After breakfast, Zhang Yi sent Yu Ruyi to the door of the hospital as usual.

Yu Ruyi went directly to the pediatric ward of the inpatient department.

As soon as she walked to the staircase, Yu Ruyi heard the cries of children one after another.

The milky smell peculiar to infant patients, the sweet aroma of breakfast, and the special smell of 84 disinfectant also came to the face.

The "big crying" at the time of waking up every morning is a characteristic of the pediatric ward.

Yu Ruyi listened attentively, and these cries were either loud or sharp, converging together noisy and loud.

Yu Ruyi bent the corners of her mouth happily.

After coming to the pediatric department for a long time, Yu Ruyi has not only adapted to such an environment, but also practiced the ability to roughly judge the physical condition of children just by listening to the cry of children.

As long as there is no hoarse, dull, weak, intermittent crying, and no children who don't eat, move, or cry, Yu Ruyi won't be too worried.

There was no one in the office.

Thinking that Dr. Wang Qiong, who was on duty last night, might be inspecting the ward, Yu Ruyi quickly put on a white coat, picked up the stethoscope and walked to the ward.

"Doctor!"

"Doctor!"

As soon as he walked out of the office and heard someone screaming in horror in the hallway, Yu Ruyi ran over quickly.

A family member of a patient looked at her with a child whose eyes were rolled up and his mouth was foaming at the mouth.

"Don't hold him!" Yu Ruyi immediately took the child, put it on the bed, quickly pulled off the scarf on the child's neck, wiped off the white foam in the child's mouth, and then took the spoon from the bedside table, wrapped the spoon handle in a towel and placed it between the child's upper and lower molars......

The nurse on duty also ran after her.

"Valium ten milligrams, intramuscularly!" Yu Ruyi ordered calmly and calmly.

The nurse quickly inhales the medicine and injects it.

After the drug slowly enters the body. Gradually, the child stopped convulsing and fell asleep.

Parents cried and picked up their children, and were afraid: "It's scary! I've been pumping a few times in a row. ”

"Put the baby on the bed and I'll check it again." Wang Qiong, who was on duty, also ran over at this time and said to her family cautiously.

The family carefully placed the child on the bed.

Wang Qiong said to Yu Ruyi while gently laying the child down: "This is admitted to the hospital in the early hours of this morning, and I have had a convulsion when I came, and I plan to do a comprehensive examination during the day today, but I didn't expect it to be convulsed again now." ”

After shining a flashlight on the child's pupils, Dr. Wang Qiong's expression suddenly became grim: "The pupils on both sides are not equal!" ”

'Intracranial lesions?' Yu Ruyi's heart tightened.

Wang Qiong nodded and instructed the nurse: "Another five milligrams of dexamethasone." Intravenous bolus! ”

"I'm going to prepare 250 ml of mannitol!" Before Yu Ruyi's words fell, he had already started to act.

Wang Qiong reminded: "Fast dripping!" ”

Assist the nurse in applying the medicine to the child. Yu Ruyi hurriedly went to the office to make up the prescription.

Wang Qiong instructed: "Open the inspection application form together." ”

"Hmm." Yu Ruyi confirmed, "The three major routine and blood biochemical tests: blood glucose, blood magnesium, blood calcium, blood sodium, and cranial CT? ”

Wang Qiong nodded: "Yes!" ”

"What are you busy with? Got a patient again? The department director, Mama Zhou, and Dr. Huang Cheng walked into the office one after another.

Wang Qiong said: "A patient with convulsions was admitted and suspected to be an intracranial lesion. ”

Zhou's mother reminded: "That has to be carefully examined, it is really troublesome for intracranial lesions!" ”

"I also have a very troublesome patient." Huang Cheng took out his work clothes from behind the office door and put them on. "It's only been a few days since I was born. Consider intestinal paralysis. It's not very much like that. ”

"We have to find a way to get a clear diagnosis." Zhou's mother sat at her desk: "I'll take a look after the shift." ”

Huang Cheng, the patient, looked depressed and seemed to have no strength to cry.

Zhou's mother touched the child's forehead: "Body temperature? ”

Yu Ruyi looked at the medical record card: "Thirty-seven degrees nine in the morning today." ”

Zhou's mother unbuttoned the child's clothes, and the child's abdomen was distended like a bulge.

Zhou's mother asked while tapping, "What tests have you done?" ”

Huang Cheng said: "Everything that should be checked has been checked." All the indicators of growth and development were normal, and B-ultrasound did not find abnormal fast, but X-ray showed intestinal inflation and dilation. ”

Zhou's mother listened with a stethoscope: "There are no obvious lesions in the heart and lungs - what treatment has been done?" ”

"Gastrointestinal decompression, symptomatic supportive treatment, antibiotic treatment ......," Dr. Huang Cheng emphasized, "after taking antibiotics, the condition not only did not improve, but tended to worsen." ”

Zhou's mother looked at the patient's family: "Did the child have a bowel movement when he was born?" ”

"Yes." The family said, "It's just that I haven't eaten for the past two days, and I have very little poop/stool." ”

"What was it like at birth?"

"When I was born, the doctor rated me very much, and I was very good at eating, but from the third day of birth, the child was always crying, and he didn't eat much milk, and his belly grew bigger and bigger, so he came to the pediatrics."

Mother Zhou said to Huang Cheng with a stern expression: "Please consult the surgery!" ”

"Is it necessary to rule out intestinal obstruction and intussusception?" Yu Ruyi asked.

Mother Zhou nodded: "Yes." ”

Yu Ruyi quickly wrote the consultation application form and handed it to the nurse on duty.

A few minutes later, Wang Hao was invited.

Wang Hao, who was wearing a white coat, was handsome and chic, walking like a jade tree in the wind, but his well-defined face was as cold as ever, and he looked like a domineering side-leaking Xuanang.

Wang Hao, who arrived at the door of the doctor's office, swept his eyes coldly, and his blazing gaze stayed on Yu Ruyi's face.

"Here." Yu Ruyi immediately got up and led Wang Hao into the ward where the patient was.

Huang Cheng, who was waiting in the ward, introduced the child's condition to Wang Hao again.

Wang Hao carefully examined the child's whole body and asked suspiciously, "Does this child have any poop?" ”

Huang Cheng said with certainty: "Yes! ”

Wang Hao said hesitantly: "There are a little signs of intestinal obstruction, but it is not like an organic lesion." ”

"So be it." Wang Hao said to Huang Cheng, "Build yì use saline enema to stimulate intestinal peristalsis and see if it can be relieved." I'm going to have another surgery. Let's go first and keep in touch! ”

Huang Cheng looked at Yu Ruyi.

"Good!" Yu Ruyi said, "I'll arrange it right away!" ”

Wang Hao glanced at Yu Ruyi and said seemingly unintentionally: "Pay attention and observe." And he left in a hurry.

After giving the doctor's order, Yu Ruyi helped with the enema supplies and followed the nurse to the ward.

The nurse cleaned up the child's feces and gently inserted a thin hose into the child's gang.

Seeing that the nurse was sweating profusely and couldn't insert it, and the poor child's cry was as weak as a kitten's meow, Yu Ruyi was a little anxious. Whispered: "Is it too coarse?" ”

The nurse said aggrievedly: "This is for newborns." The thinnest. ”

Yu Ruyi personally put on the gloves.

Gently probing in along the physiological pipeline, Yu Ruyi keenly felt that there seemed to be no road ahead, and her heart was excited, and she immediately ran to find Huang Cheng.

Huang Cheng listened to Yu Ruyi's report. glanced at Zhou's mother. Call Wang Hao immediately.

Wang Hao ran up in his hand clothes. After a closer look, he said with certainty: "It's the gang door locked!" ”

Yu Ruyi still didn't understand a little: "How can there be stool coming out when the gang door is locked?" ”

The family members of the children also said, "Yes, although it is very few. Every time I change diapers, I see stool. ”

"Herein lies the problem." Wang Hao said with a stern expression, "It is precisely because he has a little stool every day and the appearance of Gangmen is normal, so we ignore this disease." ”

Wang Hao looked at Yu Ruyi: "The gang door atresia we usually talk about mostly refers to complete atresia, and incomplete gang door atresia is rare, so it is the easiest to misdiagnose." ”

Zhou's mother looked at Wang Hao: "The only way to transfer this child to surgery is to do it!" ”

Wang Hao said cautiously: "First ask the family's opinion, if you are willing to operate in our hospital, you can transfer it, if you are not willing, you can transfer to other hospitals, you will notify me when you deal with it, and I will go for surgery first." ”

Zhou's mother looked at Huang Cheng, and Huang Cheng immediately said, "Got it." ”

Huang Cheng turned to the family: "Let's go to my office later, let's discuss the follow-up treatment of the child!" ”

On the way back to the office, Yu Ruyi said to Huang Cheng fearfully: "It's really dangerous, I almost misdiagnosed!" When you do a physical examination in the future, do you have to use instruments to check the gang? ”

"Of course, there is no need to do that kind of special examination in ordinary cases." Huang Cheng warned, "If there is any suspicion in this regard, further tests must be done to confirm the diagnosis!" ”

Yu Ruyi said seriously: "If you encounter this kind of medical record in the future, you will definitely have experience!" ”

Zhou's mother analyzed: "In fact, during the ward round just now, we also considered this problem, but the family insisted that there was stool at birth, so we did not pursue it further, so you should keep in mind that the words of the patient's family can only be used as a reference, not as a basis for diagnosis!" ”

"Yes!"

Zhou's mother further summed up the lessons: "The child's stool is not normal, and it is our mistake to not further clarify the reason. If something happens to the patient, we can't get rid of it. ”

A hint of horror passed in Yu Ruyi's eyes.

Mother Zhou looked at Yu Ruyi: "To learn and master Dr. Huang Cheng's way of dealing with problems, in the face of patients who have doubts or cannot be handled, we must seek help in time, and we must be good at using the power of the collective!" ”

"Well," Yu Ruyi agreed, "There is great power in numbers!" ”

Huang Cheng felt a little guilty: "If Wang Hao had been invited to take a look earlier, the child might have suffered a little less." ”

"Wang Hao is indeed very accomplished in surgery!" Zhou's mother said appreciatively, "He only touched it and found that there was no organic problem in the child's abdominal cavity, which is not ordinarily high." ”

Huang Cheng agreed: "He is good in all aspects!" ”

Seeing that Huang Cheng looked at himself intentionally or unintentionally when he said this, Yu Ruyi had to respond: "Maybe." ”

"Fortunately, the diagnosis was clear." Yu Ruyi said sympathetically, "That kid just can't pull it out after eating, but he is tossed by us like this, if he can speak, he will definitely scold us." ”

Huang Cheng smiled: "If he could speak, it would be impossible for him to have so much trouble!" ”

"So." Mother Zhou glanced at Yu Ruyi with a smile: "As a pediatrician, the responsibility is heavy, if you misdiagnose, even if people don't know, you can't forgive yourself." ”

Yu Ruyi said to Zhou's mother: "I won't go to the outpatient clinic with you today, I want to carefully study all the current inpatient cases!" ”

Mother Zhou smiled and patted Yu Ruyi's back: "Self-motivated, good!" ”

Yu Ruyi did what she said, took out one case after another, re-inquired about the medical history, conducted a detailed physical examination, studied the auxiliary examination report, looked through the textbook, checked the doctor's instructions, and supplemented the medical records...... While doing it, he humbly asked Huang Cheng for advice.

Although no further misdiagnosis was found, Yu Ruyi was very happy to learn from the past and learn more knowledge from it.

Looking at the few remaining medical records, Yu Ruyi stretched her waist in satisfaction.

"Ruyi" A very familiar voice suddenly sounded.

Yu Ruyi looked up and saw that it was Zhao Min, who had not been seen for a long time! (To be continued......)