I can see health

Chapter 107 The Three Monks Have No Water To Drink

Endocrine II.

doctor's office.

"Doctor Min, here comes the emergency patient."

As soon as Min Ling took over, the nurse ran into Zhi's doctor's room.

"okay, I get it."

Min Ling nodded, but at the same time she was very puzzled.

It's too difficult to take the night shift of endocrine recently!
She remembers working on a night shift, which was also very busy.

Why are there so many emergency patients suddenly?
Are you so "hot" recently?

Min Ling had deep doubts about herself.

……

On the other side, Lu Chen walked slowly into the endocrine inpatient department with anxiety.

This 300 yuan is too hard to earn!

However, the endocrine department of Jinghua Second Hospital has four wards.

The patient does not necessarily receive the Endocrine II where he goes.

but.

When Lu Chen came out of the elevator and came to the door of the second endocrine department, he saw the flat car of the emergency department in front of him.

He could only silently accept the fact that he was "black-faced".

The only good news is that there is no need to test blood sugar today.

As soon as he entered the second endocrine ward, Lu Chen ran into Min Ling head-on.

Min Ling was about to go to the ward where the patient was, when she suddenly saw a somewhat familiar figure on the way.

"You are... Lu... Chen?"

Min Ling's memory is very good, and she immediately remembered Lu Chen.

The main reason is that Lu Chen left a deep impression on him!
It was the first time for her to see such an outstanding graduate student!

When encountering emergency rescue, he is calm and orderly in clinical thinking, even better than many residents who have already worked.

"Hello, Teacher Min."

Lu Chen also saw Min Ling.

What a coincidence, she was on the last night shift with her.

Now the day shift is still with her.

"Hurry up and change into a white coat. The emergency patient is in bed 18." Min Ling smiled.

With Lu Chen as a good helper, no matter how busy she is today, she will be much more relaxed.

Lu Chen nodded: "Okay."

I have pain in my heart, I can't tell.

Lu Chen quickly walked into the duty room and changed into his white coat.

Grab the stethoscope and a small medical flashlight in your pocket.

Come to the bedside of bed 18.

On the hospital bed, the patient was still in a coma with his eyes closed.

However, his right hand occasionally waved involuntarily.

Lu Chen saw that his HP was 45 in red.

Surrounded by the bed are three middle-aged women, all of whom should be the patient's daughters.

At this time, Min Ling was already issuing medical orders.

"Enable ECG monitoring, inhale oxygen through the nasal cannula, check fingertip blood sugar, and then urgently check blood routine, biochemistry, ions, coagulation items, myocardial enzymes, and blood gas analysis."

"receive."

A nurse moved the ECG monitor, and another nurse began to take blood from the patient.

The fingertip blood sugar value came out soon.

"Doctor Min, fingertip blood sugar is 1.8mmol/L." After measuring blood sugar, the nurse replied immediately.

"So low?" Min Ling frowned, "immediately inject two high-sugar injections, and then hang a 500ml bag of sugar, and adjust the liquid speed faster."

"receive."

Min Ling then looked at Lu Chen who was on the side: "The emergency department considered this patient to be in a hypoglycemic coma, so they did a CT scan and sent it to our department."

Lu Chen frowned and said, "Mr. Min, do you still need to differentiate it from cerebral infarction?"

"Yes." Min Ling nodded slightly, "Although all the current evidence points to hypoglycemic coma, we must not forget that cerebral infarction must be ruled out. Because the treatment of cerebral infarction and hypoglycemic coma is very different."

Not only patients with hypoglycemia coma, but all delirious patients must rule out acute cerebrovascular accidents.

Afterwards, Lu Chen asked the family members beside him about the history of the patient's illness.

The patient has a history of diabetes for more than 20 years and has been taking insulin treatment at home.

I don’t know why recently, my appetite is not very good, and I eat less, but the insulin I take is still the same as before.

"Will you have a neurological examination?" Min Ling continued.

For delirious patients, in addition to the routine physical examination, there is also a complete set of neurological examination.

Examination of the nervous system is more complicated.

If it is not frequently used clinically, it is easy to forget.

Except for doctors in neurology, doctors in many other departments will ignore the physical examination of the nervous system.

Doctors with departments don't even know how to do neurological examinations at all.

"A little bit." Lu Chen said.

Min Ling nodded; "Then you start."

Lu Chen walked to the right side of the hospital bed.

The first step in the physical examination of the nervous system is to judge consciousness.

Obviously, the patient in front of him is in a coma, but it is necessary to distinguish whether it is a deep coma or a light coma.

Followed by the examination of the cranial nerves.

Focus on the examination of the oculomotor nerve, trochlear nerve, and abducens nerve, observe whether there is diplopia, whether the eyeball movement is in place, observe whether the corners of the mouth are deflected, and judge whether it is central facial paralysis or peripheral facial paralysis.

Then check the muscle strength and muscle tension of the patient's limbs to judge the level of muscle strength and whether there are extrapyramidal symptoms.

Finally, it is the examination of the sensory system, physiological reflexes, pathological reflexes, meningeal irritation signs, and autonomic nervous system.

This whole set of nervous system examinations took a lot of time.

Min Ling watched Lu Chen's physical examination and nodded in satisfaction.

This is not a little bit, but a lot!

For the student in front of her, she liked it more and more.

Check is complete.

Lu Chen was a little tired, he exhaled lightly, and said, "The patient's consciousness is lightly comatose...the left nasolabial fold did not shrink during the orbital pressure stimulation, the left limb had no spontaneous movement, and the right limb had evasion. movement, the pathological signs on the left side did not elicit..."

"In general, the patient currently has signs of left limb hemiplegia, which needs to be differentiated from cerebral infarction."

"Okay." Min Ling nodded, and then said to the family members beside her, "Which of your family members can make the decision, come with me to the office."

The three family members and three middle-aged women present looked at each other, but no one spoke for a while.

Min Ling frowned: "Who are you all patients?"

At this time, one of the middle-aged women with short stature and dark skin stepped forward.

"I am the patient's daughter, let me come with you."

"Okay." Min Ling nodded, glanced at the other family members, and then walked out of the ward.

Middle-aged women are not far behind.

……

doctor's office.

Min Ling sat in front of the computer, and Lu Chen stood beside her.

The middle-aged woman sat aside, with a reserved expression, a little restless.

"At present, the patient is in a coma and is in a relatively dangerous situation. We must first consider hypoglycemia coma, and secondly, acute cerebrovascular accident, which is what we often call cerebral infarction."

"Well, I understand." The middle-aged woman nodded, "The doctor in the emergency department told us."

Min Ling continued: "That's good. Although we have given corresponding treatment measures, in order to rule out cerebral infarction, we still need to go out for an examination."

"Do an examination?" The middle-aged woman asked nervously, "Didn't you already have a head CT in the emergency room?"

"Head CT is to rule out trauma and cerebral hemorrhage." Min Ling explained, "Only by doing MRI can we rule out cerebral infarction!"

The middle-aged woman frowned, her eyes flickered, bit her lower lip, and said, "Doctor, I, my brother hasn't come yet. When he comes, we'll discuss it with him and give you an answer later."

"Okay, but you have to hurry up. The patient's condition is serious now. If you don't make it clear as soon as possible, it may delay the best time for treatment." Min Ling said.

"Okay, thank you doctor."

The middle-aged woman nodded and left the ward.

Looking at the back of the middle-aged woman leaving, Lu Chen frowned, and said in a low voice: "Looking at the clothes of the patient's children, it doesn't seem that the financial conditions are particularly poor. How to do a checkup needs to be discussed for a long time... ..."

Min Ling smiled helplessly: "Xiao Lu, as the saying goes, one monk carries water to drink, two monks carry water to drink, and three monks have no water to drink."

"The more people here, the more the better, and here in Jinghua, patriarchal thinking is serious, and most families don't keep their daughters in their property."

"After coming to the hospital, whoever pays the medical expenses will make the decision."

　Thank you Jiuliu Adviser and Tengyubao for their rewards.

　　
　
(End of this chapter)