Emergency Department Observation of Medical Records

The weekend is the beginning of the National Day holiday, and there are seven days of rest.Fortunately, there are holidays ahead, and the two of them can spend a few days at home without shame, relieving long-term misses.If it wasn't for Luo Mingyao's body, Zhao Bin would have wished to make people stripped of their clothes.But he still knows the basic common sense. After going crazy the first day, the two of them will be more restrained in the next few days, and the next day they just touch each other to relieve their desires.

On the third day of National Day, Li Panqiu sent a message asking him to come out for dinner.There is a sentence at the end of the message: Don't take your children with you.Thinking of the fear of being dominated by Li Panqiu's rage, Zhao Bin felt somewhat guilty, so he asked Luo Mingyao for a leave of absence and went out to meet people.

Li Panqiu also came alone, obviously wanting to talk to him alone.

After ordering, Li Panqiu poured tea by himself, ignored him completely, and said angrily, "You should explain yourself."

Zhao Bin's relationship is going well now, and he feels like eating honey in his heart every day. He is not irritable at all, and he doesn't dodge his words. He just said frankly: "He and I are together. I plan to live a lifetime before we talk about it."

Li Panqiu was drinking tea, so frightened by his words, the tea was sprayed out. "What did you say?" She hurriedly took papers to clean up the mess in front of her.

"It's true." Zhao Bin looked at her in a calm manner, smiling a little triumphantly, "I figured it out, I really like this person. It has nothing to do with the students and teachers. Because I like him, I feel that there is no future, what Obstacles don’t seem to matter anymore, as if everything is torture if you’re not with him.”

Li Panqiu was shocked for the second time today, almost dropped his teacup in fright.

After a moment of silence, she seemed to be overwhelmed. She straightened her thoughts and said, "Zhao Bin, do you know that many people in the hospital know about the two of you."

Zhao Bin squeezed his hands tightly under the table.

Li Panqiu sighed, and continued: "At first, Wu Wenni from endocrinology came to ask me, she helped you find out a lot about endocrinology last year, she came to me quietly, saying that she was too embarrassed to guess randomly, she Ask me if you and Xiaoming are a couple. I was so scared that I panicked." Li Panqiu paused when he said this.

Zhao Bin's heart tightened, his throat seemed to be choked, and he felt suffocated and desperate.Although he said he was not afraid, when the feeling of being exposed came, he still felt scared and uncomfortable.The sweetness of gathering together for a few hours could not stop the intrusion of this despair, his heart was beating violently, and the road ahead turned into darkness in front of him.

Li Panqiu watched the change in his expression, and smiled leisurely: "What's the matter? You said it doesn't matter just now, but now you're scared again?"

Zhao Bin clenched his fist heavily, raised his head, and said firmly, "Things are like this, and I can't do anything about it. If it doesn't work, I'll resign, as long as Xiao Ming graduates smoothly...I'll figure out a solution myself later."

Li Panqiu stopped and looked at him in surprise. After a while, he let out a "hum" from his nose, put down the water, and said, "Wu Wenni, came to me to talk about this, with a look of nympho. I know, she is a rotten girl! She can still be cute to you! That day I figured out, what does cp mean? cp is the abbreviation of couple!" When she said the word "cute", she compared a strange movements.

Zhao Bin was stunned, his mind went blank, as if he didn't understand what Li Panqiu said at all.

Li Panqiu looked at his idiot-like expression, feeling very relieved, and continued lazily: "I asked you to help Xiao Luo find a mentor at that time. The endocrinologists have seen it. Young people probably know it in their hearts. Except Wu Wenni, Some of my college classmates also got the news from some unknown place, and I have received many people asking you on WeChat."

"What do you say?" Zhao Bin asked nervously.

Li Panqiu smiled slightly: "I didn't say anything. But whether I say it or not, they probably know it all."

Zhao Bin's heart sank again.

Li Panqiu was very satisfied seeing the change in his expression, so she finally laughed and said: "My classmates said that no matter what your situation is, they will support you and will never look at you with colored glasses!" I laughed for a while, and finally found that Zhao Bin's mood was not as good as I imagined, so I cleared my throat and said as gently as possible: "Old Zhao, the times are changing after all, and more and more people let go of their prejudices and face up to these things." Question. Don’t worry too much, don’t think about resigning, don’t think about the difficulty of the road ahead, this is not a dangerous path full of thorns, it’s just the same road as ordinary people. Take it step by step, and we will support you. "

Zhao Bin did not answer.Li Panqiu poured him some water worriedly, and wanted to persuade him a few more words, but saw this man with his head down, tears on his face.

After the National Day, Zhao Bin returned to the department to continue working.The department has already arranged shifts for him, and he still goes to work according to the previous shift method.When the morning meeting was over, the whole department applauded warmly to welcome him back.After the shift came out, Zhou Lu joked with him, saying: "You ran away for a year, and our nurses miss your irritable roar very much. That day Qiu Ting said that the rescue is now without your roar, and I feel that I have no passion."

Qiu Ting walked behind, and came up to pinch Zhou Lu's arm when she heard the words: "When did I say this? Once he left, we were so happy that it was too late! The head nurse said the day before yesterday that he was coming back, and everyone asked anxiously, who is it?" I lined up against him again, and I was too scared."

Zhao Bin was amused, and asked her, "Who is in the same class as me?"

Qiu Ting rolled his eyes at him: "It's me again, unlucky."

Zhao Bin now pretends to be very human, with a humble expression on his face: "It used to be a matter of my personal work attitude, and I will try my best to control my emotions in the future. The hospital work is a whole, and there must be spring for patients and colleagues. In the future, I will be gentle and polite, modest and prudent, patient and meticulous, and help each other."

Qiu Ting looked at him like a fool: "Mr. Zhao, don't mess around. I can't stand your gift. You should be more careful when talking to patients in the future, and we will be thankful!"

Zhou Lu covered her stomach with laughter early.

Turn on the computer, still familiar with the process, press "Next" to call the number, and let the patient enter the consultation room.

Today's first patient is a college student, dressed in sportswear, walked in with the help of a classmate in the same sportswear next to him.The patient looked very weak, had difficulty walking, and fell heavily on a chair as soon as he entered the consulting room.

"Why not?" Zhao Bin asked gently.

"Hello, doctor," said the patient classmate, "my classmate, something was wrong when he got up this morning. He had no energy all over his body, and it was difficult to get up. At first he said that it might be hypoglycemia. We bought him a meal and came back after eating. It’s still that he has no strength in his body and can’t get out of bed. We helped him up, but he couldn’t stand up. Just now he said that he felt a little unable to breathe, so I hurried him to see a doctor.”

Zhao Bin nodded and asked the patient: "Besides lack of strength and difficulty in breathing, do you have any other discomforts? For example, do you feel dizzy? Cold sweat all over your body? Do you have palpitations? Do you have muscle aches all over your body?"

The patient sat in a chair and shook his head weakly.

"The students are usually in good health, and have no similar problems? Did you do any strenuous exercise yesterday?" Zhao Bin asked.

"Yes, yes!" The patient's classmate nodded and said, "We ran 5000 meters in our physical fitness test yesterday! He still got No.1! Yesterday he was very healthy, but today he suddenly looks like this, we are all scared to death !"

Zhao Bin basically already had an idea in his mind.Manually draw out the laboratory test form on the computer. "Combining your classmate's current situation, I suspect that the fatigue is caused by potassium deficiency. Have a blood test to see the blood potassium level. It is simply a problem of potassium deficiency. Potassium supplementation will heal soon."

"Hey, good." The patient classmate took the list and was about to take the patient out for an examination.

"Don't worry." Zhao Bin waved his hand and asked him to wait a little longer. "I suggest you go to the emergency department for observation. One is that the blood potassium level is very low. There is a certain risk. The blood potassium level not only causes fatigue, but also arrhythmia. [-]. Difficulty breathing, which must be paid attention to. He has already felt a little breathing problem, let alone relax his vigilance; another point is potassium supplementation treatment, which also requires intravenous infusion, so you should think about it, it is safer to apply for observation treatment. "

The classmate nodded vigorously, and then looked at the patient: "Just listen to the doctor's arrangement?"

The sick man nodded feebly.

Zhao Bin gave him the list and asked him to go to the nurse's station to go through the formalities.The nurse checked his blood according to the emergency procedures.While waiting, Zhao Bin came to give him a bedside electrocardiogram and finger oxygen saturation to make sure that there was no bleeding, arrhythmia or respiratory depression.The emergency blood test that Zhao Bin opened was not much, and the results came back quickly. The patient's blood potassium was 2.35mmol/L.

"The diagnosis is clear," Zhao Bin said after taking the test sheet. "Look at the blood potassium value, which is much lower than the normal range. Now I will arrange potassium infusion for you. I must tell you some precautions for this potassium solution. First, The concentration of the solution is very strict, 500ml of liquid can only be mixed with 1.5g of potassium, so in order to make up the required amount, the amount of your infusion will be very large within a day; secondly, during infusion, potassium solution has certain irritation to blood vessels, so infusion The process may feel painful; the third point is to pay attention to the infusion speed, the potassium solution enters too fast, which may induce arrhythmia; the last point is to replenish the fluid today and check your blood potassium level tomorrow to confirm that it is normal before you can rest assured. You leave. Got it?"

The patient nodded on the bed, and the patient's classmates said "Understood, I understand" one after another.

Zhao Bin confirmed that they understood the condition, and then turned to greet the nurse: "This patient is a hypokalemic periodic paralysis. I will give him fluids and potassium infusions later. The fluid speed should be slowed down. Please pay more attention, reminding The two of them, don't adjust the liquid speed by yourself."

After explaining, I still don’t forget to say to the patient and the escort: “If you have any questions, you can come to the consulting room to find me. If I am not there, then tell the nurse teacher and find the doctor on duty to solve it.”

Qiu Ting heard him in the observation room, and she didn't know anyone: "Hey, Mr. Zhao, change your appearance?"

Zhao Bin smiled: "The first day you come back to work, you should have a good start."

After the patient received potassium infusion, he felt much better at noon, and basically returned to normal in the afternoon.I came to find Zhao Bin once in the middle, and wanted to leave early. Zhao Bin persuaded him a few words, and told him to wait until the next morning to check blood potassium and muscle enzymes by the way. After confirming that the indicators were normal, he let the patient leave.Before leaving, I also told me to sweat a lot after exercise, pay attention to fluid replacement, etc. If similar situations occur repeatedly, I should also pay attention to the problems of the endocrine system, such as abnormal function of the adrenal gland.When explaining to the patient, his attitude is quite gentle and amiable, and his gentle appearance can't be seen by acquaintances as a faux pas.

Such a change of attitude made the whole department feel like they had seen a ghost, and they all looked at him strangely.

"What's the matter?" Zhao Bin couldn't bear it when he was having lunch, and asked Zhou Lu, "What do you all look at me?"

"I don't have any eyes." Zhou Lu lowered her head to pick up the rice, "Are you really changing your temper or are you just back in a good mood."

Zhao Bin couldn't help laughing: "It's both. Going to Tibet, I have a lot of new ideas."

Zhou Lu let out a "tss": "The last inch of pure land in the world has accepted the baptism of the soul?"

Zhao Bin smiled without saying a word.

This incident later spread to the ears of Director Zhou of the emergency department. Director Zhou couldn't help but whisper to the leaders of other hospitals when he went out for a meeting, saying that Zhao Bin's trip to Tibet got his soul sublimated, and his sense of responsibility and work attitude were all-roundly improved. .So Zhao Bin was inexplicably assigned the task of speaking at the Commendation Conference for Aid to Tibet.