Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

"Don't talk about your Guan Pei doctor! It's because you are not in charge!"

"Let us all speculate here for so long, wasting a lot of time."

Wu Jiang looked at Wang Kuan and said.

"Yes, it is my responsibility."

Wang Kuan nodded again and again, and then said,
"Let's stop talking about this now, let's see what to do, the patient's condition is very critical now!"

Lin Yi turned to the patient's worker and said:

"The information you said is very useful, but this worker of yours is currently in a serious condition and needs to be notified of critical illness!"

"Can you contact his family members? Yan will notify his family members as soon as possible."

As soon as he heard that a critical illness notice was going to be issued, the worker nodded in fright and said:

"If we can get in touch, if we can get in touch, let's go now!"

After speaking, the two of them hurried out to make a phone call.

After they left, Wang Kuan couldn't help but said in embarrassment:

"Well... Dr. Lin, since the patient has been injured, I'll go and observe it again to see how the injured part is?"

"OK, all right."

Lin Yi nodded.

Weakly said: "Lin Yi, I didn't expect this patient to be injured, why don't I go and check him carefully."

"Go ahead!"

It is easy to misdiagnose the disease because of omissions caused by careless physical examination.

Since he is going, let him go!
After a while, Wang Kuan returned to the office.

"Doctor Lin, I saw that there is a relatively deep hole in the sole of the patient's left foot, which already shows signs of inflammation."

"I think I already have a rough judgment on his condition!"

After entering the door, Wang Kuan said immediately.

"Oh? You talk about it."

Lin Yi immediately looked at him with great interest and said,
"I think this patient should have a tetanus attack!"

"I'm really to blame for this matter. I didn't check him carefully before. Now, combined with the fact that his left foot has been pierced by a nail and has not been treated, there are already signs of infection."

"And he also has neurological symptoms such as convulsions, and tetanus can basically be diagnosed!"

"tetanus?"

Before Lin Yi could speak, Wang Qiaoya couldn't help asking back.

Tetanus was a disease that she had indeed learned about when she was studying before, and it was relatively common.

But during the period of working in the hospital, I haven't encountered it in practice.

"Yes."

Wang Kuan nodded.

Wang Qiaoya recalled the tetanus symptoms she had learned before, and matched up with the patient.

"Well, that's right, his symptoms do match."

Wang Qiaoya opened her eyes wide and nodded.

At this time, Lin Yi also said:
"That's right, this patient was infected with tetanus."

"If we had discovered his wound earlier, it would have been diagnosed a long time ago!"

When Lin Yi said this, Wang Kuan's face turned red again.

Later, Lin Yi continued:

"He had typical muscle rigidity and muscle spasms, and was very afraid of stimuli such as light and sound."

"Borui, give him a thorough debridement first."

"Remember, the wound secretion must be cultured for Clostridium tetani, and then transferred to the intensive care unit, keeping the ward quiet and protected from light."

"Yes!"

Song Borui, who was sitting by the side, immediately agreed, then quickly got up and walked out.

Lin Yi turned his head and explained to Wang Qiaoya and Chen Qiang:

"The main reason why this patient had a tetanus attack was because he did not have the tetanus antitoxin in time after he was pierced by a nail."

"Especially the rusty nails he pierced in the construction site are most susceptible to tetanus infection."

The two nodded as they listened.

They all know this knowledge point, after all, it can be regarded as the common sense of studying medicine.

It's just that the wound was not found at the beginning, so this aspect was not considered.

"Tetanus is a critical disease with a fatality rate of 20.00% to [-]."

"The mortality rate of critically ill patients is as high as 70.00%, and the mortality rate of newborns and the elderly is even higher."

"Our patient is a young man in his 20s, and judging from his condition, it is not considered heavy."

"But the condition is not optimistic. After all, he has more frequent convulsions now."

"Patients with severe tetanus are most prone to muscle rigidity and muscle spasms. It can be said that all muscles in the body will be affected."

"It is easy to have opisthotonus or lateral arch. If it affects the throat, it will cause dyspnea and cough."

"Some can even induce respiratory arrest."

"Patients like this need analgesia and sedation, and a tracheostomy should be performed early to prevent the patient from developing throat obstruction and difficulty breathing."

When Lin Yi said this, Wang Qiaoya and Chen Qiang on the side quickly took out their notebooks and memorized them frantically.

Seeing Wang Qiaoya's serious look, Lin Yi couldn't help asking her:

"Qiaoya, do you know how tetanus occurs?"

Wang Qiaoya was taking notes, she immediately came back to her senses, thought for a while and replied:
"Tetanus is a specific infection in which Clostridium tetani invades the human body through skin-to-skin wounds, grows and reproduces in an oxygen-deficient environment, produces toxins, and causes muscle spasms."

"It primarily attacks motor neurons in the nervous system."

"Clinically characterized by trismus, paroxysmal spasms, and tonic spasms."

Recalling in Wang Qiaoya's mind, she recited the definition of tetanus that she had memorized before.

"All right."

Lin Yi nodded to interrupt her, and then asked:

"Since you have a better understanding of the definition of tetanus, do you know how to deal with this kind of tetanus patients?"

"Um………"

Wang Qiaoya looked up with her big eyes, pondered for a moment, and then said:

"First of all, the wound should be thoroughly debrided, and no sinus tract or dead space should be left. Even if the tetanus attack has occurred, the tetanus antitoxin should be injected."

"Then antibiotics...mainly use large doses of penicillin or cephalosporin, and also need to add metronidazole."

"At the same time, because tetanus patients have muscle tension, they need absolute silence."

"Continue sedation if necessary to prevent the patient from having muscle spasms and causing respiratory depression. If it is severe, a tracheotomy should be performed as soon as possible."

Lin Yi couldn't help but nodded when he heard this, and affirmed:
"That's right, exactly."

"It seems that you know a lot about tetanus, but why didn't you take this into consideration when you learned about the patient's condition just now?"

Wang Qiaoya smiled awkwardly.

I thought to myself, it's not just that I didn't think about it, there are so many people in this office, who would think about it!
Neither Wu Jiang nor Yin Liang thought of it!
In addition, he didn't say that he was injured at the beginning!