My medical skills are a billion points

Zhang Hongbo seemed to have thought of something suddenly, and his face was a little ugly.

"Dad, Chen Bin won't give that Xiao Chu the seat in the emergency department, will he?"

Zhang Guoxing also frowned.

"It's hard to say. With Chen Bin's personality and Xiao Chu's ability is so strong, this spot will most likely be given to him.

After all, Xiao Chu's ability is indeed very high, and the possibility of winning the championship is relatively high. "

Zhang Hongbo became even more worried.

"Dad, what should we do? If Xiao Chu is given the spot in the emergency department, this kid spends all day in the emergency department, so he must have rich experience in first aid. I'm afraid it will be difficult for me to beat him!"

Zhang Hongbo himself still knows it well.

He only works in thoracic surgery, and he is relatively strong in thoracic surgery.

But it doesn't stop there.

As for first aid skills, not to mention compared with Xiao Chu, even compared with other doctors in the emergency department, they are far behind.

If he was allowed to participate in the first aid competition, he would definitely not be able to win the ranking.

It's just because of his father, who is the vice president of the provincial hospital, that he wants to grab a spot.

Zhang Guoxing was also a little silent.

If Chen Bin really gave Xiao Chu the place in the competition.

Then his son Zhang Hongbo, even if he can enter the finals, he will definitely miss No.1.

He is very clear about the ability of his own son.

Compared with Xiao Chu, it is simply a world of difference, there is no comparison at all.

After thinking for a while, Zhang Guoxing said, "Don't worry about this matter. If Chen Bin gives Xiao Chu the quota, let's talk about it later."

Seeing his father, Zhang Hongbo didn't have any ideas for the time being, so he left the office.

It can be said that the entire provincial hospital and other departments are also undercurrents in order to fight for this one doctor and one nurse.

They almost broke their heads, and they all showed their magical powers, trying to grab this spot.

However, it is still unknown who will get the last place in the competition.

You can only find out after three days.

Li Hongyan, who received the news at the first aid station, was shocked at first.

She did not expect that she would be able to participate in the competition, which was beyond her expectations.

What surprised her even more was that she actually wanted to form a team with Xiao Chu to compete.

While she was surprised, there was also some expectation in her heart.

After all, Xiao Chu's ability has been known to everyone in the emergency department for such a long time.

Even though the medical staff at the emergency station didn't have much contact with Xiao Chu, they still knew Xiao Chu's situation in detail.

Therefore, after Li Hongyan knew that he was going to compete with Xiao Chu, apart from being excited, he also strengthened his determination to win the competition.

And the deputy director who manages the first aid station even gave her the green light.

He asked Li Hongyan not to be on duty for a while.

Every day is to learn and train first aid skills so that we can win honor for the department.

Naturally, Xiao Chu was not like Li Hongyan, who diligently started training first aid skills.

He is still in the consulting room, seeing patients.

Just now, the ambulance brought an emergency patient.

Is an acute abdomen patient.

The patient was a man in his 30s. After lunch, he suddenly experienced severe abdominal pain, accompanied by nausea, and vomited once.

The patient thought he was going to have diarrhea at first, but he didn't have diarrhea after going to the toilet several times.

However, the stomach pain has not been alleviated at all, and it has a tendency to worsen.

Only then did I call the 120 ambulance and came to the emergency department of the provincial hospital.

After Xiao Chu saw the man, the man held his stomach, his face was painful, and a layer of sweat appeared on his forehead.

He couldn't walk because of the severe stomach pain.

Xiao Chu and the others had no choice but to use a gurney to push him into the ward.

The family member is his wife, and she is very anxious to see her husband in great pain.

Seeing her husband lying on the bed with severe stomach pain, the woman asked: "Doctor, quickly show my husband what's wrong with him. This happened suddenly an hour after lunch. "

Xiao Chu has treated many patients with acute abdomen, and has rich experience in this regard.

He first gave the patient a physical examination.

It was found that in the patient's upper abdomen, there was tenderness, but no rebound tenderness.

There was also tenderness in the lower abdomen, and there was also rebound pain.

This shows that the patient has localized peritonitis.

Moreover, the lower abdominal muscles are relatively tense, indicating that a plate-shaped abdomen has appeared.

Chapter 316 Trainee Physician Has No Human Rights

Symptoms of plate-shaped abdomen can appear, indicating that the abdominal cavity infection is relatively serious, and medical diseases can almost be ruled out.

In other words, based solely on the signs detected, this patient should be a surgical disease and may require surgical treatment.

Acute abdomen and localized peritonitis plate abdomen, nothing more than those kinds of diseases.

Although the patient was in severe pain, his consciousness was relatively clear and his vital signs were relatively stable.

And this time, his family members did not ask for painkillers as soon as they came up.

And Wang Panpan has been studying with Xiao Chu, seeing this situation, Xiao Chu also asked her to do a physical examination of the patient, and asked her to ask about the medical history, while Xiao Chu watched quietly from the side.

No matter whether Xiao Chu is teaching a trainee doctor or an intern doctor, he will ask the trainee doctor or intern doctor to consult and check according to the patient's condition.

If it was that kind of trauma, life-threatening, Xiao Chu would definitely not let the trainee doctor participate.

In such cases, first aid is usually required to save lives.

If it was an acute myocardial infarction in internal medicine, Xiao Chu would not ask the subordinate doctors to inquire about the medical history carefully.

In this case, the treatment time will be delayed.

The patient in front of him, though suffering from an acute abdomen, is not life-threatening.

So Xiao Chu asked Wang Panpan to make a diagnosis.

Of course, they cannot discuss this situation in front of patients and their families.

Instead, let the patient's family members go through the hospitalization procedures first.

After returning to the office, Xiao Chucai asked: "Panpan, you have already asked about the medical history and physical examination of this patient. For this acute abdomen, what kind of disease do you consider?"

There are many causes of acute abdomen symptoms.

Diagnosis of symptoms like this requires extensive clinical experience and theoretical knowledge, as well as differential diagnosis.

Wang Panpan thought for a while and said, "Mr. Xiao, there are many causes of acute abdomen, but the most common ones are acute appendicitis, acute cholecystitis, acute pancreatitis, and digestive tract perforation.

The patient had a meal first, then developed severe upper abdominal pain, and then developed symptoms of lower abdominal peritonitis.

And the patient had no obvious medical history before, so I consider the following possibilities for this patient. "

Wang Panpan saw that Xiao Chu was listening to his analysis attentively, so he continued:

"The first type may be acute appendicitis. After all, it has metastatic lower abdominal pain. If it is confirmed, further tests and color Doppler ultrasound are needed."

"The second is to consider digestive tract perforation. After all, he had upper abdominal pain after meals, and then lower abdominal pain accompanied by peritonitis.

If the digestive tract is perforated, the food in his stomach will flow out to the pelvic cavity, so symptoms of lower abdominal peritonitis will appear.

Of course, it may also be gallbladder perforation, and the symptoms are the same as this.

The possibility of acute pancreatitis is not too great. Although acute pancreatitis has upper abdominal pain, it usually does not appear symptoms of peritonitis in the lower abdomen. "

Wang Panpan speaks clearly and eloquently, and he has a diagnosis and a differential diagnosis.

Xiao Chu nodded.

I feel that Wang Panpan's basic skills are still very solid.

Xiao Chu said casually: "Then I will hand over the examination of this patient to you."

"Okay, Teacher Xiao!"

Sitting in front of the computer desk, Wang Panpan started to check the doctor's order.

Xiao Chu saw Wang Panpan and prescribed blood routine, crp, liver and kidney function, electrolytes, and blood and urine amylase for the patient.

Then the patient was given color ultrasound of the liver, gallbladder, pancreas and spleen, and an upright plain film of the abdomen.

After reading Wang Panpan's medical order, Xiao Chu also nodded secretly.

I think she thought of all the possibilities.

Since there was only one family member of the patient, Wang Panpan volunteered to accompany the family members to examine the patient after he finished the doctor's order.

About half an hour later, the patient returned to the ward.

Most of the inspection results have also been fed back to the computer.

Holding an X-ray film in his hand, Wang Panpan was even more excited and looked joyful.

She put the X-ray film on the reading light, and happily said to Xiao Chu: "Mr. Xiao, I'm right, this patient has perforation of digestive tract."

I saw the X-ray film on the reading light, showing free gas under the diaphragm.

Orthostatic X-rays of the abdomen of a normal person will not show anything under the diaphragm.

As long as there is gas, there is only one possibility, that is, the digestive tract is perforated.

This is the most accurate basis for diagnosing gastrointestinal perforation.

The reason why Wang Panpan is very happy is because she diagnosed the condition clearly.

So there is a sense of pride that comes from within.

Xiao Chu looked at Wang Panpan who was very happy, and praised without hesitation: "Panpan, you handled it well this time, prepare for the operation for him, and I will take you to the operation later, to do this digestive tract perforation repair."

"Okay, Mr. Xiao, I'll prepare him for surgery right away."

Hearing that Xiao Chu was going to take him to the operating table, Wang Panpan was even happier.

Now in the circle of trainee doctors in their emergency department, as long as they can follow Xiao Chu on the operating table, it is definitely an honor.

Moreover, which trainee doctor Xiao Chu asked to perform surgery with the group was also divided.

If any trainee doctor is not active in his study, then Xiao Chu would never consider letting him perform surgery.

Wang Panpan started the preoperative preparation project on the computer first.

Then I printed out the consent form for the operation, and went to the ward to ask the family members to sign it.

When the family members saw Wang Panpan approaching, they frowned.

The family members knew from Wang Panpan's badge that she was a trainee doctor, so they didn't believe her.

The family member frowned and asked, "Where is the doctor who saw us just now?"

Wang Panpan replied: "Are you talking about Director Xiao? He is preparing to operate on your husband, so let me talk to you first and sign."

"Surgery?"

The patient's wife was taken aback.

"Don't say anything about the disease, let us have an operation? You are too childish!"

Wang Panpan hurriedly said: "Your husband has a perforated digestive tract and has indications for surgery. Moreover, he has already developed abdominal infection, and surgery must be performed as soon as possible."

"You said surgery, do you want surgery?"