(Thanks to my friends Xinxian, Feng Lan Qiyi, Wei Ran Run, 1111 Xiang, Champion, Hou, and Pirate Qi Xinuo monthly ticket encouragement)

"Let's get busy first, and I'll go in and observe the patient. After being silent for a while, Liu Banxia said.

"If there is a patient downstairs who needs first aid, call me, and the patient who has had his lung tumor removed, and tell me when the results of the operation come out. ”

"Okay, Mr. Liu, just use your brain, I really can't figure it out at all. Wang Huan said with a wry smile.

"Don't worry, I'll stay here and keep an eye on Dr. Su. Liu Banxia said.

This feeling will be felt as long as you have been a doctor for a long time, and if you have diagnosed a patient's illness to the point where it cannot be cured, that feeling may not be so complicated.

Now I know that the patient is going to die, but I can't even find the cause of the disease, and the feeling of powerlessness will really overwhelm you.

made preparations and walked into the ICU ward, this is not the first time Liu Banxia has entered this special ward, but he is really a little resistant.

Because the people who live here are not ordinary patients, the mildest condition is the one who has undergone major surgery, and needs to be observed here. Even the car accident patient he rescued that night has now been transferred to the general ward.

"Mr. Liu, in fact, you should really care more about us here. The ICU of our emergency center is very different from the ICU of other departments, and there are all kinds of patients. Su Hongbo said.

"Doctor Su, I won't hide it from you. The two places I fear the most, one is here and the other is pediatrics. Liu Banxia said with a wry smile.

"Don't look at the pediatrics just downstairs, and I rarely go there. It's not because of the conflict between me and Director Chen, it's all in the past, and I can't stand it when I see my child crying. ”

"Who is not the same, can you suggest to the director that we have one more attending doctor here?" asked Su Hongbo.

"Now that there are more patients, we are working harder. You also know the schedule we uploaded, and now it's really too tired to do it. ”

Liu Banxia nodded, "I can assure you that in the future, our emergency center will definitely have to be expanded." ”

"Now the emergency center is developing a little fast, and there are more patients, which is beyond the original expectations of the hospital. There is also a staff gap in the hospital now, but it will be supplemented to our side first. ”

"After the Spring Festival, I will arrange for interns to come here for rotation. The ICU ward is the last task I left to them, and those who can stand the test here will not be bad doctors in the future. ”

"Finally, there is hope, you can observe here, I have to see other patients. Su Hongbo said.

Liu Banxia also put away his thoughts and began to think about the patient in front of him.

Heart failure is not an independent disease, but a manifestation of the final stage of the development of all heart diseases. In other words, any heart disease can cause heart failure.

These treatments currently in use can only be said to be temporarily maintained. It can't even be said to be maintained, it can only delay the progression of the disease. Because the patient has developed liver failure, the rest of the organs are next.

And are there really too many triggers for heart failure? Infections, severe arrhythmias, cardiac workload, drug effects, mood and other aspects of illness.

Is the patient taking one of the commercially available common cold medicines? Moreover, there is no private increase in measurement, and the cause of drugs can be ruled out.

Is the patient emotionally stable during the consultation? Although there is also some work pressure? But it didn't lead to the current result.

I have had an ultrasound of the heart, and the physiology of the heart is normal. Also had an ECG? The heart rhythm is normal, so now the remaining cause is also in infections and other diseases.

Excluded a lot though? The remaining two are not so easy to find either.

Needless to say, other underlying diseases? There are many kinds of causes. For example, pulmonary embolism, severe anemia and other diseases, but the current test results of the patient are not supported.

His instincts told him that the patient's condition might be related to an infection.

Because he had been in contact with a person with a high fever before, was it an infection in some part of his body? With inflammation? That's why it causes high fever.

Liu Banxia put on gloves and began to examine the patient.

If it is infected, it may be related to the patient's trauma. It may be a small wound, or it can cause an infection, leading to sepsis.

Because sepsis can also lead to high fever and acute organ dysfunction in patients? Now he doesn't have any direction, so he can only look for it blindly.

Even if you use an ice blanket? The patient's temperature is still somewhat high. Liu Banxia also checked very carefully, and carefully looked at the hands, feet, knees, elbows, and other places that are easy to touch? There were no external injuries.

He began to examine the patient's head carefully again to see if it had been accidentally bumped.

And the result disappointed him? Still nothing has been found. Infection caused by trauma? It can also be ruled out.

"Mr. Liu? How's it going?" Su Hongbo, who had been inspecting the circle, walked over.

"I thought it was more likely to be an infection, but I checked it carefully and found no injuries. Liu Banxia said.

"If it's an internal infection, it's sure to be able to detect other lesions. We did a careful enough inspection, and we didn't find it. ”

"I'm also wondering about this, do you think it could be a blood cause? But the blood test didn't show it, and it didn't match the signs of leukemia. ”

Liu Banxia nodded, "I also touched my spleen when I had a physical examination just now, and I also checked the lymph nodes under my neck, and there was no special performance." ”

"Eh, if it's blood, could it be infective endocarditis? I see that the patient has acne marks on his face, could it be caused by this?"

Su Hongbo frowned, looked at the patient's face carefully, and shook his head, "The mark was left a long time ago. If it's really because of acne, this acne is definitely still there. ”

"But what you said about endocarditis seems to be somewhat reliable, and there are many causes of endocarditis, could it be that he started with viral flu and then slowly infected the blood?"

"It seems to be a little difficult to do this, but in that case, his body will definitely behave in other ways, and it won't be as clean as it is now, and he can't find anything. ”

"The patient's family is still there, right? I'll talk to them again. Liu Banxia stood up.

"The patient's wife is here, but his parents are not here, so they won't be able to come here until tomorrow. Su Hongbo said.

Liu Banxia rushed outside and found the patient's wife. He was about the same age as the patient, and he was holding a five or six-year-old child in his arms.

"Hello, I would like to ask if your husband was otherwise uncomfortable before he caught a cold?" asked Liu Banxia.

The patient's wife thought about it and shook her head, "I haven't heard him say it, but it's starting to get a little hot, thinking it's cold and catching a cold." I didn't expect it to be like this, I ...... I ......"

The patient's wife couldn't go on anymore and was left to wipe her tears.

"Then think about it and see if you can remember your husband's medication. Sometimes he may feel that he doesn't really care about the illness and won't tell you about it. Liu Banxia said.

"It's like if I'm injured, I won't tell my family about it, so they don't have to worry about it. Did he have any trauma or anything from a previous time? Or that kind of unintentional scratch or something? ”

The patient's wife still shook her head, "He doesn't do that kind of work, and he hasn't been injured." ”

"What about taking medicine? You can put the time forward a little bit, say a month, two months. Liu Banxia still asked.

"I had a mouth ulcer again, but it didn't take a few days to get better. Also, he is prone to irritation, sometimes the corners of his mouth blister, sometimes toothache, is this counted?" the patient's wife asked after trying to remember.

"It's easy to get angry, mouth sores, blistering, and toothache. Liu Banxia muttered again, but still had no clue.

Because this is a common symptom, many people will almost have this kind of performance after getting angry, but this patient's performance is more comprehensive.

Thinking about it, he frowned, "Did he say which toothache it was?"

"Then I can't remember, it's a toothache anyway, it's not very serious, just take medicine. It's the one who is on fire, big tooth. The patient's wife was a little anxious.

"Wait a minute, we'll check again. After Liu Banxia finished speaking, he ran to the ICU.

"Got eyebrows?" Seeing his expression, Su Hongbo had a hint of anticipation.

"There's a guess, push the patient to take a CT scan, a tooth slap. Liu Banxia said.

"What?, slapping teeth?" Su Hongbo was stunned for a moment.

"The patient's wife said he was prone to getting angry and then he would have a toothache. Whether it's or not, we'll have to check it out first. Liu Banxia said.

"Okay, I'll arrange it. After thinking for a while, Su Hongbo's eyes lit up and nodded vigorously.

This patient can use the right to expedited, and he is really in a hurry.

Liu Banxia and Su Hongbo also went directly into the CT observation room, and they had to see the images for the first time.

The waiting time is a bit painful, but there is no way, the machine has its own rules of operation, and it will not speed up because you are in a hurry.

"Holy, urine. ”

After the scan results came out, Su Hongbo patted Liu Banxia's shoulder hard.

Liu Banxia also smiled, this time it was really blind, but it was right.

The image shows clearly that the patient has wisdom teeth in the lower right row. And not only is it born, but it is still the kind that has not grown, and it has broken the tooth next to the wisdom tooth.

The cause that has not been found has been found, and it is indeed endocarditis, and it is also caused by this tooth that has been broken. And because it is in the lower part, it is obscured by the gums, so even the patient himself does not know about it.