I can see health

Chapter 282

Just as Lu Chen was thinking about how to collect a wave of gratitude from his juniors and younger sisters.

Sun Guoguo led a group of trainees in white coats into the doctor's office in Xinxin District [-].

There are about ten trainees in this group.

Sun Guoguo walked towards Lu Chen and said with a smile, "Junior brother, are you busy now?"

Lu Chen shook his head: "Fortunately, the doctor's order and medical records have been processed."

Sun Guoguo smiled, "That's just right. I'm going to the teaching building to hand in materials later. There are more than ten interns here. You can take them to the ward to see patients, mainly for heart failure and coronary heart disease. patients."

"Let me take the trainee?" Lu Chen looked behind Sun Guoguo.

This is a group of immature trainees, with curiosity and thirst for knowledge shining in their eyes.

Apprenticeships are not the same as internships.

When medical students are in their senior year, they will come to the hospital to study clinically. At this time, they only come a few times temporarily, so they are called trainees.

When medical students are in their fifth year, they will be resident in the hospital and rotate in various clinical departments, which is called internship.

"Well, just take them around the hospital bed and tell them about the diagnosis and treatment of heart failure and coronary heart disease." Sun Guoguo said with a smile, "They are still trainees, so don't make too many demands. Familiarize them with how the hospital works, and then teach them to take medical histories."

"In that case, that's fine." Lu Chen nodded.

It was the first time for him to give a lecture in front of so many trainees.

But if you can teach the class well, you should be able to earn a lot of gratitude!

……

Seeing that Lu Chen agreed, Sun Guoguo handed over the trainee and rescued him from the ward.

"Do you have a team leader?" Lu Chen stood up and looked at the group of trainees in front of him.

A thin boy with glasses came out.

"Teacher, I am the group leader."

"My name is Lu Chen. I'm just a graduate student. You can call me brother." Lu Chen smiled.

"Okay, brother."

Lu Chen selected two patients who managed their own beds.

A patient with heart failure and coronary heart disease.

Before taking the trainees for rounds, Lu Chen first communicated with the patients and their families.

After obtaining consent, Lu Chen brought everyone to the ward.

"This is a patient with heart failure..." After Lu Chen briefly introduced the patient's situation, "The first step in seeing a patient is to ask a doctor. Who wants to try to have a consultation?"

There were more than a dozen trainees, but none of them made a sound.

"Then the team leader will try it." Lu Chen said to the thin boy.

The team leader dawdled for a while, then stood up, hesitated for a moment, and then began to question the patient.

Lu Chen was not in a hurry.

He also came here from this time.

Although it is written in the medical certificate how to consult a doctor, it is the knowledge in the book after all!
It is a huge leap from the knowledge in the book to the clinical skills in reality.

This is not a small challenge for the interns who are clinical for the first time.

The team leader began to ask: "Auntie, what's wrong with you?"

"Chest tightness." The patient was very cooperative, "In addition to chest tightness, there are also dizziness, headache, and loss of appetite recently."

"..."

The team leader's initial consultation was relatively methodical.

But after a few questions, he started to let himself go, asking whatever he caught.

Seeing this, Lu Chen quickly interrupted the team leader's consultation.

"The team leader has already asked a good question." Lu Chen smiled, "Is there anyone else who wants to ask?"

I looked around, but no one stepped forward.

Lu Chen had no choice but to explain it himself.

"When asking about the medical history, you should ask about the patient's main symptoms, accompanying symptoms, the cause, location, nature, aggravation or relief of the symptoms... You can't ask what you want!"

……

In about half an hour, Lu Chen took more than a dozen trainees to see the two patients, and then rescued them to the demonstration classroom in the eighth district of Xinxin.

Next, he will begin to explain the pathophysiology of coronary heart disease and heart failure.

After talking for a long time, Lu Chen felt a little dry mouth.

The trainee sitting below still had a confused look on his face.

"You can ask me any questions you have now." Lu Chen had no choice but to say.

The students present were silent for a while.

Finally a girl said: "Brother, can you ask any questions?"

Lu Chen nodded: "About clinical medicine, as long as I know, I will try my best to answer."

The girl paused, then said: "Senior brother, I just looked through the patient's medical records. I saw that there was a travel history in the medical records. What is a travel history? Is it a travel experience?"

Lu Chen was taken aback.

This problem has nothing to do with heart failure or coronary heart disease!
"Ahem." Lu Chen cleared his throat, "It's an improper relationship between a man and a woman."

The girl blushed, "I see, thank you brother."

Lu Chen thought he would let it go, but he didn't expect that some boy present shouted.

"Brother, can you be more specific?"

Lu Chen's complexion turned dark: "It means sleeping with other women besides my own wife."

The boy present replied again: "Senior brother, then I slept with Xiaosan, is this considered history?"

"It shouldn't be counted." Lu Chen paused.

"How does that count?"

Lu Chen thought for a while, and said, "Go to the heaven and earth to sleep, and you will be regarded as a travel history."

As soon as he finished speaking, all the trainees laughed out loud.

Lu Chen felt that something was wrong, and was almost led astray by the boys below!
He hurriedly said: "Everyone, please mention the issues related to coronary heart disease and heart failure!"

Lu Chen looked around, everyone was quiet, but no one answered.

"If you don't ask, then I'll ask." Lu Chen smiled.

His smile, in the eyes of all trainees, was a bit creepy.

Everyone lowered their heads slightly, not daring to look at Lu Chen.

"Just now we saw a patient with right heart failure. Compared with left heart failure, what are the more characteristic signs?"

As soon as Lu Chen's question came out, there were whispers from below.

After a while, the group leader stood up slowly and said, "Brother, is the hepatojugular reflux positive?"

Lu Chen smiled: "Not bad, do you know how to do it?"

The team leader nodded.

"Advise the patient to lie on the bed, put his head on a high pillow, and breathe with his mouth open. The examiner's right palm is lightly placed on the liver area, and the pressure is gradually increased for 10 seconds. At the same time, the degree of distention of the jugular vein is observed."

"What is the principle of this inspection?"

"The oppressed congested liver increases the amount of return blood, and the congested right atrium cannot accept the return blood flow, so the jugular venous pressure is forced to rise..."

Lu Chen nodded slightly, and the group leader answered well.

However, Lu Chen's next question made everyone look at each other in blank dismay.

"Why is the patient in a semi-recumbent position of 30-40° when doing the hepatic jugular reflux sign? Can't it be in a supine position of 60° or other angles?"

(End of this chapter)