Xu Zhuo followed Dr. Zhang to the outpatient clinic. This time, it was different from when Lu Yongju was there before. It's still the same consultation room, but Xu Zhuo has a place on the side. When Dr. Zhang saw a doctor, he sat next to him to help, helping and learning at the same time. The work of writing medical records was also handed over to Xu Zhuo by Dr. Zhang. Dr. Zhang dictated and Xu Zhuo was responsible for the record.

By writing medical records, Xu Zhuo can better understand the patient's situation and remember it more clearly.

However, in terms of writing, he is still a little "lacking in skills". At the beginning, his writing was neat, because in the medical records he usually saw, the doctors were all "cursive", "wild grass", which can be called "cursive writing", not to mention patients and their families, even if they were replaced by another doctor, they couldn't understand what was written. This made Xu Zhuo, a fledgling intern, quite unhappy, and decided to start from himself, and in the future, everything he had done in his medical records must be written neatly, stroke by stroke, and never fooled.

At the beginning, Dr. Zhang saw that he was writing so seriously, and he didn't say anything, just chuckled, Xu Zhuo was a little inexplicable, but gradually, he knew why!

Because, Nima, he can't write at all! More than 200 patients walked around in one morning, and the number of words in his medical records added up to nearly 10,000 words, and his hands were all sour.

Fortunately, in the near future, Ginkgo Hospital will switch to "electronic medical records", supplemented by handwritten medical records, and if the writing is not clear, it does not matter much. Anyway, that's how everyone used to come.

I was busy until more than 12 o'clock at noon, and the patients who registered in the morning did not finish reading, so Dr. Zhang called Xu Zhuo to eat and continue to see in the afternoon. In the afternoon, there are not many new registered patients. Therefore, this is also the reason why everyone goes to the hospital, especially the popular department, to register early in the morning, or a few days in advance.

Another reason is that if you go early, you can get the results on the same day if you get the test on the same day.

In the afternoon, I mainly followed up with the morning patients, as well as some morning patients' blood tests, electrocardiograms, B-ultrasound, CT and other reports.

The reason why the speed of seeing a doctor will slow down is that from time to time patients come back with reports, and these people no longer have to queue up by number, they can come in and find a doctor directly.

"Xu Zhuo, come and see this child's illness. Dr. Zhang got a test sheet, looked at it a few times, and handed it to Xu Zhuo.

The patient's family hugged the child and glanced at the sign of the intern doctor hanging on Xu Zhuo's chest, and wanted to say something, but still did not say anything. Perhaps, they are commonplace, and they are relatively gentle and honest, and at the same time, they feel that their children's illnesses are not very strict.

Xu Zhuo saw this child in the morning, and also recorded his medical records, knowing that he had a fever for three days, and the child's parents did not send him to the hospital, but only reduced the fever at home by physical cooling, and then the body temperature exceeded 38.5 degrees, so they gave the child a few imported antipyretics.

This is a very normal practice in the average family, and doctors often recommend yì to do so. Because toddlers are different from adults, if the body temperature is not too high, it is better to cool down physically. Even if you come to the hospital, it's built like this. A doctor who casually prescribes medicine and hangs saline is not a good doctor.

But today, the child's body temperature rose to more than 39 degrees, nearly 40 degrees, and the child's parents knew that they were afraid that they would not be able to do it at home, so they sent it to the hospital. Later, Dr. Zhang had the child have a blood test.

Now Xu Zhuo has the child's blood test report.

"The white blood cells are very high, the inflammatory markers are also high, and there are some characteristics of sepsis. Xu Zhuo groaned and muttered. However, he felt that it was not that simple. If it were so simple, Dr. Zhang would not have deliberately let him come to see it, and there was a vague sense of comparison.

Xu Zhuo calmed down, carefully examined the child, and found that his eyes were red, rashes all over his body, bayberry tongue and hard edema of hands and feet, and his heart said, is it not typical scarlet fever?

"Scarlet fever is a contagious disease caused by group A streptococcal infection. Xu Zhuo subconsciously wanted to let some of the family members around him hold their children away, but when he turned his head and caught a glimpse of Dr. Zhang's smiling expression, he suddenly felt blessed to his heart, slapped his forehead, understood, and shouted: "This is Kawasaki disease, Kawasaki disease!"

The heart said, still inexperienced, almost misdiagnosed. No wonder Dr. Zhang wants to test me!

Dr. Zhang nodded and said approvingly, "This is Kawasaki disease." You can see it independently, it is enough to see that your medical skills have touched the threshold, and there is no problem in serving as an ordinary resident doctor. All that's missing is experience. In the future, we can learn more and see more, and combine more with reality, so as to better improve!"

Xu Zhuo nodded: "Thank you, Doctor Zhang." ”

Zhang Kaiyuan waved his hand and said, "I'm the teacher who took you, you're welcome." Then, he came to the clinic again to comfort the child's parents.

The child had a fever, but he was in good spirits, and he was still smiling, but his parents were frightened. I heard Xu Zhuo call "Kawasaki disease" just now, and they didn't know how strong it was, so they were naturally very worried.

Dr. Zhang reassured: "A few years ago, this disease was very difficult to treat because it was not detected. Many children died as a result. However, since I have figured it out, there is no need to worry about this disease! Don't worry, it's fine. However, you still have to stay in the hospital!"

"Stay, stay, let's live!" the child's parents nodded again and again, and they swore that if the child had a fever in the future, he would not be a doctor at home, and he would definitely send the child to the hospital in time. After all, let the doctor take a look at it and feel more at ease.

Kawasakidiseaes, whose scientific name is muco-cuta-meouslymphnode syndrome (MCLS), is an acute febrile exanthematous pediatric disease with systemic vasculitis becoming the main pathology. In 1967, it was first reported by Dr. Tomisaku Kawasaki of Japan that due to the fact that this disease can cause severe cardiovascular disease, which has attracted people's attention, and the incidence has increased in recent years, in 1990, among the inpatient cases of rheumatic diseases in Beijing Children's Hospital, there were 67 cases of Kawasaki disease and 27 cases of rheumatic fever, and in the same data of 11 hospitals in other provinces and cities, Kawasaki disease was twice as high as rheumatism. Obviously, Kawasaki disease has replaced rheumatic fever as one of the main causes of acquired heart disease in children in China. Kawasaki disease is considered to be an immune-mediated vasculitis and is tentatively included in the chapter on connective tissue diseases.

Although the child suffered from Kawasaki disease, it was still in its early stages, and there were relatively few complications, so it was not difficult to treat.