The first patient I saw today didn't know what was wrong. Sun Lien rubbed the bandage on his arm and muttered a little in his heart. After a year of regular training, I was stitched twice. This time it is even more than he has accumulated in the past 20 years or so of his life. To say that you don't have any ideas in your heart is a lie.

"Doctor......" The door to the ninth consultation room was pushed open, and an old lady who looked a little trembling walked into the room. She looked at Sun Lien's bare and bandaged arms and asked cautiously, "Are you okay?"

When asked by a patient in his own office if he was okay, Sun Lien experienced it for the first time. He smiled, pointed to the stool in front of him, and said, "I'm fine, you can sit down." After watching the old lady sit down, Sun Lien asked, "Where are you uncomfortable?"

The old lady still looked very uneasy, chattering about her discomfort, and on the other hand, she glanced at Sun Lien's arm from time to time.

"I didn't eat seafood before, especially shrimp. Li Huizhen sat in her seat and described her background to Sun Lien, "That thing looks like a tide insect in the countryside - have you ever seen a tide bug? Speaking of this, Li Huizhen couldn't help but shudder, and made a verdict that covered the coffin, "It's disgusting to watch." ”

"Uh-huh, I know. Sun Lien nodded with a wry smile, and continued to look up at Li Huizhen's status bar - this time, even the status bar seemed to understand Sun Lien's pain of being stitched up, and gave a straightforward answer to the question, "Mild allergic reaction".

"I'm not...... A few days ago, some relatives came to the house. Li Huizhen was still muttering, "They came from their hometown and brought a lot of frozen wontons, saying that they were produced by some old store at home." ”

Sun Lien nodded his head and began to think about what medicine to prescribe to Li Huizhen. Listening to the patient's self-report as much as possible in the shortest possible time will not only help the diagnosis, but also make the patient feel valued and the supervisor feel more comfortable. This is also a technique that Sun learned from Dr. Pascal.

So they cooked it for me. Li Huizhen scratched her neck and sighed, "As a result, I have been itching all over my body since I finished eating." My daughter-in-law said that I had allergies and had to come to the hospital to see a doctor. ”

"Your daughter-in-law is right. Sun Lien nodded, put on gloves, walked to Li Huizhen's side, and cautiously glanced at her neck. "But it's not too serious, it's just a rash. ”

"I also think it's just a rash, and I shouldn't go to the hospital. Li Huizhen agreed with Sun Lien's judgment, "But my daughter-in-law has to let me come here, anyway, I don't have anything to do, just run a trip." Speaking of this, Li Huizhen looked at Sun Lien's arm again, "I just saw it, you can fall a lot at once." ”

"In order to rescue, if you fall, you will fall, and it will not be tight. Sun Lien smiled and nodded, and then said to Li Huizhen, "How long have you been itching like this?

"Almost, since I finished eating at noon yesterday until now. Li Huizhen looked at her arm, and there seemed to be some rashes on it, "Fortunately, it's a little itchy, and it's over after putting up with it." ”

Sun Lien thought for a while, put down the pen in his hand and said, "The degree of your allergy is not too serious, but it may just be because the amount of allergens ingested is not enough." He said seriously to Li Huizhen in front of him, "You must be vigilant about allergies, although most allergies may be itchy on the body and pass, but there are also some allergies that may cause serious and lasting damage." For example, asthma, even laryngeal edema leading to suffocation, cardiac arrest, etc......"

Sun Lien said seriously, but Li Huizhen didn't seem to take it too seriously, "I know this problem, it's just that itchyness on my body after eating, and it's not in the way." ”

"If you say that, I'll have to prescribe you medicine. Looking at Li Huizhen's appearance, Sun Lien had an idea, changed his way of thinking and began to persuade, "You usually eat things that cause allergies, so you have to take medication for a long time to control it, and you have to go to the outpatient clinic to open calamine lotion and rub it on the rash." ”

Sure enough, Li Huizhen immediately became serious, "Do you want to take medicine all the time?"

"If you try to avoid eating allergies afterwards, that's okay. Sun Lien lit the table with his hand, "In that case, I don't need to prescribe medicine." ”

"Then I won't eat it. Li Huizhen nodded like a chicken pecking rice, "I will never eat it again." ”

Sun Lien thought that he would have to persuade him a few more times, but he didn't expect to get such a good effect now. Shocked for a second, he returned to normal, then nodded, "That's fine." Don't take a hot shower for the next two days after you go back, and then observe the rash a little, if it goes away on your own, it's fine. If it's not going to go tomorrow, you can come back to the hospital to have a look. He quickly typed a diagnosis slip, and then pasted it on Li Huizhen's medical record, and then advised, "When you go back, you must not eat anything that makes you allergic." ”

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The first case was resolved, and the second patient quickly walked into the office. This case wasn't necessarily difficult - it was just a hot cold. After Sun Lien looked at the status bar and confirmed that there was nothing wrong with the patient, he asked the patient to go to the laboratory department for blood collection and testing. And while waiting for the test results, a third patient was admitted.

"Doctor...... I guess it should be in the outpatient department, but I've been having a fever since yesterday. The patient limped into the room and said to Sun Lien, "I really can't get the number of the outpatient clinic, so the nurse asked me to come and have a look." ”

This description is not helpful in any way for diagnosis and treatment. Sun Lien frowned and looked at the top of the young man's head, and then felt that things might be a little tricky.

Feng Yiming, male, 21 years old. Paronychia (264.51.33), increased leukocyte index (52.66.34), increased heart rate (48.44.31), high fever (35.51.45). ”

If you only see paronychia, this patient really shouldn't come to the emergency department. He should have gone to a dermatology or general surgery clinic. However, the last three states made Sun Lien suddenly more vigilant, and these three were put together...... How to look at it looks like a sign of bacteremia.

Paronychia causes bacteremia? Sun Lien frowned, it is not impossible, but it is indeed relatively rare. After all, paronychia is so tormenting that few people can carry it until the disease progresses to bacteremia before coming to the hospital.

"You may be seated. After letting the patient sit down, Sun Lien decided to start with a consultation, "Where are you uncomfortable?"

The patient pointed to his feet, "You...... Why don't you come and see this?"

Sun Lien nodded, pulled down the screen, tightened the seal on the mask, and then put on gloves and walked around from behind his desk.

This is...... A tormented big toe. Yellow translucent clots and red blood can be seen in the nail grooves on both sides of the toes, and pus can be seen under the nail slices below the clots. The skin tissues on both sides of the nail groove are red, swollen and swollen, and even break through the epidermis, forming a large area of irregular molting.

"It's paronychia. Sun Lien sat back down, "When did you start to have a fever?"

"Yesterday...... Afternoon, right?" Feng Yiming thought hard for a moment, "I feel cold all over my body, and I think I probably have a fever." ”

Sun Lien silently handed over an electronic thermometer, motioned for Feng Yiming to clinch the thermometer under his armpit, and then continued to ask, "Are there any other symptoms, such as headaches and trembling?"

"A little headache......" As soon as Feng Yiming said a word, the thermometer began to make a "dripping" sound, Sun Lien took the thermometer and glanced at it, forty degrees Celsius.

"You're probably going to have to be hospitalized. After reading the thermometer, Sun Lien turned his head and gave Feng Yiming a list of blood tests, and decided to personally operate the blood collection - patients with a high fever of 40 degrees Celsius, where can they let people go to draw blood by themselves? What can I do if I faint from the fever on the way?" ”

"Who's that...... Brother Liang!" Sun Lien caught the strong man of the security guard Brother Liang in the rescue hall, "Please push me over the bed." ”

"What's wrong?" Brother Liang ran towards Sun Lien while pushing the bed, and fainted again?

"If you have a high fever, let's send someone to the emergency room first. Sun Lien took Brother Liang to his consultation room, and then arranged Feng Yiming on the board bed, "You are lying on it, is there anyone from your house?"

"Huh?" Feng Yiming, who was already a little confused, thought for a while before shaking his head, "I'll come by myself." ”

"Call your family, I have to go through the hospitalization procedures for you, are you not allergic to cephalosporin?" Sun Lien returned to his computer, and after a burst of crazy keystrokes, he prescribed cefoperazone injection to Feng Yiming, and then thought about it, took out his mobile phone and called Puwai, "I'm Sun Lien, is there a bed in our general surgery hospital?"

"The inpatient unit is full now, and we have to have beds tomorrow. The doctor on duty on the other end of the phone checked the hospitalization form and replied, "What's the problem?"

"In one patient, paronychia may have triggered bacteremia. Sun Lien thought for a while and asked, "Then let's arrange an outpatient surgery here, right?"

"Paronychia is fine. It'll be done in a moment. The surgeon on the other end of the phone quickly agreed, "But if you are hospitalized, since it is for bacteremia, then don't give us a department." It's better to let the infectious disease department take it down for treatment. ”

Surgery, of course, is reluctant to admit patients with such minor surgeries and major treatments. Of course, it is best to be able to push the troublesome work to others. What's more, surgical treatment for bacteremia is really not a good idea.

Sun Lien thought about it and decided to wait for Feng Yiming's family to arrive at the hospital and talk to them about the situation - bacteremia is a very serious symptom. If you don't deal with it quickly, you will be worried about your life.