Interns in reality have no status.

The virtual one is not much better. The virtual is as brutal as the real.

As soon as it came up, it was deducted 10% of the degree of completion.

On Monday, I didn't dare to make a mistake again.

Honestly, bowing his head to follow Lao He for an internship.

He Congshuang crossed the week, hired Tingting to walk to the back of the desk, pulled over the chair, and sat down.

The legs are staggered, and the goddess is full of style.

Lao He is going to sit in the clinic.

Zhou Sheng was still standing, seeing that Lao He didn't care about himself, and Zhou Sheng knew that he had to be self-reliant.

He looked left and right, except for the chair where Lao He was sitting.

There is only one bed and one waiting chair in this room.

You can't just move this waiting chair and sit on your own. It is estimated that in that case, you may be deducted internship points immediately.

Helpless!

Zhou Yi could only stand beside He Congshuang like a follower.

He Congshuang didn't even glance at Zhou Sheng, and directly began to shout.

In an instant, a patient pushed the door open.

The patient was a young man, clutching his chest and looking in pain, much like the patient with a ruptured esophagus that he rescued on Monday.

But it's not that serious.

The young patient entered the examination room and saw someone in a white coat.

He sat straight into the waiting chair.

He Congshuang said "where is uncomfortable".

The patient begins to complain.

After a while, the basic condition of the patient was understood on Monday.

Patient Liu, male, 21 years old, suddenly felt right chest pain, shortness of breath, occasional cough, no obvious sputum, and fever during exercise. At first, there was no special treatment, and the symptoms gradually worsened in the past half a day, and then came to the outpatient clinic.

Chest pain again, Monday secretly worried. Isn't it also a ruptured esophagus?

Most likely, after all, the system can read the participants' memory information.

However, because it is in a virtual copy, there is no way to expand the various system artifacts on Monday.

At the moment, he can only honestly guess about the patient's condition.

As soon as the patient's complaint was over, He Congshuang began to inquire.

The main thing is to ask if there is a history of food and drug allergies.

The patient's answer was no.

After asking, it is a physical examination.

Temperature was taken, 36.6°C, normal.

Heart rate, 97 beats per minute. Normal.

Blood pressure, Hg. Normal.

This is followed by inspection and auscultation.

He Congshuang muttered while examining: "Shortness of breath, no yellow staining of the skin, tympanum sound in the right lung, and the breath sound on the right side of auscultation disappears." There were no abnormalities on abdominal examination......"

The physical examination is almost done.

Monday felt that the patient should not have a ruptured esophagus.

Because the patient's blood pressure is normal. In addition, the right side of the breath sound is absent on auscultation.

This proves that there is something wrong with the patient's right lung.

After the examination, He Congshuang only had time to deal with Zhou Shengsheng at this time, she turned her head and asked Zhou Shengsheng next to her, "What kind of examination does this patient need at present?"

Listen to it on Monday.

He Congshuang is going to teach himself!

Although it is said that there is no black technology, it has been mixed in the emergency center for so long.

I'm not an intern who knows nothing at all.

At the moment, Zhou Sheng was not ambiguous, and immediately replied: "Blood routine, electrocardiogram, and chest X-ray are necessary tests." ”

Zhou Yisheng's answer made He Congshuang very satisfied.

She nodded approvingly.

Then she goes back and asks the patient to go for a test.

The patient responded.

In the blink of an eye, he pushed the door in again.

Normally, these three kinds of examinations will take two or three hours as soon as possible.

It can take more than half a day to slow down.

But a copy is a copy, and it's all about saving time.

As soon as the door opens, the door closes.

Forget it and it's done.

The patient sent three test reports, blood routine, electrocardiogram, and chest X-ray, to He Congshuang.

He Congshuang also saw it quickly, almost a few seconds.

Then she handed the report to Zhou Shengsheng beside her without looking back.

Monday was in the know.

Take the report and read it one by one.

The ECG reported that everything was normal.

The blood routine reports are dense, but if you look closely, each item is within the normal range.

It was only on this chest x-ray that something was clearly noticed, the right lung texture disappeared, and the right lung was compressed by about 50%.

This is consistent with the results of the auscultation, which showed that the patient had a problem with the right lung.

The lungs were compressed in half. Decreased function and, of course, shortness of breath.

At a glance, it became clear on Monday that this is a common pneumothorax in thoracic surgery.

Why are lungs compressed?

In this case, gas enters the chest cavity and the lungs are squeezed due to pressure.

So why does the gas get into the chest cavity.

The biggest cause is rupture of the bullae.

Generally speaking, less than 30% atrophy of lung tissue is a small pneumothorax, which has little impact on breathing and blood circulation. More than % is a large pneumothorax, which will cause chest tightness, chest pain, coarse breath, palpitations, and tracheal displacement to the unaffected side.

A small amount of pneumothorax does not need to be treated, and it can be absorbed spontaneously in 1 to 2 weeks.

A large pneumothorax requires thoracentesis to extract the accumulated air and promote early expansion of the lung tissue. Antibiotics are also used to prevent infection.

After reading it on Monday, he immediately gave the answer: "Teacher He......"

With the previous lessons, Zhou Zhou didn't dare to call He Congshuang's wife and old He. It's safer to call the teacher honestly.

“…… I think it's a pneumothorax. ”

"What's next. ”

"50% compression, moderate pneumothorax, do not require surgical treatment, but it is difficult to recover on its own, consider thoracentesis to extract the accumulated air. ”

He Congshuang nodded, "Arrange!"

Order.

This time, there is no animation of even opening the door and closing the door.

Monday's eyes lit up, and when he recovered, he went straight to the scene of thoracentesis.

When answering He Congshuang's question just now, Zhou Zhou did not treat thoracentesis as an operation. In fact, thoracentesis is indeed an introductory first-level surgery outside the chest.

However, this surgery is too simple and common for surgeons to treat it as surgery.

It is not even as good as an appendix surgery, which is also a first-degree one.

In simple terms, this thoracentesis procedure involves making a small hole in the patient's chest with a needle and then removing fluid or gas.

In addition to the role of treating pleural effusion and pneumocele, it also plays an important role in diagnosis.

The effusion is drawn and pleural fluid smear, culture, cytology, and biochemistry can be done to identify other causes.

So, although this thoracentesis is a first-degree thoracic surgery.

But it's an operation that almost every surgeon does. Emergency centers also often use thoracentesis to test for pleural effusion.

Not only surgeons, but also interns often operate. Because this operation is the content of the clinical practice examination in the doctor's qualification examination.

Of course, for interns who lack clinical experience, this surgery is still instructive.

But for Monday, it's no different from taking your blood pressure.

However, no matter how small the operation is, it must be taken seriously, not to mention, it also involves the problem of the completion rate of copies.

Monday opens the puncture bag and prepares to remove the instruments for the procedure.

……

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