tug on the patient's arm. The resistance was quite strong, not like muscle weakness.

So focus on the heart and lungs.

For emergency patients, the first thing to do is to rule out more dangerous diseases.

Myocardial infarction, pulmonary embolism, pneumothorax...

Also consider pneumonia...

The emergency brother took out some test results.

"This is an electrocardiogram... I did it twice, I went to the emergency room once, and just once..."

Received an EKG.

Huang Li and Zhou Mo began to watch, and Huang Yiming stretched his neck to watch, too.

Obviously, the 2 ECGs did not suggest myocardial infarction!

Excluded: myocardial infarction.

pneumothorax? ?

Zhou Mo took the stethoscope and began to listen to the patient's lungs.

one listen,

Perfectly symmetrical, no problem.

Not a pneumothorax.

As I wrote earlier, pneumothorax, generally speaking, the lungs are broken, and the gas in the alveoli enters the chest cavity, which in turn compresses the lungs, causing difficulty in breathing!

If there is a pneumothorax, it must be asymmetrical. Unless there is a very small probability that the left and right sides have pneumothorax, and the size and location of the pneumothorax are the same.

Excluded: myocardial infarction, pneumothorax.

Severe pneumonia and pulmonary embolism should be ruled out.

Teacher Huang Li: "Does the patient have symptoms such as cough, sputum, and fever?"

Coughing is because the lungs are uncomfortable (foreign body), so the human body has to cough it out.

Coughing up sputum, sputum is simply an inflammatory secretion, and it must be uncomfortable in the lungs, so there will be a conditioned reflex to cough up sputum.

With a fever, the lungs become inflamed, and the body begins to respond with an immune response. As the body temperature rises, it is natural to have a fever. (When you have a fever, the function of reducing the fever is only to reduce the temperature, and has no other effect. Only by solving the root cause can you solve the fever and avoid repeated fever. So don't panic when you have a fever, thinking that the fever is the murderer, and rush to reduce the fever. It is important to find the cause carefully .)

As long as it is pneumonia, basically there will be cough, sputum, and fever.

The brother in the emergency department shook his head: "I asked my family members, but I don't have these symptoms."

Teacher Huang Li: "Did you draw blood? Did the result come out?"

"Not yet... I'll take a look now..."

The emergency brother picked up the ipad to check whether the patient's information was returned.

"Hey, it's out."

"show me."

"C-reactive protein is only 4.3 (normal value below 5)...no inflammation..."

Serum C-reactive protein (CRP) is a sensitive indicator that reflects various infections and non-infectious inflammations in the body, and is a non-specific marker of systemic inflammation.

Its accuracy is higher than that of white blood cells and other indicators of blood routine.

(Many doctors think blood routine is useless and not as accurate as other indicators. But it is cheap.)

so,

Pneumonia can be ruled out.

Then, the next step is to rule out pulmonary embolism.

Pulmonary embolism is a very serious emergency. Every minute of delay, the patient is one step closer to death.

Moreover, based on the patient's low blood oxygen, Zhou Mo concluded that the patient had a pulmonary embolism!

Teacher Huang Li: "Have you checked the blood coagulation index?"

Emergency brother: "No."

Teacher Huang Li: "Pip now, check now... and D-dimer, and then do an arterial blood gas analysis..."

Emergency brother: "Yes!"

Immediately ask the nurse to draw blood...

at this time,

Zhou Mo had already opened the patient's trouser legs.

Varicose veins!

I saw many circling blue veins on the legs of the patient and the elderly.

(Big brother, give me a picture?)

Zhou Mo: "There seems to be a bedside color ultrasound in the emergency department, right? Can you push it over for me?"

The emergency brother raised his head and looked at Zhou Mo.

stunned.

"You know how to use it?"

Huang Yiming subconsciously tilted his head back.

Hmph, I'll let you all see Brother Mo's strength!

.