Cheng Dazhuang got up and beckoned Zhou Can and said, "Ah Can, why don't we go over and have a look." ”

"Okay!"

Zhou Can agreed to stand up, and subconsciously checked what kind of book Doctor Luo Jian was reading?

There were 103 cases of abdominal pain in general surgery.

Looking at the yellowed cover of that medical book, it should have been some years. Probably a medical book from forty or fifty years ago.

This kind of medical book of case analysis, doctors like to refer to old books.

Because the conditions were very difficult a few decades ago, most of the doctors studied their medical skills carefully. The work attitude is also meticulous, and the medical records and medical records written are extremely rigorous, and the value of reference and learning is very high.

In modern times, with the rapid development of the economy, the values of many doctors have been objectified.

Plagiarism and plagiarism are the norm in the papers written, and there are even fewer good doctors who are willing to spend time writing medical records for future generations to learn from. Some doctors may have this heart, but their level is limited, and they dare not write for fear of being scolded.

A smile appeared in Zhou Can's eyes, it seemed that this Doctor Luo had encountered an unmanageable illness, so he temporarily crammed and hid in the office to flip through the books, trying to find a treatment experience that could be used for reference.

Every hospital is similar, and when doctors encounter cases that they can't handle, as long as they are not acute and serious patients, they generally turn the book first, and they will only ask senior doctors for advice if they can't figure it out.

This is especially true when it is on duty at night.

If you call the senior doctor when you are on duty, even if you don't scold you to your face, the chief doctor's impression of you will be very bad.

If there are any good things in the future, those with a bad impression will naturally be in the back row.

It's not good, because of the poor impression, some small faults and small mistakes will be magnified in the eyes of the chief physician, and then he will be scolded twice in three days.

Therefore, you must grasp the size of your life.

A little stunned, I ask the senior doctor about everything, whether people go to work or get off work to rest at home, call harassment at night, and circle around the chief physician like a fly during the day. The most terrible thing is that this kind of person is often unaware of it, and thinks that diligent questioning can leave a good impression on the chief physician who loves to learn.

As everyone knows, people have already blocked you in their hearts.

It's just that it's hard to say it clearly because of face.

"Ah Can, hurry up! I'm telling you, this case is quite difficult, and it's a very good learning opportunity. It's a good time for you to come today. ”

Cheng Dazhuang urged in front with a little excitement.

It seems that he is not unmotivated, but that he lacks learning opportunities.

In addition, the working environment is not very good, everyone is lazy, and he will fall with it.

The two of them came to the outside of a hospital room, and before they could enter the door, they heard the painful moans of a patient coming from inside.

In the ward, there are only two beds in the ward of at least 30 square meters, and all kinds of facilities are complete. The inpatient environment of the county people's hospital is quite good, even better than that of Tuya Hospital.

In Tuya Hospital, it is unimaginable that there are only two beds in such a large ward.

The nurse I had seen at the nurses' station before was also in the ward at the moment, nervously looking at the patient who was holding his stomach and crying out in pain.

The patient appeared to be about 40 years old, male, with wrinkles on his forehead.

Because of the pain, he clenched his teeth, his cheeks bulged high, and the expression on his face looked extremely painful.

Zhou Can secretly observed the patient.

This is also the first reaction of doctors after receiving a patient. The visit of traditional Chinese medicine has been well 'borrowed' by Western medicine.

"This patient was admitted at around 5 p.m. today, with unexplained abdominal pain. And it's labor pains. Now that the pain is like this, it is estimated that it has flareed up again. ”

Cheng Dazhuang whispered to the patient next to him.

Luo Jian, the attending physician, is examining the patient at the bedside.

"Do you have pain in this area?"

He pressed on the patient's abdomen and kept asking.

"Yes! Ouch, ouch...... It hurts me to death! ”

The patient was in excruciating pain, his face was pale, and sweat broke out on his forehead.

"Did the stomach ache just start today?"

"Yes, yes, yes! Doctor, hurry up and think of a way for me, the pain is so bad that I can't stand it! ”

The patient hissed and inhaled, hoping that the doctor would be able to rejuvenate him quickly and solve his pain.

That's what almost all patients think.

When they were admitted to the hospital, they thought they could be saved. There is a natural trust in doctors and nurses.

In fact, sometimes doctors and nurses are also panicked.

It's fine to encounter a disease that they can treat, but if you encounter a patient with abdominal pain of unknown etiology, as it is now, the doctors and nurses may be even more panicked than the patient.

"Take his temperature and blood pressure!"

Dr. Luo frowned, pondering the cause of the patient's abdominal pain.

Zhou Can walked to the bedside and picked up the examination done by the patient, as well as the medical record information to view.

I took a B-ultrasound of the abdomen, and even checked a CT, and did a routine blood test, urine routine examination, but because the time for submitting the specimen was too late, the blood routine has not yet produced the examination results.

The results of the urine and urine tests were basically normal, and there was no urine protein, occult blood in the stool, etc.

The main direction of the doctor may be acute appendicitis, acute cholecystitis, acute pancreatitis, acute enteritis, gastric ulcer and other common abdominal pain diseases.

Unfortunately, after the examination, no obvious lesions were found in the patient's abdomen.

"The chief complainant history says that you have had stomach aches for more than ten hours? Did you come to the hospital after a long time of pain at home? ”

Zhou Can was originally not prepared to meddle in things.

Otherwise, people will think that he is deliberately reckless.

But when he saw that the patient's chief complaint was written in the medical history, he had abdominal pain for more than ten hours. The patient develops abdominal pain after work, not persistent, but laborual pain.

After resting for a while, the stomach pain stopped.

But after a while, it started to hurt again.

This condition is often a warning sign of danger.

"I've had stomach pains before, so it's good to go to the toilet or take a break. This time the pain was a little different from the past, it hurt a lot, and the more it hurt, the worse it became. I couldn't stand it anymore, so I came to see the doctor. ”

While the patient explained, his wife was silent at the bedside.

It can be seen that the wife usually has no status at home.

"Most people think the same as you, they are afraid of spending money when they go to the hospital! Is the stomach ache dull or stinging? The stinging is like a needle sticking inside. ”

Zhou Can took the opportunity to chat with him.

"It seems like a dull ache! Anyway, it hurts so much, and it hurts for a while, as if someone is pulling the meat inside. ”

The patient replied truthfully.

"Inhale slightly, I press on your stomach and see if the pain lessens."

Zhou Can asked the patient to inhale.

However, the patient looked at him young and seemed to have little trust in his medical skills.

"This is the doctor from Tuya Hospital, you can do what he says." Cheng Dazhuang was next to him to help his buddies talk.

Dr. Luo was silent.

It is estimated that he is also not very optimistic about Zhou Can's medical skills.

"Husband, just listen to the doctor!" Family members are on hand to persuade the patient.

He inhaled cooperatively, and Zhou Can held his stomach.

"It hurts, my stomach still hurts, nothing lessened! Little doctor, your method doesn't work, it doesn't work! "The patient's temper is much more irritable than normal under severe pain.

After cooperating with Zhou Can's method, it was useless at all, and he looked quite annoyed.

Doctor Luo Jian raised the corners of his mouth slightly, thinking in his heart that Tuya's doctor was nothing more than that.

"The appendix is fine, enteritis can be basically ruled out, and there is no obvious tumor in the abdominal cavity. It is recommended to take an electrocardiogram (ECG) or do a cardiac ultrasound. Zhou Can said in a very serious tone.

"Doctor, although I don't know much about medicine, but I have a stomachache, what does it have to do with my heart? You can't let our people spend money in vain. After hearing this, the patient retorted bitterly.

"I haven't heard of heart disease causing abdominal pain."

Physician Luo Jian disagreed with Zhou Can's opinion on the side.

It's basically equivalent to dismantling Zhou Can's platform.

It's just that he didn't know how good this young trainee was.

In Tuya Hospital, people are often invited by the chief physicians to diagnose difficult cases and participate in various consultations.

Cheng Dazhuang felt that Zhou Can came at the right time and could have one more opportunity to learn and practice.

In fact, they should be glad to meet Zhou Can, a powerful doctor, who went down to the grassroots level.

"Just because Dr. Luo hasn't heard of it doesn't mean he hasn't. This patient's condition is not optimistic, I recommend doing an electrocardiogram or cardiac ultrasound immediately, or you can report it to the chief physician immediately, just say what I said, the patient may have a problem with the heart. ”

Zhou Can's tone was solemn and serious.

A life was passing away in front of him, and he felt compelled to do his duty as a doctor.

"It's not as serious as you say, is it?"

Seeing that he didn't look like he was joking, Dr. Luo felt a little uneasy in his heart.

"Ah Can, why don't you go to the office and talk to Doctor Luo!" Cheng Dazhuang played a round for the two.

In front of families and patients, many things are difficult to say.

Two doctors argue, that's even worse.

The nurse who had measured the patient's blood pressure also looked at Zhou Can with a rather repulsive look. This young doctor is really ignorant, even if he is from Tuya Hospital? At such a young age, he is either an intern or a regular trainee, and he has not studied medicine for a few days, so he dares to speak to Dr. Luo in this tone.

It's so unbelievable.

"If Dr. Luo doesn't believe my diagnosis, there is a simplest and most direct way to measure the patient's blood pressure in his left arm and right arm."

Zhou Can ignored the female nurse's strange hostile eyes, and didn't care about Doctor Luo's ugly face.

Now all he has to do is get the patient to be treated as quickly as possible.

"The nurse has already measured the blood pressure in her left arm just now, and she can just measure her right arm."

Zhou Can said to the nurse.

"Based on my more than four years of nursing experience, the blood pressure in my left arm is the same as in my right arm, and I don't need to measure it at all." Nurses are not as talkative as they think.

Don't buy Zhou Can's account at all.

This is also normal, when facing the doctors in the outer hospital, the medical staff of the hospital will instinctively stand aside and unite as one.

"You can't take a long time to measure it, maybe you can learn different clinical knowledge?" Zhou Can said lightly.

His realm and level are all there, and he won't worry about a little nurse.

"Tutu, you just measure the blood pressure in your right arm, let's see if Tuya's doctor is really different!"

Doctor Luo Jian opened his mouth, and the nurse immediately measured the blood pressure in the patient's right arm.

Everyone was quietly waiting for her results.

Gradually, the female nurse, whose face was a little cold, began to show a surprised expression.

Shock and surprise grew on her face.

"Tutu, how's your blood pressure?"

When Doctor Luo Jian saw this situation, he suddenly felt bad in his heart.

But he was more nervous about the patient's condition.

If what the doctor from Tuya said was true, the patient had been suffering from abdominal pain for more than ten hours. I am afraid that the situation is already extremely dangerous.

Because under normal circumstances, persistent chest pain for more than 40 minutes is a cause for alarm.

Why can patients with chest pain go to the hospital for medical treatment? Go directly to the center of chest pain and the green channel of sudden heart. It is because once it is a heart attack, the patient will die very quickly.

He said...... It turned out to be right, the blood pressure difference between the arms on both sides was nearly 30. It's incredible, I've been a nurse for a few years, and it's the first time I've encountered such a strange situation. ”

The female nurse's face was feverish.

More shock, but also a hint of shame, and even a hint of inferiority.

She didn't expect that there would be such a big gap with the doctors at Tuya Hospital.

It turned out that she was sitting in a well and watching the sky.

"It is recommended to send it to the emergency department immediately for a color ultrasound, now what I am most worried about is that it is a little late to find out, and the chance of rescue is gone!"

Zhou Can has spent time in Tuya's emergency department, cardiothoracic surgery, and intensive care medicine department.

The knowledge is not at all comparable to the attending physicians and nurses of these county-level people's hospitals. Some patients looked good one second, but the next second, their condition deteriorated rapidly, and the medical staff tried their best to save them, but they still couldn't save the patient in the end.

He'd seen too many of these scenes.

"Send it to the emergency center immediately, contact Director Wang of the Department of Cardiothoracic Surgery, and come to the hospital immediately! Inform Nurse Liu Bin to come over! Cheng Dazhuang, hurry up and help send the patient to the emergency department! ”

Doctor Luo Jian was already hurriedly lifting the buckle of the hospital bed, and then pushed the hospital bed directly to the emergency department.

To be able to become an attending physician, you will have some experience.

After discovering that Zhou Can's diagnosis was true, he immediately became highly vigilant.

"Doctor, my husband just has a stomachache, is it really that dangerous?" Obviously, the family is still a little difficult to accept this result. Even skeptical of hospitals.

"He seems to have a stomachache, but it's actually a heart problem, and you'll know when the test results come out. Based on my clinical experience, if there is a real problem with his heart, the prognosis will be very poor. Hurry up and follow along, there will definitely be a lot of places for you to sign in a while, but don't waste any more time. ”

Zhou Can can only say so much.

Ask him to tell the family directly in a positive tone, your husband is in critical condition, and he may not be able to save him, he is not so stupid.

Fear of being beaten by family members.

Zhou Can didn't follow him to the emergency center, he was just a guest, and he came to find a little catch.

It is certainly not appropriate to follow the doctors of the county people's hospital to participate in the first aid work.

Unless the other party invites him, then it should be another matter.

Otherwise, it is not recklessness, but the use of guests to oppress the lord and meddle in affairs.

He didn't go back to the doctor's office either, there was no one inside, and he was an outsider staying inside, which was even more inappropriate.

Under the melon field and plums, some things can only be eaten by themselves.

Self-cultivation is self-awareness that does not need to be reminded.

At night, only a few lights were turned on in the hallway, and it was quite dim. Only the large area of the nurse's station is brighter, and Zhou Can sat down directly on the row of chairs to rest, and took out his mobile phone to read the information.

"That...... Dr. Zhou, could you please come over and help save the patient just now? ”

Less than thirty minutes later, the nurse came running with an anxious face.

(End of chapter)