Opportunities are always reserved for those who are deliberate, such as Zhu Zeming.
He didn't like Lin Hao from the beginning. Not only was he younger than him, but he was also handsomer. What made him especially uncomfortable was that Ren Junqi seemed to have his own special feelings for such a young man. Where could he go?
Take him with you.
Therefore, after seeing Lin Hao throw the tube to the ground, he was more excited and excited than anyone else, and his words were a bit incoherent! Obviously he hoped to make the matter bigger and brew a medical accident, and then kicked Lin Hao out
Get out of the hospital so that he doesn't have to be an eyesore or a hindrance to your nose or feet.
Seeing that the nurse next to him, Peng Xiaojie, was just looking at him blankly and still not going out to call his family members or call the police, he immediately shouted: "What are you doing? Why don't you go quickly?"
Peng Xiaojie didn't dare to go crazy with him. She looked at Ren Junqi hesitantly and obviously asked her what to do?
Although Ren Junqi wanted to protect Lin Hao, this guy was too random and didn't know what he was doing, so she was put in a dilemma. She could only ignore it and go check on the patient!
"Idiot!" Looking at Zhu Zeming who was yelling, Lin Hao cursed, then without looking at him again, he took out another new tube and put it back into the patient's tracheal intubation site!
Speaking of which, it’s not so strange!
After a section of the tube was replaced and inserted back, the patient's condition not only recovered quickly, but his blood oxygen concentration, which was originally only around 60, soared to 98!
Seeing this scene, Ren Junqi was stunned.
Zhu Zeming, who was opening the door and preparing to wake up his family members in person, was stuck there.
After a while, he asked in confusion: "What's going on?"
Lin Hao said indifferently: "I am just a training doctor, and I am not your teacher. What obligation do I have to teach you?"
Zhu Zeming: "You——"
Ren Junqi was also confused at first, but when she saw the tube thrown on the ground and the tube on the patient, she suddenly understood. Lin Hao was not crazy and did not want to commit murder. He was just correcting Zhu Zeming.
Just a mistake.
Seeing that Zhu Zeming was still confused, she pointed out to him: "Doctor Zhu, the reason why the patient's blood oxygen concentration cannot go up is because the tube you installed is too thin. Lin Hao changed it for you."
The tube! When the tube is bigger, breathing will naturally be easier and earlier, and the blood oxygen concentration will rise."
Only then did Zhu Zeming finally realize, and then his face became embarrassed, as if someone had suddenly slapped him in the face.
When Ren Junqi saw this, he didn't reprimand him. He just said slowly: "It's better to be more careful when working!"
"Got it!" Zhu Zeming responded, but his eyes looked at Lin Hao, filled with deep resentment.
After seeing the patient with chest trauma, Ren Junqi was not so relieved and asked Zhu Zeming to take her to see other patients.
Looking all the way, there is no problem!
Although Zhu Zeming is young and his education level is not as high as that of Ren Junqi, he has stayed in the emergency department for more than two years and can handle ordinary minor illnesses and pains properly.
As I walked, I arrived at the bedside of the last patient. This was a male patient who came to see a doctor four hours ago with upper abdominal pain. He was 65 years old and had moderate pain in his navel. There was no radiation or metastasis, but he was accompanied by a fever of 385 degrees.
He also had vomiting and diarrhea. His past medical history was unremarkable. His chief complaint was that he ate barbecue oysters for supper last night.
After the patient came, Zhu Zeming performed an examination. The upper abdominal muscles were tense by palpation, Murphy's sign was negative, and there was no obvious tenderness and rebound tenderness at the appendix point. There were no abnormalities in the emergency abdominal plain film and B-ultrasound. He was considered to have acute gastrointestinal disease.
inflammation or allergy, provide analgesic, anti-inflammatory, and anti-allergic treatment!
It's just that two hours have passed and the patient's condition has not improved and he still complains of severe abdominal pain.
After Zhu Zeming heard the chief complaint, he said to the nurse: "Give him another injection of 6542!"
6542 is an anticholinergic drug that acts similarly to atropine and is used for colic caused by spasm of the gastrointestinal tract, bile duct, pancreatic duct, and ureter. It can also be used for circulatory disorders caused by vasospasm and embolism, such as cerebral infarction.
Cone artery insufficiency, thromboangiitis obliterans and infectious toxic shock.
After giving the doctor's orders, he saw Lin Hao feeling the patient's pulse, and he looked like an old god was there. What made him dumbfounded was that while feeling the patient's pulse with one hand, he also touched it with the other hand.
This way of examining the patient's abdomen is undoubtedly funny and does not comply with the examination rules. I feel very disdainful. What are you pretending to do? What can you find out?
After a while, the nurse brought the medicine and prepared to inject it into the patient.
Who knew that when Lin Hao saw this, he stopped him and said, "Don't fight, there's something wrong with him!"
Zhu Zeming immediately stepped forward and asked in a cold voice: "Tell me, what's wrong?"
Lin Hao said: "Although he said he had vomiting and diarrhea after eating oysters, it looks like he has a seafood allergy or acute gastroenteritis, but I don't feel like it!"
"No?" Zhu Zeming said angrily: "Then what did you say it was?"
Lin Hao said solemnly: "My diagnosis is acute appendicitis, and the situation is quite serious. Surgery must be performed immediately!"
"Acute appendicitis? It's really funny!" Zhu Zeming sneered and asked repeatedly with a gun and a stick: "Have you ever studied medicine? Do you know what acute appendicitis is? Do you understand the diagnostic basis of acute appendicitis?"
Acute appendicitis is one of the most common diseases in abdominal surgery. Most patients can seek medical treatment in time and obtain good treatment results. However, sometimes diagnosis is quite difficult, and serious complications may occur if not handled properly. So far,
, acute appendicitis still has a mortality rate of 0.105.
It is estimated that one person in every thousand people will develop acute appendicitis every year. According to general hospital statistics, patients with acute appendicitis account for about 15% of the total number of abdominal surgery hospitalizations in the same period, ranking first among surgical acute abdomen cases.
Ren Junqi knew that appendicitis could be a serious or minor disease, so when he heard what Lin Hao said, he became cautious and went to check the patient.
The diagnosis basis of acute appendicitis is very obvious: 1. Transferring right pain. 2. Right tenderness, rebound tenderness, and muscle tension.
However, after Ren Junqi performed a physical examination on the patient, he found that his entire abdomen was in pain, but the local pain on the right side was not obvious. For a moment, he couldn't help but look at Lin Hao with some doubts, obviously asking him what the basis for such a diagnosis was.
?
Seeing that Lin Hao didn't say anything, Zhu Zeming asked: "What's wrong? Are you mute? Are you talking?"
Ren Junqi thought that Lin Hao really didn't know, so he said: "Under normal circumstances, acute appendicitis will have obvious tenderness and rebound tenderness at the patient's Max point. Even if not, there will be progressive pain on the right side, accompanied by
Nausea and vomiting, increased white blood cells in the blood, elevated neutrophils and other symptoms."
Lin Hao asked: "Without these symptoms, can acute appendicitis be ruled out?"
Now, Ren Junqi was asked. Although what she said was the basis for diagnosing acute appendicitis, it was not absolute.
In a typical patient with acute appendicitis, the abdominal pain starts in the upper abdomen, xiphoid process, or around the umbilicus. After about six to eight hours or more than ten hours, the abdominal pain gradually moves downwards, and finally is fixed on the right side. The abdominal pain is fixed.
Afterwards, the original site of pain can be significantly reduced or even disappear. This change in abdominal pain is called metastatic right pain, which is also the basis for differential diagnosis from other acute abdomens. About 80% of patients have this characteristic.
However, this is only a typical patient. In atypical patients, the initial pain may be in the upper abdomen, the entire abdomen, or even the waist. Therefore, even if there is no metastatic abdominal pain, the existence of acute appendicitis cannot be easily and completely ruled out.
Zhu Zeming didn't expect that Lin Hao would still be entangled at this time, so he pointed at Ren Junqi and said: "Director, don't listen to his nonsense here. This patient clearly has acute gastroenteritis. No matter which doctor comes to see him, he just..."
Just saying it’s acute appendicitis is just nonsense!”
Lin Hao shook his head, "I'm not messing around. He does have acute appendicitis. For the sake of his safety, I suggest..."
"What do you suggest? What nonsense do you suggest? As a training doctor, what qualifications do you have to suggest?" Zhu Zeming was so excited that he became violent on the spot. In the end, he even pointed at Lin Hao and said: "This is my patient, don't you?"
If you are gesticulating here, get out of here!"
Lin Hao did not rush to him, but said calmly: "Dr. Zhu, I know that his current indications for acute appendicitis are not very obvious, but my diagnosis is not wrong. Not only does he have acute appendicitis, but also
It is very likely that there will be a perforation soon. If you don't send him to the general surgery department quickly and let him have surgery, the consequences will be disastrous!"
"Are you still here making alarmist remarks?" Zhu Zeming became even more furious, raised a big slap and said: "If you don't get out of here, believe it or not, I will slap you?"
Lin Hao backed down slightly because he didn't want to fight with this guy, but he didn't leave either. He firmly believed in his diagnosis, but he couldn't explain it.
The Emperor's Sutra has reached the fourth level, and its function has become extremely powerful. It can incorporate a breath into the pulse when taking the pulse, making one's sense of touch sharper and the diagnosis more accurate. When he was taking the pulse just now, he felt that this patient was not just an ordinary patient.
Gastroenteritis was so simple, so he put his hand on his abdomen to check. When he touched the appendix, he felt that the qi and blood there were obviously severely stagnant. Combined with the patient's nausea, vomiting, fever and other symptoms, he made the diagnosis.
It's acute appendicitis, and it's an extremely serious kind.
Severe acute appendicitis is prone to perforation, and once perforated, it will be life-threatening. If the treatment is not appropriate, the patient may die in the emergency department, so he did not leave in anger, but said to Ren Junqi: "Ren Junqi.
, you’d better listen to me and transfer him to a general surgery department as soon as possible, otherwise there will be problems!”
Ren Junqi didn't want to listen to Lin Hao, because she was the teacher and Lin Hao should listen to her. But after these few days of contact, she already knew that she was not as good as him and she was not qualified to be his teacher.
, on the contrary, he taught her a lot of valuable knowledge. But even so, it does not mean that she will blindly obey him. This patient does not seem to have any indications of acute appendicitis!
When she was hesitating to call the general surgery department, the patient, who had been rolling around because of pain, suddenly became quiet, and then opened his mouth and said: "Doctor, please stop arguing, I don't seem to be in pain anymore!"
The patient said: "Yes, it was relieved a little when you started arguing, and now it doesn't hurt at all."
Zhu Zeming suddenly became proud, pointed at Lin Hao and shouted: "Did you see that my treatment worked, my diagnosis was accurate, he just had ordinary acute gastroenteritis! You still think you are right?"
What am I talking about with acute appendicitis and perforation? I am a top student who graduated from Yangcheng Medical University. Do I need you, a training doctor with only a technical secondary school degree, to teach me how to do things and how to make a diagnosis? I really don’t know what to say!"
Lin Hao said: "I..."
"What are you?" Zhu Zeming gave orders and said unceremoniously: "You'd better say goodbye to you, get out of here, and get out of here as far as your thoughts go!"
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