This Doctor is Great
Chapter 28 I want to diagnose myself!
"The electrocardiogram in the emergency department did not show any problems for the time being, but the frequency is a bit fast..."
"In addition, I also ordered a color ultrasound of the heart. I haven't done it yet. I will send it for a color ultrasound after the ward rounds..."
Zhou Mo was a little sleepy at first, but now a new disease monster came, Zhou Mo couldn't help but want to fight the monster and upgrade to get rid of this patient.
"What is the disease?"
"Let me take a look!"
Zhou Mo came to the ward with excitement.
at this time,
Patient Li Haiyan is lying on the hospital bed, has been connected to the ECG monitor, and has non-invasive breathing...
The yellow-haired boyfriend finished the admission procedures and was holding the patient Li Haiyan's hand beside the bed. He didn't know what he was talking about, but he was clearly in a good relationship.
Zhou Mo walked into the ward, and the yellow-haired boyfriend stood up immediately, and respectfully said: "Hi doctor, please help me to see my girlfriend, what is the problem..."
Zhou Mo nodded: "I will try my best... Now I want to ask some questions, I hope you can cooperate as much as possible..."
The yellow-haired boyfriend nodded again and again: "Definitely! Definitely!"
Zhou Mo glanced at the ECG monitor:
·Blood pressure: 88/57mmhg
Blood oxygen: 95
Heart rate: 90
Breathing: 27
This is very numerical and problematic!
Blood pressure is low, a little lower than normal.
And there is also a problem with the blood oxygen. With the addition of oxygen inhalation, it is only 95. Obviously there is a problem with the itching. Lung problems?
In addition, the heart rate is fast. The ideal heart rate for normal people is 55-70 beats/min, and the normal heart rate is 60-100 beats/min.
Also, breathing is also high, the general breathing is 12-20 times / minute.
To sum up, there is something wrong with the heart and lungs, the most likely cause is itching, or blood pumping...
Zhou Mo began to ask the doctor: "Will you have chest pain?"
Patient Li Haiyan looked distressed: "(shakes head slightly)..."
Zhou Mo: "What about chest tightness?"
Patient: "(nodding slightly)..."
Zhou Mo: "Did you take any medicine after you had a fever?"
The yellow hair next to him "doctor, I know, I took all the medicine..."
Then he took out his phone, and showed Zhou Mo several pictures of medicine boxes.
Zhou Mo took a look, antipyretics + antibiotics, nothing special...
Then I asked another question,
Nothing was found.
Zhou Mo took out his stethoscope and began to listen.
The first is the lungs.
Upon hearing it, it is obvious that there are tiny moist rales in both lungs...
What are rales? In layman's terms, it is the sound of gas passing through liquid.
Abnormal sound caused by air flowing through water or liquid parts, then bubbling and bursting. Similar to the boiling sound made when water boils.
So, what do lung crackles represent?
Given that Zhou Mo didn't have a very comprehensive knowledge of lung diseases, he subconsciously thought it should be pneumonia!
Pneumonia, on the other hand, naturally causes fever.
Correspond with patient Li Haiyan's fever. Then it corresponds to the itching and the difference, and the itching and the difference will naturally increase the heart rate and breathing frequency...
It seems that everything corresponds to it.
Evidence-based medicine seems to be fine.
Monism is correct.
But...the only doubt is that Li Haiyan has had a fever repeatedly for a week, so it is impossible for the pneumonia to be 'mild', right? Crackles are also unlikely to be 'mild'.
Also, there's no way to explain the slightly lower blood pressure...
"Is there any other reason?"
"heart?"
"The deputy director Zhang who diagnosed Li Haiyan, did he find something? Then he pushed the cardiology department here?"
Zhou Mo pondered.
Go ahead and take the stethoscope and listen to the patient's heart.
Although the patient Li Haiyan is a woman and also a young woman, Zhou Mo still has enough professionalism to listen to the patient Li Haiyan's heart without any fluctuations.
It is said that before the invention of the stethoscope, doctors put their ears against patients to listen to lung murmurs and heart abnormalities.
Then in 1816, the French doctor Reinek invented the stethoscope, and it has been two centuries since then. Many doctors can't forgive him, especially male doctors!
Dog head saves life~~~
Zhou Mo listened carefully.
The first is the fifth intercostal space on the left midclavicular line, which is the mitral valve area.
"It seems... there is no problem..."
Zhou Mo listened for a while, and felt that there was no problem. But when I listened carefully, it didn't feel right.
"Wait... there seems to be something wrong..."
"The sound seems a bit wrong, but it seems to be okay..."
For a while, Zhou Mo couldn't judge whether there was really a problem.
Then move on to the other three auscultation areas...
To be honest, Zhou Mo didn't put in a lot of effort in the "stethoscope", so his skills with it are not strong.
After listening for a while, I still can't judge whether there is a problem...
"Let's do this first, wait until 3:30, go to the B-ultrasound room, and do a color ultrasound of the heart..."
Zhou Mo said goodbye and left the ward.
Returning to the duty room, Zhou Mo opened the database, found some papers about stethoscopes and heart and lungs, and read them.
First pile up the skills of "stethoscope, heart sound".
Dark blue, give me more!
20 minutes later...
"Ding...you read "Time-Frequency Analysis of Heart Sound Signals"...understand the essence..."
45 minutes later...
"Ding...you read "Discrimination of Apical Valve Heart Sound Signals"..."
Regardless of whether it is useful or not, let's brush up the skills first.
In a flash, 2 hours passed.
Zhou Mo felt that he had almost piled up his skills.
get up,
go to the ward.
...
Ward, 29 beds.
Zhou Mo walked in.
"Doctor..." The yellow-haired young man saw Zhou Mo stand up quickly and greeted him.
"Well..." Zhou Mo nodded, and then said to the patient Li Haiyan, "I'm going to give you another physical examination, especially the heart..."
Patient Li Haiyan nodded tiredly.
This time, Zhou Mo put the stethoscope on the mitral valve auscultation area of patient Li Haiyan's left chest.
This time,
The accumulated experience just now gave Zhou Mo a new harvest!
Immediately felt that there was something wrong with this heart sound! !
However, because this stethoscope is relatively cheap, Zhou Mo bought it for a few hundred dollars, which is a bit short.
"This stethoscope is not working, I need to change it..."
"The department seems to have a stethoscope..."
"etc……"
"Huang Yiming's stethoscope seems to be 3m, Littmann 3200, Rolls Royce among stethoscopes..."
Zhou Mo said to the patient: "Wait..."
Then when he walked out of the ward, he happened to see Huang Yiming chatting with a girl at the nurse's station.
"Xiaoyue, I know there are three people who like you..."
"Who..."
"Me, me, me..."
"..."
vomit~~~~
Dirt wears the earth! !
Maybe it was because of the pimples on Huang Yiming's face, or maybe he didn't show his identity as a native of Guangzhou, so the nurse girl didn't accept this outrageous confession.
"Yiming!"
"Hey~~ Who called me..."
"Here..." Zhou Mo waved.
"What's wrong?" Huang Yiming stopped chatting when he saw Zhou Mo calling.
"Your stethoscope, I think it's a 3m Littmann 3200..."
"yes……"
The nurse girl next to her suddenly brightened her eyes.
Looking at Huang Yiming's eyes, it suddenly became brighter, and even the pimples felt pleasing to the eye.
—————————
ps: Ask for recommendation tickets, monthly tickets, feeding ports...
.
Thank you book friend one=1 for the 100 reward! Thank you~O(∩_∩)O
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