“…… Typical intracranial hypertension table xiàn! ”

After roughly cleaning up the filth on his body, John didn't have a disgusting expression on his face, but said in a deep voice with a frown.

Projectile vomiting is typical of intracranial hypertension, and he knows it all too well.

High fever, high blood pressure, chills, chills, and symptoms of respiratory infections, including petechiae on the patient's body, are typical symptoms of purulent meningitis. So after reading the medical records, John now has 80 percent approval of Professor Wolfgang's diagnosis.

But......

"I need to do another check-up!"

Taking a deep breath, John said earnestly to Professor Wolfgang, "Also, could you please send someone to inform Dr. Paul from the surgeon and ask him to come over with the instruments for neuraxial puncture...... By the way, it would be nice to get me another white coat. ”

"No problem."

Nodding, Professor Wolfgang immediately turned his head to look at Dr. Berg beside him. Berg was stunned for a moment, then nodded with a wry smile and walked away as John had instructed.

"What tests are you going to do other than neuraxial puncture?"

Walking over to the side of the bed, Professor Wolfgang asked, frowning.

"Validation of meningeal irritation."

After saying something casually, John smiled at Aina and said softly: "Aina, I need to do some simple physical examinations for you next, you just need to lie here and cooperate with me, okay?" ”

"Okay, okay."

Biting her lip, the little girl Aina nodded with a flushed face, and responded in a voice like a mosquito.

Maybe it's because of his own high fever, or maybe it's because he just vomited on this doctor. The patient Aina was a little embarrassed, and she had no intention of refusing John's request, even if the other party asked her to lift the quilt and lose the warm protection.

"Meningeal irritation?"

On the other side of the hospital bed, Professor Wolfgang's mind was filled with doubts.

After a brief conversation with the patient's mother, John quickly began his own examination. And except for the girl's mother. Professor Wolfgang didn't blink his eyes, and watched John's movements carefully.

"First of all, I need to check your neck......"

As Wolfgang watched, John removed the girl's pillow and told her to lie down, while he put his right hand under her neck and lifted it up.

"Ahh

It didn't rise much high, and the girl snorted softly in pain!

But as soon as she exhaled in pain, Aina immediately covered her mouth with her hands, and at the same time, her panicked eyes involuntarily looked at the young doctor who was examining her. Subconsciously. The little girl felt a little ashamed that she couldn't help the pain just now.

After hearing the patient's cry of pain, John's brow suddenly furrowed.

After a deep sigh, he then smiled softly: "Aina, next I will lift one of your calves up, if it hurts, I will call it out, don't bear it, because I need to judge the situation according to your reaction, understand?" ”

"Understood. Mr. ”

Aina bit her lip hard, and two bloody streaks appeared on her pale lips.

"Ahh

This time John had just lifted less than 100 degrees. The little girl screamed in pain.

"Sir, this ......"

Hearing her daughter's screams, the girl's mother immediately became nervous. This time, because of John's special explanation, the little girl didn't deliberately endure it, so her voice sounded quite painful.

John smiled slightly, waved his hand, and said, "Madam." Don't worry, I'm just trying to confirm some symptoms! ”

"Mom, I'm fine."

At this time, Aina herself let out a low cry.

After the girl's mother's love had calmed down, John turned his head to look at the little patient on the bed. Smiled and encouraged, "You're really great, Aina!" Then straighten your legs and let them relax, and then I'll repeat the first one again......"

As he spoke, John placed his left hand on the girl's body, and then put his right hand under the girl's neck and lifted it up......

"Huh?!"

After seeing the scene in front of him, Professor Wolfgang's expression was stunned for a moment, and his eyes instantly widened......

……

“…… Explain it carefully to the child and her mother. ”

Facing Paul, who hurried to the internal medicine ward, John said: "I must let them understand what is the use of this kind of operation, and dispel their concerns, understand?" ”

"Understood!"

Nodding immediately, Paul's face was calm.

Since following John, Paul has now completely given up on becoming a surgeon in the future, and is ready to become the world's first full-time anesthesiologist, as John asks. After months of practice and practice, neuraxial puncture is no longer difficult for him, and he has a lot of experience in dealing with frightened patients. Without the patient explanations of doctors and practical examples, it would have been impossible to insert a long, thin needle into people's lumbar spine and extract cerebrospinal fluid or inject drugs from it.

After Paul went to work, Professor Wolfgang saw the opportunity to come over, and asked in a deep voice with a frown: "Mr. Huntelaar, can you explain to me the so-called meningeal irritation now?" Also, you obviously lifted the patient's head just now, but why did her legs suddenly bend? I can see it clearly, she definitely didn't bend it on purpose, but because you lifted her neck! ”

"This ......"

Looking at Professor Wolfgang's inquisitive eyes, John suddenly had a headache.

Meningeal irritation is not a symptom, but a collective term for several symptoms. For example, neck stiffness, patients with meningitis have stiff neck muscles and feel pain when they lift their heads; Another example is the Keernig sign, in which the patient's knee joint cannot be straightened, and the pain will be obvious when it is raised; There is also the Brudzinski sign, which occurs with hip-knee flexion if the neck is bent forward when lying on the back......

As soon as he said it, John threw the concept out.

But if you think about it now, internal medicine doctors of this era of neck rigidity have already discovered it, and Mr. Kernig also proposed the concept of Kernig's sign five years ago, but Brudzinski's sign ......

How to explain it?

And John knows very well that if he just describes the symptoms, it would be fine, but it would be a big problem to explain them. To explain it in principle, you need to use the theory of reflection, and Sherrington has only just received his Ph.D., and Pavlov is still studying at the University of Leipzig in Germany......

"What a headache!"

While secretly complaining in his heart, John said with a smile on his face: "Professor, I can write something for you to see when I look at these things, but for now, let's focus on this little patient first, if I don't think of an accident, we can give her sulfonamide drugs today......" (to be continued......