My medical skills are a billion points

In this way, the patient will have a more accurate understanding of his disease.

"Okay, doctor, thank you, I'm leaving!"

After the old man finished speaking, he picked up all his checklists and walked out of the consulting room slowly.

His figure was full of loneliness and desolation.

Seeing the old man walk out of the consulting room, Xiao Chu turned around and gave a wry smile.

"Do you think I'm cruel? I told him the truth and didn't give him any treatment."

Wang Panpan shook his head.

"No, Teacher Xiao must have your reasons for doing this."

Xiao Chu sighed and said:

"In foreign countries, once a patient is diagnosed with advanced cancer, there is no point in any treatment.

Doctors usually tell them the truth and let them go home and enjoy their final days. "

Chapter 302 So young, he got this disease

Xiao Chu paused, and then explained: "If we treat them, there will be no healing effect.

And in most cases, it exacerbates the progression of their condition.

And make them suffer painful torment.This is inhumane. "

Wang Panpan understood what Xiao Chu said.

For cancer, foreign treatment concepts are very different from domestic treatment concepts.

Generally speaking, once a domestic patient is diagnosed with advanced cancer,

Not to mention the patient himself, but his family members, on the contrary, they will always try their best to treat them, without any intention of giving up.

As a result, in the end, he still lost his personal fortune.

However, this is due to the general trend in the country.

Doctors can't play a leading role in this regard.

Looking at the lonely back of the old man going away, Xiao Chu and Wang Panpan could only lament the fragility of life.

The two of them hadn't finished sighing when they heard an ambulance roaring towards them.

Xiao Chu and Wang Panpan hurried out to see the doctor.

At the same time, Gao Yingjun followed.

Today he is on the day shift, that is, the shift that takes in patients.Zhao Fangshu is also in the day shift, but she is an assistant.

She only accepts patients when there are too many patients to handle.

One of Li Xiang and Zhou Ziqiang was off the night shift, the other was on the night shift, and they were all busy.

Therefore, Xiao Chu usually treats patients brought by ambulances.

Because in his eyes, they are all points.

The patient is a 25-year-old young man, but he is obese and looks to weigh more than 200 kilograms.

The emergency doctor said: "The patient was in a coma for about half an hour. After being discovered by his family, he called 120. The patient is still in a coma."

"Is there any nausea and vomiting?"

Xiao Chu asked.

"No vomiting."

Everyone carried the patient to the emergency bed and pushed him to the emergency room, where the nurses connected him to various monitoring instruments.

Xiao Chu took out the flashlight and looked at the patient's pupils.

The pupils are equal in size and round in size, and their light reflexes are a little slow.

Xiao Chu used the stethoscope again to listen to the patient's heart and lungs.

No obvious murmurs were heard in the heart, and no dry or wet rales were heard in both lungs.

Since the patient was in a coma, the muscle strength of the limbs could not be detected.

But the muscle tone is normal, and there are no abnormal nerve reflexes.

At this time, the patient was lying on the hospital bed, still in a coma, and still twitching non-stop.

After Xiao Chu checked the patient, Wang Panpan checked again.

Confusion appeared on her face.

Obviously, there is no clue about the symptoms of this patient.

Xiao Chu has already given the patient a detailed physical examination, and has a general understanding of his condition in his heart.

The family member who came was a middle-aged woman in her 40s who was the mother of the patient.

At this time, she looked at her son lying on the bed, still unconscious, with a nervous expression on her face.

Even holding Xiao Chu's hand did not let go.

"Doctor, what's wrong with my son? Hurry up and save my son!"

The mood of this family member was too unstable, and they stayed in the emergency room, which affected the rescue of patients.

Xiao Chu led her out of the emergency room and asked about the conditions of some patients.

"Does your son have any illnesses?"

"No, he's usually very healthy, but he eats a lot and doesn't like to exercise, that's why he's fat like this."

The man is only 25 years old, but his weight has reached 120 kg.

A body mass index that is seriously overweight is considered obese.

It's normal to not like to be active. Once a person of his size is active, he is prone to chest tightness and discomfort.

Xiao Chu asked again: "Then what does your son usually do?"

Sometimes the nature of the patient's work can also determine some situations.

The family member hastily replied: "My son is a food broadcaster, and he doesn't go to work."

"Eating broadcast?"

Xiao Chu finally understood why this man was so fat.

It turned out to be a gourmet anchor, who eats delicious food all day long, so it's no wonder that he isn't fat.

"Then your son doesn't usually measure his blood pressure? Has he tested his blood sugar?"

The patient's mother shook her head.

"He is usually healthy and has no discomfort, so he has never had a medical examination."

Obese people are generally more prone to high blood pressure and even diabetes.

The monitor just now showed that the patient's blood pressure reached 160/90mmHg.

Already have high blood pressure.

Combining the man's medical history and physical examination, Xiao Chu had a rough judgment on his illness in his mind.

Back in the emergency room, he said to Wang Panpan:

"Check the patient's blood routine, random blood sugar, urine routine, blood gas analysis, liver and kidney function electrolytes, myocardial enzymes,

Contact the color ultrasound room, do a heart color ultrasound, and then prepare for a head MRI and chest ct examination. "

There are many causes of coma.

The most common is cerebrovascular accident.

But this man is relatively young, and the possibility of a cerebrovascular accident is unlikely.

Therefore, Xiao Chu considered that the possibility of blood sugar problems was higher.

However, because the patient is now comatose with convulsions, it is necessary to go further to rule out head and heart problems.

This is often said in diagnostics, diagnosis and differential diagnosis.

After the nurse took the man's blood, he sent it to the laboratory in time.

Then Wang Panpan and his family pushed the gurney, and checked the patient's brain MRI and heart color Doppler ultrasound.

And then the blood sugar came out quickly.

The patient's random blood sugar value was as high as 32mmol/L, and the blood gas analysis even indicated acidosis.

The urine routine shows three plus signs for sugar in urine and three plus signs for ketone bodies.

Wang Panpan also turned his head to look at the result in Xiao Chu's hand.

"Is this diabetic ketoacidosis?"

"Ok!"

Xiao Chu nodded.

"It's really diabetic ketoacidosis, and it's still type [-] diabetes!"

Wang Panpan was surprised.

"Having diabetes at such a young age, how should I live in the future?"

Wang Panpan looked at the comatose patient lying on the hospital bed and sighed.

Once the patient's disease is diagnosed, it is easy to treat.

Xiao Chu began to give medical orders to the nurse.

"500 ml of normal saline, plus 20 units of regular insulin intravenously, and a random blood sugar test every half an hour."

"When the blood sugar drops to 13.9mmol/L, switch to 5% glucose plus insulin intravenous infusion!"

"..."

Xiao Chu ordered the doctor orderly.

Patients with diabetic ketoacidosis coma mainly need to lower blood sugar, correct acidosis, and replenish fluids.

Xiao Chu is naturally handy in the treatment of this disease.

After the patient wakes up, insulin is needed to control blood sugar and diet conditioning.

Of course, if conditions permit, you can also install an insulin pump on your body.

If you don't install an insulin pump, you need to inject insulin into your body for a long time.

It is also very painful.

And Wang Panpan followed Xiao Chu closely, watched carefully, and took out a notebook to write down the main points of diagnosis and treatment from time to time.

Chapter 303 Drug Poisoned

Diabetic ketoacidosis is also a very common condition in emergency departments.

But most of them are found in that kind of type [-] diabetes, and they are still elderly patients.

A young man in his twenties who suffers from diabetes and shows signs of acidosis is usually type [-] diabetes.

Type [-] diabetes requires life-long insulin injections, and taking hypoglycemic drugs will not work.

And the most serious complication of type [-] diabetes is ketoacidosis.

If the rescue is not timely, it will be life-threatening.

Like this young man, he has never had a physical examination, and he is a foodie and broadcaster, and has not exercised all year round.

So as soon as it was found to be diabetes, ketoacidosis appeared.

If it wasn't for the coma this time, his family still wouldn't even know he had diabetes at a young age.

After the illness was diagnosed, Xiao Chu communicated with the patient's mother in time.