Chapter 141 Damn it, he got it again! (Please subscribe!)
"Will you come back later?" Luo Yun said more, mainly because he felt that the patients he just saw were too unpleasant.
Although he has returned to his profession.
But all the opportunities to show off were taken by Zhou Cheng, leaving him only with words.
While Luo Yun was reluctant to leave Zhou Cheng and left after pretending to be cool, Zhou Cheng actually didn't want to leave either.
Following Luo Yun, Zhou Cheng felt the long-lost feeling of being able to learn knowledge and skills from real people.
And this feeling is not found in other people.
It's not that Cai Dongfan and others are not qualified to teach Zhou Cheng anything, or that Zhou Cheng can learn nothing from them, but they simply don't have the awareness to teach.
He just asked Zhou Cheng to do things and did not take the initiative or consciously teach him.
But Luo Yun did it.
Moreover, Luo Yun allowed Zhou Cheng to see another side of medicine——
Medicine is not simply about diagnosis, prescribing medicine, and surgery, which is about curing diseases and saving lives.
"Teacher Luo, I came over immediately to help after I finished the emergency room. Zhang Zhengquan happens to be here to help." Zhou Cheng hurried back, thinking that Luo Yun was bringing someone to help him write medical records.
The person on duty today is not Du Yanjun, but Xu Yanlin from Yan Haihan's group.
This month's shift schedule is strictly as follows: Min Chaoshuo, Lin Lin, Du Yanjun, Xu Yanlin, Du Ruiqi, Zhang Zhengquan, Huang Yu, and Wang Yongxiang are on duty at Xianghaibin in turn.
There are three groups of three-day shifts. Whether it is a weekend or a weekday depends entirely on luck. This is also the fairest method of duty.
Du Yanjun was on duty on the third day, that is, he was on duty yesterday, but he called Zhou Cheng to prove that Du Yanjun had not finished the work in the department and had not returned yet, and happened to encounter another emergency patient.
The reason why Zhou Cheng thinks about this is mainly because he feels that he came to the clinic not long ago.
Very reluctant to leave.
Then Zhou Cheng walked towards the ward, his feet speeding up several points.
As a veteran who has entered the third year of training, Zhou Cheng knows very well that there are not many learning opportunities during the training period.
If he hadn't obtained the simulator system by chance, he would only be slightly stronger than Zhang Zhengquan now.
After getting a simulator, you can only improve your skills through simulated copies.
It will not improve other abilities, just like the very strong communication skills and control demonstrated by Luo Yun just now.
Yes, Luo Yun showed this strong control over the medical process, which made Zhou Cheng's heart beat.
Want to learn.
He almost ran to the department at a trot.
Then I hope to finish it as soon as possible and go back to the outpatient clinic as soon as possible to continue to figure out Luo Yun's thoughts.
When he came to the ward office, Zhou Cheng first saw Du Yanjun who was busy in front of the computer. However, Zhou Cheng was not prepared to look for him. Instead, he asked: "Yan Jun, where is Xu Yanlin on duty? Didn't he say there was an emergency call?"
?”
Du Yanjun stood up immediately when he saw Zhou Cheng and quickly replied:
"Brother Zhou Cheng, Yan Lin went to the emergency department for emergency consultation."
"When I was leaving, another child came into the department for emergency treatment. Brother Yan Lin took a casual look and found no fractures."
"So Brother Yan Lin asked me to help with it, so I called you!"
Zhou Cheng nodded. It was very normal for residents to help each other. Even if they were not in a group, they would not divide their respective tasks into such details.
Du Yanjun pointed to the computer and said: "I just finished asking about the medical history and am now watching the movie."
"I still don't quite understand it."
"Brother Zhou Cheng, why don't you come over and take a look first?"
The patient's plain radiographs were printed and placed in an imaging data bag, but in front of the patient, Du Yanjun knew that it would be inconvenient for Zhou Cheng to take him to see the films.
Although Zhou Cheng was anxious, he also felt that he had to watch the movie first to have a little bit of confidence in his mind.
only?
At least seven or eight minutes have passed since Du Yanjun called him. Du Yanjun still hasn't understood?
Could it be that this patient is still difficult to deal with? It will take a lot of time?
Thinking this, he frowned slightly.
Then Du Yanjun took the initiative to pull out the stool and let Zhou Cheng sit down. He pointed at the film and said, "The patient is a little girl about three years old. She has a history of trauma, but the history of trauma is not clear."
"Her mother said she took a picture in the emergency department and was brought to our department."
Speaking of this, Du Yanjun touched his head a little embarrassed and said: "Brother Zhou Cheng, because the epiphysis of a child is not fully developed, I am not sure whether the patient has a fracture or not."
"It's still dislocation."
"The sign of physical examination is pain when pressing, and other physical examination signs are uncooperative."
Zhou Cheng nodded and looked at Ping Pian.
It is very difficult to read orthopedic radiographs in children because the epiphysis is not completely closed and there may be hidden fractures that are difficult to detect.
And because the epiphysis is discontinuous, it is difficult to evaluate even slight dislocations.
If you encounter the radiograph of the wrist joint, it is even more complicated, because the bones of the wrist joint only appear together every few years.
It's even harder to judge.
If orthopedics must be separated into a separate department, pediatric orthopedics can definitely be listed separately...
However, when Zhou Cheng looked at the flat film, he also frowned slightly.
Because according to Du Yanjun's guidance, he also looked at the child's elbow joint. Although the epiphysis was separated from the backbone, the edges were basically flat and aligned.
Under such circumstances, obvious fractures can basically be ruled out initially.
The reason why only obvious fractures can be excluded is because occult fractures may require CT and MR to be further displayed, and plain radiographs cannot show fracture information.
However, the child was in pain during the physical examination and was unable to cooperate.
Therefore, the possibility of hidden fracture cannot be completely ruled out——
Continue to look at the joints, the joints are in place...
"Are there any lateral plain films?" Zhou Cheng asked again after seeing no problem in the front view.
"Yes, it's on the next page." Du Yanjun hurriedly replied.
Zhou Cheng clicked the mouse. After reading, he put his hands on his chest and frowned even more.
Not dislocated?
No fracture?
What's the reason for the child's pain? Could it be that the ligament is broken?
He touched his head and turned around and asked: "Have you done a physical examination? How is the triangle relationship behind the elbow joint?"
Zhou Cheng asked quickly.
When plain radiographs can’t tell you anything, you have to look for clues through physical examination!
The patient is a three-year-old girl who was brought here by her parents. No fracture or dislocation was seen on the plain radiograph. This is very similar to the subluxation of the radial head that cannot be diagnosed by imaging examination and needs to be confirmed by medical history!
However, one of the diagnostic differences between radial head subluxation and other dislocations of the elbow joint is whether the posterior triangular relationship of the elbow joint is normal.
If it is abnormal, it is definitely not radial head subluxation, but if it is normal, it may not be certain that it is radial head subluxation.
To understand this situation, you may have to ask the family members carefully.
The diagnosis can only be made by looking for clues from the medical history, physical examination results, and imaging examinations.
"I've touched it and found that the triangular relationship behind the elbow is normal and not a posterior dislocation of the elbow joint." Du Yanjun nodded quickly and even eliminated one of Zhou Cheng's inner doubts.
If the elbow triangle position is normal, elbow joint dislocation can basically be ruled out.
Then this patient is probably that thing.
Zhou Cheng breathed a sigh of relief and said, "Let's go check on the patient's condition together. I really haven't figured it out yet."
But Zhou Cheng didn't say it clearly. This was just his empirical judgment. In many cases, experience cannot be simply used as dogma, nor can experience be ignored.
We absolutely cannot rely on empiricism to automatically determine the diagnosis!
Will suffer a loss.
Soon, Zhou Chengcheng and Du Yanjun came to the operation room.
After walking in, Zhou Chengcheng saw that the patient was a very cute little girl with two pigtails and a pink and fleshy face. She should be a very cute little girl in normal times.
But at this moment, her eyes were red, her mouth was depressed, as if she had suffered endless grievances, and her nose was stuck to her nostrils, making her look a little dirty. Her mother was going to wipe her nose.
But the little girl always let her mother's hand hold her little fleshy forearm and refused to let her go, as if she would be in great pain if she let go.
Seeing the white coat coming in, the little girl seemed to remember the pain of having a needle tap her butt again, and she shivered dominantly.
He quickly got into his mother's arms and started crying: "Mom, Mom, I'm afraid."
However, her mother still hugged her and stood up slowly. At this moment, her face was very distressed and she said: "Doctor, what's going on with my daughter's hand? Have you seen the film and found that there is no problem?"
His eyes were full of nervousness.
"There is nothing special so far. Are you her mother? When you were playing with her, did you lift her or pull her and she cried?" Zhou Cheng asked.
The diagnosis of radial head subluxation strictly requires parents or caregivers to confirm the medical history.
The child is ignorant and incapable of acting, so it is impossible to ask her.
Pediatrics is a dumb department, that's how it comes about.
But the little girl's mother shook her head and said, "I didn't lift my Qiqi's hand. How could I lift her hand so hard?"
"She is still so young, how could I possibly pull her with all my strength?"
"She's such a doctor. Actually, I don't know what's going on with her."
"I had just sent her to kindergarten, and before I even got home, her teacher called to tell me that Qiqi was crying. She said that she suddenly started crying when she was playing with the children."
"Is this a joke among children, so you are injured? Is it serious?"
She is a mother. Her daughter is just three years old this year and goes to kindergarten.
She had just entered the workplace again. On weekdays, her grandparents would pick her up and drop her off. Today happened to be the weekend. In order to spend more time with her child, she went to see her off in person. But she made her daughter so beautiful that she even agreed to pick her up and take her home.
Be good in kindergarten.
It's just that she sent her daughter to kindergarten, and before she got home, the teacher called like this!
Fortunately, the child's grandparents don't know the situation yet, but they will definitely know. I don't know what they will say about me then.
It's usually fine, I only delivered it once, and something like this happened.
After hearing this, Zhou Cheng frowned: "You didn't pull her? Did this happen when she was playing with children?"
"Then you didn't ask the teacher about the specific situation?"
"It is difficult for children to cause subluxation of the radial head if they are fighting among themselves. They should not be so vigorous."
"Can you please call and ask her teacher, because this is very important."
"We didn't find any other special conditions on the plain radiograph, but you also saw that your daughter's hand hurts a lot."
"But based on your current description, we don't have enough evidence to give a diagnosis that we think is the most likely."
Zhou Cheng was bitten by a snake once and was afraid of well ropes for ten years.
Zhou Cheng still has lingering fears about the child who was brought here by his grandparents and the whole family.
Even though I later gave him fruits and banners, when he started scolding me, it was really unpleasant.
The diagnosis of radial head subluxation requires medical history.
The child is mute and cannot explain the situation clearly by himself.
Parents don't know the situation, so they can't guess. If it hurts for no reason, then if they try to reset it rashly, they will be in real trouble.
Moreover, clinical medicine is a rational subject. Without corresponding incentives, you cannot make a diagnosis on your own!
Otherwise, your knowledge system will not form a circle. If you cannot cause and effect each other, there will eventually be a big mess.
Subluxation of the radial head requires a history of relatively violent trauma.
Without this inducement, this diagnosis cannot be made.
"Ah? You still need to call her teacher to ask her? Is this important?" The woman was about 26 or 7 years old, the same age as Zhou Cheng. When she heard this, she obviously felt quite troubled.
In fact, she didn't want to embarrass the teacher too much. She thought she was a difficult person because she had just passed the teacher exam herself. She knew that a teacher had to deal with many students alone.
I was asking the teacher here and there.
To be honest, how can the teacher control everyone from playing with and contacting each other?
Isn't it normal for children to fight with each other?
Zhou Chengcheng said: "It is better to ask clearly, because the medical history has always been an important evidence in the diagnosis process. How was the injury sustained? Will it affect the direction of diagnosis?"
If there are incentives, it's easy to say. Anyway, the patient just needs to make a phone call.
But if there is no inducement and pain occurs for no reason, the child's current age is also the age when osteosarcoma is most common. What if there is a sudden destruction of the periosteum and severe pain?
That's not something that reset can solve...
Bone tumors will cause bone destruction, and the hardness of the damaged fractures is not high. Even a slight force can cause hidden fractures. These are completely different things...
The diagnosis of radial head subluxation is easy to diagnose, but very difficult to diagnose. However, in the process of reading the literature, Zhou Cheng discovered that similar medical disputes had existed in the past...
The woman immediately dialed the number, but during the process of asking, she turned on the loudspeaker.
But the teacher on the other side said very firmly: "Child Qiqi suddenly started crying when she was playing with other children. Which hospital did you go to?"
"I'm at Shashi No. 8 Hospital," the woman replied.
The person on the other side probably didn't know that the woman was using the loudspeaker, so she said, "Why are you going to the No. 8 Hospital? It would be better if you go to the No. 2 County Hospital or a larger hospital."
"I asked my colleague's husband, who is also a doctor, and he said that the level of orthopedics at the Eighth Hospital is not very good. Of course, as a teacher, it's not easy for me to talk about this." The teacher opposite was quite polite and cryptic.
say.
The woman turned off the loudspeaker halfway through, but Zhou Cheng and Du Yanjun both heard what was supposed to be heard.
The woman also said a little apologetically: "I'm sorry, the two doctors and the teacher may not know the specific situation, so they are worried about my daughter's condition, so their language is a little extreme."
But the woman obviously believed what the teacher said, and asked again: "I think you two are not very old. If you are not sure, can you please call your superior doctor or director to come and help?
"
The woman's cultivation was pretty good, and she relayed the meaning of her daughter's teacher in a rather subtle way.
Du Yanjun suddenly smiled bitterly!
Well, here comes another person who doesn’t believe in Zhou Cheng.
Zhou Cheng also nodded: "Okay, you may have to wait a while."
"Today is the weekend and our director didn't come to the ward, so I have to call him. Maybe one of our superiors happens to be visiting the outpatient department today. How about we go to the outpatient department to see him together? It's better than just waiting here.
Be faster."
"And there is no need for you to go back and forth. If you want to review the results of the plain film later, you can go directly to the outpatient clinic to do it."
"What do you think?" The woman was polite, and Zhou Cheng also gave a more pertinent suggestion.
Zhou Cheng was not angry, because anyone could find a reason to despise him because of his age. There were so many such things, and young doctors couldn't see it right. It was normal to want to find an experienced doctor.
It's something that everyone has, it's not specific to him.
"Thank you, doctor." The woman nodded, picked up her daughter and stood up.
Although Du Yanjun was a little unhappy at the moment when Zhou Cheng took the patient away, because she wanted to see how Zhou Cheng would deal with it later, either to learn or to be an assistant.
But the patient doesn't trust Zhou Cheng, and there's nothing he can do about it. He hasn't finished the work in the department, so he can't leave.
He turned around, sighed, and returned to the office to continue his work.
Soon, Zhou Chengcheng came to the clinic with a woman and a child.
There were many people queuing up outside the clinic. When they saw Zhou Cheng was about to lead the woman and the child in, someone immediately shouted: "Hey, doctor, what are you doing? Do you want to bring your relatives to jump in the queue?"
Zhou Cheng hurriedly took out the emergency medical record book the woman bought in the emergency department and explained: "It's not that she jumped in line. This little girl came from the emergency department."
"If you have some understanding and patience, it won't cost you a lot of time."
After hearing this and seeing the emergency medical records, the speaker pursed his lips.
The woman bowed slightly and said, "I'm sorry, everyone, my daughter suddenly had severe hand pain, so the emergency department asked us to come here to find a doctor."
When she bent down slightly, she may have accidentally touched the elbow of the little girl in her arms. The little girl immediately cried in a low voice: "Mom, it hurts!"
Her hands were still trying their best to hide.
Seeing the little girl's expression, everyone felt soft in their hearts.
An aunt in front quickly said: "You go in first, don't delay here, your baby looks pitiful, everyone needs to understand a little bit, do you think this baby is crying?"
…
When Zhou Cheng brought these two people into the consulting room, Luo Yun and Zhang Zhengquan were treating another patient.
Luo Yun raised his head, glanced at Zhou Cheng and others, and continued to see the doctor without Zhou Cheng being disturbed.
After sending the patient for examination, Luo Yun asked: "Xiao Zhou, what's the situation with you?"
The woman then explained the child's condition, and Zhou Chengcheng also explained: "Teacher Luo, this little girl's elbow pain is severe, but she has no history of violent stretching. She said the pain suddenly started when she was playing with children."
"On physical examination, there was tenderness and the posterior elbow triangle relationship was normal. No fracture was found on the X-ray. The patient said I couldn't understand it and asked the superior doctor to take another look."
"I brought them to you." Zhou Cheng explained seriously, fearing that Luo Yun would suddenly think of the subluxation of the radial head.
"Isn't this subluxation of the radial head?"
How experienced is Luo Yun?
Would this kind of disease still cause trouble to him?
Children and parents come to the department together with a history of trauma and pain in the elbow joint. This is the diagnostic formula for radial head subluxation.
If Zhou Cheng doesn't know how to read this, then he really thinks highly of Zhou Cheng.
But out of trust in Zhou Cheng, Luo Yun still said to Zhou Cheng: "Can you hand over the film and take a look?"
Zhou Cheng quickly found the plain film and placed it on the reader.
Luo Yun and Zhang Zhengquan both stood up and came over to watch carefully.
Only a minute later, Luo Yun turned around and asked: "Have you really never mentioned your child's hand? This is very important!"
"If you haven't mentioned it before, this issue may require an MRI. Think about it carefully."
"Don't complicate simple things so as not to cause too many misunderstandings."
"Let's put it this way, in her current situation, if there is no history of violent stretching, we may have to consider cancer. This is time-consuming and labor-intensive..." Luo Yun didn't understand the other problems, so he treated the woman like this
Said.
I just hope women can stop hiding their medical history.
When she heard the word cancer, the woman's face immediately changed, her eyes turned red immediately, and she quickly said:
"Doctor, I don't know the specific situation. Can I make a call and ask?"
"Can my daughter sit here for a moment?"
"I don't want it, Mom, I don't want it, I'm afraid." Qiqi immediately shook her head like a rattle.
She was afraid of being with these white coats.
Luo Yun said: "You can make a call here. Let's listen together and we can ask more clearly."
"Aren't you always with your daughter?" Luo Yun preconceivedly thought that the mother and daughter had always stayed together.
The woman dialed the phone again and asked the same teacher the same questions.
Luo Yun probably knew what was going on.
The woman said: "Teacher Wu, I'm sorry to disturb you again. The doctor here, and he is also the attending doctor, is here to ask if Qiqi has ever been pulled hard by anyone at school!"
"How did she get injured? Can you tell the doctors in detail?"
Teacher Wu on the other side heard this and snorted very displeasedly.
Then he opened his mouth and said in a long voice: "I have told you several times that she suddenly started crying when she was playing with the children. Why don't you believe me?"
"Then why do you want me to ask? Do you think your daughter was injured by a classmate? But I have asked all the classmates in the class, and none of them had a conflict with Qiqi."
"Mom Qiqi, you don't believe me even if I ask you to go to a larger hospital and take a closer look."
"Then what exactly do you want me to say? I can't just say that your daughter was beaten out of thin air, right? If she was beaten, there must be scars on her body, right?"
"Qiqi, you didn't fight with anyone today, right?" She then asked Qiqi.
Qiqi quickly said: "Teacher, I didn't fight, I was very good!"
At this time, the woman also looked at Luo Yun in embarrassment.
Luo Yun looked into the phone from a distance and said, "I probably understand what it means. That is to say, the child was at school, just playing with other children, and then he suddenly started to feel pain, right?"
"Who were the people playing with her? What were they playing with? Were the parents of other children present?"
"Her current pain symptoms are not like children's play."
"Children don't have that much power!"
"If you insist on explaining the situation clearly, teacher, I would suggest this lady to call the police directly, saying that someone is abusing her child?"
Luo Yun knew very well that the diagnosis of radial head subluxation required a relatively large amount of external violent intervention.
This kind of inducement is extremely normal and common, but such an inducement is needed to confirm the diagnosis. If it is kept hidden and delayed, the child will be in pain and it will be difficult for them to make a diagnosis.
Clinical medicine itself is rigorous and has its own logical thinking.
And we can also deduce some of the following things. This has not been revealed yet, but if the battle breaks out, it will not look good on everyone.
After Luo Yun said this, the voice of Teacher Wu opposite him immediately became louder:
"What's wrong with you, the doctor?"
"Do you have any evidence? Why are you talking nonsense? What kind of abuse? Who are you saying is the abuse?"
"Who are you suspecting?"
"Are you a police officer or a doctor?"
Luo Yun replied truthfully: "I am a doctor. I am only responsible for treating patients, not for suspecting or investigating cases. I am not even responsible for finding evidence."
"but."
"I can't find the cause of the child's pain now. I asked the family member and she also said that she was not present. Based on my experience, I can confirm that the child is very likely to have suffered violence from the outside."
"But you also said that there is no such situation, so I can only advise them to go to Shonan University Affiliated Hospital for treatment, and suggest that she should call the police."
"What does this have to do with whether I am a policeman or a doctor?"
Luo Yun was already certain of the child's diagnosis and suspected that the teacher was lying.
When Qiqi's mother heard this, she interrupted and asked, "Doctor? Is this really my child?"
"Do you really want to call the police?"
Luo Yun said: "If it is confirmed that there is intervention from outside forces, the matter is actually not serious. Just do a manual reset and go back to have a good rest for a few weeks. But the specific reason for this kind of thing has not been found yet, and I can't explain it.
.”
"So I don't rule out that your child may have been subjected to unknown threats or abuse. Now the country attaches great importance to this area, and you have to report it to the police."
"Anyway, the child has such symptoms now. As for whether it is real, I don't know. I am just inferring based on my experience. I believe the police will also provide us with a final answer."
What Luo Yun was waiting for was the teacher's conclusive words.
There has been trauma.
There has been external intervention.
The person on the other side was silent for a while, and then said angrily: "You are a doctor, you are simply unreasonable, your skills are not good enough, and you cannot diagnose the patient accurately, so you start to act rogue, making excuses here and there."
"Wouldn't it be better if you take good care of the doctor and deal with the child's problems? This is what you should do."
"Mother Qiqi, I really suggest you change to another hospital. The quality of these eight hospitals is not good. They can't understand it at all and they can't see it well."
"Don't waste time there anymore, go to the No. 2 County Hospital."
She mentioned Qiqi's mother directly and confidently, but she obviously lacked confidence.
Luo Yun didn't say much, he just said to Zhou Cheng: "Zhou Cheng, write down the child's emergency medical record carefully. Write it clearly!"
Then he said to the woman: "Actually, I have a diagnosis in my mind, but now there is no evidence to support my diagnosis, so I cannot rashly treat your child."
Luo Yun has already made it very clear.
When treating a disease, you should not just look at the surface of the problem. Your child may have a hidden history of trauma. I have reminded you of this level.
If the other party, as a parent, is not willing to care about such things, then Luo Yun will not be too troublesome. He is just a doctor, and he only needs to take good care of the disease. As for the cause of the disease, he will just treat it as a confused account.
It's just that the reason why Zhou Cheng and Luo Yun were entangled before was to avoid a similar situation happening again.
After all, if it happens the first time, if you don’t find out the reason, it is very likely to happen a second time.
If one kindergarten doesn't work, you can just find another one.
But this kind of thing is not something Luo Yun should directly interfere with.
The woman's expression became tangled. She looked at Luo Yun and asked, "Doctor, do you suspect the teacher and others are lying?"
"My Qiqi? Is she really?"
"It's impossible." I couldn't believe that my child might have encountered it.
Abuse, or the teacher knew about the situation but didn't say anything.
Luo Yun did not make it clear, but just said: "The textbooks we study are the summary of a lifetime of hard work by the older generation. It is also the experience that many, many children have personally experienced in the past."
"Would you rather believe that the teacher is lying, or would you rather believe that your child has encountered a rare exception?"
"I still prefer the diagnosis that she has subluxation of the radial head!"
Then Luo Yun changed the subject again: "Of course, if you don't want to perform a surgical reset so recklessly, we can also continue to investigate other aspects and wait until we take an MRI."
The woman's expression immediately changed and she said: "Doctor, it's not that I don't believe you. It's just that my husband is a police officer here in the Star District."
"The kindergarten teachers also know about this situation. I think they should not lie to her, or take the initiative to abuse Qiqi!"
"Isn't this asking for trouble?"
"My daughter's current condition, shouldn't it be cancer?" This is a question that women are more concerned about.
After hearing what the woman said, Zhou Cheng, who was writing medical records on the other side, immediately froze!
He looked at the little girl, his eyes moved slightly!
Damn it?
Really? No history of trauma!
If what this woman said is true and her husband, Qiqi's father, is the police here, then the possibility that the kindergarten teacher will deliberately lie about the medical history is extremely small. The possibility of harming her will certainly be even smaller.
Let's be honest, who would want to abuse a police officer's child?
Isn't this a lantern in the toilet?
If you say this, then the situation that you suspect, the situation that Zhou Cheng least wants to see, becomes true.
He raised his head and looked at Luo Yun.
Luo Yun's expression suddenly changed and he said, "Your husband? He is a policeman, and the kindergarten teacher also knows about this?"
If this is true, then all previous inferences must be overturned again!
His empirical diagnosis was wrong. Zhou Cheng said that he couldn't understand it and that this was normal.
The woman saw Zhou Cheng and Luo Yun's expressions changing so drastically that she was also frightened: "Why don't I call my husband and ask him to ask them properly."
As she spoke, the corners of the woman's eyes turned red.
It was obvious that he was extremely unwilling to accept that his daughter was the most impossible thing.
Then, Zhou Cheng asked with a slight breath: "Can I do another physical examination on your daughter?"
Zhou Cheng was obviously unwilling to admit this fact. He did not personally conduct a physical examination on the patient. The physical examination was performed by Du Yanjun. Zhou Cheng also believed that the physical examination performed by Du Yanjun was definitely correct.
But I also feel that he may not have checked thoroughly.
So I hope I can make something different.
The woman was extremely helpless at the moment and nodded sharply.
Zhou Chengcheng rubbed his hands and then explored them with his fingertips.
The physical examination of joint dislocation and the physical examination of tumors are actually different.
What I am confused about now is whether the radial head is subluxed. There is no visible deformity in subluxation, and it cannot be seen in plain films, but there is tenderness and limited movement.
If it is a tumor, you need to check the texture, base, mobility, edges, etc.
Zhou Cheng naturally followed the dislocation check first.
He just discovered that, with the permission of the child's mother and the patience of Qiqi with her eyes closed, when he palpated the upper section of the patient's radius, which is the position of the radial head, Qiqi did not cry out in pain.
You know, children are not adults. If they are in pain, they cannot help it!
Moreover, she shrank when Zhou Cheng touched her elbow!
Activities available!
This moment made Zhou Cheng's heart suddenly freeze.
This is not dislocation, then wouldn’t it be, completely...
Pain without obvious cause?
This made Zhou Cheng think of that bad thing, and then he checked the triangular relationship behind the elbow that Du Yanjun had checked, and it turned out to be normal.
Immediately afterwards, Zhou Cheng probed the lateral condyle of Qiqi's humerus and touched it. Qiqi immediately cried loudly in pain.
Half of the body was twitching!
It was obvious that he had touched a painful area.
"Mom, it hurts!" She put her hand away and got into her mother's arms.
Although her mother feels sorry for her child at the moment, she also knows that now is not the time to feel distressed. Even today can determine the fate and length of Qiqi's life!
However, Zhou Cheng did not touch anything he shouldn't have touched, but the child was in great pain, so he was not allowed to touch it.
Zhou Cheng quickly turned around and said to Luo Yun: "Teacher Luo, just take an MRI."
At the same time, I was very happy in my heart. Fortunately, I did not use empiricism to subjectively add a possible medical history to the patient - a history of trauma.
Otherwise, if we really reset her and then let her go, it would be really difficult to end it.
You know, even if it is a tumor, today's bone tumors are treatable. If treated early, it is very likely to be benign and lead to a normal life cycle. What if it is misdiagnosed?
Zhou Cheng's back felt a chill——
Quack doctors mislead people.
Luo Yun nodded, asked Zhang Zhengquan to write the examination form, and told the patient's family members: "You should take the examination form for the examination right away, and then after you finish it, you don't need to wait for the results, just come back here and I will read the pictures."
"Thank you, Doctor Luo." The woman worriedly took the examination sheet, hugged her child, and walked out...
Luo Yun was not in a hurry to call the next patient.
He just looked at Zhou Cheng and said somewhat complicatedly:
"This patient is so inductively pointing to a simple subluxation of the radial head. Why don't you perform a reduction on her?"
Subluxation of the radial head is best diagnosed by taking a medical history and does not even require auxiliary examinations.
It is especially likely to happen to children.
Good guy, he has just fallen into a misunderstanding. Before he can come out of it, he almost told his child's mother directly that your child's teacher is abusing your child. This is a history of trauma. Go ahead and sue her.
This is damn fixed thinking.
And Zhou Cheng!
He was actually able to proactively avoid this stereotyped thinking.
Even he wanted to diagnose her as radial head subluxation empirically, but Zhou Cheng avoided it.
It seems that he has been pretending again!
Moreover, the patient was specially brought from the ward with outpatient clothes.
Luo Yun really wanted to hit someone, so he glanced at Zhang Zhengquan sideways and found that his face was full of disbelief, as if he couldn't believe that his teacher Luo would make such a big mistake.
Luo Yun was so confident just now, but now he feels so embarrassed inside.
Zhou Cheng explained sincerely: "Teacher Luo, the main reason is that I can't find a medical history that can confirm the diagnosis. The diagnosis of radial head subluxation must be based on a clear medical history."
"Without such a medical history, I would not dare to make such a diagnosis."
"In fact, my first reaction was that her teacher lied to avoid her trouble."
"So I asked the child's mother to call and confirm."
"It's just that the child's teacher said that our hospital is unreliable and the doctors here are not good. I am not Teacher Luo, who can be so calm, so her mother did not let me see her child."
"This didn't give me a chance to make a mistake!" Zhou Cheng finished these words!
Then he responded with a silly smile.
Zhang Zhengquan's eye circles shrank slightly, and he was a little surprised. It turns out that Zhou Cheng can lick someone so comfortably?
Luo Yun rolled his eyes——
You don't have the chance to make mistakes, you are too cowardly!