My medical skills are a billion points

A manic patient, who bites and beats others, is he a mental patient?

Xiao Chu was slightly taken aback.

If it's a mental patient, shouldn't it be pulled here?

It should be taken directly to a mental hospital!

However, Xiao Chu did not dare to neglect.

Now that the patient has been brought to them, he has to go out for consultation.

A group of people also hula followed out.

I saw a middle-aged man in his forties in the ambulance.Manic and restless, shaking hands and feet, swearing indiscriminately.

If it wasn't for the patient's family members and emergency doctors who held him tightly, he would probably be able to run away by jumping off.

Looking at the patient like this, it really looks like a psychotic attack.

Xiao Chu frowned slightly.

If the patient is really mentally ill, it is really not suitable to come to them.

It should be sent directly to the Provincial Psychiatric Hospital, after all, the treatment of mental illness is professional there.

If they treat mental illness, they only give sedative treatment, and they cannot give very professional medicine.

In the end, it was necessary to be transferred to a mental hospital for treatment.

However, since the patient was sent to them first, Xiao Chu had to see him.

After the diagnosis is clear, if the diagnosis is mental illness, then transfer to a mental hospital.

The patient is now manic, insane, and swearing at others.

There is no way to ask about the medical history, and the examination cannot be done for the time being.

If the patient does not cooperate, he can only ask his family members.

"Does the patient have a history of mental illness?"

"no!"

A female family member shook her head.

"He's usually in a normal body. He just likes to drink a little bit of wine, and he suddenly became like this today. Doctor, my husband isn't really mentally ill, is he?"

I love to drink, but I don't smell alcohol now, which means I didn't drink it today.

Sudden mental symptoms appear, it is hard to say whether it is mental illness!

Xiao Chu continued to ask the family members: "Does your husband drink a lot?"

"Drink it every day! About half a catty a day! I think he will die sooner or later!"

Speaking of this, the woman was full of dissatisfaction.

It seems that no one can bear the alcoholic husband.

"Has this ever happened before?"

"It's never happened before. Today we were having dinner at home, and he suddenly vomited a mouthful of blood, and that's it."

"Still vomiting blood?"

Xiao Chu was a little surprised.

"Well, I only vomited, not too much! I have never vomited blood before, doctor, what is my husband's disease? He used to be very healthy."

The woman's tone was rapid, and she really wanted to know what kind of disease her husband was suffering from.

Without past medical history, sudden onset of mental abnormalities, first of all, cerebrovascular disease cannot be ruled out.

Seeing this situation, the trainee doctor Wang Panpan next to him felt a little nervous.

No past medical history, a sudden mental condition, can't it really be a mental illness?

She thought for a while and asked in a low voice, "Mr. Xiao, is this person mentally ill?"

"If you haven't checked clearly, don't make a random diagnosis."

Xiao Chu frowned.

The patient vomits blood, drinks alcohol frequently, and suddenly becomes mentally disturbed.

Combining these words together, Xiao Chu has already made a rough judgment on this patient in his mind.

But still need to do some physical examination, and related tests to be clear.

Because the patient was manic, he didn't cooperate with the physical examination at all.

Xiao Chu had no choice but to give him a diazepam to make him fall asleep.

Then give him a physical examination.

The complexion on the patient's face was strange, sallow and sallow, not like normal complexion at all.

Xiao Chu opened his eyes and looked at his sclera, which was also yellow.

The skin on the body is also yellow.

After auscultation, there was no obvious abnormality in his lungs, and his heart rate was normal.

There is no obvious tonic reflex in the neck.

Xiao Chu palpated the patient's abdomen.

It was found that the volume of his liver had shrunk.

And when percussion, there is obvious shifting dullness.

This shows that there is a lot of ascites in his stomach.

Moreover, there was obvious edema in both lower extremities.

After the whole examination, combined with the patient's symptoms, Xiao Chu has already made a diagnosis of the patient's disease.

But definitely need to check the results, to support.

So Xiao Chu asked the patient's family members to go through the hospitalization procedures before issuing the checklist.

Mainly check blood routine, urine routine, liver and kidney function, electrolytes, blood ammonia, liver color Doppler ultrasound, coagulation function and head CT.

The patient may wake up again at any time, and he must be checked as soon as possible.

Xiao Chu asked a few interns and their family members to quickly push the patient to do relevant examinations.

Half an hour later, all the inspection results came out.

As Xiao Chu expected.

The manic restlessness of the patient was caused by the early stage of hepatic encephalopathy.

The prodromal stage is the early stage of hepatic encephalopathy, and in the later stage, it is a direct coma without screaming at all.

Hepatic encephalopathy is the most serious complication of liver cirrhosis.

Hematemesis is caused by upper gastrointestinal bleeding.

Gastrointestinal bleeding is caused by rupture of esophageal and gastric varices.

In the final analysis, it is all caused by liver cirrhosis.

The cause of cirrhosis is the alcoholic liver caused by the patient's drinking all year round.

And there have been complications such as splenomegaly and ascites.

Xiao Chu took the test sheet, explained to the patient's family the severity of the patient's disease, and gave him a critical illness.

If hepatic encephalopathy cannot be cured, the patient will face death.

Xiao Chu quickly gave the patient a treatment order.

"Lactulose oral liquid, intravenous infusion of sodium glutamate and arginine, lowering blood ammonia, white vinegar enema. Losec and octreotide intravenous infusion."

Xiao Chu finished all the doctor's orders in one breath.

Because this patient is in a serious condition and difficult to treat.

Therefore, a doctor's order was issued, and the intern doctor was not allowed to do it.

The prodromal period of hepatic encephalopathy is mental abnormality.

If a coma occurs, the patient is very dangerous.

The key point is that if the patient continues to vomit blood, it will be very troublesome, because it is not easy to stop the bleeding.

When necessary, endoscopic hemostasis is the only option.

But for the hemorrhage caused by liver cirrhosis, the effect of microscopic hemostasis is not optimistic.

It can only be said that this patient has cirrhosis of the liver, all due to his long-term alcoholism.

Because the patient was in critical condition, he was temporarily sent to the intensive care unit.

After working on this patient, it's time to get off work.

Xiao Chu had a dinner in the staff cafeteria, then returned home.

……

In the evening, at Zhang Guoxing's home.

Zhang Hongbo took the mobile phone and handed it to Zhang Guoxing.

"Dad, look, Xiao Chu was photographed accepting red envelopes."

Zhang Guoxing took the phone and squinted for a while.

He said sadly: "Send him to Douyin and the scarf. Find some sailors to fuel him!"

"Okay!"

Zhang Hongbo's eyes brightened.

Chapter 237

The next day, when Xiao Chu arrived at the department, he found that the atmosphere was not quite right.

The medical staff who were originally in the office, waiting to take over their shifts, talked and laughed and talked a lot.

But as soon as he entered, he immediately became silent.

And the way he looked at him was also very strange.

Xiao Chu was still a little puzzled.

What happened to these people today?

Usually, before the director comes to take over the shift, it's either the boss's parents and the west's family, or gossip about which department of the hospital.

Why did everyone suddenly quiet down when I came here?

Since it was not yet eight o'clock, not all the people in the department came together.

Most of the doctors who came were interns and fellow doctors.

Zhou Ziqiang, Zhao Fangshu and others have not arrived yet.

However, Gao Yingjun is on the night shift, and he is always there.

Seeing Xiao Chu coming in, he hurriedly pulled him aside, and whispered: "Xiao Chu, have you seen Douyin?"

"No, I haven't downloaded Douyin on my phone."

"Oh, no wonder you look all right!"

"Something's up! Don't you know that?"

"What's the matter? It's so mysterious."

Gao Yingjun didn't speak, took out his mobile phone, opened the Douyin app on it, and handed it to Xiao Chu.

As soon as Douyin's advertisement interface passed, the first video that appeared made Xiao Chu's eyes widen suddenly.

What was shown in the video was the scene where Xiao Chu received the red envelope from the woman yesterday.