【153】Sometimes the patient's family members are more nervous than the patient
"Okay, you said she has an irregular heartbeat. Where does the electrocardiogram show a problem?"
Zhao Zhaowei frowned and tried hard to recall the electrocardiogram of the patient he had just seen: "Yes, there is more than one P wave. This is -"
"What is it?"
"Sinus arrhythmia?"
"Do you think she has sinus arrhythmia? Just to make sure."
Zhao Zhaowei wanted to cry again. Even the diagnostics textbook and internal medicine textbook didn't seem to explain the electrocardiogram in such detail.
"Teacher, I don't know how." Zhao Zhaowei admitted defeat again.
"I can't read the electrocardiogram after making it. What do you think is going on?"
"It's my fault." Zhao Zhaowei surrendered for the third time.
Dr. Lin turned to Xie Wanying and asked: "What do you think?"
"It is very common to have an electrocardiogram but not be able to read the problems in the electrocardiogram, because many heart diseases are hidden. If you want to draw a conclusion, it is impossible to determine it by just relying on an electrocardiogram. In addition, the electrocardiogram itself will be subject to a lot of objective
The influence of factors. For example, the patient's mood. Like this female patient, it is obvious that she has respiratory sinus arrhythmia, which is a very common manifestation in teenagers, with the pp interval greater than 0.12 seconds. She was also very abnormal during the examination just now.
Nervous. But you must know that the patient’s main complaint was that he was sent to the emergency room because of panic, dizziness, or fainting. Other diseases cannot be easily ruled out.”
After listening to Xie Wanying's words, Zhao Zhaowei remembered: "Yes, it's not that there is more than one P wave, it's that the P wave interval has been extended."
Of course Dr. Lin knew that sinus arrhythmia was correct, otherwise he would not have questioned the student. He was focused on Xie Wanying's next sentence: "What other possibilities do you think may have caused her to faint?"
"In addition to other cardiac tests, we should first do a blood test to rule out abnormal thyroid function, rule out blood potassium problems, and rule out whether she has taken any drugs that have affected her body. Let's do a comprehensive examination.
"As she said that, Xie Wanying looked at the patient, and she really couldn't tell that this female student had a particularly big problem. If she had to say there was a problem, maybe the parents of the female student standing outside had some health problems because she was older.
Dr. Lin knew it by looking at her expression, smiled slightly and walked away. Basically, Xie Wanying agreed with him.
For high school seniors, parents are always more nervous than students. Therefore, Xie Wanying is right. Helping patients conduct a comprehensive examination is also responsible for parents who are too nervous.
Seeing the teacher leaving, Zhao Zhaowei and Xie Wanying walked to the side and wiped their sweat: "Yingying, from now on -"
"Otherwise, I will avoid being with you in the future." Xie Wanying also knew that her rebirth had an advantage over Zhao Zhaowei, which was unfair to Zhao Zhaowei and the others.
Who would have thought that as soon as she said these words, Zhao Zhaowei held her hand hard and begged: "No, no, no. You must not do this. You must know that I have been in the neurology department these two days and have no chance to do anything.
I don’t know what I’m doing wrong at all, because the teacher can’t get excited when he sees me.”
Clinical teachers are not like lecturers in the classroom. Most of them are extremely busy seeing patients on weekdays. They have not received training in education and have no eloquence in teaching. If you tell students a few sentences and find that they don't understand, you will definitely stop talking.
It's nonsense, talking like a chicken and a duck. If you want clinical teachers to speak more, they must at least be at the level of Xie Wanying.
Dr. Lin was willing to talk more because Xie Wanying made him feel the same atmosphere of academic discussion as his colleagues, which felt good.