My medical skills are a billion points

Looking at the electrocardiogram, Xiao Chu frowned.

This myocardial ischemia is too serious!

Seeing that Xiao Chu's expression was not right, Chen Bin hurriedly took the electrocardiogram and looked at it.

His complexion also changed in a blink of an eye.

The electrocardiogram showed obvious ST-segment depression in the chest leads, and T wave inversion in all leads.

This is myocardial ischemia, a very obvious sign!

Acute myocardial infarction can occur at any time!

In addition, I often have chest pains and tightness in the chest, which is very typical of coronary heart disease, angina pain!

Although Chen Bin is not a professional cardiovascular doctor, he is also aware of the seriousness of his problem.

After he saw his electrocardiogram, he suddenly felt chest pain again, and the chest tightness worsened.

His symptoms were aggravated. First, the condition itself was not mild, and second, it also had certain psychological effects.

With a solemn expression, Chen Bin thanked Xiao Chu, and took the electrocardiogram and went to the cardiology specialist.

And Liu Jiaxin felt that she had been hit, so she came out of the operating room and went straight back to their hospital.

After the pancreatic cancer patient was settled, Gao Yingjun brought an amazing news to the people in Corey.

Their director, Chen Bin, was hospitalized because of a heart attack.

Now I am preparing for coronary angiography. If it is serious, I may need to put a stent.

After hearing this news, the stone in Xiao Chu's heart was finally let go.

Now that Chen Bin went for examination and treatment, he would not die from a heart attack.

At eleven o'clock, Xiao Chu saw an old man in his 60s with white beard and hair.

Lying on the rescue bed, his consciousness was a little fuzzy.

Accompanying him was his son.

Xiao Chu asked: "What's the matter with the patient?"

The man replied: "Half an hour ago, my dad was eating, and suddenly passed out, and then woke up a few minutes later, vomited once, and his speech was a bit awkward."

"Have you ever been sick before?"

"My dad has three highs. He is taking medicine, and the control effect is mediocre."

Xiao Chu had roughly understood the medical history, and he began to examine the patient.

Measure your blood pressure!

Ho!

Up to 200/110mmHg.

It's ridiculously high!

This is the rhythm of cerebral hemorrhage!

Check the pupil size, and the light reflex is a little slow.

There was no obvious neck stiffness, and there were no problems with cardiopulmonary auscultation.

However, it was found that the muscle strength of his left upper and lower limbs was level 0.

And the Papanicolaou sign on the left is positive.

Through these symptoms and signs, it is easy to diagnose the disease.

Xiao Chu asked Wang Li and Liu Qing to do a head CT with the patient.

The two of them were fine, so they often studied with Xiao Chu.

Among them, Wang Li made faster progress.

She looked at the patient and guessed: "Mr. Xiao, is this patient cerebral hemorrhage?"

Xiao Chu nodded.

"The possibility is high, you will know after the CT scan!"

The two of them, together with their family members, pushed the patient to the examination.

Liu Qing asked Wang Li in a low voice: "How do you know he has a cerebral hemorrhage? Could it be a cardiovascular disease or a cerebral infarction?"

"The patient's symptoms are quite typical, and he has a history of high blood pressure, and the blood pressure is so high that the effect of medication is not good.

The onset of the disease during activity, and vomiting once, accompanied by the left limb movement disorder, these symptoms have already pointed to the diagnosis of cerebral hemorrhage. "

Wang Li said, pointing to the door of the CT room.

"When the CT comes out in a while, we'll know."

Ct film will come out soon.

The patient had bleeding in the right basal ganglia, and the amount of bleeding was not small, about 30 ml.

It belongs to the category of massive cerebral hemorrhage.

Chapter 221 Cerebral hemorrhage does not necessarily require surgery

Seeing the video, Liu Qing stuck out her tongue at Wang Li.

"Wang Li, you are amazing now! This can be judged right!"

The patient was pushed back to the ward, and the two returned to the office with the CT film.

Xiao Chu looked at the CT film, then looked at Wang Li and Liu Qing.

"What do you two think about this case?"

When there are more typical cases, young doctors and interns are always tested.

Since the two often practice with him, Xiao Chu also intends to teach them more.

As for how much the two can learn, it depends on their understanding.

Anyway, in terms of learning, Liu Qing is a little worse than Wang Li.

Liu Qing said first:

"Mr. Xiao, the patient's consciousness is blurred now, and the amount of bleeding is relatively large. According to the film, it has reached 30 milliliters. I think we should consult with a brain surgeon and perform a craniotomy."

Xiao Chu looked at Wang Li.

Wang Li thought for a while and said, "I think the current patient's condition can be treated conservatively.

He is only confused now, not in a coma, although the amount of bleeding has reached the indication for surgery,

But you can see on the film that the midline has not shifted, the pupils on both sides are equal in size and round, and there is no sign of brain herniation.

Therefore, I think conservative treatment should be taken first, but close observation is required. If there is any change in the condition, a brain surgery consultation is required immediately. "

Xiao Chu appreciated Wang Li's analysis.

"According to the current situation of the patient, it is indeed possible to treat conservatively. For this type of cerebral hemorrhage, the amount of bleeding, even after surgery, the patient is not 100% awake.

We are going to take conservative treatment now, use mannitol dehydration to lower the intracranial pressure, pay attention to blood pressure control, prevent infection, and we must pay attention to reexamination of the head C and T in time to observe whether the bleeding has increased. "

"Once the bleeding increases, the brain midline shifts, and the pupils are unequal, it is a brain herniation, and surgery must be performed immediately."

"If the patient's bleeding volume does not increase and there is no special change in consciousness, then it is enough to continue conservative treatment. Generally, the bleeding will be significantly absorbed in about half a month."

For Xiao Chu's careful teaching, the two of them also worked hard to remember.

Wang Li even took out a notebook and wrote down the knowledge points Xiao Chu said.

Seeing that the two were more attentive, Xiao Chu decided to take them with him more.

After checking the room at noon the next day, everyone except the staff on duty came to the cardiology ward with flowers and gifts.

After all, the director of the department, Chen Bin, was hospitalized, and as a subordinate, he must come to visit him.

After all, Chen Bin is the director of the emergency department, and he has a good relationship with the director of the cardiology department.

The Department of Cardiology has prepared a single ward just for him.

When Chen Bin saw the staff in Corey, they all came to see him, and said hurriedly: "I have a stent in my heart now, and it's fine. You don't have to work so hard.

But I'm resting for a few days, and Corey's work will be presided over by Xiao Chu for the time being.Although there is no major problem with my heart now, the heart function has declined after all.

In the future, if there are any difficult operations in our department, or operations that take a long time, I am afraid that Xiao Chu will lead you to do them, and you must cooperate with him well in the future. "

What Chen Bin said made everyone stunned for a while.

His words were like confessing his last words.

But from Chen Bin's words, everyone also got a message.

Although Xiao Chu is temporarily in charge of the emergency department, I am afraid that after Chen Bin retires next year, the chief director of the emergency department may be Xiao Chu's.

Although his professional title is relatively low, since he is now Liu Qiming's celebrity, he might really become the chief director of the emergency department.

Some doctors were really jealous of Xiao Chu's luck.

At such a young age, he might become the chief director of the emergency department in the future.

But they had to submit in their hearts.

After all, Xiao Chu's medical skills are definitely the leader in the whole hospital, no one can match them.

After a group of people chatted with Chen Bin for a while, they returned to the emergency department and started to do their own work.

Li Xiang's group is on duty today, and Gao Yingjun is resting.

Xiao Chu took Wang Li and Liu Qing and asked them to follow him more and learn clinical experience.

After all, Xiao Chu's diagnostics has already been promoted to the world class by him.

He knows all the diseases that have been documented in the world.

Like other subjects such as internal and external women and children, pathology, physiology and biochemistry, etc., they are all at the advanced level.

Not only is Xiao Chu's surgical ability, even in terms of diagnosing diseases, it can be said that in the entire academic world, no one can compare.

No way, this is the advantage of hanging up!

In the emergency room, a young man walked in.

The man was probably in his 20s, clutching his stomach, bending over, and kept "Aiyo".

It seems that the stomach hurts badly.

The man came to Xiao Chu's consultation room with beads of sweat on his face.

Xiao Chu didn't move, and motioned for Wang Li to ask a doctor.

"Why are you uncomfortable?"

"stomachache."

The man said while holding back the pain.

"How long has it been hurting?"

"It's been more than an hour. Can the doctor give me a painkiller injection first? I can't stand the pain."

The man clutched his stomach, unable to straighten his waist, and broke out in cold sweat.

"Pain relief injections must not be given, because your current condition is not clear. If you are given pain relief injections now, then your condition will be covered up, which will easily lead to misdiagnosis. Do you understand?"

Wang Li has been an intern for several months, and she works very hard. She is much better than Liu Qing in terms of ability.

I know that I have unexplained abdominal pain, so I can't take painkillers for the time being.

"Be patient for a while, I will give you a good examination, the diagnosis of the disease is clear, and I will give you medicine immediately."

Seeing what Wang Li said, the man had no choice but to bear the pain and lay down on the examination bed.

According to the action essentials taught by Xiao Chu, Wang Li gave the man a detailed physical examination.

It was found that the man's left lower abdomen was positive for tenderness and no rebound tenderness.

Percussion pain in the kidney area is positive.