Gou is practicing medicine in the clinic

Chapter 349: The improvement of the condition may be just an illusion. I support Dr. Li unconditionally.
Because the child is now unconscious and his heart rate is frighteningly low.In this case, the vital signs were unstable and the fracture of the arm did not affect his life. If he had kindly connected the fracture of the child's right arm.

If the child is not saved later, will the family blame him for curing the child?
Therefore, in this case, it is absolutely impossible to reset the fracture of the child's right arm.

Otherwise it will be easy but not good.

He examined it carefully and found that the sick child's bones had osteoporosis.Moreover, the child is relatively thin.

Some parents love their children very much and keep them full of all kinds of snacks.

Carbonated drinks, candies, and pastries with high sugar content are eaten by children every day. It’s no wonder that they are not healthy.

Li Jingsheng also specifically checked the child's head again and found no obvious trauma.

"Miss, do you have a stethoscope?"

"Have!"

The nurse seemed to know Li Jingsheng and was very warm and friendly to him.

He quickly brought a stethoscope over.

Li Jingsheng listened carefully to the heart and lung sounds of the sick child, and the results were consistent with the examination results of the attending doctor.

"You haven't used the cardiotonic pills yet, have you?"

"The directors' consultation has not yielded results, so how dare we use medicine! Now we just hang a bottle of hypertonic glucose solution to rehydrate him."

There are strict procedures for rescuing a patient.

For this special patient, treatment is usually more conservative when life is not in danger.

Medication will not be started until the chief physicians find out the cause of the disease and issue medical orders.

Unless the patient has symptoms such as respiratory failure or cardiac arrest, it is possible to administer emergency measures such as epinephrine, external cardiac compressions, and defibrillation.

Li Jingsheng probed the sick child's forehead with the back of his hand, and the temperature seemed to rise slightly.

He touched the child's hands and feet again, and they felt a little cold.

When he returned to the consultation room, he had a very bad feeling in his heart.The child's condition is serious and the cause is unknown, making him prone to accidents.

"Director Hua, I checked and found that there is a slight fracture in the right arm, a dislocation of the elbow joint, and osteoporosis. However, it should not have a direct impact on the child's coma and extremely low pulse."

Basically, this means that the injury to the right hand has nothing to do with the child's current condition.

"Secretary Bei, when I checked the child just now, I found that the child's physical condition is poor. Did the child have any illnesses such as colds or viral infections before the onset of the disease?"

"Well...probably not! I'm usually busy with work, it's my husband, and my parents take care of a lot more. It's just that my son is more prone to getting sick. He has to go to the hospital seven or eight times a year. When he was four years old That’s right, I almost stayed in the hospital for more than three months.”

Secretary Beiyan was a little unsure when he answered.

From her answer, Li Jingsheng discovered an important clue.

"What disease did the child get when he was over four years old?"

Needing to be hospitalized for more than three months shows that the illness is very serious.

Of course, families like theirs may also be squeamish.The child's illness was not cured, so he was kept in the hospital. It was safer for him to be cared for by medical staff.

"That time it was because of a fever, persistent fever, and then joint pain. After the doctor's diagnosis, he also said that there was a heart murmur, and he was diagnosed as rheumatic heart disease. After treatment, it has not relapsed. Occasionally, there is a small cold, stomachache, etc. .”

Her attitude towards Li Jingsheng was quietly changing.

Because she could feel that the young doctor gave substantive answers.

Not as slick as those directors.

The consultation is also very targeted.

"The blood test results show that the lymphocyte count is only 0.31, and the white blood cell count is significantly elevated. I wonder if the child's heart may be infected by a virus? I suggest you ask your family now to see if the child has had a cold or been infected with a virus recently. . Personally, I think there was probably a problem before the child fell, but I just didn’t tell you adults.”

Li Jingsheng expressed some of his diagnostic views.

Since it is a discussion, you can naturally speak freely.

"Myocardial viral infection usually causes chest pain and other symptoms beforehand, which don't feel like it. However, I think it is right to investigate the viral infection mentioned by Dr. Li."

Director Yan also looked at Li Jingsheng with admiration.

There is no falsehood under the reputation.

This young man was able to steal the show in the skills competition, and he really had real talent.

The skills displayed now are obviously not just good at bone-setting techniques.

"Okay, I'll go and inquire about it right away. You guys can discuss it first."

Secretary Bei saw the progress of the consultation and actively cooperated.

Not long after, the chief physician of the Department of Cardiovascular Medicine rushed over.This is a male doctor who has lost all his hair and is severely overweight. He must be close to 60 years old, but he has a kind face.

Many physicians are friendly and kind, which may be related to the nature of their work.

A doctor who is too impatient cannot practice internal medicine.

Because internal medicine treats patients, the results are often not immediate, but it takes a certain amount of time to see the results.

Once you take the medicine, you can see your condition improve the next day, which is very fast.

More often than not, it may take three to four days or even longer to see any effect.

There is no way, this is how internal medicine treats diseases.

It is not like surgery, where one cut is performed and the lesion is removed directly.

It requires the use of drugs to control the condition bit by bit, and then use the body's own immunity to slowly recover.Diseases come and go like a mountain, and diseases go away like silk threads. This is actually internal medicine.

The cardiovascular medicine department of the Second Hospital has always been a weak point.

The director of the Department of Cardiovascular Medicine was caught as a young man. No matter what his level was, he had to grit his teeth and get over it.

"Director Jin, the situation of this sick child is extremely complicated. We have been discussing it for a long time. Now we suspect that there is something wrong with the child's heart. We are waiting for you to come to the doctor."

Director Luo took the initiative to say hello.

Li Jingsheng usually has little contact with Director Luo. He only knows that Director Luo and Director Mu have a good relationship.

I saw Director Luo's performance in this consultation today and it was really shocking.

I didn't expect him to be so cunning.

"You have so many chief experts here for consultation. As an old man from the cardiovascular department, I don't dare to be the chief physician. Let me cooperate with you and be an assistant. That's fine."

Director Jin didn't accept the call at all.

Which chief physician who can live to be over 50 years old is not a human spirit?

"Then take a look at the patient's information first. The results of the current discussion include two initial diagnosis opinions. The dural hematoma is accompanied by concussion, and there may be a viral infection in the heart."

Director Luo sent the information to him.

After receiving the information, Director Jin looked at it carefully.

"Viral invasion may not be ruled out, but I personally think that this child's heart problem should not appear just once. It is very likely that there has been a similar medical history before, or this situation has occurred for a long time."

Director Jin was so good that he directly pointed out that the child was likely to have a similar medical history.

"The child's mother reported that when she was four years old, her child was hospitalized for more than three months and suffered from rheumatic heart disease."

"Well, that's right."

Director Jin nodded after hearing this.

"Should we give the child a heart attack first or what should we do? The pulse is only 47. If there is indeed a subdural hematoma, such a poor heart rate may aggravate the edema."

The heart needs to expend more energy to supply blood to the head.

"You can first try the treatment of rheumatic heart disease. If the child fell on the ground, the possibility of heart disease is very high. Give intravenous rehydration of hypertonic glucose, and then use a large amount of vitamin C, atropine and penicillin."

Director Jin was not vague and directly gave a series of medications.

After taking the medicine, the child's condition improved significantly.

The heart rate rose to more than 70 beats/minute, and consciousness gradually returned to consciousness.

The child's mother was very excited and happy to see her son awake.

Li Jingsheng felt that the crisis had not been resolved.

In the consultation room, the chief doctors were still discussing.

Director Luo of the Department of Neurology believed that subdural hematoma was more likely.

Because of the reaction of the child's mother, after asking the family members just now, the child's grandmother reported that the child hit his head on the door while playing a few days ago.She cried for a while, and after taking a nap, everything was fine, so she didn't care.

Director Jin believed that rheumatic heart disease was a possibility, but it was more likely to be heart disease such as acute myocarditis.

Although the patient's condition has improved significantly after taking the medication according to Director Jin's medication plan, he bluntly said that it will have to wait until at least tomorrow to see the real treatment effect.

The current improvement may also be just an illusion.

In clinical treatment, it is extremely common for the condition to improve after taking medication, but to rebound after a period of time.

Li Jingsheng listened to the directors' discussion without interrupting.

The same is true for Director Hua.

Orthopedic surgeons generally only give opinions on bone treatment during consultations.

For diseases in other fields, opinions are often not readily expressed.Because I’m really not good at it.

"If Director Jin thinks that the patient may not have rheumatic heart disease, but more likely to have acute myocarditis, then I suggest that the patient have an electroencephalogram." Li Jingsheng spoke at this time.

"Dr. Li, do you think that acute myocarditis has affected the brain?"

Director Jin asked rhetorically.

"There is a possibility. There is a possibility of subdural hematoma, but I personally think it is relatively low. Whether the sick boy's grandmother had hit her head on the door a few days ago or fell this time, it should not be enough. to cause subdural hematoma. What I am more worried about is that viral infection affects the heart and brain at the same time. If acute myocarditis is established, the possibility of viral encephalitis is more than 90%."

Li Jingsheng expressed his own views.

Whether he is feeling the bones of a sick child or making a comprehensive diagnosis based on a series of symptoms of the sick child, Li Jingsheng believes that the possibility of subdural hematoma is minimal.

Even if this situation does exist, the condition should be progressive.

It usually doesn't happen suddenly.

"I unconditionally support Dr. Li's diagnostic opinion and recommend that EEG and brain CT be checked immediately."

After Director Jin heard this, he directly supported Li Jingsheng's point of view.

This surprised everyone present.

He even used the word unconditional support.

(End of this chapter)