Gou is practicing medicine in the clinic

Chapter 350 Veterans are in charge, please come back

Director Jin, what happened today?
Although he usually smiles and looks kind, he never accepts any doctor easily.Ask him for consultation, either do Tai Chi or be very opinionated.

This is the first time that I have unconditionally supported a young doctor's diagnostic opinions like today.

"Director Jin, checking EEG and brain CT will waste a lot of time. After cardiotonic treatment, the patient's condition has improved significantly. It means it is a heart problem! Should we focus on the heart first? , wait until the child’s condition is stable, and then check for brain problems?”

Director Yan of the emergency department even felt that it didn't matter whether the brain was checked or not.

Now it's obviously a heart disease!

It is an ironclad fact that the heart rate is too low and the head does not receive enough blood supply to cause coma.

"I think heart problems can be diagnosed later. Now it is best to check the electroencephalogram immediately and draw the cerebrospinal fluid for testing. If possible, it is best to check the serum antibodies first. Have the directors ever thought about the low heart rate of the child? , it is not a recurrence of the heart disease, but maybe there is something wrong with the brain, causing the heart rate to slow down? There is such a phenomenon in the surgical cases I have been exposed to, where nerve problems lead to insufficient blood supply to the limbs, and the patient always feels that one side The lower limbs were very cold. And there was muscle atrophy in the lower limbs on that side.”

Li Jingsheng boldly expressed his views.

Nerve problems can cause muscle atrophy and poor blood supply. This is practical clinical knowledge.

Experienced surgeons know this best.

Li Jingsheng has undergone many surgeries in the past few months, and has accumulated more and more practical experience.

At this moment, the diagnosis of this sick child has begun to show results.

This is the result of an improvement in overall level.

"Although the child's current condition has improved, if the cause of the brain disease is not identified as soon as possible, I think the child's condition is likely to take a turn for the worse in a very short period of time. Therefore, I suggest that the brain be checked immediately for inflammation. , viral infection and other issues.”

Li Jingsheng's almost paranoid diagnosis method made Director Yan and Director Luo feel that this young man was still too young.

Because Li Jingsheng believed from the beginning that the child might be infected by a virus.

Now after consultation, they believe that the patient has a recurrence of rheumatic heart disease and is more likely to have subdural hematoma.

It's not a viral infection.

"Xiao Li, we cannot make assumptions based on experience when diagnosing patients. You are still young and your clinical experience is actually quite limited. If you are paranoid about your initial diagnosis and do not look at the factual basis, it is very easy to get into trouble. I worked in the emergency department. It’s been almost 30 years, and I can’t say how rich my experience is. Right now, I think it’s most important to check for cardiac problems first.

You say there is something wrong with the child's brain, but I don't deny that either.

But what are the results after giving children cardiotonic treatment?The child regained consciousness immediately and woke up from the coma.All physical signs have improved. This is an ironclad fact. "

Director Yan even changed his name.

From Dr. Li to Xiao Li.

Obviously, when Li Jingsheng stated his opinion just now, he used personal experience, which made Director Yan a little unhappy.

A young doctor showing off his old age in front of chief physicians who are in their 60s and [-]s?
It's simply ridiculous and arrogant.

"I support Director Yan's opinion. Rhetoric should not be harsh. Diagnosing the cause of the disease should not be too subjective. It must be based on facts. Diagnose the heart problem first, find ways to stabilize the heart rate, and even restore it to normal levels. This is the solution. The crux of the matter."

Director Luo of the Department of Neurology took the side of Director Yan.

I also gave Li Jingsheng a few words, telling him not to be too paranoid when making a diagnosis, otherwise it would become arbitrary.

"Secretary Bei, you also listened to our discussion just now. Do you think we should check the child's heart problem first, okay?"

When Director Luo asked this, he seemed to be asking for credit.

Among the several directors, the most cunning one is Director Luo.

When there's a risk, throw the blame around.

When there is merit to be gained, there is no ambiguity about it.

He only dared to come forward after seeing that the child's condition had improved after the first round of treatment.

Secretary Bei nodded, "You are all experts in emergency medicine and neurology. You are more experienced and more authoritative. I believe you. It is good to check for heart problems first. Because my son had rheumatic heart disease when he was four years old and was hospitalized. There was also a coma during this period, which was very similar to this coma."

"Okay, we'll apply for inspection immediately, take the green channel and seize the time to do the inspection."

Director Luo was very happy to be recognized by the family.

Don’t forget to please all kinds of things.

"We at the Department of Orthopedics can't help here for the time being, so let's go first. If you need it, you can call me at any time. The child's right arm is fractured. Once the condition stabilizes, he will be transferred to our Department of Orthopedics for treatment. .”

Director Hua stood up and prepared to leave with Li Jingsheng.

Director Yan and Director Luo criticized Li Jingsheng, which obviously made him unhappy.But what they said seemed to make some sense, and it was hard for him to refute.

What's more, there are family members present, so it's easy to be laughed at.

"Okay, it's Director Xinhua!"

Director Yan stood up to see him off.

"Hard!"

Secretary Bei also shook hands with Director Hua.

Then he shook hands with Li Jingsheng and said, "Thank you Dr. Li for your active participation in rescuing my son. Although I failed to adopt your suggestion in the end, I am still very grateful to you."

"You are welcome, this is what I should do."

There was a worried look on Li Jingsheng's brows.

The child's condition appears to be stable now, but the real danger remains.

Now Director Yan and Director Luo insist on checking for heart diseases first. It's okay if the check is correct. If the diagnosis is not made in the wrong direction, it may be fatal.

He has also performed many surgeries in cardiothoracic surgery, and has a deeper understanding of the characteristics and working principles of the human heart.

As long as it is not a cardiovascular disease that may be fatal at any time, such as myocardial infarction or aortic dissection, there is no problem even if the examination time is slightly delayed.There are many ways to save the patient's life.

But if the problem is in the head and it is a viral infection, every minute of delay will significantly increase the patient's chance of death and disability.

To put it simply, check for brain diseases first and then the heart. Even if it turns out that there is nothing wrong with the brain, it will not cause too serious consequences.

Instead, they checked the heart first, with zero chance of trial and error.

As long as the diagnosis direction is wrong, the patient is likely to die directly.

Director Hua and Li Jingsheng had just walked out of the consultation room. Before they left the emergency department hall, they saw a nurse from the emergency room rushing towards the consultation room in a panic.

"I'm afraid something is wrong with that child."

Li Jingsheng saw this scene and said to Director Hua.

"People obviously look down on us, so there is no need to join in the fun. If we really need it, we have to ask them to come and invite us back. Otherwise, wouldn't it mean that our orthopedic surgery doctors have dropped in price?"

Director Hua said calmly.

No one who can be the head of a department is a good person.

You must have an attitude when you should have an attitude.

Otherwise it will just make people feel easy to bully.

An honest person who is too talkative is almost a toothless worm in the workplace and will eventually be eliminated.

Li Jingsheng nodded and said nothing more.

Follow Director Hua forward honestly.

"Jingsheng, when I discussed the development of the department with Vice President Jin yesterday, Director Jin praised you. He said that you trained his nephew very well, even better than entering the military training camp. He was very happy. In the future When you are in need, he will definitely help you and reciprocate!"

Director Hua intended to keep him out of trouble.

Vice President Jin sent his nephew to the Department of Orthopedics, ostensibly saying that he would be disciplined and he would be dealt with as he should.

In fact, maybe it really doesn’t matter?
It's just a scene talk.

After several rounds of treatment by Li Jingsheng, Jin Yanyu has indeed become obedient and obedient, and he no longer dares to act like a young man.

Bone-setting techniques, orthopedic knowledge, and clinical experience have all been greatly improved.

Vice President Jin saw his progress and was naturally happy in his heart.

Li Jingsheng has this kind of relationship, and even a fool knows that Vice President Jin will be particularly kind to him.

Not to mention anything else, just because he is the teacher of Dean Jin's nephew is enough to elevate his status in the hospital.

"Please tell Vice President Jin that I am just taking care of a student normally, so he doesn't have to be polite. The key is that Jin Yanyu's talent is not bad, but his character needs to be polished. Sometimes, my methods are rough, please ask him Never mind."

Li Jingsheng's emotional intelligence has obviously improved compared with before.

He actually had the contact information of Vice President Jin, but he did not reply directly.

Instead, let Director Hua convey the message on his behalf.

This is a kind of respect for Director Hua.

"Director Hua, Director Hua, please wait a moment."

An emergency department nurse gasped and caught up. "Is there a problem?"

Director Hua turned around and asked.

"The child's condition has taken a turn for the worse. Director Yan would like to ask you and Dr. Li to go back and help with the diagnosis."

"We have already participated in the consultation just now! Tell Director Yan that Dr. Li and I have already given us all the opinions we should give. Our orthopedic surgery department is not good at this kind of rescue diagnosis, and we can't help. "

After saying that, Director Hua ignored the little nurse's embarrassed look and left directly with Li Jingsheng.

He was probably secretly feeling happy. Now that the child has a problem, does he know that our orthopedic surgery diagnosis is correct?
Just send a nurse over to ask them to go back. Do you really think it's like children playing house?
Just now in the emergency consultation room, Director Yan and Director Luo not only refused to listen to Li Jingsheng's advice, but also gave Li Jingsheng a severe scolding.

This little nurse was quite smart and dialed Director Yan's number directly from where she was.

"Director, please don't move! Director Hua said that they have given all the opinions they should give, and also said that they are not good at first aid diagnosis."

The nurse reports to Director Yan.

"Director Hua is sulking! I'll come here to invite him in person. Please ask him to wait a moment."

Director Yan is an experienced man and he will know what is going on as soon as he hears it.

Go away when asked, and come back when asked. Orthopedic surgeons are not just balls.

Director Yan was sweating profusely and caught up with Director Hua and Li Jingsheng who had already walked out of the emergency department.

"Director Hua, Doctor Li, please wait a moment. The child's heart rate started to drop again, his face started to become cyanotic, and his breathing didn't seem to be good. Director Jin of the Cardiovascular Department asked us to bring you back quickly. Director Luo also said that there may be a serious brain problem. Dr. Li, your diagnosis may be in the right direction, but I was wrong just now, please forgive me."

Director Yan had no choice but to lower his head.

Otherwise, why should people care about this matter?
"I'm serious, I'm just a young doctor, so I can't be sure of what I say."

Li Jingsheng replied.

"No, no, no, the level of medical skills has never been distinguished by age. Dr. Li's ability to not be fooled by appearances and stick to his own opinion is very admirable."

Director Yan waved his hands repeatedly and praised Li Jingsheng.

"Aren't you going to say that Dr. Li is just trying to get over the top?"

Director Hua curled his lips.

"Brother, I've always been outspoken. It's not like you don't know it. I did have a cognitive problem at the time, and I shouldn't despise Dr. Li because he was too young. Please come back with me, that child The situation is critical now, and only you can possibly save the child."

Director Yan repeatedly begged for mercy.

Even my old brother was called.

"We don't dare to wear this high hat. But when the patient has a problem, we just have to do what we can and make some efforts. This is what we should do." Director Hua's tone was smooth and he didn't say anything more.

Take Li Jingsheng back to the emergency department.

This time, the two did not enter the consultation room, but went straight to the emergency room.

Director Hua is really not good at rescue matters.The real main force at this moment is Li Jingsheng.

But Director Hua is the top leader of the Orthopedic Surgery Department and was on hand to check on Li Jingsheng.

If Li Jingsheng is ignorant and takes too many risks, he will definitely stop him in time.

After all, Li Jingsheng is now a shining star in orthopedic surgery.

No room for error.

In the rescue room, Secretary Bei looked at his son who had fallen into coma again, almost paralyzed.

A middle-aged man in pajamas was supporting her.

This person should be her lover.

Otherwise, it would definitely be inappropriate to support him like this.

"Please save my son, I will agree to any amount of money you want."

Bei Yan is no longer a superior secretary now, but a mother who cares about sick children.I just hope that my son can survive this.

"Doctor Li is invited back."

Director Yan's forehead was filled with sweat.

It can be regarded as inviting people back.

Who would have thought that the child would get better after taking medicine not long ago, but after a while, problems would arise again.

Beiyan is now extremely sad and worried about her son.

If something goes wrong with the child, she will definitely blame Director Yan and Director Luo.

"Dr. Li, maybe your diagnosis is in the right direction. Please help me take another look. I heard Director Mu say that your diagnosis in respiratory medicine is also very good. Now the child's breathing has become a little worse. .”

Director Luo also looked a little pale.

It's a matter of asking for credit. If you do it, it's a credit. If the child can't be saved, it's a big mistake.

Li Jingsheng walked to the emergency bed and carefully checked the condition of the sick child.

"The pupils are dilated, the person has fallen into a coma, breathing is very poor, and the pulse is weak, indicating that the heartbeat is weak..."

He turned to look at the ECG display.

"Ventricular tachycardia! Congestion in the hilus has been detected before. Now are we preparing for endotracheal intubation and pressurized oxygen?"

"Correct!"

Director Yan nodded.

At this time, the child's father seemed to have finished making the phone call,
He said to Director Yan, "If my son is transferred to the People's Hospital now, will the success rate of rescue be much higher? I just called a leader from the People's Hospital and he said that he will soon invite the top people in the cardiovascular field of the People's Hospital. Professor Wang Weiwei contacted us.”

The child's father doesn't know what he does, and he feels that his energy is not as good as his wife's.

But even if he is just a fool and his wife is a secretary, he can't be any worse.

"I estimate that the effect of the second cardiotonic medication will be worse than the first. It means that the child's condition is progressing faster than I expected. In this situation, even if he is sent to the People's Hospital, he will have a narrow escape."

Li Jingsheng expressed his own views.

It's not that he is arrogant, let alone show off, but he happens to be good at neurology, cardiovascular medicine, cardiothoracic surgery, and respiratory medicine.

After seeing the child's condition, he believed that the child's condition was uncontrollable and he might not be able to survive a day.

Death will occur within a dozen hours at most.

And the further the disease progresses, the more difficult it becomes to rescue.

"How can you, a doctor, say something so unlucky about my son still being alive?"

The child's father was already upset, and he was even more disappointed with the inability of the second hospital to rescue him.Now when I heard what Li Jingsheng said about a narrow escape from death, it was like adding fuel to the fire, and he immediately became angry.

"He is Dr. Li Jingsheng. During the consultation just now, he has been actively rescuing our son. And his diagnosis seems to be more accurate than other experts."

Beiyan grabbed her husband and introduced a series of Li Jingsheng's outstanding performances.

"Dr. Li, please forgive me. My husband was also anxious to see the child comatose again."

"fine."

Li Jingsheng waved his hand.

"The child has a subdural hematoma and should be investigated immediately. Now it seems that I suspected the possibility of a subdural hematoma from the beginning."

Director Luo, the hero who wanted to take credit, showed up again.

When you reach the level of chief physician, your medical skills will not be much worse no matter how bad you are.

Everyone is often confident in their diagnosis.

The condition is now very confusing, and it is clear that the likelihood of the disease being in the heart and cardiovascular system is decreasing.

Everyone couldn't help but once again aimed the diagnosis at the head, which had been ruled out before.

"I suggest you seize the time to draw cerebrospinal fluid for examination, and then check for serum antibodies. Cerebral hematoma may exist, but it should be relatively small."

Li Jingsheng couldn't help but despise Director Luo.

The children are already like this, and they are still trying to prove that their diagnosis is correct, without respecting objective facts at all.The Neurology Department of the Second Hospital has never been very good, and there is a reason for this.

If the leader of the Department of Neurology has this kind of virtue, can the department be good?
Almost most departments follow the example of what goes up and what follows.

The head of the department is so happy about his success, and most of the doctors and nurses below him are just as happy.

Those who are pragmatic, as long as they are not of the same school as the department director, will most likely be ostracized and not stay long.

One emperor and one courtier are applicable to almost any unit.

(End of this chapter)