"Simply, I'll treat this discussion as a teaching round. There are so many graduate students and interns, and there are several new faces in the department. I ask questions, and everyone answers. Of course, it must be Director Dong and Dr. Zi."

"Okay, that's good." The studious Ye Xiu was the first to applaud.

"Starting with the disease of this department, this patient, it has been more than three weeks since the onset of the disease, and I just found that the patient's right limb muscle strength is grade 2, muscle tone is low, tendon reflexes are lost, and pyramidal signs are positive."

"Why do a patient with brain damage, a patient with central nervous system damage, have such contradictory signs? Dr. Zi said first." Lin Lin directly named him.

"Uh......" Zi Xuan prepared thousands of times, all around the issue of body temperature, he definitely didn't expect that Lin Lin would start with neurology problems.

"I didn't pay attention to this question, and I don't understand it now." Zixuan already fully understood the characteristics of Lin Lin's ward rounds and the characteristics of doing things, so he didn't dare to answer randomly.

"Director Dong is here." Lin Lin did what she said, that is, she had to start with the doctor in charge.

"This condition, which is more common when the central nervous system is severely damaged, lasts for about a month. The more severe the injury, the longer it lasts. If the damage is in the brain, it is called brain shock, and if the injury is in the spinal cord, it is called spinal shock."

"At this time, in addition to the positive pathological signs, the patient's other signs are very similar to the manifestations of peripheral nerve damage. If you don't understand, you're easily confused."

"Although I understand this situation, to be honest, if it wasn't for Dean Lin's physical examination today, I wouldn't have noticed it, so there is no reflection of this aspect in the medical records. In a moment, please ask Dr. Zi to make up for this."

Zi Xuan listened and glanced at Lin Lin.

"Well, Director Dong said very comprehensively, which shows that Director Dong's neurology skills are very deep. Well, next question." Speaking of this, Lin Lin paused.

In the office, it was extremely quiet, some people were nervous, some people were excited and eager.

"The treatment of this patient is very correct, and if ventricular drainage is not done in time, this patient will not survive acute hydrocephalus. The question is, how long do ventricular drains usually sit in? How long can it be?" With that, Lin Lin looked at Zixuan.

Zi Xuan's face was red and purple, looking very embarrassed. This kind of knowledge seemed very profound to him, and he never looked up the information.

"I...... I...... I'm sorry, Dean Lin, I don't understand."

"The first question, you don't understand, I forgive you, although it involves basic skills, it has little impact on the treatment of patients. If you don't understand this question, I'm going to criticize you."

"As the doctor in charge, for you, you should figure it out, you have to figure it out, you can figure it out. Because it's a matter of life and death for the patient."

"Director Dong will not answer this question for the time being, I hope that other young doctors will take the initiative to answer this question."

"I'll answer." Liu Yulan spoke.

"Under normal circumstances, the period of detention does not exceed one week to ten days, but it can be extended to two weeks in special circumstances. If it grows longer, it will not work, and it will easily lead to secondary infection in the ventricles."

"Good, very good. Director Ding, how long has it been since you studied business in the department?"

"It's been a long time, since you and I left the company, and we haven't recovered yet." Ding Fengke didn't care what Zi Xuan felt, she had always felt indignant about what happened to Lin Lin, and naturally she didn't have a good impression of Zi Xuan.

"Next month, next month will start to recover, or the same as before, there will be exams, and the results will be related to promotion and use."

"For this patient, the drain has been in place for far more than two weeks. I tried it just now, and the intracranial pressure is not high, Director Dong, don't suffer from gains and losses, pull it out."

"Well, I'm really suffering from gains and losses. I'll unplug it when we're done discussing it." Dong Huayu said.

"Now, we have to get to the core issue of the day. Why does the patient's fever not go away? Dean Ye put forward her views just now, and this kind of thinking is worth learning from. I still

Let's do it in the form of questions, so that everyone's attention is more focused."

"Hehe, Dean Lin, we've all been nervous by you." Ling Xiaoyun said with a smile.

"Yes, okay, it's better to be nervous, when you study, you have to be nervous, and when you play, you can relax."

"When Dr. Zi was reporting his medical history, I looked through your examination application form, and one of them was a request for blood drawing and culture, which was issued last Thursday. I would like to ask, how long does it take to see the growth of bacteria after a blood culture?"

Lin Lin's question is extremely tricky.

Silence, a silent silence.

"I'll answer." Ye Xiu is really extraordinary, no wonder Lu Han is so optimistic about her.

"Generally speaking, the blood culture of bacteria can see if there is any growth of pathogenic bacteria in a week, of course, the laboratory will not report immediately after a week, they will continue to observe for a week."

「erfecton!」 Lin Lin suddenly burst into English.

"Did Dean Ye do it?"

"Yes, I did it when I was in graduate school. If you do a susceptibility test, you have to wait two weeks."

"Okay, great, you've got the second question I wanted to ask. People think it's a good discussion."

"Okay." In the silent office, a neat voice suddenly erupted.

"What is the current daily intake of this patient? Remember, include the amount of fluid and the amount of food taken orally."

"The statistics of the patient's family are not very accurate, and it is estimated that it is around 2,000 ml." Zi Xuan rushed to answer this time.

"For a patient with a fever, is 2,000 ml enough?"

"Not enough." Zi Xuan knew that this was another big problem.

"I'll ask again what is the daily output of this patient."

"The urine output is more than 2,700 milliliters." Yu Ling was very clear about this and immediately replied.

"You see, the doctor's orders you prescribe are not as clear as the chief nurse knows. I have emphasized many times before that any doctor's prescription must have his purpose. If you drive out, you have to follow it to the end. Obviously, you didn't do that."

"Comparing this amount of sputum, you should know why the patient's sputum is so viscous, right?"

"This could also explain part of why the patient's white blood cells, red blood cells, and hemoglobin are elevated."

"Just now, Dean Ye asked if it was a central fever. This can be considered, but, in general, central fever, which usually occurs at the peak of the disease, and the temperature will be relatively high, and at the same time, most patients are accompanied by delirium and impaired consciousness. This patient is not qualified."