(Thanks to my friend Ultraman Variant, Book Friend 110316151302234, Book Friend 2019072705832637 Monthly Pass Encouragement)

The needle is not as difficult as he imagined, Liu Banxia also broke through the small obstacle in his heart, and basically the babies who needed infusion had to be injected by him for the rest of the time.

But even then, he couldn't do it all.

Or because there are too many small patients in the pediatric department, and some older children have to be handed over to other nurses to deal with.

"Has the child's condition improved?"

After a busy day, Liu Banxia came to Chen Hongyang's side again.

Chen Hongyang shook his head, "It's still like that, it's still hard to breathe." Now that oxygen has been given, the child is somewhat more relaxed after giving oxygen. ”

"Don't worry, when it's time for lunch, I'll take a bite of food first, relax my mind, and then help you figure it out. Liu Banxia said.

Chen Hongyang nodded, this case is indeed very complicated, and Liu Banxia has helped the pediatric side a lot today.

He's a hospitalist, so he can't be tied to the pediatric side all the time.

"Qingkova, what do you think about celebrating the Spring Festival with us?" asked Liu Banxia when he came to the cafeteria to eat.

"Can I go for a barbecue or a beer?" asked Qingkova after a moment's thought.

"Don't expect barbecue beer, you can still eat chicken thighs and dumplings in the hospital. Liu Banxia said with a smile.

"When the time comes, I'll study it with the canteen, and everyone will report a favorite dish, and we will have to go through the New Year and the first day of the new year. ”

"Tsk, Mr. Liu, this is a big deal, and there are many medical staff in the emergency center. Wang Chao said with a smile.

"It's been a whole year of hard work, and I have to enjoy the festival. Liu Banxia said.

"I can't go home and reunite with my family, so let's reunite ourselves in the courtyard. After all, the feelings of the New Year are still a little different, and we are the first year in the emergency center. ”

Everyone was happy, not to mention, there were some expectations for this Spring Festival.

The days of holiday duty are very difficult, just like Liu Banxia said, the feelings of the Spring Festival are always a little different.

After lunch, when he returned to the emergency center to change shifts, Liu Banxia was also thinking about the child's asthma.

At present, it can be judged that there must be a direct correlation between the child's febrile cramps and the current asthma becoming severe. I can't figure out this case anymore, so I still have to face this little patient directly.

He originally wanted to talk to Xu Hui as well, but Xu Hui also received a lot of patients over there. After reading the child, if there is no new discovery, let's touch Xu Hui.

This is also a difficulty caused by the increase in patients now, and it is more troublesome to find internal medicine consultation. In the Department of Internal Medicine, Wang Huan and Xu Hui came in turn, and the two interns, Zhou Shangkai and Cao Peng, were not able to receive patients independently.

He also looked up some information about asthma, which is really annoying. Especially when you have an attack, although it is not that painful, the feeling of being suffocated and out of breath should be very uncomfortable.

When Wei Yuan and the others also came back from dinner, Liu Banxia slipped to the pediatric side again.

"Look at the kids, it's a little better now, in the ward. Chen Hongyang said.

"Look at it, I can't figure it out. If you really don't understand, ask someone from the inpatient department to come over for a consultation, but there's really no way. Liu Banxia said.

"It's pretty much the same as I thought, but it's best to be able to solve it in our emergency center. Chen Hongyang nodded.

In the ward, the child was lying on the bed drinking yogurt. The child's parents sat on the side, their faces sad. The lunch box on the cabinet was not opened.

"This is Dr. Liu from our emergency center, and I invited him to come over and help diagnose him. Chen Hongyang introduced.

"Do I need any more checks? I'll go pay the bill. The child's father stood up.

"Don't worry, because the child's asthma is a bit complicated now, we can't do random checks. Liu Banxia said.

"Have you ever noticed what are the most obvious triggers before your child has an asthma attack, such as cold air, secondhand smoke, smog?"

The child's parents thought about it and shook their heads in unison. This time it was the child's mother who spoke, "Nothing special, every time the situation seems to be a little different." ”

"What about in the past, when was the child diagnosed with asthma?" Liu Banxia asked.

"When I was four years old, then the doctor said that it was possible to get better as the body's immunity strengthened when I grew up. But no, it's getting worse and worse. The child's mother said.

"Doctor, does this time also have something to do with the febrile cramps two months ago? Anyway, it seems that the child's asthma attacks have been a little frequent since that beating. However, spraying used to work well, but today it doesn't work. ”

The child's father frowned and glanced at the child's mother.

Liu Banxia also pondered, this medical history is long enough.

I looked at the child again, he was a little thin, and his face was wrinkled, even if he was eating yogurt, he was not very happy. And now there are still some problems with breathing, and after two bites, the panting will be louder.

"What about your usual diet?" Liu Banxia asked again.

"We also paid special attention to the diet, which was what he used to eat. There is no problem in this regard, and the soup is always warmed before letting him drink it. The child's mother said.

"Even when he wants to go outside to play, I will put a mask on him, for fear that the air outside will be dirty and make him have another seizure. In the past two years, I have thought of all the methods I can think of, and I have tried some home remedies, but it still does not improve. ”

"Some say it's hereditary, but none of our relatives have ever had this disease. We all want to move to the south, saying that the air in the south is good. ”

"I'm going outside for a cigarette. ”

At this time, the child's father stood up.

"Smoke, you know smoke, can't you stay with the child for a while?" the child's mother raised her voice.

"If you hadn't taken the kids out to play, would you be like this now? You're out every day, and you know how hard it is for us to be at home. ”

The child's father looked at him and did not speak.

"Mom, huh...... Call...... Whew......"

At this time, the little guy lying on the hospital bed shouted, and then he covered his chest and began to gasp for air, and he had a seizure at this time.

Chen Hongyang didn't dare to delay, directly turned on the nebulizer on the side, and put the mask on the child.

Liu Banxia frowned, could it be that the trigger factor for children's asthma is spiritual?

"Did you also quarrel when the child had a seizure at home today?" asked Liu Banxia.

The two of them were stunned for a moment, but still nodded.

"Then you can recall that when children were sick in the past, it was all because of emotions...... Well...... Wait a minute. Liu Banxia said halfway, took out his stethoscope, and began to auscultate the child.

Listened first to the lungs, then to the heart.

"Mr. Liu, have you made a judgment?" After Liu Banxia took the stethoscope away, Chen Hongyang asked anxiously.

"Let's do an ECG and an ultracardiogram, just heard some friction rubs. It's cardiac asthma, and the last heat cramp was not really a heat cramp, but a heart attack. Liu Banxia said.

Chen Hongyang was stunned for a moment, and hurriedly beckoned the nurse to push the machine here.

This is really very possible, and I didn't even think of it in the process of receiving the treatment.

The machine pushed over, and the first thing to do was an electrocardiogram, but the result made Chen Hongyang frown, and there was nothing abnormal.

"It's a good thing that proves that the child's heart disease is not very serious. Liu Banxia said.

"Now the child's breathing has returned, proving that he has passed the heart attack period during this time. It feels like myocardial ischemia, so let's just do a coronary angiogram. ”

"Otherwise, we can only do a stress test to induce the child's myocardial ischemia, which can be seen on the electrocardiogram. Combined with the child's current age and the age at the time of onset, I can't tell that it is caused by coronary artery malformation, and the small intersection is easy to ignore. ”

"How did you judge that?" Chen Hongyang frowned.

"I must have checked the heart in the previous check-ups, and when I looked back at the X-rays, the heart was basically normal. The electrocardiogram just now is back to normal, and it can only be due to blood supply. Liu Banxia said.

"If the recovery is so fast, it should be an arterial malformation, but the connection of the malformation is not very large. After the child is emotionally stable, the blood supply returns to normal. ”

"The patient we received in the emergency department today was suffering from myocardial infarction. It can be seen on the electrocardiogram and is done directly with coronary angiography. ”

Chen Hongyang thought for a while and nodded, and then introduced the operation of coronary angiography to the child's parents.

His heart is now inclined to Liu Banxia's judgment, if the deformity is very small, even if he does a cardiac diagram, he can't see it, and he wastes that time.

The child's current symptoms are lumpy and the recovery is fast, and it is likely that Liu Banxia judged that the deformity was very small.

For this matter, where will the child's parents disagree.

Liu Banxia didn't follow, he was very confident in this diagnosis, even if the system hadn't given a hint yet.

Now it can be said that all the impossibilities have been eliminated, and this is what cardiogenic asthma looks like. If your child's heart proportions change somewhat, an echocardiogram is about the same.

Not long after I came back, I received a message from Chen Hongyang on my mobile phone, which was indeed an arterial malformation.

Ding! Complex asthma mission accomplished

Gain 200 XP and 100 Diagnostics Skill Mastery

Looking at the dry reward, Liu Banxia was stunned for a moment and shook his head helplessly.

Preconceived notions are the main thing, whether it is him or Chen Hongyang, they all fall into the main belief that it is the reason in the airway.

Therefore, the heart aspect is not considered at all, and if you come to the emergency center for a comprehensive examination, you don't have to worry for so long.