At six o'clock in the morning, Xu Yi had already brought his usual small book to start his daily ward rounds, and the palm-sized crust was already a little white because it was often turned over, and the corners were a little rolled up, as for the medical records, Xu Yi didn't need to bring them. Although the internal medicine ward occupies two floors on the third and fourth floors of the inpatient department, with a total of 100 beds and 42 extra beds, Xu Yi is familiar with each patient's condition and treatment.

As soon as I walked out of the duty room, I saw the family members who accompanied the patient who was admitted to the hospital last night were wandering around the door of the duty room.

"Auntie, you have something, how long have you been here, why didn't you call me earlier?"

"Doctor, the old man of my family woke up, but when he saw himself in the hospital, he said that he was a little confused, and he had to go home from the hospital, saying that he spent too much money here, and the family was still busy planting seedlings, how could he have time to stay here, just now I persuaded my son for a long time, and he didn't listen, my son was going to be busy planting rice today, so I went home and explained, let the person I find help someone else's family first, and then borrow some money, the family's money is to buy seeds and fertilizers or something, not enough for the number you said last night. ”

"Okay, I'll take a look, and then persuade him, this cerebral infarction is a big or small problem, it's a good thing to wake up so quickly, but maybe there are any sequelae that haven't been found, why do you have to observe for a few more days, if this is not completely cured, it can't be said when it will attack again, and then it will be troublesome." By the way, Auntie, I forgot to say, to apply for NCMS, you have to bring the old man's ID card, does your son know?"

"I told him that it was too late to rummage through the cabinets last night, so I drove directly here, and he would bring it, and we were not far away anyway, and he would be back at about ninety o'clock. ”

As they spoke, the two of them arrived at the door of the observation room between the doctor's office and the nurse's office, pushed the door and walked in

"Uncle Xie, you can't be in a hurry, even if you want to farm, you have to take care of the problem first, this has just improved, you are in a hurry to go back, this will definitely not work, let's wait and talk, I will help you check it first, if you have anything uncomfortable, you have to tell me, so that the problem can be cured as soon as possible, and you can go home early." Xu Yi said, and bent down to check the old man's body.

The old man's name is Xie Chunlin, he is 59 years old this year, and he was admitted because of a lacunar cerebral infarction. At about ten o'clock last night, the doctor on duty at the outpatient department called, and Xu Yi ran to the outpatient clinic and took the person to the hospital. After consulting with the family about the symptoms, and then after some physical examination, the outpatient doctor came to the same conclusion: the preliminary diagnosis is cerebral infarction, and the size and location of the infarction can only be determined after the magnetic resonance examination.

Cerebral infarction is a disease in which the intracranial blood vessels are guided by thromboembolism to lead to local ischemia and necrosis of the brain, resulting in damage to the functional area and various clinical symptoms.

At this time, it is undoubtedly a waste of the patient's treatment time and treatment time to conduct too many examinations, so Xu Yi immediately decided to give thrombolysis and diuresis in time, and at the same time inhale oxygen to reduce the lack of oxygen in brain tissue.

In the interval of treatment, Xu Yi asked the nurse to establish intravenous access and draw two tubes of blood at the same time, and when it was empty, it was sent to the laboratory to do four tests of blood type and coagulation, after all, it is thrombolytic therapy, if the patient has abnormal coagulation, it is very dangerous, and it is necessary to observe closely, and if the abnormality is found, it must be rescued in time, and it is also necessary to consider whether there will be an accident of bleeding after thrombolysis.

Only then did I start to call, and called the doctor on duty in the radiology department to come from home - no way, the small scale of the traditional Chinese medicine hospital, the shortage of manpower, coupled with the limited source of the disease, really let all the departments be on duty in the hospital all night is a very unrealistic thing, such as the stomatology department or pediatrics do not work night shifts, in addition to the laboratory, other departments like radiology and ultrasound departments are to adopt the system of listening, if the emergency department wants to check ultrasound or take an image or something, you have to call the department to listen to the phone, and ask the doctor to come from home. Of course, like the routine chest X-ray and abdominal ultrasound examination in the hospital, you just have to wait for tomorrow to go to work during the day, and it will not affect the treatment, and there is no need to toss people over.

Just like the treatment has begun, but the admission procedures will not be handled until tomorrow morning after the staff on duty in the inpatient department go to work, in fact, this is also considering that most of the patient's family members are in a hurry when sending the patient, some are not enough money, some do not understand, do not know to bring a medical insurance card, ID card or something.

After all, it was a county seat, so it only took less than an hour for Dr. Sun from the radiology department to call and say that the machine had been debugged and could be checked down. After giving the patient another physical examination and seeing that the patient's condition was stable, Xu Yi pushed the patient by himself, asked the old man's son to accompany him, and sent the patient to the magnetic resonance room on the first floor of the outpatient clinic to take a brain MRI photo.

While waiting for the results of the examination, Xu Yi carefully and systematically learned more from the patient's son this time, such as what major problems the patient had had in the past, and whether he had any allergies...... While consulting, while recording some important information in the notebook, but also to comfort the family, saying that they sent it in a timely manner, from the onset of symptoms to now is less than four hours, generally within three to six hours can be thrombolysis, if the infarction is not large, the general treatment effect is good, in a large range of dù can control the condition, reduce the sequelae of infarction......

When the result came out, it was a lacunar cerebral infarction in the sac area of the left thalamus.

But after all, it is a night emergency, although the diagnosis is clear, but the result is that you can't get it until you go to work during the day, explain to the patient that this is for the accurate diagnosis, and the morning meeting of the radiology department will focus on the discussion of the positive films of the night emergency department, and there will be a formal report after the discussion, so that he will come over to get the report at that time, and then push the patient back to the department with the man.

The blood clotting results have also come out, and there is nothing abnormal in it, so I will first arrange it to the observation room and wait for the admission procedures to be completed before arranging the bed, and this location is convenient for night rounds. After thinking about it again, I gave a temporary medical order, and explained to Sister Wang and her family on duty, if there was anything abnormal, I hurriedly called someone, raised my hand to look at the watch, and found that it was almost three o'clock, and the medical records and the first course of the disease were too late, so I could only wait until tomorrow to write during the day.

Although it was too late, it was past the usual time for night rounds, but Xu Yi still got up and walked out of the office, and then went to the ward to inspect the room before going to the duty room and falling asleep.

In this era, although traditional Chinese medicine has been inherited for thousands of years, clinical treatment, especially this kind of cardiovascular and cerebrovascular accidents and infections, is mostly based on Western medicine treatment, and the description of clinical symptoms is mixed with a large number of Western medicine vocabulary.

However, Xu Yi does not see it that way, after all, there are specializations in the art industry, each has its own strengths, as long as you can see the disease, you can let the patient go home healthily, and it is just a means, and it is a matter of the same end, so why bother with the process? The development of Western medicine is completely different from that of traditional Chinese medicine, Western medicine regards the lesion as a local, and the extreme of Western medicine treatment tends to solve the lesion from the molecular level, and its development trend is the same, similar to genetic diseases, The treatment of tumors is also gradually developing towards the genetic level, and traditional Chinese medicine is to regard the human body as a whole, emphasizing the unity of nature and man, the balance of the five elements, and emphasizing the harmony and unity of the organs of the body, but in any case, the ultimate goal of the two is to treat diseases, or to prevent diseases, and there is no conflict.

However, when Xu Yi had just finished the examination, he only heard the sound of his fingers snapping the glass from the glass observation window on the opposite wall, and when he looked up, he saw that the nurse on duty last night stretched out his hand and pointed to the phone taken off the table, made a gesture of calling, and said: "Xu Yi, come over quickly, you have called from home." ”

"Here, thank you, Sister Wang" Xu Yi agreed, turned around and said to Xie Chunlin, "I'll answer the phone and come back later." With that, he turned and walked out of the observation room to the nurse's station.

"Xu Yi, I'm the village head, you hurry home and come here, the three fat people were bitten by a snake on the mountain, the snake medicine here at the health station has run out, I called over, the township health station is gone, can you come back and send some?"

"I'll go back, what snake bit me?"

"Fly on the grass. ”

"Where did the bite go?"

"Bite on the top of the neck of the foot. ”

"Did you do what I taught you before?"

"Well, it's tied up, and the blood is squeezed out, so it's just snake medicine. This bear child, in the early morning had nothing to do to run up the mountain, was bitten and didn't know how to call someone, ran home by himself, delayed for almost half an hour before being found by Guihe, we took half a lotus to him to put on it, but this bear child can't drink, this is only half a bowl of rice wine drunk, this is all in bed to play the handle. ”

"Then I know, wait until I bring the medicine back, you watch him, don't let him move anymore, so that the blood circulation is too fast and the toxin spreads. ”

"Sister Wang, you help me get a bottle of snake medicine from the medicine cabinet first, and then return it when I come back to the pharmacy to open a bottle. The director hasn't come here today, when he comes, you can help me ask for leave with him, there is a child in my village who has been bitten by a snake, and I have to catch the first train back. And I did my rounds last night, and the patients are quite normal, that is, the trouble that just came next door, I want to be discharged, I just saw it, there should be no sequelae, you wait to help me persuade him, and let him do the work when the director comes, and if the medical record comes, I will come back and write it, and let the director see if there is any omission, so please trouble Sister Wang to help me talk to the doctor and the director who came to take over, you know, I don't have time to write this shift record. ”

"Okay, then you be careful on the road, you also know that we have two doctors here recently went to the provincial hospital for further study, and one is on maternity leave, you go again, the manpower really can't be arranged at once, if you can't come back tomorrow, call over in the afternoon, so it's good to make temporary arrangements." ”

"Well, then thank you, Sister Wang, I'm going to the long-distance station. Taking the snake medicine handed over by Sister Wang, Xu Yi nodded, took off his work clothes as he walked, rushed to the doctor's office next door, changed into his coat, and walked towards the stairs.

Looking up at the slightly emaciated figure disappearing at the entrance of the building like a whirlwind, Sister Wang laughed softly: "This kid ......"