"I feel like when he cries, his voice is hoarse. It is not okay to have a long lack of water in the throat. ”

Zhou Can frowned slightly, turned his head to the nurse.

"Are there clean straws? The kind with a balloon. ”

"Yes!"

"Please bring one over, I'll feed this little baby some water first, it's too distressing to watch."

He gently patted the baby's back to soothe it.

After the nurse took the straw, he asked the nurse to help open the feeding bottle, and then sucked a few drops of water from it and squeezed it into the baby's mouth.

The whole process was very gentle and attentive.

The baby stuck out his tongue and licked the water stains on his lips, and the crying stopped, and he looked at Zhou Can with longing eyes.

As if to say, uncle, give me a little more.

"It turns out that we can feed water like this, why didn't we think of it? I tried to feed the water with a small spoon before, but he choked and cried, so I didn't dare to feed it anymore. ”

The mother watched Zhou Can easily feed her child, not only did the baby not choke, but also enjoyed it.

immediately trusted Zhou Can's ability.

The eyes of the family members looking at Zhou Can also became different.

With respect and trust.

"Spoon feeding is good for older children, and at about six months, spoon feeding is not so easy to choke. Also, if you always choke on water when feeding, it is easy to cause problems such as pneumonia, so you must pay attention to this. ”

Zhou Can didn't completely scare the family.

Babies are born and their lungs are not fully developed. Because they are in their mother's belly, they are breathing with the umbilical cord all the time.

In addition, crying in babies is not a bad thing, it helps to exercise the function of the lungs and helps the lungs adapt to the outside world.

Especially for newborn babies, if they don't cry or make a fuss, the midwife will be very anxious.

Will try to make the baby cry.

For example, slapping the soles of the baby's feet, etc. Of course, this scene should not be seen by the family as much as possible, so as not to cause unnecessary misunderstandings.

"Did you have a vaginal birth or a caesarean section?"

"Smooth delivery!"

"Since the child can drink water, he should be able to use this method to change to milk. Breast milk is rich in nutrients and has many special elements that can enhance the baby's immunity. If he doesn't want to suck, you can squeeze it out, put it in a bottle, and feed him little by little with a straw. When feeding with a straw, be careful not to suck too much at a time, so as not to cause your baby to choke. He choked twice more, and because it was uncomfortable, he would reject this way of eating. ”

Zhou Can explained the essentials of feeding to the mother.

Now we must find a way to let the baby eat some milk to maintain the body's immunity and nutrient absorption.

"Okay, I'll do it later."

Now that there are so many people, mothers naturally can't express milk. She learned how to do it, and when the doctors were gone, she would be able to do it on her own.

Zhou Can continued to feed the baby some water.

The expression on the child's face is also much more comfortable and natural. The original frown has spread a lot.

The family and the mother are very happy to see all this.

Children are born without food for so many days, and their hearts are hanging higher and higher. Now it's a little bit behind.

"I'm going to do some medical check-ups for my baby and I'm going to need to put him in the crib."

Zhou Can greeted his family.

"Yes."

The family and the mother readily agreed.

Now, in their hearts and eyes, Zhou Can is an absolute expert. I am very happy to let Zhou Can help their children diagnose and treat.

Zhou Can first touched the pulse of the child's neck and felt very fine.

In people with heart failure, the pulse is often thin.

Next, he did a detailed examination of the child's whole body, including auscultation of heart and lung sounds.

On auscultation, he noticed a murmur in the child's left chest.

Upon closer examination, it was found to be a murmur emanating from the mid-upper part of the left sternal border.

And this murmur is very regular, and it only comes out when the heart contracts.

Ordinary doctors may not be able to distinguish whether heart sounds are in contraction or diastolic when they are produced, but doctors who have reached Zhou Can's level can distinguish them very accurately.

"The X-ray examination done by the patient showed that the heart was enlarged, the pulmonary vascular opacity increased, and some even showed pulmonary vein congestion. In addition, the patient's electrocardiogram also showed right axis deviation and right ventricular hypertrophy. So I highly suspect that there is something wrong with the aorta. ”

A number of chief doctors were present at the scene, including Director Le of the Department of Cardiothoracic Surgery.

Zhou Can now has a certain result of the diagnosis, so naturally he doesn't need to cover it up, just say it and discuss it together.

The only thing to keep in mind during the discussion on the ward is to respect the senior doctor.

You can't hit them in the face.

For example, the senior doctor just said in front of everyone that there might be a problem with the left ventricle, and he immediately said that the problem was in the right ventricle, which is basically singing against the senior doctor.

It will make it difficult for senior doctors to step down.

"Director Le, what is your opinion?"

Director Tang Fei is not very good at cardiac surgery, so he can only ask Director Le's opinion.

"Zhou Can's suspicions have a certain basis, and an echocardiogram can be done to clarify it."

Director Le's diagnosis level is not low, but in many ways, Zhou Can has opened up the gap. He seems to rarely refute Zhou Can's diagnosis. Because of the only few rebuttals, only one was not slapped in the face.

That was a long time ago.

Now Zhou Can, whether it is diagnosis or surgical level, has left him far behind, and he dare not easily refute Zhou Can's diagnosis.

Doing an echocardiogram can really be of great help in diagnosing the aorta.

Considering that the child's condition is very dangerous, an echocardiogram was arranged for the child to be done on the spot.

Upon examination, it was found that the child's aortic valve was stenosis, and it was quite long. The blood signal in this segment is poor.

"It's most likely an aortic canyon lesion."

Zhou Can said after reading it.

"It was almost already certain that there was a narrowing of a section of the aorta that caused a severe weakening of blood in the aorta." Director Le also agreed with Zhou Can's diagnosis.

"The child is just three days old, and I think surgery can be avoided, so I think it should be avoided as much as possible. Medical treatment can be tried to control heart failure, followed by elective surgery if appropriate. ”

After Zhou Can's diagnosis was supported, he gave further treatment advice.

Director Le belongs to the kind of fierce general type doctor who looks elegant and decides on the treatment plan as fiercely as thunder.

It is better for Zhou Can to make the idea of the treatment plan for newborns.

"What kind of internal medicine methods is Dr. Zhou going to use?" Director Tang Fei also thinks that it is safer for newborns to be treated by internal medicine as much as possible.

"Prostaglandin E1 is a good choice to open the ductus arteriosus. It can effectively reduce the hypoxia of children. ”

Zhou Can gave the answer after thinking carefully.

[Pharmacological Pattern Differentiation Experience +1, Bonus Experience +10.] 】

[Congratulations on your promotion to level 6 in pharmacological differentiation. The current experience value is 1/1000000, and the chief physician is at the primary level. 】

His pharmacological differentiation has long reached the tipping point of escalation.

This skill is extremely important, but the speed of leveling up is not comparable to other medical skills. It is even slower than the upgrade of pathological diagnostic medical skills. Now that he has been promoted to the level of chief physician as he wishes, Zhou Can has finally made up for a huge shortcoming.

The situation of being beaten by her nurse Jiang Wei was also changed.

Now that both pharmacology and pathology have reached level 6, his clinical level is already a real director's level.

Whether it is a consultation, surgery, or ward rounds, rescuing critically ill patients, it can provide great help to Zhou Can.

He carefully felt the changes brought about by the upgrading of pharmacological differentiation.

It is obvious that the clinical use of various drugs is more flexible and accurate, and the subtle differences can be well controlled and grasped. What surprised Zhou Can the most was that now the specific effect of the drug after use, and how much it can be absorbed by the patient, can naturally form a prediction in his mind.

For example, when the prostate E1 is used for the child in front of him, he can make a comprehensive evaluation based on some examination reports of the child and form a map in his brain. What drugs should not be used, what drugs can be tried in an emergency, how long after prostate E1 is used, what drugs should not be used, and whether it will hinder the child's subsequent emergency surgery, etc.

He can form a drug map in his head.

This is an ability that you don't have at level 5.

Let him faintly touch a trace of the realm of medicinal effects that everyone in Chinese medicine often says.

When the injection was last promoted, when the drug was injected into the patient's skin, muscle, etc., he was able to judge whether the drug absorption in the patient's area was saturated. This ability, in fact, has faintly touched the realm of medicinal effects.

If the level of injection can be further improved, reaching the intermediate level of the chief physician, or even the advanced level, this ability is likely to be improved.

For example, it is still only possible to judge which part of the skin and muscles have reached the saturation of drug absorption.

Further, it may be possible to determine whether a certain organ is saturated with drug absorption.

Now that pharmacological syndrome differentiation has been promoted to level six, it is basically equivalent to stepping directly into the door of drug efficacy attribution with one foot.

"Director Tang, Director Le, Director Zhuang, I suggest waiting until the child's condition is slightly stabilized before giving him a cardiac catheterization and retrograde aortic rootography. In this case, where the isthmus of the aorta is long, surgery is often often required in the end. It is necessary to identify the location of the lesion and the corresponding situation in advance to eliminate potential hidden dangers before surgery. It can also provide a good basis for the formulation of surgical plans. ”

Zhou Can felt that the examination done by the child was not perfect enough.

According to his surgical experience, the use of internal medicine treatment for this child can only alleviate the condition, but cannot cure it completely.

The best thing to do is to wait until your child's condition allows.

"Yes! If the family agrees, I will choose the most appropriate time to make arrangements. ”

Director Tang Fei nodded in agreement.

"It's really necessary to have an aortic rhizogram."

Director Le also strongly supported Zhou Can's proposal.

Pediatrics does not have the capacity to perform cardiac surgery, and the child will definitely eventually be sent to the cardiothoracic surgery department for surgery. Allowing the child to complete the preoperative examination can greatly reduce the risk of surgery and allow the doctor to be fully prepared before the operation.

Basically all major surgeries have preoperative preparation requirements.

If you have to have aortic surgery in the heart, and you are still a newborn, the preoperative preparation will only be more.

"We're totally fine. With so many of your directors and experts helping to diagnose and treat my child, our family members should only be grateful to the hospital, and the only thing left should be trust. The hospital's treatment plan, examination plan, our family members are willing to fully cooperate. ”

It should have been the patient's grandfather who spoke.

Although he is a grandfather, his age is not particularly old, and he is less than fifty years old.

As for the parents of the affected children, they are both young people in their early twenties, and they are quite immature.

The decision of major events is basically handled and presided over by the child's grandparents.

"Okay, thank you for your trust and cooperation, our hospital will definitely do its best. In fact, everyone's goal is the same, and they all hope that this smart and cute baby will recover as soon as possible. ”

Director Tang Fei made a concluding speech, and the consultation basically came to an end for the time being.

……

When it was time to eat at noon, Zhou Can checked his mobile phone, and Director Tang Fei sent him a WeChat voice. Tell him that the child's symptoms have improved significantly after treatment with intravenous prostaglandins.

The most important manifestations of heart failure are chest tightness and difficulty breathing.

She also told Zhou Can that the child's mother specially brought him a message to thank him for helping to use the dropper to feed the child.

Although this method is a bit time-consuming, after feeding the child breast milk, the child has been sleeping peacefully for more than two hours and has not woken up. This was almost unimaginable in the first two days.

The child is almost day and night, and is always crying.

Because babies can't speak, they can't tell their parents when they have pain and itching, and crying is the only natural way to express it.

Even we adults cry when we are physically uncomfortable.

When encountering a particularly noisy child, especially a child who has just been born, you must be alert to whether the child has disease or pain.

When Zhou Can was in the pediatric department, he once treated a child who was only more than four months old. The child's mother was about to collapse and told Zhou Can that she didn't know why the child had been crying in the past few days.

She barely closed her eyes at night.

Later, after examination, Zhou Can found that the child had a plaster attached to his navel.

After inquiry, I found out that it was the child's grandmother who saw the hot weather, and the child was sweating from the heat at every turn. She was worried that her child would suffer from heat stroke, so she took her child to the small clinic downstairs and put up a pediatric heat patch.

Some of the child's colleagues all reported that the effect of the children's summer patch was good.

It can prevent children from heat stroke, prickly heat and so on.

Then the 'doctor' of the clinic also hyped up the plaster as a pure Chinese medicine with no side effects and so on.

The child's grandmother is naturally abnormal in trust.

The first two days of the plaster were applied, and the child slept very peacefully. Especially at noon, usually because it is too hot, the child always refuses to sleep.

Pasted a children's summer sticker, and the child slept soundly for two days in a row.

By the third day, the child was a little crying.

By the time I brought him to the hospital to see a doctor, it was already the morning of the fifth day. At that time, after Zhou Can received the consultation, with his experience, he immediately deduced that the problem was likely caused by plasters.

When the plaster was carefully removed from the child, it was found that the child's tender skin was already red and swollen.

And the navel seems to have a tendency to suppurate, faintly emitting a stench of rotting corpses.

If you come a day or two late, the consequences will be unimaginable.

At that time, the weather was hot, and the child's resistance to bacteria and viruses was already weak. The navel is the 'eye' of the abdominal cavity, which is responsible for the baby's absorption of nutrients and oxygen from the mother during the fetal period.

All of them have begun to decay and suppurate, and continue to invade the abdominal cavity, and a single sepsis can easily kill the child.

(End of chapter)