I'm really an intern

Chapter 141 Who Am I, Where Am I, Who Is The Attendant, Who Is The Intern?

"what happened?"

The male doctor was a little surprised. Why did the second patient have a diagnosis and a doctor's order in addition to the chief complaint and course of disease?

Is it another viral flu?

The male doctor looked up and glanced at the patient's face.

It's not like a viral flu!

After carefully looking at the chief complaint and the course of the disease, he nodded.

"Sure enough, it's not a viral cold, it looks like a bacterial cold."

The main complaint and medical history are still very complete, the diagnosis is "upper respiratory tract infection", and the doctor ordered blood routine and infection.

The two items of infection include PCT and CRP, which are inspection indicators for bacterial infections, and it is very timely to prescribe them.

No problem!

The male doctor quickly asked again about key points, and then gave the patient a physical examination.

Just like the previous patient, the male doctor sent the patient for an examination without changing a single word of Zhang Tianyang's diagnosis and doctor's order.

After quickly treating the two patients, the male doctor only felt refreshed.

Compared with the entanglement of the first two patients, the treatment of these two patients was simply amazing!

Especially when facing these two patients, the feeling of stretching out his clothes and opening his mouth made him extremely superior!

I casually glanced at the time in the lower right corner of the screen, and found that less than 2 minutes had just passed.

In 2 minutes, seeing two patients, not only the diagnosis of the main complaint and the doctor's order, but also the time for the physical examination are included!

If it only takes so long to see all the patients, there won't be such a long queue outside.

The male doctor secretly sighed while calling the next patient over, then shook his head again.

"I guess this is the only time that such a cool situation happened? After all, it is impossible to have several colds in succession. If you encounter other diseases, it is estimated that the younger brother will not do so well."

While muttering, the male doctor took the new patient's medical card and placed it on the sensor.

"Sure enough, this is a patient with abdominal pain."

Abdominal pain still requires differential diagnosis. There are many possible diseases, ranging from acute gastroenteritis to acute myocardial infarction.

Compared with the common cold, it is not a level of difficulty in diagnosis.

For some reason, the male doctor subconsciously breathed a sigh of relief when he finally saw a patient whose junior brother might not be able to yell at him.

Looking at the chief complaint, "Sudden abdominal pain, diarrhea, and vomiting for 3 hours."

I looked at the patient again, and found that he was holding his stomach, and his whole face wrinkled into a flower due to the pain.

For patients with acute abdominal pain and severe attacks like this, even if the doctor below has already consulted the doctor, the doctor at the higher level will often ask again.

It is really because the junior doctors are inexperienced, and the superior doctors are afraid that they will miss the question, or don't ask at all, so they just write down the symptoms for granted.

So he didn't read the long paragraph written by Zhang Tianyang carefully at all, but quickly sorted out his thoughts and began to ask the doctor himself.

The patient is obviously still in pain, and the abdomen will be affected when talking, especially the pain.

So he only answers one question when he asks the patient, and he never speaks two words if he can answer one word.

After finally asking about the scope, nature, triggering and relieving factors of the pain, the male doctor wanted to continue to inquire, but the patient quit.

"boom!"

Perhaps it was because of the pain that his hand slapped on the table turned into a smash, and it was with great difficulty that he squeezed out a complete sentence from his mouth with the pain.

"Your question has been asked by the doctor just now. Don't bother, hurry up and prescribe medicine."

Ever asked?

The male doctor was taken aback, seeing that the patient was really suffering, so he could only give up his idea of ​​asking each patient in detail, and read the history of present illness written by Zhang Tianyang.

Seeing this, he was a little dazed again.

"Why did you ask all the points again?"

"And this order looks very comfortable!"

When many interns write medical records, they only know to write all the positive symptoms.

As for which symptom comes first and which comes later, they don't care.

Write whichever you think of, anyway, if you don’t miss anything, everything will be fine.

Looking at the entire medical record, you can only see that he asked a lot about symptoms, but you can't see why he asked about these symptoms in a random manner.

But in fact, there is a certain order when experienced doctors write the history of present illness.

By looking at the symptoms and signs he described, we can see his diagnostic thinking.

The combination of several positive symptoms is to indicate that there is a high possibility of a certain disease.

Several negative symptoms are put together to show that the possibility of a certain disease can be basically ruled out.

And the history of present illness written by Zhang Tianyang gave the male doctor the feeling of a sense of logic rushing to his face.

Looking at the whole thing, he could clearly see Zhang Tianyang's thoughts during the consultation process.

From acute myocardial infarction, to acute appendicitis, to cholecystitis, pancreatitis, and then to acute gastroenteritis, we used the method of exclusion to finally confirm the diagnosis.

The diagnosis was "acute gastroenteritis". At the end of the history of present illness, Zhang Tianyang concluded that "acute gastroenteritis caused by norovirus infection is considered."

A very reasonable guess, and the most likely guess.

The male doctor gave up struggling, and resigned to his fate, he began to perform physical examinations on the patients.

Like the previous two patients, this patient's diagnosis and doctor's orders have not been changed.

Look at the time again, because he spent a full 2 ​​minutes repeating the consultation and physical examination.

And in these 2 minutes, Zhang Tianyang has sent a new patient to wait in line next to him, and the second patient has also finished the consultation and is typing the medical records. It is expected that he will join the queue in ten seconds.

"Why can junior brother ask questions so quickly and make judgments so quickly without making any mistakes?"

The male doctor has no time to think about this problem.

Subconsciously, he started to speed up and opened the information of the fourth patient.

This is a patient who suddenly developed a rash all over his body. After a glance at the medical record, Zhang Tianyang wrote it in detail.

After picking the key points and quickly asking a few questions, the male doctor quickly entered the physical examination session.

In the end, unexpectedly and seemingly reasonable, he again kept Zhang Tianyang's diagnosis and doctor's order unchanged, and sent the patient to pay for the medicine.

The fifth patient had fever.

The male doctor did a physical examination, and the doctor's order for diagnosis remained unchanged.

The sixth patient suffered from dizziness.

The male doctor did a physical examination, and the doctor's order for diagnosis remained unchanged.

seventh patient eighth patient

No.13 patients

From the initial surprise and joy, to the later shock and doubt, to the final numbness and calmness.

Who am I and where am I?

Who is attending and who is intern?

The male doctor only felt that the world had lost its color and time had lost its flow.

He didn't ask about the medical history, he didn't make the diagnosis, and he didn't prescribe the doctor's order.

The sense of accomplishment of accurately judging the disease does not belong to him, nor does the sense of satisfaction that the patient's condition improves after treatment.

After the pleasure of saving lives and healing the wounded as an emergency doctor disappears, all that remains is simple work and physical exertion.

His body is still repeating mechanical labor.

But the mind sometimes enters the point of self-doubt.

Where is the problem?

God knows, he originally borrowed an intern to come here to relieve his fatigue.

But why do you feel more tired now?

When this junior brother was called over to help, didn't he only have one hour left to get off work?

How many patients can I usually see in one hour?fifteen?twenty?

How many 15 patients have you seen now?

After all, when can I leave work?

(End of this chapter)