After more contact with Mr. Cao, I know that Mr. Cao is actually very lacking in clinical experience. He was a graduate and soon became an attending physician at the hospital, but he spent most of his time in the laboratory during his graduate studies. Lack of clinical experience, many times, the treatment experience of the disease is very lacking, and when encountering a patient, it is often necessary to consult certain information to be able to formulate the corresponding treatment plan. A few days after I came here, during the daily routine ward rounds, Director Shi Tingbang asked about the treatment of several common cases on the spot, but Mr. Cao couldn't answer, which made Director Shi angry. I was unlucky to fall into his hands. Luckily, I'm different from other interns.

Zhou Huaifang didn't know when he slipped over, "Huang Jingyang, why are you still staying in the department at this time?"

"What's wrong? Teacher Cao didn't dare to leave, and naturally I couldn't go. "I thought Zhou Huaifang said I didn't go back.

"I'm not talking about that. I mean, with such an important patient in the Department of Internal Medicine, how can you still stay in the department, why don't you go to the expert consultation? The expert consultation is a very rare learning opportunity. Let's go, let's go in and listen. Zhou Huaifang said.

"Teacher Cao didn't even have a chance to get in, how can I get in?" I shook my head.

"What are you afraid of? We're not the same as their regular doctors. We're interns anyway, and even if we offend people, they can't really deal with us. Besides, we're just going to sit in and listen. As long as you don't talk much, it's definitely fine. By the way, Dong Fucheng has already mixed in. It was a text message he sent me. Walk. Let's go together. Zhou Huaifang said.

I couldn't resist Zhou Huaifang's strong invitation, so I followed him to the consultation room.

The patient complains of cough, breath-holding and dizziness. Chest pain lasted for nine days, and there was a fainting.

Li Shun, an expert in internal medicine, had a serious expression, and the patient's identity was special, so he naturally did not dare to slack off, "Judging from the current examination results, the pharynx is slightly congested, and the breath sounds in both lungs are rough. There was no abnormality in X-ray, the electrocardiogram was generally normal, and the patient had already taken compound antihypertensive tablets and other drugs. Symptoms did not resolve. This morning, the patient suddenly fainted while urinating, his eyes rolled up, and he woke up a minute later, dizzy and chest tightness before he was diagnosed and treated. In addition, the patient developed hypertension six years ago. According to the results of the current examination. The cause of cough and fainting has not been confirmed. ”

"Now it's not for you to talk about your illness. It's about determining what kind of disease the patient is suffering from. If the cause is not identified, a comprehensive examination is carried out immediately, and the true cause of the patient must be clarified as soon as possible. Do you have anything else to add?" Zhang Zhenyuan was very irritable. After checking for so long, no cause was found. looked at Li Shun very annoyed. Li Shun is an expert in internal medicine, but at this critical time, if he can't show the value of an expert, what kind of expert can he be considered?

Zhang Zhenyuan hurriedly turned to Lu Maozhu again, "Director Lu." When Ms. Lei entered the hospital, I had already applied for expert assistance from Yenching Union Medical College Hospital. Now the experts are on their way to the East China Sea. It is estimated that it will be able to arrive soon. The expert I invited was Shi Weiming, an authoritative expert in internal medicine at Union Medical College Hospital. ”

Lu Maozhu is a senior official in the health system. Naturally, I have heard of the name of the authoritative expert Shi Weiming. But because he was still worried about his wife's situation, he was a little annoyed, "Tell me about your Ruihua Hospital, which is also a hospital with a reputation in the East China Sea." I often say good things about your Ruihua Hospital outside. If there is any financial need, I will try to lean towards you. Why did you drop the chain when it came to a critical moment? As I told you, Donghai is a world-class city, and there must be an international hospital to be able to match it. Each department should find a way to be equipped with heavyweight experts. If you don't lack funds and conditions, why can't you have a group of high-level medical experts?"

Lu Maozhu's words were obviously very dissatisfied with Zhang Zhenyuan, the dean.

Zhang Zhenyuan looked at the group of experts in the conference room with a pale face, and saw that these experts were silent. The interns standing around were also stunned by this atmosphere, and they had a feeling of trembling.

The dean's secretary hurriedly walked in and whispered something in Zhang Zhenyuan's ear. Zhang Zhenyuan's face immediately turned shocked, and he hurriedly said to Lu Maozhu, "Director Lu, expert Shi Weiming is here. I'll go out and meet you. ”

"I'll go with you. Lu Maozhu heard that Shi Weiming was coming, and he was also very happy.

Zhou Huaifang gently pulled me, "It's an eye-opener today, this Shi Weiming is a real authority." He is very powerful in internal medicine, and his name can be seen in many internal medicine textbooks. ”

"Where's the patient?" I asked.

"At this time, it must be in the intensive care unit. Ask Dong Fucheng, he must know. Zhou Huaifang said.

Zhou Huaifang tiptoed to Dong Fucheng's side and gently pushed Dong Fucheng.

"Don't mess around here. Otherwise, you won't be able to eat and walk around. Dong Fucheng was taken aback.

Zhou Huai glanced at Dong Fucheng, and the two walked outside together.

"What are you doing?" Dong Fucheng asked.

"Huang Jingyang asked where your patient is?" Zhou Huaifang asked.

"What are you trying to do? This patient is no ordinary person. Don't mess around. Dong Fucheng said nervously.

"We don't know anything here, so what's the use of listening to these experts? I said.

"In the intensive care unit. It was useless for us to go, there was someone guarding there, and we couldn't get in at all. Dong Fucheng shook his head.

"Let's go, let's see. "I pulled Zhou Huaifang and walked to the intensive care unit.

"You two really go over, don't mess around, something big is going to happen. Dong Fucheng hurriedly reminded again.

"Don't worry. We're not stupid, so how can we be in the limelight? I laughed.

When Zhou Huaifang and I came to the intensive care unit, we saw that the atmosphere in the intensive care unit seemed to be much heavier than usual. There are hospital security guards standing guard at the entrance. Through the glass, you can see that there are doctors on duty inside, especially one of the hospital beds. After guarding two or three doctors, I don't have to think about it, the big man who came over today must be lying in this hospital bed.

"Hey. You two interns, don't come here and make trouble. The hospital security guard smiled at us.

"What are we messing with? Just take a look out there and here. I said with a smile, looking through the glass to see the patient lying on the bed. I actually saw that there was already an imperceptible black qi on her body that began to escape from her body, and it seemed that she was in a very bad condition. If you can't get effective treatment, I'm afraid you won't be able to survive for too long. However, looking at the consultation, Ruihua Hospital has not yet found the real cause of the patient's illness. The treatment of the patient is not right at all. If this continues, the consequences are really serious. I don't know if there will be any improvement after the experts come.

I stood with Zhou Huaifang for a while. I saw a large group of people walking towards the intensive care unit.

The security guard brother hurriedly said to us: "Hurry up, hurry up, the leader is here." Let them see it, and I'll be out of luck. ”

Zhou Huaifang and I hurriedly stepped aside.

"Shi Lao, please come here. Ms. Lei entered Ruihua Hospital. Placed in the intensive care unit. The hospital has several experienced doctors to monitor at all times. Keep an eye on Ms. Lei's condition as she changes. Zhang Zhenyuan's posture at this time was very low.

Shi Weiming was surrounded by everyone, reading the patient's examination report as he walked. His brows furrowed, and from these examination reports, he could not confirm the patient's condition.

"Is there a possibility of cerebral thrombosis? Has the brain CT been done? Has the chest X-ray been done? Is the heart normal?" Shi Weiming asked a lot of questions along the way.

"CT has been done, there is no bleeding in the brain, and there seems to be no problem with the chest X-ray in both lungs. Percussion of both lungs was clear, and there was no abnormality on X-ray fluoroscopy. Aspartate aminotransferase and alanine aminotransferase were normal, which could rule out the possibility of myocardial infarction. Bedside chest x-ray shows no significant abnormalities in the cardiopulmonary and diaphragm. Li Shun hurriedly said.

Shi Weiming's brows furrowed. From the results of these tests, he was unable to determine the cause. However, the patient's cough, dizziness, and chest pain must be extremely related to the cause. But some of the illnesses he thought of were ruled out one by one.

Just as Shi Weiming entered the intensive care unit, the patient lying on the hospital bed suddenly vomited. Breathing becomes short, and there are symptoms of convulsions.

"Quickly, give low molecular weight L-anhydride and 5% glucose salt. Shi Weiming said.

However, the patient's condition has not improved, but has been deteriorating. The patient's condition did not improve, but the ends of his limbs began to become cold, the skin on the dorsum of his feet appeared purple reticulation, and his consciousness began to become blurred. The mind expands slightly to the left. Occasional fine crackles are heard at the base of both lungs.

I saw that the patient's black breath seemed to be accelerating, and the situation became more and more critical.

Zhang Zhenyuan naturally knew that the situation was not good, and the beads of sweat on his forehead rolled down like rain.

This Zhang Zhenyuan is a student of Teacher Qi, and I was able to come here for an internship thanks to him. He is also kind of kind to me, so at this time, I can't sit idly by.

"Dean Zhang, since the patient has symptoms such as coughing, breath-holding with dizziness, chest pain, etc., why not consider pulmonary thrombosis? I know that our hospital has minimally invasive hemodynamic monitors. I walked up to Zhang Zhenyuan and said quickly.

Originally, Zhang Zhenyuan had just come out of the intensive care unit, and he was blocked by an intern, and he was very annoyed, but after listening to me, his expression moved.

"Time is running out, if the best treatment time is delayed, the gods will be saved!" I hurriedly warned.

Zhang Zhenyuan hurriedly returned to the intensive care unit, this kind of instrument was already available in the intensive care unit, but because the possibility of myocardial infarction was ruled out before, this kind of instrument was not used at all.

"Quick! Get on the minimally invasive hemodynamic monitor!Focus on checking for pulmonary thrombosis!" Zhang Zhenyuan yelled to the doctor in the intensive care unit.

Misdiagnosis is often misguided by one misleading with another. In fact, all doctors are misled by some of the results of the examination. Because the pulmonary thrombosis has been directly ruled out before, there are electrocardiograms, fluoroscopy results, and percussion results, as if the pulmonary thrombosis can be ruled out. Everyone is starting to ignore this and think about more complex symptoms. Shi Weiming was also misled. He didn't think about pulmonary thrombosis in the first place. But now that Zhang Zhenyuan drank it so seriously, everyone suddenly woke up.

In fact, it is very simple, a normal ECG cannot rule out pulmonary thrombosis, and fluoroscopy results cannot tell people the true condition of the lungs in complete detail.

Although there are common symptoms of pulmonary blood clots, such as cough, chest pain, and syncope, no one suspects pulmonary blood clots. If it weren't for my special ability, I'm afraid that no one would want to think about the patient's condition from scratch, and maybe it would not be until the autopsy to wake up.

The results of the minimally invasive hemodynamic monitor showed pulmonary hypertension and pulmonary capillary pressure was normal or low. This is clearly the strongest proof of pulmonary thrombosis.

Urokinase 264000IU plus NS100ml intravenous infusion or intravenous injection for 10 minutes, followed by 132000IU/h for a total of 12 hours. Shi Weiming hurriedly said. After symptomatic treatment, the patient's condition quickly turned to safety.

"Shi Lao, this time it's really thanks to you. By this time, Lu Maozhu's face had also improved a lot. He could clearly see that his wife's illness had been diagnosed and improved.

Shi Weiming is not greedy for credit, after all, everyone on the scene saw that the turning point of the treatment was because Zhang Zhenyuan suddenly advocated focusing on the investigation of pulmonary thrombosis, "This time it is thanks to Dean Zhang that he thought of pulmonary thrombosis." There are many signs that rule out pulmonary thrombosis. But it is the excluded pulmonary thrombosis that causes the patient's condition to become more and more severe.

"I'm ashamed, but it's not what I thought. My teacher, Professor Qi Binhua, recommended me to a clinical intern. He just reminded me to consider a patient's pulmonary thrombosis. Zhang Zhenyuan wanted to take this credit, but the scene at the door just now was also seen by many people. He simply did not covet Huang Jingyang's merits.

"Oh, where is this classmate? It seems that he is really a bystander, and a fan in the play. There comes a time when we are deceived by instruments. Therefore, those who are healers should be cautious. Patients entrust us with their lives, and we must be cautious and walk on thin ice. Shi Weiming sighed.

"I'm going to call him in. "Zhang Zhenyuan has long forgotten my name, for him, how can a little person like me get into his eyes?

Zhang Zhenyuan strode out of the intensive care unit and stopped me who was about to leave, "Hey, wait a minute." ”

"I knew I couldn't escape. I had to turn my senses. Dean Zhang, do you call me?" I said helplessly.

"Yes, thanks to your reminder. The experts from Yanjing want to see you. And Director Lu also wants to see you. "Zhang Zhenyuan thought I should be flattered. But my performance was very calm, which surprised him. (To be continued.) )