When doctors have a simulated operating room

The more you know about the pain, the more you will suffer.

When female patients are not sure about the point of abdominal pain, they should consider whether it is a problem with the uterus and its appendages.

If it is a problem with the uterus and its appendages, then women like this who are paralyzed and have their husbands to take care of them should be asked whether they have sex.

Vaginal ascending infection can also cause abdominal pain.

If it is not a problem with the uterus and its appendages, then the stomach, intestines, appendix, liver and gallbladder should be considered.

When the family members heard Chen Fang ask this, they immediately felt a little embarrassed.

"She eats normal meals, three meals a day, and doesn't eat anything too spicy... No diarrhea, but she hasn't had a bowel movement for several days. As for sex... well... yes, but does it have anything to do with her abdominal pain?"

Chen Fang nodded:

"Maybe. Women's abdominal pain covers a wider range than men's. Sex is the only way to cause pain caused by female genital infection, so I asked.

And you said she hasn't had a bowel movement for several days? How many days exactly?"

Several days without a bowel movement?

Then it may not be a problem with the uterine appendages, but a problem with the intestines.

The family members were thinking carefully, and the patient in the wheelchair slowly said:

"I... I haven't had a bowel movement for seven days... seven days."

Chen Fang was stunned: "Seven days?"

As he said that, he stretched out his hand and pressed a few times on the patient's abdominal intestines.

Sure enough, it was hard!

And the patient felt very painful while pressing.

"Your abdomen is bloated and hard. Go get a CT scan to see if it's blocked by stool. If it is, I'll prescribe two bottles of suppositories to help you defecate."

If it's constipation, it's easier to treat, but if it's constipation caused by intestinal obstruction, it's troublesome.

But the family member immediately said:

"No, doctor..."

Chen Fang looked up: "What's wrong? Enema?"

The family member nodded: "She has been paralyzed for more than ten years. I know about enema. Since she was paralyzed, she can't move her lower body. She lacks exercise for a long time and often can't defecate for two or three days.

So there are a lot of enema at home, but after I used two on her last night, she only defecate a little bit, about the size of sheep feces.

This morning, I didn't believe it and used two more, but still didn't defecate much, just the length of the little finger.

Plus, she started to have stomach pain yesterday, so I thought of taking her to the hospital."

Zhang Yi nodded in understanding at this time.

No wonder I saw a belly full of excrement when I came in...

So the enema didn't work and she wanted to go to the hospital for an enema? ?

"Okay, it may be constipation, but let's do a CT scan to see the specific cause of the pain, so it's safer." Chen Fang said.

The family member also nodded: "Okay, let's do a CT scan."

Soon, the family member pushed the patient outside for examination.

After the two left, Chen Fang sighed:

"Oh my god, this woman's belly is so hard! I guess there is a lot of shit piled up!"

"So this is how a constipated belly feels after seven days?" Gao Han looked at his hand and said softly.

Zhang Yi glanced at the two interns and asked:

"Gao Han, let me ask you, what diseases are common when there are lumps or board-like abdomens during abdominal palpation?"

Gao Han's face froze!

Oh my God! I just touched my belly and I have to be questioned? !

"Hmm..."

After thinking for a while, Gao Han replied:

"If there are lumps on palpation, it may be constipation. Of course, if it is a board-like abdomen, it means that the rectus abdominis is in a tense state. Generally, inflammation often causes rectus abdominis tension, such as peritonitis, digestive tract perforation, or simple gastroduodenal perforation."

Zhang Yi nodded with satisfaction.

Not bad, I can answer it.

The next patient is a mother.

She hurried in with her child, and said nervously as soon as she came in:

"Doctor, my child has a fever! Please prescribe some antipyretic medicine, doctor!"

Zhang Yi frowned. The child looked only over one year old. Only if the fever was particularly severe could medication be considered.

Generally, physical cooling can be tried below 38.5. If physical cooling doesn't work, consider medication.

Zhang Yi asked Shen Lingyue to measure the child's temperature.

"Don't use a thermometer, use mercury."

"Okay."

Five minutes later.

The child's temperature was 38.3℃.

Zhang Yi: "Are you coughing? Are you having a runny nose?"

Family member: "A little cough, a little runny nose, but the fever is the most serious.

He started to have a fever. I used the child's fever-reducing patch at home, but it didn't work. "

After thinking for a while, Zhang Yi said, "Your child's temperature is 38.3. Generally, we recommend physical cooling for temperatures below 38.5.

Let me teach you a physical cooling method, and then prescribe you acetaminophen drops and cough syrup.

If physical cooling doesn't work, take this medicine again."

The family member frowned slightly and said, "I tried it at home... physical cooling doesn't work."

Zhang Yi: "Your physical cooling method is wrong. Let me tell you a way.

Go directly to a pharmacy near the hospital and buy two bottles of 75% alcohol and some medical gauze.

Then apply the gauze soaked in alcohol to the child's carotid artery, that is, on both sides of the neck, in the elbow pit, and behind the knees where there are large arteries.

Rub more while applying, mainly rubbing the aorta.

Keep changing the gauze, dip the gauze in alcohol, wipe it and stick it again.

Or buy an ice pack, hold it with a pillowcase and keep it around these major arteries for a while.

These are physical cooling. It doesn't mean that physical cooling is useless if the child doesn't get rid of fever after applying a fever-reducing patch.

Physical cooling is very useful for children, but your method is wrong, do you know? "

The mother nodded angrily:

"Oh... So that's what you mean, okay, thank you doctor, then I'll buy it and try it first, and then take medicine if it doesn't work."

"Well, your child is just over one year old, his organs are not mature, and he can't metabolize too much medicine."

"So that's the case, okay, okay, thank you doctor! "

After saying that, the mother took the child out.

Ten minutes later.

The last constipated patient came back.

He came back with the examination form.

A few people took a look!

Wow, there was a substantial gray-white shadow on the entire CT form.

And the intestines were enlarged. What else could it be but being bet on by shit??

Zhang Yi quickly arranged an enema.

Enema is the job of nurses, so after giving the doctor's order, Zhang Yi and others continued to see patients in the clinic.

As a result, twenty minutes later...

A nurse from the emergency department rushed in with a painful look on her face.

When she rushed in, she could vaguely smell a little... shit...

Zhang Yi quickly put on an extra mask to prevent poisoning.

"What's wrong? What's going on? "

Looking at the panicking nurse, Zhang Yi asked.

The nurse said with a painful and tearful face:

"Doctor Zhang, go see the constipated patient. I used a lot of paraffin oil, but the enema tube can't be inserted into the anus!"