I can see the status bar
Chapter 562 Bacteremia (6 words for subscription on June 2)
Chapter 562 Bacteremia (6 words for subscription on June 2)
The first patient received today did not know where he felt uncomfortable.Sun Li'en stroked the bandage on his arm, feeling a little guilty in his heart.After working as a regular trainer for a year, she was stitched twice.This time is even more than what he has accumulated in his life in the past 20 years.It would be a lie to say that I have no idea.
"Doctor..." The door of the ninth consulting room was pushed open, and an old lady who looked a little trembling walked into the room.She looked at Sun Li'en's bare, bandaged arm and asked cautiously, "Are you all right?"
It was the first time for Sun Lien to be asked by a patient if he was okay in his consulting room.He smiled, pointed to the stool in front of him and said, "I'm fine, you can sit down." Seeing the old lady sit down, Sun Li'en asked, "What's wrong with you?"
The old lady still looked very worried. While talking about her discomfort, she glanced at Sun Lien's arm from time to time.
"I didn't eat seafood before, especially shrimp." Sitting on the seat, Li Huizhen described her background to Sun Li'en, "That stuff looks exactly like the woodworm in the countryside—you, woodworm. Have you seen it? The back is semicircular, and there are many legs under the stomach." At this point, Li Huizhen couldn't help shivering, and made a final judgment, "It's disgusting to look at."
"Yeah, I know." Sun Lien nodded with a wry smile, while continuing to look up at Li Huizhen's status bar—this time even the status bar seemed to be understanding of Sun Lien's pain from the stitches just now, and asked the question straightforwardly The answer is "mild allergic reaction".
"Didn't I... Some relatives came to my family a few days ago." Li Huizhen was still muttering, "They brought a lot of frozen wontons from their hometown, and they said they were produced by some old store over there. .”
Sun Li'en nodded, while lowering his head, he began to think about what medicine to prescribe for Li Huizhen.In the shortest possible time, listening to the patient's self-report as much as possible will not only help the diagnosis, but also make the patient feel that he is taken seriously, and the supervisor can feel more comfortable.This is also the skill that Sun Lien learned from Dr. Pascal.
"In the end, they cooked it for me." Li Huizhen scratched her neck and sighed, "As a result, I have been itching all over my body since I finished eating. My daughter-in-law said that I am allergic, and I have to Let me come to the hospital to see a doctor."
"Your daughter-in-law is right." Sun Li'en nodded, put on his gloves, walked to Li Huizhen's side, and carefully glanced at her neck. "It's not too serious though, just some rashes."
"I also think it's just a rash, so I shouldn't go to the hospital." Li Huizhen agreed with Sun Lien's judgment, "But my daughter-in-law must ask me to come, anyway, I have nothing to do, so I will just go once in a while." Oh." At this point, Li Huizhen looked at Sun Lien's arm again, "I saw it just now, your fall was not light."
"For the sake of rescue, it doesn't matter if you fall once, it doesn't matter." Sun Lien nodded with a smile, and then said to Li Huizhen, "How long have you been itching? One day?"
"It's almost there, since I finished eating at noon yesterday." Li Huizhen looked at her arm, and there seemed to be some red rashes on it. "Fortunately, it's a little itchy, and it will pass after a bit of patience."
Sun Lien thought for a while, put down the pen in his hand, and said, "Your allergies are not too serious, but it may just be because the amount of allergens you ingested is not enough." He said seriously to Li Huizhen in front of him, "Your allergies are not too serious." You must be vigilant, although most allergies may pass with an itch on the body, but some allergies may cause serious and long-lasting damage. For example, asthma, or even suffocation caused by laryngeal edema, cardiac arrest, etc... ..."
Sun Li'en said seriously, but Li Huizhen didn't seem to take it seriously, "I know about my problem, it's just itching after eating, it's not a problem."
"If you want to say that, I have to prescribe you medicine." Seeing Li Huizhen's appearance, Sun Li'en had an idea, and began to persuade him in a different way, "You always eat things that cause your body allergies, then It has to be controlled with medication for a long time, and you have to go to the outpatient clinic to prescribe calamine lotion and rub it on the rash."
Sure enough, Li Huizhen immediately became serious, "Do you want to take medicine all the time?"
"If you try to avoid eating things you are allergic to in the future, then it's okay." Sun Lien pointed the table with his hand, "In that case, I don't need to prescribe the medicine."
"Then I won't eat it." Li Huizhen nodded immediately, "I won't eat it again."
That's okay too?Sun Li'en thought he would persuade him a few more times, but he didn't expect to get such a good effect now.After being shocked for a second, he returned to normal, then nodded his head and said, "That's fine. Don't take a hot bath for two days after returning home, and observe the rash a little bit. If it disappears by itself, it will be fine. If tomorrow You don't need to come to the hospital to have a look." He quickly typed up a diagnosis sheet, and then pasted it on Li Huizhen's medical record, and then said, "When you go back, you must not eat anything that makes you allergic. .”
·
·
·
The first case was resolved, and the second patient quickly entered the consulting room.The case this time is not necessarily difficult - it's just a cold.After Sun Lien checked the status bar and made sure that the patient was fine, he sent the patient to the laboratory to collect blood for testing.And while waiting for the test results, please enter the No.3 patient.
"Doctor... I guess this disease should be managed by the outpatient clinic, but I have been suffering from fever since yesterday." The patient limped into the room and said to Sun Lien, "I really can't get the number for the outpatient clinic. So the nurse asked me to come over and have a look."
This description is not helpful for diagnosis and treatment.Sun Li'en frowned and looked at the top of the young man's head, then felt that things might be a little tricky.
"Feng Yiming, male, 21 years old. Paronychia (264.51.33), white blood cell index increased (52.66.34), heart rate increased (48.44.31), high fever (35.51.45)."
If you only look at paronychia, this patient really shouldn't come to the emergency department.He should go to a dermatology or general surgery clinic.However, the latter three states made Sun Lien immediately more vigilant. Putting these three together... No matter how you look at it, it looks like a manifestation of bacteremia.
Paronychia causing bacteremia?Sun Li'en frowned. It's not impossible, but it's indeed relatively rare.After all, paronychia is so tormenting that few people come to the hospital until the disease progresses to bacteremia.
"Please sit down." Let the patient sit down, Sun Lien decided to start with the consultation, "What's wrong with you?"
The patient pointed to his feet, "Will you...won't you take a look at this?"
Sun Li'en nodded, pulled down the screen, tightened the seal on the mask, then put on gloves, and walked around from behind his desk.
It's... a tortured big toe.Obvious yellow translucent coagulation and red blood can be seen in the nail groove on both sides of the toe, and pus under the nail plate can be seen under the coagulation.The skin tissue on both sides of the nail groove was red, swollen, and even broke the epidermis, forming large areas of irregular molting.
"It's paronychia." Sun Lien sat back down again, "When did you start to have a fever?"
"Yesterday...afternoon?" Feng Yiming thought hard, "I feel cold all over, I think I probably have a fever."
Sun Li'en silently handed over an electronic thermometer, motioned Feng Yiming to clamp the thermometer under his armpit, and then continued to ask, "Are there any other symptoms? Such as headache? Shaking?"
"I have a headache..." Feng Yiming just said a word, and the thermometer started to make a "didi" sound. Sun Lien took the thermometer and took a look. It was forty degrees Celsius.
"You might have to be hospitalized." After reading the thermometer, Sun Lien turned around and gave Feng Yiming a blood test order, and decided to do the blood collection himself - how can a patient with a high fever reach [-] degrees Celsius get someone to walk by himself? Draw blood?What should I do if I faint from a fever on the way? "I'll take a blood sample for you, you wait here first."
"Who is that...Brother Liang!" Sun Lien caught the young man of Brother Liang, the security guard, in the rescue hall, "Please push me a bed."
"What's wrong?" Brother Liang ran towards Sun Lien while pushing the bed, and fainted again?
"I have a high fever, let's send him to the emergency room first." Sun Li'en took Brother Liang to his own consultation room, and then arranged Feng Yiming on the plank bed, "You just lie on it, is anyone coming from your house?" ?”
"Ah?" Feng Yiming, who was already a little confused, thought for a while before shaking his head, "I did it myself."
"Call your family, I have to go through the hospitalization procedures for you, are you allergic to cephalosporin?" Sun Lien went back to his computer, and after a while of typing on the keyboard, he wrote Feng Yiming a prescription for cefoperazone injection , Then after thinking about it, he took out his mobile phone and called the general foreigner, "I'm Sun Lien, do we have any beds in the general foreign hospital?"
"The inpatient department is full now, and there will be no more beds until tomorrow." The doctor on duty at the other end of the phone checked the inpatient form and replied, "What's the problem?"
"There is a patient whose paronychia may have caused bacteremia." Sun Lien asked after thinking for a while, "Then can we arrange an outpatient surgery here?"
"There is no problem with paronychia. It will be over in a while." The surgeon on the other end of the phone quickly agreed, "But if you are hospitalized, since it is for bacteremia, then don't give it to us. Let infectious diseases It is more right for Ke to accept it and treat it."
Of course, the surgery department is unwilling to accept such minor surgery and major treatment patients.It is of course best to be able to push the troublesome work to others.What's more, surgery is really not very good at treating bacteremia.
Sun Li'en thought about it, and decided to wait for Feng Yiming's family members to arrive at the hospital and talk to them about the situation—bacteremia is a very serious symptom.If it is not dealt with quickly, it may be life-threatening.
Dr. Hu Weifeng passed away unfortunately at 5:45 am today.Many people, like me, remember his face that turned black from the treatment.
Well done hero, thank you for your hard work for us.
May there be no sickness in heaven.
Goodbye.
(End of this chapter)
The first patient received today did not know where he felt uncomfortable.Sun Li'en stroked the bandage on his arm, feeling a little guilty in his heart.After working as a regular trainer for a year, she was stitched twice.This time is even more than what he has accumulated in his life in the past 20 years.It would be a lie to say that I have no idea.
"Doctor..." The door of the ninth consulting room was pushed open, and an old lady who looked a little trembling walked into the room.She looked at Sun Li'en's bare, bandaged arm and asked cautiously, "Are you all right?"
It was the first time for Sun Lien to be asked by a patient if he was okay in his consulting room.He smiled, pointed to the stool in front of him and said, "I'm fine, you can sit down." Seeing the old lady sit down, Sun Li'en asked, "What's wrong with you?"
The old lady still looked very worried. While talking about her discomfort, she glanced at Sun Lien's arm from time to time.
"I didn't eat seafood before, especially shrimp." Sitting on the seat, Li Huizhen described her background to Sun Li'en, "That stuff looks exactly like the woodworm in the countryside—you, woodworm. Have you seen it? The back is semicircular, and there are many legs under the stomach." At this point, Li Huizhen couldn't help shivering, and made a final judgment, "It's disgusting to look at."
"Yeah, I know." Sun Lien nodded with a wry smile, while continuing to look up at Li Huizhen's status bar—this time even the status bar seemed to be understanding of Sun Lien's pain from the stitches just now, and asked the question straightforwardly The answer is "mild allergic reaction".
"Didn't I... Some relatives came to my family a few days ago." Li Huizhen was still muttering, "They brought a lot of frozen wontons from their hometown, and they said they were produced by some old store over there. .”
Sun Li'en nodded, while lowering his head, he began to think about what medicine to prescribe for Li Huizhen.In the shortest possible time, listening to the patient's self-report as much as possible will not only help the diagnosis, but also make the patient feel that he is taken seriously, and the supervisor can feel more comfortable.This is also the skill that Sun Lien learned from Dr. Pascal.
"In the end, they cooked it for me." Li Huizhen scratched her neck and sighed, "As a result, I have been itching all over my body since I finished eating. My daughter-in-law said that I am allergic, and I have to Let me come to the hospital to see a doctor."
"Your daughter-in-law is right." Sun Li'en nodded, put on his gloves, walked to Li Huizhen's side, and carefully glanced at her neck. "It's not too serious though, just some rashes."
"I also think it's just a rash, so I shouldn't go to the hospital." Li Huizhen agreed with Sun Lien's judgment, "But my daughter-in-law must ask me to come, anyway, I have nothing to do, so I will just go once in a while." Oh." At this point, Li Huizhen looked at Sun Lien's arm again, "I saw it just now, your fall was not light."
"For the sake of rescue, it doesn't matter if you fall once, it doesn't matter." Sun Lien nodded with a smile, and then said to Li Huizhen, "How long have you been itching? One day?"
"It's almost there, since I finished eating at noon yesterday." Li Huizhen looked at her arm, and there seemed to be some red rashes on it. "Fortunately, it's a little itchy, and it will pass after a bit of patience."
Sun Lien thought for a while, put down the pen in his hand, and said, "Your allergies are not too serious, but it may just be because the amount of allergens you ingested is not enough." He said seriously to Li Huizhen in front of him, "Your allergies are not too serious." You must be vigilant, although most allergies may pass with an itch on the body, but some allergies may cause serious and long-lasting damage. For example, asthma, or even suffocation caused by laryngeal edema, cardiac arrest, etc... ..."
Sun Li'en said seriously, but Li Huizhen didn't seem to take it seriously, "I know about my problem, it's just itching after eating, it's not a problem."
"If you want to say that, I have to prescribe you medicine." Seeing Li Huizhen's appearance, Sun Li'en had an idea, and began to persuade him in a different way, "You always eat things that cause your body allergies, then It has to be controlled with medication for a long time, and you have to go to the outpatient clinic to prescribe calamine lotion and rub it on the rash."
Sure enough, Li Huizhen immediately became serious, "Do you want to take medicine all the time?"
"If you try to avoid eating things you are allergic to in the future, then it's okay." Sun Lien pointed the table with his hand, "In that case, I don't need to prescribe the medicine."
"Then I won't eat it." Li Huizhen nodded immediately, "I won't eat it again."
That's okay too?Sun Li'en thought he would persuade him a few more times, but he didn't expect to get such a good effect now.After being shocked for a second, he returned to normal, then nodded his head and said, "That's fine. Don't take a hot bath for two days after returning home, and observe the rash a little bit. If it disappears by itself, it will be fine. If tomorrow You don't need to come to the hospital to have a look." He quickly typed up a diagnosis sheet, and then pasted it on Li Huizhen's medical record, and then said, "When you go back, you must not eat anything that makes you allergic. .”
·
·
·
The first case was resolved, and the second patient quickly entered the consulting room.The case this time is not necessarily difficult - it's just a cold.After Sun Lien checked the status bar and made sure that the patient was fine, he sent the patient to the laboratory to collect blood for testing.And while waiting for the test results, please enter the No.3 patient.
"Doctor... I guess this disease should be managed by the outpatient clinic, but I have been suffering from fever since yesterday." The patient limped into the room and said to Sun Lien, "I really can't get the number for the outpatient clinic. So the nurse asked me to come over and have a look."
This description is not helpful for diagnosis and treatment.Sun Li'en frowned and looked at the top of the young man's head, then felt that things might be a little tricky.
"Feng Yiming, male, 21 years old. Paronychia (264.51.33), white blood cell index increased (52.66.34), heart rate increased (48.44.31), high fever (35.51.45)."
If you only look at paronychia, this patient really shouldn't come to the emergency department.He should go to a dermatology or general surgery clinic.However, the latter three states made Sun Lien immediately more vigilant. Putting these three together... No matter how you look at it, it looks like a manifestation of bacteremia.
Paronychia causing bacteremia?Sun Li'en frowned. It's not impossible, but it's indeed relatively rare.After all, paronychia is so tormenting that few people come to the hospital until the disease progresses to bacteremia.
"Please sit down." Let the patient sit down, Sun Lien decided to start with the consultation, "What's wrong with you?"
The patient pointed to his feet, "Will you...won't you take a look at this?"
Sun Li'en nodded, pulled down the screen, tightened the seal on the mask, then put on gloves, and walked around from behind his desk.
It's... a tortured big toe.Obvious yellow translucent coagulation and red blood can be seen in the nail groove on both sides of the toe, and pus under the nail plate can be seen under the coagulation.The skin tissue on both sides of the nail groove was red, swollen, and even broke the epidermis, forming large areas of irregular molting.
"It's paronychia." Sun Lien sat back down again, "When did you start to have a fever?"
"Yesterday...afternoon?" Feng Yiming thought hard, "I feel cold all over, I think I probably have a fever."
Sun Li'en silently handed over an electronic thermometer, motioned Feng Yiming to clamp the thermometer under his armpit, and then continued to ask, "Are there any other symptoms? Such as headache? Shaking?"
"I have a headache..." Feng Yiming just said a word, and the thermometer started to make a "didi" sound. Sun Lien took the thermometer and took a look. It was forty degrees Celsius.
"You might have to be hospitalized." After reading the thermometer, Sun Lien turned around and gave Feng Yiming a blood test order, and decided to do the blood collection himself - how can a patient with a high fever reach [-] degrees Celsius get someone to walk by himself? Draw blood?What should I do if I faint from a fever on the way? "I'll take a blood sample for you, you wait here first."
"Who is that...Brother Liang!" Sun Lien caught the young man of Brother Liang, the security guard, in the rescue hall, "Please push me a bed."
"What's wrong?" Brother Liang ran towards Sun Lien while pushing the bed, and fainted again?
"I have a high fever, let's send him to the emergency room first." Sun Li'en took Brother Liang to his own consultation room, and then arranged Feng Yiming on the plank bed, "You just lie on it, is anyone coming from your house?" ?”
"Ah?" Feng Yiming, who was already a little confused, thought for a while before shaking his head, "I did it myself."
"Call your family, I have to go through the hospitalization procedures for you, are you allergic to cephalosporin?" Sun Lien went back to his computer, and after a while of typing on the keyboard, he wrote Feng Yiming a prescription for cefoperazone injection , Then after thinking about it, he took out his mobile phone and called the general foreigner, "I'm Sun Lien, do we have any beds in the general foreign hospital?"
"The inpatient department is full now, and there will be no more beds until tomorrow." The doctor on duty at the other end of the phone checked the inpatient form and replied, "What's the problem?"
"There is a patient whose paronychia may have caused bacteremia." Sun Lien asked after thinking for a while, "Then can we arrange an outpatient surgery here?"
"There is no problem with paronychia. It will be over in a while." The surgeon on the other end of the phone quickly agreed, "But if you are hospitalized, since it is for bacteremia, then don't give it to us. Let infectious diseases It is more right for Ke to accept it and treat it."
Of course, the surgery department is unwilling to accept such minor surgery and major treatment patients.It is of course best to be able to push the troublesome work to others.What's more, surgery is really not very good at treating bacteremia.
Sun Li'en thought about it, and decided to wait for Feng Yiming's family members to arrive at the hospital and talk to them about the situation—bacteremia is a very serious symptom.If it is not dealt with quickly, it may be life-threatening.
Dr. Hu Weifeng passed away unfortunately at 5:45 am today.Many people, like me, remember his face that turned black from the treatment.
Well done hero, thank you for your hard work for us.
May there be no sickness in heaven.
Goodbye.
(End of this chapter)
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