I can see health

Chapter 315 Meet the Vampire Again

On the second floor of the emergency department, in the observation room.

Although the hiccupping uncle was sent to the CCU, Cheng Peng still couldn't figure it out.

Why does myocardial infarction cause intractable hiccups, but the patient has no obvious symptoms of chest pain?
"I don't really understand either." Although Wang Xiaodong is a doctor at a higher level, he has just started working not long ago. He has not seen much about this rare case, so naturally he doesn't know the reason.

After thinking about it, Cheng Peng still sent a WeChat to Lu Chen, asking why.

Lu Chen received the WeChat message and quickly replied.

"The hiccups caused by myocardial infarction, I guess, may be due to the fact that most elderly patients are accompanied by varying degrees of cerebral arteriosclerosis and autonomic dysfunction (reduced sensitivity to pain)."

"Especially when the patient has diabetes, both pain and sensory nerves are damaged, resulting in necrotic myocardium stimulating the vagus nerve, causing only hiccups but no chest pain."

"That is to say, it's not that there is no chest pain, but that the patient's pain sensation has subsided and he can't feel pain."

After reading Lu Chen's explanation, Cheng Peng finally understood.

"Myocardial infarction manifested as hiccups is really rare!" Cheng Peng exclaimed.

But Lu Chen said again: "Actually, apart from hiccups, there are other uncommon symptoms, which may also be the manifestation of myocardial infarction. For example, toothache, headache, neck pain, and frozen shoulder, what's more. , It was a toe headache, and it was finally found out that it was a myocardial infarction.”

"In short, no matter what the chief complaint is, detailed physical examination and medical history are very important. In addition, there is an electrocardiogram on admission. All these things are gathered together, and finally we can make an accurate diagnosis."

……

After experiencing this somewhat rare patient, the emergency internal medicine outpatient department ushered in a short window period.

It's already ten o'clock in the evening.

In the night sky, the stars nodded.

There are fewer and fewer people on the street.

Except that the hospital not far away is still brightly lit, and the surrounding area is pitch black.

Lu Chen was sitting in the emergency room.

Although the emergency department is very busy, he feels that he is just a tool person.

As long as you listen to the superior doctor, you don't need to use your brain at all.

This is not in line with Lu Chen's style at all.

He came to the emergency department, but to exercise.

If you don't see patients in person, you can't get gratitude!

I have been working as a tool person, but wasting so many resources in vain.

"Ms. Wang, why don't you let me come for the patient's physical examination and consultation later?"

Lu Chen volunteered.

"Huh?" Wang Xueyang frowned.

This was the first time she heard such a request from a student!

Wang Xueyang wished that the students could help her instead.

But the reality is that most of the students are not very reliable!
Let the students check up, and the auscultation of the heart and lungs is a problem.

This is not as fast as myself!

You know, the flow of patients in the emergency department is very large.

After a few minutes of delay, the patient and his family members may yell and quarrel!

However, Wang Xueyang thought about it.

Lu Chen was able to make such a request by himself, and considering his previous performance, he should not be that kind of unreliable student.

"Well, for the next two patients, you come to ask about medical history and physical examination." Wang Xueyang said, "Let me take a look first."

Students have this kind of thinking, of course they should be encouraged.

Besides, if Lu Chen can really replace her, then she can relax a lot this night!
"Okay." Lu Chen smiled.

Finally, I have the opportunity to meet patients.

It's only ten o'clock in the evening, if the next patients are all treated by him.

Then he earns gratitude points and improves the efficiency of system upgrades, and he will definitely go to the next level!

……

As soon as the two finished talking, a patient with abdominal pain walked into the emergency room.

Abdominal pain is one of the most common types of patients in the emergency department.

This time, it was Lu Chen's turn to see the doctor.

The patient is a 30-year-old middle-aged man.

His face was flushed and he smelled of alcohol.

It's just that the man is covering his stomach now, with a painful expression on his face.

Lu Chen hurriedly helped the family move the patient to the bed.

"Why are you uncomfortable?"

The middle-aged man pointed to his stomach, "It hurts...it hurts..."

Lu Chen asked about the medical history and started the physical examination.

From the origin, inducement, location and nature of abdominal pain, whether there is transfer pain, radiating pain, and the way of relief, etc., everything is detailed.

At the same time, Lu Chen was also checking the patient's abdominal signs, whether there was tenderness, rebound tenderness, etc.

Wang Xueyang on the side watched Lu Chen's movements and nodded with a smile.

This kid is really good!
Whether it is an interrogation or a physical examination, they are all performed perfectly.

This professional skill does not look like a freshman student at all.

For example, asking a doctor is the simplest clinical skill.

But many medical students don't pay much attention to it. They just ask whatever they want, or they don't have any rules, so it's easy to miss a lot of things.

But Lu Chen was different. From the main symptoms to the accompanying symptoms, as well as the negative signs with differential diagnosis, he was able to ask clearly.

Most importantly, there is no unnecessary nonsense.

In the shortest possible time, he was able to grasp the first-hand information of the patients.

"Teacher, the patient has tenderness under the xiphoid process and no rebound tenderness. The rest of the physical examination is normal."

"What about auscultation of the heart and lungs?"

"It's all normal."

……

After seeing two patients in a row, Wang Xueyang felt relieved.

Lu Chen can really replace her for a medical examination.

This is Wang Xueyang's dream.

With the help of a student, she can relax more than half of the night.

"Lu Chen, next, you continue to see patients, and I will be by your side. If you encounter places that you don't know, I will give you tips."

"Okay, thank you Teacher Wang." Lu Chen smiled.

Through his own efforts, he can finally see patients in person.

However, the next patient made Lu Chen's face change.

……

This is a woman wearing a black turban.

She was supported by a young man and walked slowly into the consulting room.

Her face was pale, and the expression on her face was extremely painful, and she groaned in pain from time to time.

"Doctor, my mother has been complaining of a stomachache!" The young man walked into the consulting room and shouted.

The middle-aged woman next to him was holding her belly.

"My stomach hurts, stop the pain quickly!"

Lu Chen's pupils shrank slightly.

If he remembered correctly, this woman wearing a black turban seemed to be the "vampire" he met when he went to the temple to pray for blessings!
Seeing that this female patient was in a hurry, Wang Xueyang didn't intend to let Lu Chen come to see her. She wanted to come to see her in person.

She hurried to the front of the female patient.

But when she first saw the patient, she was frightened.

The whiteness of this woman is not the delicate fairness of the skin, but a sickly whiteness!
On her ears and nose, there are large scars, which seem to be corroded.

And her teeth, those fangs!
(End of this chapter)