Liu's Pharmacist Hall

The author has something to say: Well, the second article comes, not many words.

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1,

What does it mean to be a resident in a hospital?It means working non-stop.Although he passed the attending physician examination last year, the hospital refused to hire him for a long time, so Liu Xiyan is still an old resident.But in fact, in their department, professional titles don't mean anything at all. There are only a few people, and the director is on the first shift.Sometimes the doctor is too busy at night, or there is a problem that cannot be solved, and the doctor on duty will report to the director. Because they live close together, the director used to come here by himself—but these days, the director just shamelessly told the other two seniors Residents with low salary: You can call Dr. Liu, since he lives in the hospital anyway.

Half a month later, Liu Xiyan was worried every night. Before going to bed, he had to pray that the two colleagues were safe on duty. Every day, he had to go to the opposite store to buy a fresh apple and enshrine it in the office bookcase. There are fewer days of sleeping soundly than before, and I have fully realized why Ye Wenxuan always looks like he is dying before he gets old.

At twelve o'clock in the evening, just after coming down from the ward—he had just finished his night shift the night before—he was washing his face in front of the blurry and dirty mirror in the general duty room of the inpatient. While reciting the heart-clearing spell, he dialed the phone number of his psychotic brother.

"Nanwu Ksitigarbha Bodhisattva, little brother, what's the rush at midnight?" Liu Xisheng was obviously woken up from a deep sleep.

Thinking that the other party can sleep happily in his own den every day, but he has to suffer here, Liu Xiyan couldn't help becoming irritable: "Liu Xisheng, have you found a way?"

"any solution?"

"..." Liu Xiyan gritted his teeth, "When will you be able to take your Xiaolian away?"

"Ah!" An interjection that fully revealed that the other party had completely forgotten about this matter, followed by a deep disguise, "I've been thinking of a way."

"It's been ten days since July and a half, right? Can I go home and live?" Liu Xiyan continued to grit his teeth.

"Think carefully about this. It's hard to completely suppress Xiao Lian with a spell. I'm worried that if you accidentally do something that will make you regret it forever." Liu Xisheng persuaded earnestly, "You don't want to, do you? After all, we are brothers. "

"Suddenly I don't mind much. Xiaolian may be able to cure my erectile dysfunction. As for you brother, it doesn't matter if you have been wronged a few times. Anyway, you people who practice Taoism cultivate the Dao, incest and other homosexuality What's the point of worrying about such insignificant things?" Liu Xiyan finally stopped gnashing his teeth, and he said to Liu Xisheng with a very calm smile.

"I'll take care of it when you come back at noon tomorrow, good night."

But Liu Xiyan still didn't have the good fortune to sleep. As soon as he lay down on the bed, he received a call from Dr. Lin, informing him that a patient with severe preeclampsia and heart failure had come to the critical obstetrics department on the [-]th floor. Director Wu of the pathological obstetrics department had returned to the hospital. Please ask them for emergency consultation.There are seven or eight emergency patients queuing up at Dr. Lin's place, and he really can't leave - the patients on the [-]th floor may have to accompany them to the operating room, and they will be directly transferred to the internal medicine ward after surgery.

Liu Xiyan hurried to the twelfth floor of the inpatient department, and saw director Wu Tingfang, who was known as the most bleak second commander of the whole hospital and their department directors——to be exact, the deputy director.Because the patient is special, he is also the master who will be called back if there is any movement in the department.

Director Wu was talking to a male family member. This family member looked polite, dressed well, and his facial expression seemed reasonable.When Director Wu saw Liu Xiyan, he paused for a moment, and said to the family members: "The attending physician of internal medicine, Dr. Liu, is here, and he will see your wife right away."

With just such a sentence, Liu Xiyan immediately understood Director Wu's hint that it was difficult to deal with, and this family must be quite difficult to deal with.

Liu Xiyan didn't say anything, and went directly to bed 1 to see the patient. A 34-year-old female patient was in a semi-recumbent position, and her abdomen was bulging. The number of weeks should not exceed 230 weeks.As far as the mental state is concerned, the patient is not very bad at present, his mind is clear and his energy is good, but he has a little cough and a little shortness of breath.But looking at the ECG monitoring is a big problem. The blood pressure is 158/122mmHg, the heart rate is 32 beats/min, the breathing rate is 95 beats/min, and the respiratory oxygen saturation is [-]%.

Liu Xiyan didn't talk nonsense, and directly listened to the patient's heart and lungs. The gallop rhythm had come out, and there were wet rales at the bottom of both lungs.At this time, Director Wu and his family members also arrived at the hospital bed. Director Wu briefly introduced the condition: the patient is 36 years old, and the child is a test-tube baby, more than 29 weeks old. She had a bit of a headache and her feet were swollen badly, so I asked a doctor I knew to visit her at home. The blood pressure was measured to be very high, and she was advised to be hospitalized immediately. On the way to the hospital, she started to cough a little.After being admitted to the hospital, it was found that the blood pressure was high, the heart rate was fast, the breathing was fast, and there were wet rales in both lung bases. It was considered that severe preeclampsia caused acute left heart failure, and the heart failure needed to be controlled immediately and sent for surgery.The test results are urgently checked, and the results have not yet been returned. The bedside chest X-ray has been taken, and the doctor of the heart color Doppler ultrasound is also coming up. For the treatment, furosemide and cedilan have been used.

"On this point, our husband and wife don't quite agree." The patient's family member spoke at this time, speaking in a gentle manner, "We think that if there is a problem, we can solve it. There is no need to perform an operation early to take the child out."

"Heart failure caused by pregnancy-induced hypertension will not get better if you don't bring out the child." Seeing that Wu Tingfang didn't speak, Liu Xiyan said directly, "If you ask for this, then the end result is that both adults and children will disappear. Acute left heart failure itself is half It can't be saved."

"We don't think this is likely to be the case. According to this theory, what if she doesn't have left heart failure? The doctor we met just now said that it might just be pneumonia. Child?" The family member pushed the glasses and said, "I checked the information, and it is very difficult for a child to live at 29 weeks."

"The heart already has a galloping rhythm, which is a unique sign of heart failure. We can't judge wrongly. You should know which is more serious, pneumonia or heart failure. Heart failure can be fatal, but pneumonia is not necessarily. Now that we have judged It is a serious illness, and it is reported that it is a serious illness, so it should be handled according to the principle of serious illness." Liu Xiyan continued.

"The problem is that you have already taken the medicine, and I think she is still coughing. Is your judgment wrong?"

Wu Tingfang said at this time: "The medicine is just to prevent her from getting worse and die before she is sent for surgery, and to promote the maturity of the fetal lungs. The real solution to the problem is to take the baby out. Heart failure is caused by high blood pressure, which cannot be controlled. Heart failure cannot be controlled, high blood pressure is caused by pregnancy, pregnancy cannot be terminated, and high blood pressure cannot be controlled." He has said this sentence more than ten times.

"The problem is that you don't have a clear diagnosis, how can you kill a child so arbitrarily?" The family members finally showed a little anger.

"I don't do surgery." The female patient coughed and said, "I'm fine, I just caught a cold."

At this time, the front-line doctor outside came in and said, "Director Wu, the results of the bedside chest X-ray have come out. Consider differentiating heart failure from pneumonia."

Wu Tingfang almost quietly glared at the front-line doctor, and Liu Xiyan couldn't help but also glared at him—of course, out of the family's sight, the front-line doctor immediately realized that he had said something wrong, and made a bitter face.

Yes, at this time, it's not that there are always hospitalizations that can't hold back the situation, it's because the hospitalizations always go to the emergency surgery in the delivery room.

The family members immediately reasoned: "Hasn't this been identified yet? You doctors can't be so irresponsible."

"The identification is made by the clinician, and the radiologist just gives a suggestion. In fact, the result of our clinical identification is heart failure." Liu Xiyan said, "Time is running out."

"Everything must be based on evidence. You haven't produced reliable evidence, so why are you so arbitrary?" The family member heard the patient cough, and said, "I asked our doctor that pneumonia requires anti-inflammatory drugs, but you didn't use it! "

Liu Xiyan and Wu Tingfang had nothing to say together.Comrade Liu Xiyan finally couldn't bear it any longer. He tried his best to restrain himself, he didn't want to get burned, and he didn't want to give up the bonus he lost this month, but he felt that if he didn't say a word, he would be sorry for his nature, so he said: "If you trust that Doctor, let’s go to that doctor to see a doctor.”

Wu Tingfang said to the front-line doctors in front of his family members: "I will report to the medical department and call the police if necessary."

Liu Xiyan couldn't leave, and the patient's family members were still stalling for time.Although he has been floating for several days in a pseudo-hospital life, he behaves like a lost soul.

The front-line doctor told Liu Xiyan intermittently about the patient's situation in his spare time. This is her third child, and the first two were daughters. She was sterilized after giving birth because she wanted a son very much. This time she resigned. Those who were conceived by embryo implantation may undergo gender selection and get pregnant with a male fetus as they wish.This fetus is very important to the man, and even more important to the woman, because according to the woman's opinion, the man seems to plan to divorce her if he can't have the child, and find a younger one for rebirth.

Liu Xiyan said calmly to the front-line doctor: "Social problems are not for us to solve. We just need to remember to save lives. If there is anything more important than life, it is her own choice."

The chief executive on duty happened to be the deputy chief of the medical department. After learning about the situation, he began to negotiate with the family members and patients. Before the negotiation, he secretly ordered the front-line doctors to record.Liu Xiyan decided to make a video because he saw the family member of the patient taking out his mobile phone to record it openly.