There is no trivial matter in clinical practice

Having a major heart surgery done, that would be an absolute honor.

It's just that the doctor who heals the sick and saves people is beaten, but it's a shame.

Tension between doctors and patients is a real social problem.

In the process of patient visits, it is not uncommon for doctors and patients to have opposing views.

There can be many reasons for conflicts between doctors and patients, such as patients who are in an extraordinary period, who are more impatient, and who may lack trust in doctors. Doctors can also feel stressed when faced with a large number of patients every day.

If both doctors and patients can empathize, tolerate and understand each other, and can rationally realize that quarrels not only cannot solve the problem, but also intensify the relationship and cause more people to be harmed, if both doctors and patients can abide by the constraints of social morality and be able to empathize when encountering incidents, this contradiction can be avoided.

However, the contradiction encountered by Chen Ling and Yan Xinyue is basically unavoidable. So in addition to thinking that he is unlucky, he can only blame himself for not being good at learning, but when it comes to this, it is even more helpless, patients are people, doctors are also people, doctors are not immortals, and they can not calculate what kind of ability the future will be in advance.

......

No matter how big the impact and shock of this operation is on the doctors and nurses of the provincial affiliated hospitals, and whether people will change their feelings about the five departments of emergency surgery after this operation, for the medical staff of the five departments of emergency surgery, this matter is over!

In the past, there is no need to talk about and dwell on it. So the five departments of emergency surgery have returned to their original state, what should everyone do.

As for Chen Ling, there is no excuse to be lazy anymore, and he honestly commutes from 8 to 6 in the morning.

In his spare time, the work of the emergency department is still not too busy, and when he is busy, Chen Ling and others are still so busy that they have leg cramps.

For example, now, Chen Ling has just come down from an operation, and the nurse immediately comes to inform, "Doctor Chen, a new patient is very urgent, can you come and take a look?"

As an emergency physician, you should be able to recruit and fight, and win when you come. It's just that there are not many doctors in the five departments of emergency surgery, and Chen Ling is just the most outstanding one among the few, so now when the doctors and nurses of the five departments of emergency surgery have something, they almost immediately look for him.

Hearing the nurse's urgency, Chen Ling couldn't care about the fatigue after the operation, so he took his full-time nurse Liu Shiya over without saying a word!

At this time, it was already 5:40 in the evening, and at this time, the doctors and nurses on the day shift had basically gotten off work, but the emergency department, a special department, did not get off work if they wanted to.

Chen Ling rushed to the bedside of the patient and immediately picked up a stethoscope and a blood pressure monitor to check the patient.

Under the pressure of Yan Xinyue, Chen Ling has become accustomed to first using Western medical methods to examine, and finally supplemented by traditional Chinese medicine.

The patient is an elderly male, 88 years old.

At this time, it is a semi-recumbent position, and the blood pressure is 110/70mmHg, which is still a normal value, but it is sighing breathing, and it should not be breathed!

Bilateral pupils are about 3 mm in diameter, light reflex is dull, lips are cyanotic, breath sounds are decreased in both lungs, dry and wet rales can be heard, arrhythmia, soft abdomen, and swelling of both lower limbs.

This is a critical and complicated sick number, Chen Ling didn't dare to claim to be big, and hurriedly asked about his family.

After asking, I found out that the patient had a history of COPD and diabetes in the past, and he usually used insulin to control blood sugar.

When Chen Ling asked about his medical history, the patient's family repeatedly told Chen Ling that once the condition was not good, in order to alleviate the patient's pain, they refused invasive treatment such as tracheal intubation and ventilator-assisted ventilation before death, and at the same time refused blood biochemistry, **** CT and other related examinations and signed.

Although Chen Ling has been a doctor in his past life and this life, it is the first time he has encountered this kind of request, but he saw that the patient's age is indeed too old, and the failure of various systems in the body is extremely serious, so he has to reluctantly respond!

Although the family members had obvious intention of giving up treatment, Chen Ling, as a doctor, had to do his duty, diagnose the patient after a detailed examination, consider the possibility of pulmonary encephalopathy caused by type II respiratory failure, and immediately give intravenous respiratory stimulants. At the same time, the patient's family is also informed that the patient's condition is critically ill and that death may occur at any time, and the family is more understanding of the patient's condition and prognosis.

After giving the doctor's order, Liu Shiya went to carry it out, Chen Ling was about to leave, but he just glanced at the old man lying on the bed again, and felt a little unbearable, because respiratory stimulants may not be able to make him wake up, so he couldn't help but ask his family again, "How is his diet in the past few days?"

This is a dispensable, insignificant, and even superfluous sentence. However, it was this sentence that made the patient's situation turn around.

The family reported that the patient's appetite was extremely poor in the past two days, and said that after insulin was injected subcutaneously at around 10 a.m., he ate a few tablespoons of gruel.

This detail opened Chen Ling's mind, and a noun crossed his mind: "hypoglycemic coma!"

Chen Ling hurriedly stopped Liu Shiya, who was about to carry out the respiratory stimulant doctor's order, and asked her to immediately check the blood sugar at the end of her finger first.

The test of the portable blood glucose machine is very convenient, and in less than two minutes, the result is out, and the blood glucose value at the end of the finger is: 0.6mm0L/L!

This result surprised all the doctors and nurses present, not to mention that this is a diabetic patient, even if it is a normal person, the fasting blood sugar should be at least 6.1mm0L/1 value standard, and fasting diabetic patients should be 7.0mm0L/1.

This is the lowest blood sugar value that the doctors and nurses present have ever seen, and it also confirms Chen Ling's judgment!

Now that the verdict has been confirmed, the treatment is much simpler, with an intravenous bolus of 50 percent glucose of 80 milliliters, and a 10 percent glucose infusion at the same time for maintenance.

After 30 minutes, the patient's consciousness gradually cleared up. Not only did he wake up, but he was also able to say his own name, the names of his relatives present, and what was even more surprising was that the patient was able to write down his blood sugar values word for word.

The effect of the treatment is so miraculous, it is indeed gratifying, perhaps in terms of coma caused by many causes, perhaps the treatment of hypoglycemic coma is the most immediate, just a little common glucose, so that the severe coma wakes up.

As a doctor, Chen Ling felt that while he was accomplished, he was also frightened.

Because when he diagnosed the patient, he first thought of pulmonary encephalopathy caused by respiratory failure, and at the same time considered that the patient had diabetes, so he habitually thought of intravenous infusion of saline and respiratory stimulants. Just imagine, if you don't ask more questions and then check your blood sugar, the blood sugar of only 0.6mm0L/L will disappear quickly, and even if you are actively treated, the efficacy will be greatly reduced, and even lead to the death of the patient, and the consequences will be unimaginable.

After recovering from his woes, the patient was transferred to the Department of Endocrinology, and it is said that the patient was discharged from the hospital within a few days. It's just that this incident left Chen Ling and his team of doctors with a lot of insights, when diagnosing a disease, don't blindly take it for granted, grasp every clue, maybe it will improve the patient's condition at the corner of thinking, and its prognosis will be completely different. Each step of treatment will directly or indirectly affect the patient's condition, and the clinical situation is no trivial matter, and it is constantly improving, worthy of the sacred duty of the doctor, and worthy of every doctor's order and clinical decision.

After dealing with this sick number, Chen Ling saw that there was nothing to do, so he returned to his office, and after a while, Liu Shiya actually walked in with him......