The young man who was outspoken and dared to say anything ran over. In the cold winter weather, he was wearing a short-sleeved upper body, and he smelled of sweat.
"My mother complained that her back hurts again." He held on to the wall and panted towards Sun Li'en, "Can you go and have a look?"
At the beginning, the measures arranged for the young man and his wife, apart from racemic anisodamine hydrochloride and progesterone, were only "drink more water and wait for the passage of stones" and "stay in the hospital for observation".
The location for hospital observation was placed in the corridor next to the emergency room. After all, the emergency room was full of critically ill patients. Kidney stones are not life-threatening, and because of the severe pain, patients may vomit, cry out in pain, etc.
Situation. Observation in the emergency room is not conducive to the rest of other patients, nor is it conducive to the rest of this middle-aged and elderly woman with kidney stones. Therefore, Sun Lien specially arranged people to be next to the emergency room. There are not many people walking here at night, but it is the departure room.
It is very close to the nurse's desk. If anything changes, it will be more convenient for the medical staff to rush to the scene. Although the urology department can also receive patients, considering that she is in pain now, and the inpatient department needs emergency surgery, it is still difficult to
He had to push the person back to the emergency building, so Sun Lien decided to keep the person nearby to see the situation.
Again, kidney stones are not life-threatening. However, severe pain may cause dangerous changes in physiological reactions. If the patient has any problems such as aneurysm, and the pain causes a sharp increase in blood pressure, it may lead to
Aneurysm rupture and bleeding. Moreover, multiple vomiting and rapid breathing caused by continuous spasms may also lead to disorders of the blood environment. For example, hypokalemia or respiratory alkalosis caused by hyperventilation, etc. Therefore, for patients with kidney stones in the emergency department, it is generally
It is defined as Level 3 patient observation. For patients like this patient who still have persistent pain despite taking antispasmodics, they may need to be upgraded to Level 2 patients.
Pain will not kill you, but the impact of pain is hard to say.
"I'm going to take a look." Sun Lien stood up and asked Rachel to stay in the consulting room. He followed the young man and trotted out the door.
In the passage, the light is not too strong. At night, few people will walk in this corridor leading to the imaging department. Especially after twelve o'clock in the evening, in order to respond to the initiative of energy conservation and emission reduction, the property management will clear this corridor
Nearly half of the energy-saving LED lights are turned off. In this kind of place, the light is not too strong, allowing patients to close their eyes and sleep for a while. At the same time, it is not too dark for doctors to see the patient's condition directly.
"Doctor." Accompanying the middle-aged woman lying on the bed is her husband. He is standing on the bed, holding his wife's feet in his hands. His hands are not too big, but he still continues to press her
Rubbing her feet. Maybe this kind of rubbing can relieve her pain a little bit. "Look at this... what should I do?"
Sun Lien looked at the status bar of the middle-aged woman. There was nothing special. It was just the same "ureteral stone". He thought for a while and asked, "It still hurts a lot now? Have you vomited again?"
The young man nodded, "Originally, after the injection, the pain was not relieved much. My mother probably fell asleep for less than an hour, and then she was woken up by the pain again."
Although the middle-aged woman lying on the bed screamed in pain and even cried from the pain, Sun Lien sounded like she was at least confident. The status bar did not indicate symptoms of hypokalemia or acidosis.
"Doctor, what should we do about this?" The middle-aged man who was rubbing his wife's feet had no idea that "this behavior is not good-looking". He just looked at Sun Lien worriedly, "Can you stop the pain first?
"
"How long has she been in pain?" Sun Lien frowned and asked, "What time did the pain start in the evening?"
"About seven o'clock in the evening." The young man replied, "It has been more than five hours."
"Did she go to the toilet in the meantime?" Sun Lien asked, "Has she ever used the toilet from the time she came to the hospital to now?"
The young man shook his head and said, "My mother was in so much pain that she couldn't even drink water. She finally drank a little, but she vomited it all again when the pain hit her."
Sun Lien sighed, "Ureteral stones are not serious in nature. But if the stones are stuck in the ureter, if they cannot be passed out for a long time, they may cause hydronephrosis and urinary tract infection. I can give her more powerful painkillers,
But as long as the stone doesn't come off, she will still feel pain."
The young man was so anxious that he was sweating. He said urgently to Sun Lien, "Even if you need surgery, you have to stop the pain first, right? I also know that ureteral stones cannot kill people, but this kind of pain is too painful..."
"I'm going to prescribe pethidine for her." Sun Lien thought for a while and felt that this was really not an option. "You still have to let her drink as much water as possible. If the stones can be flushed out without surgery, of course.
It will cause minimal damage to the body. If the stone still cannot come out after taking painkillers, then you have to prepare for surgery."
"I am mentally prepared for this." The young man nodded helplessly, and then asked, "Which teacher in the department of urology is on duty today?"
When he first heard this young man talking, Sun Lien thought that this might be a colleague. Now when he heard the name "teacher", it seemed that he was indeed studying medicine. "Then you have to call and ask to find out. What, you
Are you also studying medicine?”
"I am from Ningyuan Medical College, and Dr. Cao Xin is my senior brother." The young man smiled sheepishly, "If possible, can I ask my mentor to do the surgery?"
Sun Lien was shocked when he heard this. Cao Xin is a doctor of urology. However, Ningyuan Medical College does not have an eight-year tutor training plan for undergraduates. Therefore, the title "senior brother" must at least be a master's student in the same laboratory.
Yes. But the person in front of me looks much younger than myself.
"I'm going to prescribe medicine first." Although he was very curious about the young man's identity, the first priority was to prescribe painkillers to relieve the symptoms. Sun Lien thought for a while and simply called the young man to the clinic together. He pointed at Rachel.
The seat next to her said, "You sit down first. I'll make a call."
Sun Lien's call was to Zhou Jun. Pethidine is pethidine, which is a controlled drug. Sun Lien did not have the right to prescribe, so he could only ask Zhou Jun to prescribe the medicine, "Teacher Zhou, I have a patient with ureteral stones here who needs anticonvulsant medication."
If the effect is not good, please come over and prescribe meperidine."
Zhou Jun agreed readily on the other end of the phone. It just so happened that he still had something to talk to Sun Lien about.
"You don't have the right to prescribe?" the young man asked curiously, "can the trained doctors now make independent diagnoses?"
"I am a special case." Although this sounded a bit pretentious, Sun Lien could only explain it this way, "I am using Director Zhou's prescription right now, but I can't prescribe pethidine directly, so I still need to Invite him."
Before Zhou Jun came to the ninth clinic, Sun Lien chatted with the young man for a few words, and then he was surprised to find that he had met a real academic master.
The real kind.
The young man's surname is Shen Mingxi, he is 21 years old this year. He is studying for a master's degree at the Institute of Urology, Ningyuan Medical College and is in his second year of graduate school this year.
In other words, Shen Xi was admitted to the clinical medicine major of Ningyuan Medical College at the latest when she was 15 years old. Although she was four years younger than herself, the young man in front of her was Sun Lien's senior brother.
"Hello, senior brother." Sun Lien, a graduate student who has not yet entered school, met his second-year graduate student, and his first reaction was to give in.
Although Shen Xi was confused when talking to Zhao Mengli, who had a ruptured corpus luteum before, she now showed an easy-going attitude, "Brother Sun, don't be so polite. I have something else I need to ask you for help."
Shen Xi was really not being polite. His question was quite direct, "It's one o'clock in the morning now. With my mother's condition, even if she can undergo surgery, it doesn't seem appropriate to drag my mentor out of bed at one o'clock in the morning..."
"Actually, that's what I mean." Sun Lien followed the other person's words. We are all colleagues, so we can say many things directly. "No matter what, surgery always has risks. The url method with the least side effects is your mother's. The smooth muscle of the urethra is spasming so much now, and the hard tube cannot be inserted. If a soft endoscopic tube is used, there is nothing to say about the surgical process, but the tube is disposable and a new product. It costs 20,000 per time. It costs so much, but it’s really unnecessary.”
Shen Xi sighed and continued to ask, "Then this is all we can do now?"
"You also saw the B-ultrasound before. The location of the stone stuck is in the middle and lower segments." Sun Lien explained, "You are also from the Institute of Urology. You should also know that in this case, the best way is to let the aunt herself Drain the stones. Then admit them to the hospital and give them some anti-inflammatory drugs to prevent urinary tract infection. This method will cause the least damage and the fastest recovery. After the painkillers are prescribed, you can advise your aunt to drink more water. Let's see. If she can't drink it, I can give Auntie some Ringer's solution."
Shen Xi nodded, "Then we can only do this for now." He stood up and nodded towards Sun Lien and Rachel, "I'll trouble you, then. I'll go check on my mother first."
When Zhou Jun arrived at the clinic, Shen Xi had long disappeared. As soon as Zhou Jun entered the room, he saw Rachel in the clinic. He was stunned and asked, "Is there a patient?"
"This is Doctor Rachel." Sun Lien introduced, "She is... Dr. Xu's friend."
"Oh?" Zhou Jun probably didn't know about Xu Yourong's situation. He regarded Rachel as someone who was about to be poached by Sun Lien, and extended his hand to Rachel enthusiastically, "Hello, you are here to visit our hospital. In a therapeutic setting?”
Rachel blinked, then nodded and smiled, "Yes." She gave Sun Lien a look of help, which clearly meant who was this?
"Dr. Rachel is a former classmate of Dr. Xu and is very familiar with Dr. Pascal." Sun Lien continued to introduce, "She is an expert in oncology."
"I'll prescribe a medicine for the patient first." Fortunately, Zhou Jun still remembered the main purpose of coming here. He nodded towards Rachel first, then walked behind the computer and quickly prescribed an injection of pethidine hydrochloride.
The liquid came out. Then he said to Sun Lien, "Go and get the medicine. You have to do a good job of receiving Dr. Rachel. If you have any questions, please contact me directly." After saying that, Zhou Jun turned around and walked out of the emergency room of the clinic.
A girl was sent here who committed suicide by drinking sleeping pills. The situation was not very good. Zhou Jun had to go back and keep an eye on the situation.
"Does this doctor think I'm here to apply for a job?" Rachel thought for a while before she realized what was going on.
"After all, Lao Pa has already made a name for himself in the clinic." Sun Lien stood up with a wry smile and said, "Excellent doctors are a scarce resource no matter where they are."