Chapter 193: The Patient Who Vomited Blood. Back in the emergency department, I was timid
Most of the modern women are highly educated, and their knowledge and ability are not inferior to those of men. They are more than capable of earning money to support themselves.
This has greatly improved their social status and family status, and they are more independent.
There is no need to be a vassal of men anymore, as in the old society.
"It's not good for you to think like this, men should get married, women should get married, this is a good lesson left by the ancestors. Not all men in the world are unreliable, and the vast majority of men are responsible and good men. If you meet the right one, don't miss the good fate. Find a husband who loves you, start a family, and you will feel happiness like never before. ”
Director Jia used the experience of the past to tell her how to live correctly.
Only when a woman marries a man can she enjoy the beautiful feeling of being protected and pampered by a man, can she get pregnant and give birth to a child, and enjoy the joy of a family.
After listening to Director Jia's advice, Qiu Hong turned her head to look at Zhou Can.
"Senior Brother Zhou, do you have a girlfriend?"
She suddenly asked, which scared Zhou Can enough.
"Yes, I have! Senior Sister Qiu is so good and beautiful, I am absolutely unworthy of you. ”
Zhou Can was very worried about this beautiful senior sister, and suddenly fell in love with him on a whim.
"Hey, what do you think? Look at your bear-like appearance, am I so terrible and hateful? Just wanted to ask, are you good for your girlfriend? After hearing Zhou Can's answer, she couldn't help but feel a little embarrassed.
After understanding that Zhou Can would be wrong, he hurriedly explained clearly.
"Oh, I see! I can't say anything special to my girlfriend, I can only say it's okay! ”
Zhou Can's answer was quite modest.
"Does your girlfriend feel happy with you?" She asked again.
"You have to ask my girlfriend to get a more accurate answer. Judging from her reaction, it should be considered relatively happy! They often come to see me, give me gifts, read books with me, or something. Her smile will be very bright when we are together. I could feel that she was happy inside. ”
Zhou Can thought about it, and then replied seriously.
"Senior Sister Qiu asked me this, don't you have a female friend who has a good time around you?"
"My circle is relatively simple, just two female friends of the same age. One of them has been divorced twice, and one of them would often complain to me that after getting married, her husband didn't do housework, was not self-motivated, and even occasionally quarreled, and once broke her phone. So, I'm quite afraid of being in love and getting married. ”
No wonder she is so beautiful, has a stable job, and is nearly thirty years old and has no partner.
"Qiuhong, I tell you from the experience of those who have come before that the female friend who told you all kinds of bad things about her husband is actually just confiding in you the grievances and bad side she suffered when she got along with her husband. The next time we chat, you can ask her to leave her husband, do you think she will say yes? Marriage and love are neither as beautiful nor as unbearable as you young people think. ”
Director Jia smiled and shook his head.
She happens to receive messages that are not good for love and marriage, so she has a phobia of marriage and love.
"You have a point, I'll ask her another day."
Qiu Hong nodded thoughtfully.
Then he looked at Zhou Can again.
"Do you think you're happy in a relationship?"
"Of course I'm happy! When you are with your beloved, you will feel especially sweet, peaceful and happy. Love is one of the most beautiful things in the world, so be bold and try it! ”
Zhou Can persuaded this highly educated senior sister.
The three of them chatted for a few words, and another patient came in.
An elderly couple came in with an emaciated middle-aged man.
The middle-aged man staggered when he walked, his eyes were foggy, his eyes were red around his eyes and his face, and there was still a trace of blood at the corners of his mouth.
Most of the patients who came to Director Jia for treatment were incurable diseases.
There are very few people with this type of acute illness.
"Gross!"
As soon as the middle-aged man opened his mouth, blood spat out of his mouth.
It's a terrible situation.
The outpatient clinic can receive a variety of patients, and Director Jia and Qiu Hong are very calm. Only Zhou Can, a novice, felt a little frightened.
Hematemesis indicates that it is most likely upper GI bleeding.
Before the man came in, he must have started vomiting blood. No wonder there was a trace of blood on his mouth.
A strong smell of wine hits the nose.
It seems that the middle-aged man was vomiting blood from drinking.
It's likely that the stomach is bleeding.
Drinking alcohol on an empty stomach, or drinking large amounts of strong alcohol, is prone to stomach bleeding.
In addition, drinking alcohol hurts the liver.
In the process of alcohol metabolism, a large amount of reduced coenzyme I can be produced, which can change the redox state in liver cells, inhibit protein, glucose synthesis and gluconeogenesis, and can also lead to the accumulation of triglyceride in the liver, thereby increasing the incidence of fatty liver.
In addition, a large amount of acetaldehyde can be produced in the process of alcohol metabolism, which can be combined with a variety of proteins to form acetaldehyde-protein adducts, which not only has a direct damage effect on hepatocytes, but also can lead to hepatocytes being attacked by immune responses, affecting hepatocyte function, and then leading to hepatocyte steatosis.
In addition to causing serious damage to the liver, drinking alcohol can also damage the brain.
People who are often drunk are prone to various pathologies in their brains.
"Director Jia, please save my son! Today, as usual, he drank alone, and as he drank, he began to vomit blood. We're just a seedling, you have to find a way to save him. ”
The old couple was very tight about this son's baby.
It is roughly estimated that their son is at least thirty-seven or eighteen years old, but they still spoil him like a child of two or three years old.
Habitual son is like a killer.
Their son turned into a drunkard, which had a lot to do with their connivance.
"Have you done a check-up?"
Director Jia saw that the patient was vomiting blood, and he didn't dare to be careless.
The main fear is that something will happen.
"I haven't done it. We were going to go to the emergency department, but we heard that your medical skills are very good, so we bought a number from a scalper, thinking that we would be more sure if we asked you for treatment. ”
Looking at the clothes of this old couple, they must be from the city.
In order to save their son, they were willing to spend money.
even asked scalpers to buy Director Jia's same-day diagnosis number, just to have a doctor with better medical skills to treat their son.
Of course, it is also possible that scalpers deliberately fool the old couple in order to sell the diagnosis number in their hands.
"Oops, this is vomiting blood! The condition is so serious, you have to find a doctor for treatment immediately! Ordinary doctors may not be able to see it well, if you look for Director Jia of the Department of Digestive Surgery, you will definitely be able to save your son......"
The dealer has the most powerful ability to observe words and looks.
The mouth is also very good at speaking.
even bluffed and frightened, and then praised Director Jia, the old couple who were eager to save their son obediently paid for the scalper number of the dealer.
Scalpers hoarding expert diagnosis numbers sometimes pose a certain risk.
If you don't sell it, won't you be rotten in your hands?
A special needs expert is hundreds of years old.
So in the outpatient hall of the hospital and the front door of the hospital, you can always see some traffickers wandering around, looking for targets.
These people are very smart.
Knowing that the hospital cracked down on scalpers, they solicited customers at the entrance of the hospital under the banner of 'accommodation and meals'. These people have a special way of survival.
In addition to secretly giving some benefits to hospital security guards and building good relationships, they will also be engaged in providing temporary accommodation, meals, and car rental transportation for patients and their families.
It is generally difficult to get an expert number from a large hospital.
In particular, for patients who come from other places to seek treatment, waiting for one more day will increase the cost of various expenses. The disease itself cannot be delayed.
Obediently looking for a dealer to buy a scalper has become the only choice.
Zhou Can once saw the dealer peddling a plus note with the expert's autograph. With that plus note, the patient's family successfully hung up the expert number of the day.
It can only be said that these people have great magical powers.
The involvement of the experts themselves is not excluded.
Director Jia briefly inquired about the patient's condition, and then did a physical examination.
"He should have upper gastrointestinal bleeding, and I first prescribed him five examination applications, blood routine, stool test, liver function, coagulation function and gastroscopy. Hurry up and take him to do it, this disease can't be delayed. ”
In the patient's condition, hospitalization for surgery is extremely high.
These necessary routine tests are also done in preparation for hospitalization.
The old couple took their precious son for a check-up.
"This patient, I don't think his illness is difficult to treat, but the difficult thing is to get him to quit drinking. He was cured this time, and he will drink it again next time. ”
"He can only blame his parents, who spoil their children too much."
Qiu Hong answered.
"Not really! Habitual children are like killing children, and being parents is equivalent to harming children if they rely on their children for everything. ”
Director Jia is famous, and the patient who vomited blood has just left, and a new patient has come in. Zhou Can followed the expert for the first time to experience the consultation, and he felt what it means to be busy.
Every patient comes with different demands, and the causes are complex or clear.
Director Jia treats every patient very seriously.
Following Director Jia's consultation, you can not only learn a lot of useful practical knowledge, broaden your horizons, and increase your knowledge, but also be influenced by him, and you will be more serious and responsible in treating the diagnosis and treatment work.
Shortly before noon, the patient who had been drinking alcohol and had vomited blood had returned from a check-up.
The results of the examination were esophageal and gastric varices and ruptured bleeding.
Director Jia took the gastroscopy results and looked at them.
"Ouch, your veins have burst! Fortunately, the tear is not particularly large, so you can try a more conservative treatment first. First, let him fast for a while. Second, the portal pressure is reduced and appropriate nutritional support is given to improve liver function. Third, drugs are used to increase blood clotting. For example, thrombin or vasopressin is used. ”
The patient's symptoms seemed to be severe, but after the examination, the results were better than expected.
"Doctor, we all listen to you, please hurry up and treat my son!"
The patient's father urged.
Director Jia looked embarrassed.
"He must be hospitalized for this disease to be considered safe, we don't have a bed here! He can't wait, so why don't you take the diagnosis and go to another hospital where there is no shortage of beds, okay? ”
This patient should actually see a gastroenterologist for a better time.
The beds on the surgical side are too tight.
Many surgical patients are waiting for the beds to come out, and it is difficult for him, a non-surgical patient, to arrange a bed.
This is basically the case in well-known hospitals.
The beds are seriously tight, and some minor illnesses that don't matter can only be pushed to the outer hospital.
"Director Jia, please help me think of a way! My son has been vomiting blood until now, and I have to register and wait when I take him to another hospital, we are afraid that something will happen! ”
The patient's mother was about to kneel down directly.
Zhou Can's eyes were quick, and he hurriedly helped her.
"I'll help you ask first! If it really doesn't work, the beds in the Provincial People's Hospital are not so tight, and the level of medical skills there is also very good, you can go there for hospitalization. ”
After Director Jia finished speaking, he asked Qiuhong to call and ask the inpatient department.
Qiu Hong called, "Hello, let me ask, can the inpatient department arrange a bed now?" There was a patient who was vomiting blood and needed to be hospitalized. ”
The answer over there should be that there are no beds.
Qiu Hong continued: "Can you help me think of a way?" The patient's condition is quite urgent. ”
Soon, she ended the call with some disappointment.
"There are no beds in the inpatient unit right now, and if there is a real urgency, they advise patients to wait and see if there are any beds available tomorrow. Call again when the time comes. ”
This is also the most common practice.
There are so many beds in the digestive surgery department that they are already full of patients, and only when the patients are discharged will there be beds vacated.
Hospitals generally ask these patients who need to be hospitalized to leave their phone numbers and wait in line for a bed.
The discharge process is often in the morning.
That's why patients are asked to wait until tomorrow to see again.
"He's been vomiting blood, and it's too risky to wait until tomorrow morning." Director Jia looked embarrassed.
In many cases, it is not how to treat the disease, but the lack of beds.
"Director Jia, can you let him go directly to the emergency department for treatment? He can stay overnight in the observation area of the emergency department. "Zhou Can has been trained in the emergency department for three months, and he knows the situation over there better.
In fact, this patient should not have a special needs expert number. It is just an ordinary disease in itself, and even an ordinary gastroenterologist or surgeon can take care of it.
In addition, for an emergency like his, he can often receive treatment in the shortest possible time by going through the emergency channel.
If you go to the outpatient clinic, just queuing for a check-up is already enough to choke.
The patient was able to complete the examination so quickly, and it is estimated that his parents did not cut the queue with him.
After all, vomiting blood, it's really scary to watch, and it's a good excuse to cut in line.
"Yes, yes, it's a good idea to go to the emergency room."
After listening to it, Director Jia felt that Zhou Can's suggestion was quite good.
"Zhou Can, you're familiar with the emergency department, right?"
Director Jia knew that Zhou Can was from the emergency department.
"I should be able to take them over and get this done!"
Zhou Can didn't dare to talk too much.
It's been more than a year since he came out of the emergency room, and he is so busy that he hardly goes back to the emergency department.
There is only a New Year's holiday, call or send a message to Dr. Xu, Director Lou, Qiao Yu and others to say greetings and blessings.
Director Lou, Chief Physician Han Changqing, Dr. Xu and others will definitely buy his account.
Ordinary doctors and nurses are not so easy to say.
Because they had been away for too long, and they didn't know Zhou Can's dazzling achievements in other departments. It is inevitable that there will be a phenomenon of people taking tea and cooling.
When the patient's family heard that Zhou Can could help their son get hospitalized, it was like grasping a life-saving straw and thanking Zhou Can for their kindness.
Zhou Can led him to the emergency department.
When he arrived at the waiting corridor outside the emergency department, Zhou Can felt a little 'homesick'.
Once upon a time, it was all familiar people and things here.
More than a year ago, with the ardent expectations of Director Lou, Vice Chairman Han, Dr. Xu and others, he embarked on a journey to study in surgical training.
Originally, he was preparing to return from his studies after two years and nine months and make a big career in the emergency department.
Now he has only completed a small part of the regular training, and he has not even completed the surgical training, in fact, he is unwilling to go back to the emergency department at this time.
Even if it's just a trip and leave soon, he doesn't want to.
Deep in his bones, Zhou Can is a person with very strong self-esteem.
At the beginning, he promised Director Lou, Dr. Xu and others, and he hoped to come back after completing his studies.
"Wow, Dr. Zhou, it's really you! I haven't seen you in over a year! I don't usually come back to sit. ”
Ye Tingting is simply everywhere.
Her eyes were also pointed, and she found Zhou Can at a glance.
"Hello Sister Ting! I'm not busy, I don't have time to come back and sit! I haven't seen you for more than a year, and you're still so beautiful, haven't changed at all. ”
Zhou Can responded with a smile.
When she was in the emergency department, Ye Tingting had a good relationship with him.
"You take them with you?"
Ye Tingting's eyes looked at the patients and family members behind Zhou Can.
"There are no beds in the digestive surgery department, so I brought the patient over to see if I could treat him first in the emergency department." Zhou Can explained with a smile.
"Are you a relative or an acquaintance?"
Ye Tingting felt that if she could let Zhou Can personally bring her over for treatment, it would definitely be a treatment that only relatives or acquaintances have.
"Neither, just an ordinary patient in digestive surgery. He had no way to wait for the disease because of the esophageal and gastric varices and their rupture and bleeding caused by the wine. I volunteered to bring them here. ”
"Understood. Give me the information, and I'll go to Dr. Elle to talk to you. ”
Ye Tingting is quite enthusiastic.
She is only a nurse in the observation area and does not have the authority to decide whether or not to keep a patient under observation. You'll have to find a doctor for this.
At this time, Dr. Lin in the operating room should have just returned from the cafeteria after lunch.
Seeing Zhou Can, he hurriedly walked over and took the initiative to say hello.
"Zhou Can, Doctor Zhou! But I haven't seen you for a few days, how about it, the rotation of other departments for regular training, it's still going well, right? Dr. Lin warmly inquired about Zhou Can's current situation.
"Thank you for your concern, my training went well. As for you, after more than a year of development, it must be good! ”
Zhou Can remembers that when he left, the operating room of the emergency department activated the competition mechanism.
Dr. Lin, who has mediocre talent, and Dr. Lu, who is messing around, are at risk of elimination.
"Alas, don't mention it. It's not like you don't know my talent, I haven't slept before 1 a.m. in the past year. I am desperately practicing the basic skills of surgery every day, and I can be regarded as staying for the time being. ”
Dr. Lin was full of bitterness when he talked about it.
"Hehe, stay and have a chance. I'm sure you're going to get better and better. ”
Zhou Can was genuinely happy for him.
Although Dr. Lin has such and such defects, no one is perfect, and everyone has been together for so long, and there must be feelings.
"Dr. Xu should miss you a lot, whenever we didn't make obvious progress in the operation, or made mistakes, he would often say how good Zhou Can was in front of us. I went to talk to Dr. Xu, and it was time for him to go to dinner. ”
After Dr. Lin finished speaking, he didn't wait for Zhou Can to agree, and walked quickly to the operating room.
Thank you book friend Echo for your support!
(End of chapter)