(Thanks to my friend for my friend's encouragement, Renyijie's reward and monthly pass, and thanks to my friend Jade Emperor for praising my handsomeness, mangmangliu, empty and lonely cold 671112, sleepwalker, and Lu Tiezhu monthly pass encouragement)

Even though Liu Banxia tried hard to warn himself in his heart to be steady, the slightly upturned corners of his mouth still betrayed his good mood.

It's not what it used to be.

In the past, I begged my grandfather to tell my grandmother in the emergency department, just to be able to drink a sip of soup. But this soup is not so easy to drink.

Now, it's almost the same as holding your head and stuffing meat in your mouth.

All thanks to the system, if there is no system, I don't know what my life will become.

Returning to the emergency center, I didn't stop downstairs, but went straight to the ICU ward upstairs.

"Good news for you, I just went to consult with the dean. Our fourth floor will set up the CCU in the near future, even if there are only ten beds for the time being, it can relieve you of a lot of pressure here. Liu Banxia said.

"Mr. Liu, is it really fake? You're not coaxing me, are you?" Su Hongbo was skeptical.

"What am I trying to do with you, and you won't give me a raise. Liu Banxia said with a smile.

"The problem with CCU is not only you talking to me, but also Dr. Meng. The main reason is that at the beginning, no one thought that our emergency center would be so popular, so the preparation was a little insufficient. ”

"Now the problem is highlighted, and the construction of other departments can be pushed back, but the CCU thing can't wait. The wards are all ready-made, and the pipelines have long been reserved. ”

"Hey...... , I feel a little more relaxed when I say this. With 10 beds to spare, we can be much more relaxed here. Su Hongbo said with emotion.

"Otherwise, our nurses would have to face the reproaches of patients who need to be transferred to the general ward every day, but there is no way, if they don't make up the bed, people really can't get in. ”

"It's going to get better slowly, and the hospital attaches great importance to us here. Liu Banxia said.

"I also have to go down and help with debridement and stitching, which will reduce the waiting time for patients. It's the flu season again, and it's really dangerous for so many patients to wait. ”

Su Hongbo nodded, he didn't have so much time to chatter. Patients who can be admitted to the ICU will have the mildest symptoms after major surgery.

Back downstairs, Liu Banxia put on the field again. The main subject is debridement and suturing.

The current interns have completed this stage of training and have all passed. Although they still need to be strengthened, they also need to be trained in other aspects.

For example, receiving patients independently and communicating with patients' families are all essential skills for practicing medicine.

"Teacher Liu, I'll handle it for you. After receiving the consultation for a while, Huang Bo walked in.

"What's the matter, do you want to make a performance with me? Are you a little anxious now that you see that Su Wenhao and Xu Yinuo have their own special patients?" asked Liu Banxia.

Huang Bo shook his head, "Teacher Liu, I hope that such a patient can come later, so that I can have stronger strength and come back later." ”

"There are a lot of patients outside now, you want to give us a chance to exercise, and we can't watch you hold back here." I'll take care of the rest, and I'll brush up on the basics. ”

"Okay, I'll leave it to you. I hear that there seems to be another emergency patient outside?" asked Liu Banxia.

"Yes, there are three first aids, and one of those who was stabbed in the abdomen has been taken to the operating room by Dr. Wei. There is also a tendon that is broken, and Miao Rui is stitching it up. Huang Bo said.

"It's good, you've all grown up and can handle it. You can take the next patient, and I'll take a look outside. Liu Banxia nodded and gave approval.

Outside, there are still a lot of patients. glanced at it, Liu Yiqing and Miao Rui were not there, they should have come to power with Wei Yuan.

At this time, the ambulance sent a patient, and Liu Banxia saw that others had work on hand, so he greeted him directly.

"A 33-year-old woman who fell on a treadmill in the gym. Vital signs are stable, pain in the ankle, and a fracture is suspected. The first responder said.

"Okay, leave it to me. Liu Banxia said.

"Did you hit your head when you fell?" asked Liu Banxia.

The patient shook his head, "No. I was so unlucky, I wish I hadn't broken a bone, but it hurt. ”

"What about fitness? That's not too hard, I'll check it out for you first. Liu Banxia said casually.

The trouser tube was rolled up, and the swelling above the ankle of the left leg was severe. Looking at this, Liu Banxia had already given up digital diagnosis.

"Let's just take a film, there is a high chance of a fracture or a cracked bone. But don't worry too much, you can recover in two months with a plaster. ”

"Hey...... , I just lost some weight, I can't move for two months, and I don't know what I'll be fat. The patient sighed.

"That's also a matter of the body, you must take it step by step. Don't push yourself too hard, otherwise your body is prone to problems. Are you alone?" asked Liu Banxia.

"My boyfriend was at work, and it wasn't too serious, so I didn't inform him. The patient said.

"Okay, I'll arrange a nurse to borrow a wheelchair to push you to take a film. Now that there are quite a few patients, you may have to wait a little longer. Or you can do a bedside X-ray in the emergency room, and the results are very fast, but the cost will be higher. Liu Banxia said.

"Then do this bedside X-ray, I'm walking too hard now, otherwise I wouldn't have called 120. The patient hurriedly said.

Liu Banxia nodded, although there was a price difference, it was not too bad. There are no patients who need emergency care, so this is a flexible operation.

After the X-ray, it clearly showed a fracture of the distal fibula.

"It's not very serious, and it may be recovered in a month and a half. Liu Banxia said with a smile.

"When the time comes, rehabilitation is equivalent to fitness, don't worry at that time, otherwise the fracture is too stressed, and it is likely to be affected. ”

The patient nodded.

It's just that when Liu Banxia was about to call the nurse to prepare for a plaster, the patient rolled his eyes and had epilepsy.

Liu Banxia was startled, and hurriedly turned the patient's body on its side to prevent the patient from suffocating.

The epilepsy lasted for nearly a minute, and after the patient stabilized, Liu Banxia breathed a sigh of relief.

"Even the monitor, do a rapid blood test, make an appointment for head CT, and the airway is no problem for the time being. Liu Banxia said.

"You just had a seizure, and now you're fine. Did you feel anything else before you fell? Think about it, did you hit your head or your neck when you fell?"

The patient shook his head, no longer able to speak.

Liu Banxia nodded, "Don't worry, give the contact information of our relatives to our nurse later, and we will take a head CT immediately." In the hospital, it's safe. ”

The patient nodded with difficulty.

"Mr. Liu, what's the condition of this patient?" After the patient pushed the CT scan, Wang Chao came over.

"It's not clear yet, let's see the results of the examination. At first, I thought it was because I was too tired from losing weight, but now it seems that I may have had some brain problems and had an epilepsy. Liu Banxia said.

At this time, the ambulance pushed another patient, Liu Banxia gave Wang Chao a look, and continued to work.

"A 57-year-old man fell on a coffee table while mopping the floor at home, and his vital signs were stable. The first responder said.

"Diagnose the bed, did you fall on your head?" Wang Chao shouted.

"I must have fallen, I was a little confused before I fell, and then I realized that I was in the ambulance. The patient said.

"Doctor, give my dad a proper check-up. Said the patient's son, who accompanied him.

"I'll check it first. After Wang Chao finished speaking, he began to auscultate.

"The lung and heart sounds are normal, and I just looked at the back injury, and it is not very serious. Since you are dizzy before you fall, you should do a brain CT scan first. ”

The patient's son nodded and hurried to pay the fee.

"Mr. Liu, the results of your patient's blood test have just come out. Then the nurse came running.

"It seems that it was a coincidence, and it happened to be in this batch. Liu Banxia said and took the result.

Just one glance, his brow furrowed, the patient's blood ammonia level was high, and it was because of this that the patient's epilepsy was caused.

High blood ammonia is not very common on medical tests. If it is detected, it is often related to the urea metabolism in the patient's body. So it also has another name, which is called urea metabolic circularism.

However, this disease is a recessive genetic disease, and patients are still developing it at this age, which is somewhat unusual.

Another possibility is that there is a problem with the liver, because urea synthesis requires the participation of six enzymes. If one of these six goes wrong, it will affect the crafting effect.

Just as many people get red when they take a sip of wine, it's because the body lacks this enzyme to process alcohol.

"Mr. Liu, let's estimate whether it is a genetic disease or a liver problem. Wang Chao said.

"There is a higher chance of genetic disease, but you still need to see the CT results. Liu Banxia said.

"Patients with urea cycle disorders often have edema in the brain in the acute stage, and the patient falls while running today, which may be caused by edema. ”

Because this disease is very special, just a hyperammonemia Liu Banxia and Wang Chao can see so much. Of course, the next step is to do a detailed laboratory examination before we can finally be sure.

"Mr. Liu, did you think of something?" Suddenly seeing the smile on the corner of Liu Banxia's mouth, Wang Chao was a little uneasy.

"It should be urea metabolic circularity, and the patient is losing weight. In the process of losing weight, you will go on a diet, and sometimes you can't control it when you are on a diet, so you may supplement a large amount of protein in a short period of time. ”

"So even though the patient has a genetic disease, it is only now that it manifests itself. Well, it should be. It doesn't seem to be very serious, just control it. ”

Wang Chao was stunned for a moment, shook his head, and really didn't know what to say.

Basically, I didn't run, don't look at Liu Banxia's prediction. No wonder this product is so good at diagnosis, there are too many things in this head, and it can cover all the situations.