Doctor of Healing

Ji Xiang's performance was more sophisticated than that of an experienced emergency doctor, especially the last step when he jumped up, kneeled and sat on the patient's abdomen, and performed chest heart compressions with both hands. Meng Qingfei looked like a slippery veteran All were ignited.

But the question immediately came to Meng Qingfei, what is the patient's condition!

"Director Lu, you haven't diagnosed yet?" Meng Qingfei asked cautiously.

Lu Gang shook his head, indicating that he did not know.

He wanted to follow along to have a look, but as soon as he raised his leg, he stopped again, staring blankly at the end of the empty corridor in the distance, at a loss for what to do.

"Doctor Meng, do you know the patient's condition?" Lu Gang asked.

When he was free, Meng Qingfei told Lu Gang about the patient's condition.

A middle-aged man took a large amount of toilet water orally, and developed symptoms such as nausea, vomiting, and abdominal pain half an hour after oral administration.

Everything is proved to be caused by toilet water, as long as the gastric lavage is enough, and there is no abnormality in the physical examination.

Similar patients are common.

wrong!

A shooting star flashed across Meng Qingfei's mind, tearing up the shady scene.

"The patient's body temperature is high! His body is red and hot!" Meng Qingfei said in a deep voice.

He remembered a sentence that the emergency physician said casually, so it was so!

"Body temperature...irritability..." Lu Gang murmured to himself in confusion.

"Director Lu, I still remember..." Meng Qingfei only said one thing at the beginning, and Lu Gang continued, "Three years ago, there was an emergency in the gastrointestinal surgery department."

"Correct!"

That was a past event three years ago.

A patient with abdominal pain came to the emergency department, with a body temperature above 40 degrees Celsius, nausea and vomiting accompanied by tenderness, but no rebound tenderness.

Considering it was an acute abdomen, the gastrointestinal surgery department did not know what the diagnosis was, because the abdominal pain was getting worse and worse, so he could only do an exploratory laparotomy after explaining to the patient's family.

result!

After opening the stomach, there was nothing wrong with it. I stroked the intestines to make sure there was no strangulated ileus and other internal organs were fine.

Ask for a consultation on the stage. Since it has already been opened, let all the departments take a look at it at this time, so as not to be unclear after going down.

The last problem was solved by Lu Gang - the patient diagnosed adrenal crisis.After symptomatic treatment, the patient's condition improved and he was finally discharged smoothly.

That "medical accident" was due to insufficient technical level, and the communication between the gastroenterology department and the patient's family was smooth, and the family did not pursue responsibility, so the matter was peaceful.

Meng Qingfei and Lu Gang thought of this at the same time.

The patient has fever, rapid heart rate, and irritability.

The digestive system also has anorexia, nausea, and vomiting, which are often early symptoms.

right!And blood pressure! !

Meng Qingfei and Lu Gang thought at the same time that the patient's heart rate was rising and blood pressure was falling at the same time. When the patient was finally pushed away, the patient's high pressure had reached about 85mm.

Drinking toilet water will not lead to hemorrhagic shock. The shock manifestations of increased heart rate and decreased blood pressure, together with other symptoms, are more and more consistent with the diagnosis of adrenal crisis.

"I know!" Lu Gang clenched his right hand into a fist, and slammed it on the palm of his left hand with a slap.

"It's Addison's disease!" Meng Qingfei said at the same time.

"Yes, it's Addison's disease. The sudden death just now was Addison's sudden death!"

The two looked at each other and smiled, as if they had solved an extremely difficult math problem.

But in an instant, both of them were a little embarrassed.

This is not an exam, but clinical emergency first aid.An afterthought diagnosis is meaningless to the patient. Ji Xiang just immediately defibrillated, performed chest compressions, and contacted the ICU bed in advance. These are the keys to solving the problem.

If there is no Jixiang, not to mention whether the correct answer can be obtained, even if there is a correct diagnosis of Addison's sudden death, the patient is probably hopeless.

Meng Qingfei smiled embarrassingly, "Xiaoji is really amazing."

Lu Gang was still a little unconvinced, but the successive blows in the past few months made him feel a little lonely.

The only strand of hair on the top of his head was hanging down, listless.

The bald head has lost its glossy light and is gray.

Lu Gang pondered for a few seconds, and said bitterly, "I came late this time, and the patient had a problem just after arriving in the emergency room. Next time, definitely!"

Meng Qingfei glanced at Lu Gang in surprise, he knew that Lu Gang was competitive and wanted to compete with Ji Xiang.

Does it make sense?

Lu Gang's actions made no sense at all.

"Director Lu, forget it." Meng Qingfei smiled and said, "Take a break, take a rest, my whole body seems to be aching right now."

This is a side reaction after stress, and Lu Gang also understands it.

"Wait a minute, I'll make an appointment for a B-ultrasound." Lu Gang said, "Since it's an adrenal crisis, there must be something wrong with the adrenal glands. Xiaoji, he may not know."

With that said, Lu Gang took out his mobile phone and made a call.

"Icu?"

There was a loud noise on the other side of the phone, apparently in the emergency department.

Lu Gang understands that this is not a good time to be long-winded, so he wants to make a long story short.

"The patient just sent, I think it is an adrenal crisis, immediately call the bedside B-ultrasound."

"Director Lu, the B-ultrasound is being done. The patient... oh, oh, the patient's right adrenal gland has calcification, and adrenal tuberculosis is considered." The doctor in the ICU replied.

Obviously, he was watching the rescue while answering the phone.

"Then hurry up." Lu Gang hangs up the phone in a sense of loss.

Lu Gang knew very well that the critical strength of the Second Affiliated Hospital was second to none in the province, but when a patient with an inexplicable cardiac arrest was sent, they could immediately discover the adrenal crisis...

Ahem, a figure appeared in Lu Gang's heart.

No way, if the rescue is timely, it can be explained by Ji Xiang's youth and quick response.

However, adrenal crisis is extremely rare in clinical practice, and it will be misdiagnosed every time it occurs.Every misdiagnosis will most likely lead to the death of the patient in the end.

Few family members in China agree to autopsy, so patients who die inexplicably have no diagnosis, which in turn leads to lack of experience of clinicians.

It was also because of the incident three years ago that Lu had established a general understanding of adrenal crisis just now, so he and Meng Qingfei were the first...the second to give a diagnosis.

What about Jixiang?

Where did his diagnosis come from!

Where does his clinical experience come from!

Lu Gang coiled his bald head, and the drooping hair became more and more listless.

"Xiaoji really diagnosed it? This is too fast." Meng Qingfei was a little surprised.

Although Lu Gang didn't speak, his expression said everything.

Ji Xiang got the correct diagnosis in the blink of an eye, and the emergency treatment was successful.

What the hell, Meng Qingfei cursed in his heart.

For a patient who suffered cardiac arrest after drinking toilet water, Ji Xiang actually judged the adrenal crisis while rescuing him, which can only be done with deep clinical experience.

Chapter 371

The emergency department was very busy, and Meng Qingfei was called back to see the patient without giving him any time to think.

The emergency physician went to the ICU, and Lu Gang was not hypocritical. He sat in the internal medicine consulting room and began to see patients.

Half an hour later, Ji Xiang and Zhao Zhe came back.

Meng Qingfei read the patient, pulled Ji Xiang and asked, "Xiaoji, is it really an adrenal crisis?"

"Yeah." Ji Xiang nodded.

"You knew early on?"

"I don't know." Ji Xiang opened his eyes and said nonsense, "I only found out after I went to the doctor on the ICU side and asked for a bedside B-ultrasound."

"..." Zhao Zhe was speechless.

It was clear that Jixiang wanted a bedside ultrasound after entering the ICU, but he denied it when he came back, telling lies with his eyes open.

He couldn't figure out why Jixiang was so low-key. No matter from which point of view, the diagnosis and treatment of this patient was extremely good. If it was him, he would be able to boast about it for three days and three nights, the kind with joyful eyes.

But Jixiang is very low-key, unexpectedly low-key.

"Xiaoji, don't hide it, tell me." Meng Qingfei saw Zhao Zhe's constipated expression, he knew it, and said with a smile.

"I really didn't find out, it was because the patient's condition was wrong and a defibrillation was performed. The chest compressions were performed only after seeing the patient's failure. a little better."

Meng Qingfei looked at Ji Xiang helplessly, maybe this is the truth?

Ji Xiang's performance today can already be described as monstrous, Meng Qingfei finds it unbelievable.

The dumplings are already cold. It's really good to eat dumplings for dinner. You can eat them even if they are cold. It's not like a meal.

It's just that there are too many Lu Gang, and the dumplings are not enough.

After eating a few mouthfuls indiscriminately, Meng Qingfei was called out to see the patients repeatedly.

After ten o'clock, Ji Xiang saw that the number of patients gradually decreased, so he told Meng Qingfei to ride home.

Zhao Zhe's rental house was close to the hospital, and when he wanted to leave, Meng Qingfei stopped him.

"Doctor Zhao, go smoke a cigarette." Meng Qingfei dragged Zhao Zhe to the fire escape.

"Brother Meng, don't ask me, I don't know anything." Zhao Zhe knew what Meng Qingfei was doing with him, he had a weird expression on his face, and refused directly.

"Hehe, if you have anything to ask, just chat for a while. By the way, how about you working with Xiaoji?" Meng Qingfei changed the subject.

"Very good!" Zhao Zhe regained his energy all of a sudden, "Brother Meng, let me tell you, I used to have no idea how much money a higher-level hospital could earn. I didn't believe it when I heard it was about 20 yuan a year. I thought it was impossible."

"How much do you earn in Yuanliao?" Meng Qingfei asked.

"After deducting 3500 yuan in one month, the year-end bonus is about 5 yuan throughout the year." Zhao Zhe said, "Xiaoji doesn't have much to do, except for the surgery, which I think is worth it.

I thought of various ways on Yuanliao's side, but you, Brother Meng, who is a doctor, you also know that how much a little doctor can earn depends on whether the director's heart is black or not, and his fingers are loose or not. "

"Hey." Meng Qingfei nodded.

"I have worked in urology for ten years, and I have been outpatient for two years. In the end, I still felt that orthopedics was making money, so I changed the door to take an exam for an attending physician's certificate in orthopedics. But it's useless to have a certificate. That kind of fat and oily place It’s not my turn at all, and I can’t go to the orthopedics department even if I try my best.”

"You took the test alone? It's very thoughtful." Meng Qingfei was not surprised, but just smiled.

There is not only one practicing certificate, as long as you want to, you can take it at will.In the Second Affiliated Hospital, Meng Qingfei knew that someone had four practice certificates.

But there is only one person, and he doesn't know how to separate himself, so it's useless to have too many practice certificates.

"After I divorced my wife, I felt that I couldn't be poor for the rest of my life. Let me tell you a joke. When I was young, I thought that money was not important, but ideals, struggle, healing and saving talents were important. But look at me. Ion scattered. Useful? Shit use!"

Zhao Zhe shook his clothes and sighed, "But we are ordinary people, and what I can understand can be understood by others. Our orthopedic department has the most doctors. The urology department has a class every 3 or 4 days, and the orthopedics department has a class every 10 days." , How bad do you think the doctor on duty is?"

"That's right, the Second Affiliated Hospital is the same. Orthopedics doesn't even require overseas returnees' doctorate." Meng Qingfei said.

"However, it just so happens that Dr. Xiaoji's second rotating department is the Department of Orthopedics, so I'm right. My intermediate certificate is for Xiaoji!"

"Is there a lot of work in the department? When will you be promoted to the deputy director?"

Meng Qingfei asked.

Having said that, Zhao Zhe's eyes lit up.

"Brother Meng, Doctor Xiaoji is really prosperous, really."

"Ok?"

"I have been working on data statistics for more than ten years. Dr. Xiaoji did not know who to do the copywriting, and he has already sent an email to the editorial department." Zhao Zhe said with a smile, "The periodical with the Chinese prefix is ​​a case report. Ye Dao sent the full text."

"And the lancet!"

"Hey, I used to dream about it when I was dreaming, but I didn't dare to think about it at all. I have to say that a young man like Dr. Xiaoji not only dared to dream, but also dared to think about it."

"The strides are too big, be careful not to scratch your head." Meng Qingfei said with a smile, "But I am very envious."

"It seems that there is still a provincial self-administration department. Director Bai is helping to operate it. Director Liu has already greeted all the big men in the province."