My medical skills are a billion points

Or when necessary, make a gravel.

I have been asking the patient's medical history here, are you afraid of delaying the illness?

Naturally, Xiao Chu would not guess what Wang Panpan was thinking, but said to the patient according to his own premonition:

"Let's do an electrocardiogram and a color Doppler ultrasound first. I don't think the patient's pain is caused by stones. Let's rule out heart problems first."

Xiao Chu explained politely.

He knew that at this time, the family members would not understand his actions.

Sure enough, as soon as Xiao Chu finished speaking, the patient's daughter said angrily:

"Doctor, what do you mean? My dad's pain was obviously caused by stones. Instead of giving my dad painkilling injections, you asked my dad to do this check and that check.

What the hell do you mean?In the past, my dad asked you to see high blood pressure, and you were fine, but now you seem to be a different person, turning a blind eye to the pain of patients, is this how you are a doctor? "

Xiao Chu was very angry at the patient's family's ignorance and pointing fingers.

But he had no choice but to suppress his anger, and patiently repeated what he had said countless times.

"Now your father's cause is unknown, so he can't take painkillers casually. I have to rule out other heart diseases before I can use painkillers to relieve his pain.

You also know that your father has a history of high blood pressure.Did you know that high blood pressure can cause many serious complications? "

"To tell you the truth, I now suspect that your father suffered from aortic dissection, not the pain caused by kidney stones, do you understand?"

The patient's family members didn't respond, but Wang Panpan who was next to him was really shocked.

No, this patient seems to be suffering from pain caused by kidney stones.

Why did Mr. Xiao think about aortic dissection?

Is this patient really aortic dissection?

But it doesn't look like it!

Aren't aortic dissections all painful in the chest?It's rare to have back pain!

Wang Panpan's face was full of doubts, but he didn't speak out, but stood silently aside.

"What is aortic dissection?"

Not only Wang Panpan questioned, but the patient and his daughter were confused.

For the disease of aortic dissection, there is no concept at all.

"Aortic dissection refers to the blood in the aortic cavity, which enters the aortic media from the aortic intima tear, separates the media, and expands along the long axis of the aorta to form a true and false two-chamber separation state of the aortic wall .”

"Hypertension and arteriosclerosis are the main causes of aortic dissection: Aortic dissection is caused by hypertensive atherosclerosis, accounting for 70% to 80%."

"Hypertension can put the arterial wall in a state of stress for a long time, and the elastic fibers often undergo cystic degeneration or necrosis, leading to dissection."

"Early diagnosis and treatment of aortic dissection are very necessary. Once the dissection ruptures and hemorrhages, death can basically be declared."

Hearing what Xiao Chu said, not only the patient's daughter was stunned, but even the patient's painful groans suddenly stopped.

"Doctor, are you joking? It's so scary!"

The patient's daughter asked stammeringly.

Xiao Chu looked serious.

"I'm not joking with you. I never joke with family members about patients."

"You have to know that even if the kidney stone is painful, it won't kill you, but if it's aortic dissection, you really can't afford it if something happens."

Seeing Xiao Chu's serious expression, the patient's family members realized the seriousness of the matter.

There was no longer any complaints, so she helped her father and followed Xiao Chu to the electrocardiogram room.

However, after the patient's ECG came out, it only indicated that the T wave was inverted, which indicated myocardial ischemia.

This also ruled out acute myocardial infarction.

Then Xiao Chu led the patient to have a color ultrasound of the heart.

The color Doppler ultrasound doctor had just done half of the examination on the patient, and suddenly stopped, and then looked at Xiao Chu.

"Director Xiao, this patient may have aortic dissection."

Xiao Chu could understand the color Doppler ultrasound. The reason why he led the patient to do the Doppler Doppler Doppler was to leave evidence to confirm the diagnosis.

However, the diagnosis of aortic dissection by color Doppler ultrasound can only be approximate, and a CTA of the aorta is required for a true diagnosis.

This is the gold standard for diagnosing aortic dissection.

But what the color Doppler doctor said was like a thunderclap to the ears of the patient's family.

If my father really had aortic dissection, how could he have such a disease?

Although Wang Panpan didn't speak at the side, he was also stunned.

She was still muttering in her heart that Xiao Chu made a big fuss, instead of relieving the patient's pain, he did other examinations instead.

Now it seems that I am too superficial and have too little clinical experience.

If this patient really followed her own idea, she would give him painkillers first, and only consider kidney stones, not other diseases.

Then this patient is likely to die due to rupture of aortic dissection.

Think what a terrible thing this is.

Since the color Doppler ultrasound had already suspected that the patient had aortic dissection, Xiao Chu asked Wang Panpan to go through the hospitalization procedures for the patient immediately.

Then the patient was placed on a stretcher and taken to the CT room for CTA of the aorta.

After the results came out, it was clear that it was aortic dissection, and it was still type II.

Chapter 342

For aortic dissection, Xiao Chu is familiar with it and cannot be more familiar with it.

Regardless of whether it is Type [-] or Type [-], for Xiao Chu, the operation is easy.

But after all, it is a level [-] operation, and the understanding ability of patients and family members is not very good.

Xiao Chu then explained the patient's examination results to his daughter in detail.

Aortic dissection definitely needs surgery. If it is not operated, it will be a time bomb, which may detonate at any time, and the patient's life will be in danger.

Xiao Chu not only explained the dangers of the disease in detail to the family members of the patient, but also drew and analyzed her.

In the end, the patient's daughter finally understood the danger of the disease, and finally signed the consent form for the operation.

Since the family members have agreed to the operation, Xiao Chu did not neglect.

Aortic dissection surgery, of course, the sooner the better.

Xiao Chu, Zhou Ziqiang and Gao Yingjun performed aortic dissection repair on this patient.

As a trainee doctor, Wang Panpan is naturally not qualified for this operation.

She was just watching from the sidelines.

After Xiao Chu had the operation, Wang Panpan followed closely behind him and asked in a low voice:

"Ms. Xiao, this patient has a history of kidney stones, and the painful parts are so similar. How did you figure out that he had aortic dissection?"

Xiao Chu glanced at Wang Panpan who was full of admiration towards him, and said in a deep voice, "This is my intuition as an emergency doctor."

"Of course, rich clinical experience is also indispensable. The location and nature of the patient's pain made me feel that something was wrong. It sent out a dangerous signal from my heart. This is the feeling of an emergency doctor."

Xiao Chu glanced at Wang Panpan: "If you encounter this kind of patient after you return to the hospital, how would you deal with it?"

Wang Panpan froze for a moment, then shook his head.

"If the diagnosis is aortic dissection, our hospital can't perform surgery at all. It must be transferred to your place."

Xiao Chu smiled.

"It's normal that county-level hospitals can't perform aortic dissection surgery, and even some prefecture-level hospitals can't do this surgery.

After all, it is a level [-] surgery that is very difficult and dangerous.

If you find such patients in the course of your work in the future, you must transfer them to the hospital in time.Otherwise, the patient will die, which will easily cause doctor-patient disputes. "

"That's right, Teacher Xiao!"

Speaking of this, Wang Panpan felt the same way.

"Mr. Xiao, there are really too many medical troubles in our county hospital."

"Sometimes, when a patient with acute myocardial infarction is encountered in the emergency department, if he dies, his family members will make a fuss in the hospital and ask us to compensate.

But who doesn't know that acute myocardial infarction is very dangerous and can kill people!

But the family members just didn't understand and insisted on asking the hospital to compensate. "

"Sometimes our hospital has no choice but to swallow our anger and pay tens of thousands of yuan in compensation."

As he spoke, Wang Panpan changed the topic.

"However, Mr. Xiao, I found that in your hospital, there are very few medical troubles. It should be that patients have a natural fear of your large hospitals."

Xiao Chu shook his head.

"Panpan, you're wrong. It's really rare to see medical troubles in our hospital.

After all, the security force of our hospital is relatively strong. If there is a medical disturbance, we will call the police in time, and the security department will also control the medical disturbance. "

"But there are more medical disputes than your county hospital."

"what?!"

Wang Panpan was a little surprised.

"I have been here for such a long time, and I haven't found any medical disputes, and medical disputes are rare."

Xiao Chu smiled and shook his head.

"It's just that you didn't see it. In fact, in our hospital, there are several medical disputes every day.

It's just that these people were all invited to the medical office, which is dedicated to solving this problem. "

"If it doesn't work, go to court. The leaders of our hospital will not let these medical disputes affect the normal work of doctors."

"Oh, so it is!"

Wang Panpan nodded.

"I thought there would be no medical disputes in large provincial hospitals."

"The larger the hospital, the more medical disputes, but they usually resolve it through legal channels, so you can't see the medical disputes on the surface."

Wang Panpan sighed.

"Hey, Mr. Xiao, it's better to be a big hospital. If there is a medical trouble in our hospital, our dean will just calm down."

"As long as someone dies, whether it's a real accident or because of a disease, as long as the family makes a fuss, our hospital will choose to compensate. This also encourages the arrogance of those medical staff."

What Wang Panpan said is about hospital management.

If there is a medical trouble, the hospital chooses to compromise and compensate, which will affect the development of the hospital.

All unreasonable medical troubles should be dealt with forcefully by the hospital, and legal channels should be taken, and the arrogance of these medical troublemakers must not be encouraged.

Otherwise, these doctors will only become more and more arrogant.

However, Xiao Chu couldn't comment too much on the practices of the county-level hospitals.

This is the responsibility of their hospital leaders, Xiao Chu just needs to do a good job in curing diseases and saving lives.

Xiao Chu and Wang Panpan didn't delve into the issue of medical disturbance either.

After finishing this aortic dissection operation, it was almost time to get off work.

Even if there were more emergency patients who came to the doctor, Xiao Chu did not see them again.

After all, he is going to play tomorrow.

Tonight, he needs to maintain good energy to deal with tomorrow's game.

Although this match was easy for Xiao Chu.

But don't take it lightly.