Sun Lien looked at the pictures with cold sweat on his head. He really didn't understand why similar scenes that appeared in his dreams appeared directly in reality.
Dr. Cao saw that Sun Lien's expression was a little strange, as if he had noticed something, and said sheepishly, "Yes... this is the case I called about this afternoon... Did it bother you to sleep?"
So... I dreamed of this scene purely because Dr. Cao spoke too loudly on the phone? So he guided his dream? Sun Lien raised his eyebrows and did not continue to dwell on this problem. "The patient is now
How is it going?"
"Not very good." Dr. Cao continued to chew on the mutton in front of him. "Continuous high fever, stubborn anemia, acute renal failure, jaundice, unexplained bone destruction... He has six or seven unrelated diseases, but they are all
Symptoms that could kill him. But no matter how we sample and culture, no matter what type of examination we do, we still don’t even have a relatively reliable guess."
This feeling is also very familiar. Sun Lien glanced at Dr. Cao, your voice on the phone was really loud today.
"I'm not sure whether I can handle this patient." Sun Lien thought for a moment and decided to tell the truth to his roommate. "Our current treatment group is mainly for emergency patients. We have not accepted patients from other departments.
...To be honest, very few patients are transferred from specialists to emergency departments for treatment. I’m not sure if there are any process problems in transferring patients from other departments to us.”
Dr. Cao looked a little disappointed, but Sun Lien's words quickly revived his energy. "However, I think we can try another direction. Can you just call us for consultation after you go back?"
"Good idea." Dr. Cao nodded seriously, then glanced at Sun Lien, "Have you finished eating?"
"Yeah." Sun Lien nodded. The mutton tasted really good. The hand-caught mutton looked like it had been boiled in water, just the color of cooked meat. But the taste of the meat was surprising.
It's delicious. If it weren't for the limited capacity in his stomach, Sun Lien would never stop talking.
"Then let's go." Dr. Cao paid the bill on his mobile phone, stood up and said to Sun Li'en, "Go to the hospital. You first check on the patient's condition."
Sun Lien was caught having sex right after dinner, but considering the value of the mutton meal, he really had no complaints. When Hu Jia came back, he planned to bring his girlfriend back for another meal.
"This patient's case is here." Dr. Cao picked up a bulging folder from his desk. "You take it and take a look first. It's time to go to bed in the inpatient department now. I'm applying now.
Consultation, let’s go see the patient’s condition together tomorrow.”
Sun Lien took the folder, looked at the case, pondered for a moment and said, "Time waits for no one, let's check on the patient first." The status bar is only useful after seeing the patient himself. Urology and other departments
The department has been wrangling for several days but has not been able to find the problem, so the documents in hand will definitely not be of much use, at least there will be no obvious hints. So if Sun Lien is asked to look at the cases, the effect will definitely not be very good.
.
"Go now?" Dr. Cao was stunned, and then readily agreed to Sun Lien's request, "Then let's go now, please."
Sun Lien smiled and shook his head, "Serving the people, there is no trouble." He followed Dr. Cao all the way, relying on his peripheral vision to follow, and the rest of his attention was focused on the case in hand.
Before seeing the status bar, it is helpful to understand the basic situation of the patient through the case, which will be very helpful for subsequent diagnosis.
The patient is 51 years old and has worked in Guangdong. After living in Guangdong Province for more than ten years, he returned to Ningyuan to visit relatives a month ago. Subsequently, he developed fever, cough, sputum, hemoptysis and other symptoms, and was admitted to the Fourth Hospital for treatment.
After being hospitalized for three days and testing negative for Mycobacterium tuberculosis-specific antibodies twice, the patient was discharged on his own initiative. He felt that his problem was not serious.
Twenty-five days later, the patient was admitted again. This time, in addition to pulmonary symptoms, his problem was also accompanied by more strange problems. His urine output these days was terrifying. Although it is easier to go to the toilet in winter, he
The number of times he went there was too much. However, the record of twenty-nine trips to the toilet in one day still failed to send him back to the hospital. The main reason why he came to the hospital was because of a sudden attack of kidney stones.
If it is simply frequent urination, then the nephrology department where Zhou Ce works should be the one to take over the treatment.
After the stone was resolved, the patient began to experience further symptoms such as difficulty breathing. He even broke the humerus of his right arm when he turned over in the hospital bed.
"This patient... shouldn't you have transferred him to another department a long time ago?" Sun Lien looked at the case and was a little confused. This patient's problems were obviously beyond the capabilities of the urology department.
"We also want to..." Dr. Cao sighed, "But the problem is that several other departments feel that this patient is not within their scope of treatment. His condition is very serious, but they just don't know where he should be sent.
Go to the department. Whether it's general internal medicine, nephrology, orthopedics, or endocrinology, they all say they have never seen such a patient. Coupled with the first-diagnosis responsibility system... we can only transfer him after confirming the content of the patient's disease.
Go to the corresponding department."
Sun Lien was quite sympathetic to Dr. Cao's experience. Not long after leaving, they came to the inpatient department of the Department of Urology together.
"This is it." Dr. Cao pointed to a room with a closed door. "In order to prevent him from contracting any strange infectious diseases, we specially arranged a single room for him. So before you go in, remember to put on your clothes first.
Put on protective gear.”
Like the emergency department, the protective equipment in the urology department is uniformly distributed goggles, gloves and N95 masks. After Sun Lien put on the equipment, he opened the door and walked in.
The patient seemed to be in good spirits. He sat up from the bed, looked at Sun Lien standing at the door and asked in confusion, "Who are you?"
"I'm a doctor." Sun Lien pointed to Dr. Cao, who was also wearing equipment. "I'm here to participate in the consultation."
"Wu Wei, male, 51 years old. The total number of peripheral blood white blood cells increased (), moderate anemia (), C-reactive protein increased (), bone destruction (748.18.27) CD4 lymphocytes 217/μl..."
Sun Lien was a little surprised when he looked at the long list of status bars on Wu Wei's head. At a sudden glance, there were at least twenty or thirty abnormal conditions on Wu Wei's head. In addition to the first four, they also included acute renal failure, supraclavicular lymph node
Swelling, extensive and diverse inflammatory infiltrates in both lungs, tracheal submucosal polypoid nodules and hepatomegaly, etc.
Judging from the prompts on the status bar, this should be a patient with pneumonia and acute kidney injury caused by some kind of infection. Sun Lien recalled the case records he had seen before. During the days of hospitalization, the Department of Urology not only provided him with
We did many pleural effusion, peripheral blood and sputum cultures, and even used antibiotics for him based on experience. But the effect was very limited. After using cephalosporins, his body temperature briefly returned to normal levels, and the swollen clavicle
The swelling of the upper lymph nodes also subsided for a few days. But before Dr. Cao could be happy for two days, his temperature went up again.
"I will discuss it with Dr. Xu tomorrow." After careful consideration, Sun Lien felt that this patient's problem was indeed a bit difficult. Just looking at the status bar, Wu Wei's disease involved multiple organs such as the lungs, liver, kidneys, and lymph nodes. Although
It is unreasonable to send the patient to the emergency department for treatment, but if we only rely on the capabilities of the urology department, we will definitely not be able to handle this patient.
"Then I'll trouble you." Dr. Cao nodded seriously. Although it was hard to say something in front of the patient, he really had nothing to do. If Sun Lien and his treatment team couldn't figure out what the patient was like,
If there is any disease, in the end he can only advise the patient to be discharged voluntarily, or to be transferred to a higher-level hospital than the fourth hospital. Then he can only go to the capital and Shanghai to try his luck.