"Dr. Zhou, does my brother need a thoracotomy?"

The patient's younger sister was only half-aware and worried about her brother's treatment.

Her family background was not good, and she had just graduated and interned in a company.

Even the inspection period has not yet passed, and the salary received in a month is pitiful. Nowadays, most black-hearted bosses set up internships of more than three months. The longest can even reach more than a year.

There are no bonuses for interns, and there is only a minimum base salary per month, which is basically a consensus.

Because the labor cost is much lower than that of regular employees, both hospitals and other units like to have a long internship period.

The blackest should be the hospital, where I have a one-year internship and a free day job.

It is even necessary to pay the hospital backwards.

The next three years of regular training have only a minimum basic salary.

A large number of undergraduate and graduate students have been used as cheap labor for more than four years.

"Judging from the patient's current postoperative performance, it should be relatively optimistic. But what the final result will be, no one can predict. The answer given by Zhou Can basically belongs to the doctor's standard speech.

Give hope to the patient and family first, and then tell the family and the patient that the final outcome is not known.

……

After seeing the patient from the cardiothoracic surgery department and returning to the emergency department, I had just arrived in the hall when I was stopped by Dr. Xie at the triage desk.

"Dr. Zhou, Dr. Zhou, this pregnant woman was unfortunately in a car accident and was seriously injured. Please help me see how to get it! ”

Zhou Can raised his eyes and looked over and found that he had gone to the cardiothoracic surgery department to take a turn, and several car accident injuries were actually delivered. In the emergency room, medical staff are constantly rushing in and out, and seriously injured patients may have been sent in for rescue first.

Pregnant women are injured and very tricky.

The pregnant woman seemed to be badly injured, with blood on her body and her belly bulging high. There are at least eight or nine months old fetuses.

For obstetrics, Zhou Can is not good at it.

Whether the child needs to be dissected first will definitely need to be assessed by a specialist in obstetrics and gynaecology.

"Have you checked your basic signs?"

"Body temperature, blood pressure, heart rate, breathing were measured, blood pressure was a little high, heart rate was fast, shortness of breath, everything else was normal. After a preliminary examination, it is likely that her right leg has been fractured, her lower body is bleeding, and she has abrasions of varying degrees on her back, right shoulder, and right arm. There is a significant bruise and hematoma on the forehead. ”

Dr. Chia only did the most basic tests.

This is also a common problem for many novice doctors, who will only follow the textbook process.

Experienced doctors will ask patients questions and do various examinations, which will be clearly targeted.

"Has the fetal heartbeat been measured?"

"Nope! However, I listened with a stethoscope and it seemed to be normal. ”

Dr. Xie hesitated for a few seconds before saying.

"Let's do an abdominal ultrasound first! Now give her a blood test! The right leg will definitely need to be X-rayed, and if you have dizziness, headache, or confusion in the head, it is best to have a CT of the head. ”

Zhou Can gave Dr. Xie some guidance.

"Her lower body is bleeding, don't you care?"

Dr. Xie asked, worrying about the baby in the pregnant woman's womb.

"B-ultrasound must be done first to clarify the situation in the abdominal cavity before the next step of diagnosis and treatment. Blood tests should be done quickly, and the first thing to do when such patients are treated in the future is to take blood tests. In case it's Xiaomei or something, you can find out in time. In addition, the injured person was bleeding, and her blood type could be known in time if she needed a blood transfusion. ”

The Xiaomei that Zhou Can said is syphilis.

The most feared front-line nurses in clinical practice should be syphilis and AIDS patients.

In front of the patients, some of the words of the doctors and nurses are in code.

The main purpose is to avoid causing resentment to patients and avoiding doctor-patient disputes.

"By the way, hurry up and ask a specialist in obstetrics and gynecology to come and consult."

After finishing speaking, Zhou Can walked directly towards the operating room.

With his director-level hemostasis, when he observed the patient just now, he could basically conclude that the bleeding was not as serious as he imagined. It should not be life-threatening for a short time.

There was another thing that made him particularly puzzled.

When I looked at the face of this pregnant woman, there was no appearance of pregnancy. Usually, after pregnancy, a woman is affected by estrogen in her body and her appearance becomes ugly. The result is a unique appearance of pregnancy.

However, this female patient did not have this characteristic.

In addition, he asked Dr. Xie to check the blood routine of the pregnant woman first, because he always felt that the patient was not like an ordinary patient with the director-level hemostasis and the fifth-level pathological diagnosis.

In clinical practice, we often encounter a variety of special patients.

Among them, syphilis and AIDS patients are the most common.

Even if they are professional medical professionals, it is sometimes difficult for them to tell from the appearance that they have an infectious disease.

……

In the operating room, Zhou Can had just undergone three surgeries, and Dr. Xie came over to send a message to Ma Xiaolan and asked her to tell Zhou Can that the pregnant woman was really a carrier of syphilis and HIV at the same time.

Three of the injured who arrived with the pregnant woman were later found to be infected with both viruses.

The medical staff in the rescue room were directly scared into a cold sweat.

Because one of the wounded they rescued was one of the three.

Blood-borne transmission is one of the most dangerous routes of infection.

When rescuing patients, the doctors and nurses did not think so much, and various emergency operations at that time inevitably came into contact with the blood on the patient's body. No protective equipment was being worn, not even the simplest pair of rubber gloves.

The other three infected people are all men, namely the pregnant woman's boss, her current boyfriend, and a male colleague.

It is said that the current boyfriend of the pregnant woman turned green on the spot when he heard the news.

He was angry not that he had been infected with syphilis and AIDS, but that his boss and male colleagues had also been infected. You know, whether it's syphilis or AIDS, ordinary physical contact is not contagious at all.

Infection is often only susceptible to infection if it comes into contact with the body fluids of a sick person.

In addition, when the skin on the surface of the hand, such as comes into contact with the patient's body fluids, as long as the skin does not break, the infection will not occur. The skin is the first line of defense in our immune system, and it's much more powerful than you think.

Almost 99.9% of bacteria and viruses can be blocked from the body by this barrier.

Therefore, it is no coincidence that the pregnant woman's boss and another male colleague were also infected with syphilis and AIDS. They must all have been infected by pregnant women.

How exactly you get infected, as long as you are not a fool, you will understand.

A few minutes later, a word came in from outside, asking Zhou Can to go out and help with the consultation.

Zhou Can quickly debrided and stop the bleeding of the surgical patient on the table, and then handed it over to Yang Zhi, a medical assistant, to suture the patient.

In many surgeries, he will deliberately leave some surgical exercise opportunities to Yang Zhi.

Sometimes he will also guide Yang Zhi's deficiencies in surgery and make mistakes. Of course, this kind of thing is usually said when the patient leaves the operating room.

Yang Zhi also lived up to his high expectations, his growth rate was very fast, and he already had good surgical skills, so he could now share Zhou Can's worries in a variety of situations.

After Zhou Can handed over the patient to Yang Zhi, he came outside to help consult the patient with confidence.

"Where's the patient? What is the condition? ”

As he walked, he asked the nurse who had come to ask for him.

"It's the pregnant woman who infected Xiaomei and Xiaoai, and there was an abnormality in her abdominal ultrasound. Dr. Yang from the obstetrics and gynecology department would like to ask you to help with the consultation. ”

While speaking, the two of them had already arrived at the emergency hall.

Zhou Can saw a pretty figure standing there, it was none other than his college classmate Yang Chan.

Like Zhou Can, she is now a resident doctor.

"Hello squad leader!"

Zhou Can stepped forward to say hello.

He was actually a little scared to see Yang Chan now. Because when she looked at Zhou Can, her eyes were very hot.

That's not a good thing.

If Zhou Can doesn't have a girlfriend, that's okay.

Yang Chan is beautiful in appearance, and her medical strength is also quite outstanding. I heard that she has been successfully admitted to graduate school and is currently a graduate student.

In terms of academic qualifications, she has been ahead of Zhou Can.

"Zhou Can, this pregnant woman's B-ultrasound is very strange, please help me consult!"

She basically calls Zhou Can by his name.

Compared with others calling him Dr. Zhou, calling him by his first name seems more relevant.

After receiving the patient's checklist, Zhou Can was stunned.

Only a large vague gestational sac can be seen on the ultrasound sheet, but the fetus is not visible at all. It stands to reason that with such a large belly of a pregnant woman, even the worst ultrasound equipment can detect the fetus and show the specific appearance of the fetus.

When he saw this pregnant woman for the first time, Zhou Can felt that this pregnant woman did not appear to be pregnant.

However, stretch marks can be seen on her belly.

As for whether there are stretch marks on the thighs and groin, Zhou Can did not check it.

Female patients should be examined with special care.

It is easy to be beaten by family members if you look indiscriminately.

"Can you hear me?"

Zhou Can asked the pregnant woman.

"Yes!"

The voice of a pregnant woman is sweet and glutinous, and it can touch a man's heart very well when he listens.

Zhou Can said secretly, no wonder her boss and male colleagues were in love. If it weren't for a strong-willed man who had more contact with her at work, and she was more casual, few people would be able to clean themselves.

"How long have you been pregnant?"

"Uh...... It's probably more than eight months! ”

"It should be more than nine months and two days." Next to him, a middle-aged man with an angry expression was lying on a flat bed, seemingly injured in his lumbar spine and unable to move.

"Who are you?"

"Boyfriend!"

It turned out that this man was the unjust boyfriend of a pregnant woman.

"I remember it clearly! Your lumbar spine looks like it's hurting so much that you'll have to be taken to an orthopedic surgeon. ”

Zhou Canting sympathized with this man.

He can clearly remember the time of pregnancy of the pregnant woman, which shows that he cares very much about the relationship between the two.

It's just that at the moment, my head is green, and I'm afraid that I feel uncomfortable.

"We've contacted the orthopedic surgeon, but he won't go and wants to stay here with his girlfriend." The nurse explained.

"Lumbar spine injury needs to be treated quickly, what if it drags on for too long and is paralyzed?"

Zhou Can persuaded this unjust man.

"I had to see that she and the baby in my belly were safe before I went to the orthopedic clinic. You don't have to worry about me, please help her treat her quickly! ”

The man is an infatuated species.

Zhou Can no longer persuaded him, and his eyes returned to the pregnant woman again.

"Squad leader, have you measured her fetal heartbeat?"

Zhou Can asked Yang Chan.

Although Dr. Xie has measured the fetal heart rate of the patient, he is not professional.

For novice doctors, Zhou Can is not at ease.

In particular, the situation of this pregnant woman is extremely strange, she can see a large gestational sac, but she cannot see the fetus.

"This is what I wonder the most, the fetal heart rate is clear and normal."

Yang Chan estimated that it was the first time she had encountered such an evil thing.

Zhou Can's back hair stood on end, he was an atheist. Such a bizarre thing is enough to make him wonder if there really is a 'ghost fetus' in this world?

Nezha appeared in ancient mythology.

The fetus cannot be seen on ultrasound, but the energy reaches the fetal heartbeat, and the pregnant woman's belly is no different from that of eight or nine months old.

"Teacher Lu, give me a pair of rubber gloves."

"Give!"

It's already available next to it.

After all, everyone already knows that this pregnant woman is infected with syphilis and AIDS, and it must be guarded against.

Truth be told, if you are infected with one of the two viruses alone, it is possible that the patient is unfortunately infected by the other half. Or when stealing outside, unfortunately hit.

Infected with two viruses at the same time like this, this woman's life style is definitely not good.

The private lives of adults are chaotic, and no one can control them. But for men and women who don't love themselves, syphilis and AIDS are definitely their nightmares.

Zhou Can put on rubber gloves and lifted the pregnant woman's blouse up, revealing her round belly.

Then touch your abdomen with your hands.

The purpose of this is twofold: to see if the fetus can be felt and to see if there is fetal movement.

"Hmm......"

When he tried to touch the pregnant woman's abdomen for further examination, he felt a distinct fetal passage. It's like a rat swimming under the palm of your hand.

There is fetal movement and fetal heartbeat, but the fetus cannot be seen on ultrasound.

Could it be that B is beyond the problem?

This possibility is not ruled out.

However, Tuya's ultrasound department has a strict examination system, and if there is a real problem with the ultrasound machine, it will be discovered when examining other patients.

What could be the problem?

Zhou Can didn't know how to judge for a while.

When the pregnant woman's stomach is pressed slightly, it is quite soft and there is no sign of fetal presence at all.

The belly in the third trimester of pregnancy feels very leathery, and you can even feel the contours of the fetus.

"What is the fetal heartbeat?"

He asked Yang Chan.

"109 times/min."

Hearing this result, Zhou Can was slightly stunned, and then took the patient's medical record. When Dr. Xie received the consultation, the heart rate of the pregnant woman was measured at 110 beats per minute. The heart rate of the fetus is now about the same value.

Is it a coincidence or is there a close connection between the two?

The normal heart rate for adults should be between 60 and 100 beats per minute. Some eminent monks and Taoist monks who have been meditating and practicing for a long time have a much slower heart rate than ordinary people.

The heart rate of pregnant women reaches 110 beats per minute, which is obviously too fast.

A normal fetal heart rate is usually between 110 and 160 beats per minute. The pregnant woman's fetal heart rate was 109, which was barely qualified.

"Squad leader, you measure her fetal heart rate again, and I'll measure the pregnant woman's heart rate!" We do it at the same time. Mr. Lu, please help us call the start. ”

"Ah...... Okay, okay, no problem. ”

Nurse Lu was stunned for a moment, and then agreed.

Yang Chan didn't understand Zhou Can's intentions at first, but she instinctively agreed.

"Let's go!"

When the two were ready, Nurse Lu waved her hand and gave orders.

If you don't know about it, you think there's a tournament going on here.

Yang Chan measured the fetal heart rate while thinking about Zhou Can's intentions. Immediately, his eyes lit up slightly, and he seemed to understand a little.

Soon, the measurement ended.

The pregnant woman's fetal heart rate is 112 beats/min, and the fetal heartbeat is also 112 beats/min.

When they saw this result, the doctors and nurses present were all surprised.

(End of chapter)