Taking out the pen from his pocket, Nie Jiamin placed his eyes on the medical record, his silent face obviously thinking about something.
There must be some differences between overseas teachers and domestic teachers. Xie Wanying was observing the outpatient medical record that Teacher Nie corrected for her. Unlike Teacher Tan, Teacher Tan almost did not correct what she wrote. Domestic outpatient medical record writing book
It's relatively simple, just reflect the patient's main symptoms.
It seems that she is known to be very careful in her work, and her writing usually exceeds what the teacher requires.
Unexpectedly, after Teacher Nie picked up the pen, she added a lot of things to the back of the medical record she wrote. For example, she wrote on the auscultation record of the child that the breath sounds in the right lower lung disappeared. Nie
The teacher added that the child's lung inspection, lung percussion, and lung palpation should be performed, whether there is any abnormality or not, all should be written down.
Taught a lesson. Xie Wanying recalled that her colleagues in the past seemed to have said that doctors abroad pay great attention to paperwork because once overseas doctors get into lawsuits, the legal system and paperwork are stricter than in China. Writing down the patient’s normal physical signs is equivalent to the doctor doing this to the patient.
Regarding the investigation, if you don’t write it down, you may not be able to verify whether the doctor has done it himself. This means that the doctor may be irresponsible and miss the diagnosis if the investigation is not careful.
The domestic situation is different from that overseas because there are so many patients in China. The number of patients that domestic outpatient doctors see in a day is unimaginable by doctors in developed countries. Given the large domestic population base, the number of patients is huge.
Overseas doctors don't seem to have the concept of shortening the consultation time for each patient in order to see all the patients.
Looking at a sick child, Nie Jiamin looked at it slowly and thought about it slowly.
No other doctor in the country would dare to do what he did.
After all, they are experts specially hired by the hospital.
Xie Wanying never dared to urge Teacher Nie to speed up, even if she reminded Teacher Nie of the long queue of parents and children.
It is better to spot a sick child accurately than to read a bunch of sick children and identify the wrong child. I guess this is what Teacher Nie thinks.
Finally, Nie Jiamin's pen tip gave the child's preliminary diagnosis: foreign body in the lower trachea of the right lung to be investigated.
Since he was not very good at Mandarin, Nie Jiamin asked the student to communicate with his family. He didn't seem to have to worry too much about this, because looking at the student's performance just now, he was more reassured. However, after all, he was very meticulous in his work and needed to
Then ask the student what he thinks.
"When did you suspect that she had a foreign body in the trachea?" Nie Jiamin looked at her with a steady gaze and asked.
Xie Wanying recalled her thought process: "When the patient was not coughing, she began to suspect that her breathing was abnormal. Her chest was asymmetrical when it rose and fell with breathing movements, and she became more and more obvious to bend to the right when coughing, indicating that the right lung
It is blocked. The right lung bronchus is divided into ten segments. The foreign body is stuck between the mouth of positions 6 and 5. The foreign body may be small and does not completely block the trachea for the time being, but it will move down to positions 7 and 8.
Those thin bronchial tubes in position No. 1 are very dangerous."
Her sudden series of detailed answers surprised Nie Jiamin: She could actually determine which bronchus the foreign object was in? This is not equivalent to her eyes or brain being like an X-ray machine or CT machine that can see through.
Got the machine?
"It depends on the patient's CT examination results." Xie Wanying added cautiously.
