Gou is practicing medicine in the clinic

Chapter 372 Super Nutritionist’s Plan List, Surgery Suggestions
It wasn't until more than a month ago that I started experiencing sore throat, then chest pain, fever, and now I have serious symptoms such as cough, purulent phlegm, difficulty breathing, and high fever that persists.

No one could have imagined that the culprit turned out to be a bone that got stuck in the throat while eating duck meat three years ago.

At Li Jingsheng's suggestion, a scar and damage to the esophagus were discovered through fiberoptic bronchoscopy. Then further inspection revealed the bone, which revealed the real cause.

If the real cause cannot be found, the doctors over there are already preparing to perform a bone marrow examination on the patient.

Because these symptoms of patients are also highly similar to blood diseases.

At present, the teenager has undergone closed chest drainage and was transferred to the Department of Surgery to consider surgical treatment.

Although problems have been identified, patients have suffered from esophageal rupture, mediastinitis, mediastinal abscess perforation, gram-negative bacilli sepsis, toxic hepatitis, and possibly pericardial suppuration.

This requires further investigation.

Even without examination, it is basically certain that the patient has suppurative pericarditis.

With so many diseases combined into one body, the boy's condition was no better than that of the old man.

The only good thing is that the cause was discovered as quickly as possible.

It buys extremely precious time for doctors to save the patient's life.

Whether the patient can be saved in the end is hard to say yet.

After all, patients with worsening conditions like this cannot be cured by finding out the cause.

How to treat it and what changes will occur in the patient's body during the treatment are all unknown.

Then again, if this boy still dies despite the full rescue efforts of the People's Hospital, then the result will basically be the same if he is transferred to another hospital.

The comprehensive strength of the People's Hospital in all aspects is still one of the best.

Although many top hospitals that surpass the people's hospitals have popped up in some developed cities and provinces, this does not affect the evergreen existence of this ancient public hospital.

On the contrary, central hospitals, No. [-] hospitals, maternal and child health care hospitals, etc., which once dominated the limelight, have all lost their color in the historical development trend.

Not that this is the case in every region.

At least this is the general trend in most areas.

Some older people will find that the once glorious large hospital has become less popular now.

When everyone gets sick, they go to the People's Hospital and the head compound of the regional development.

This is also one of the people’s expectations for future medical care.

Life is more valuable than money.

As long as the financial conditions permit, as long as the illness is a little serious, I will rush to the strongest hospitals in the region for treatment.

In fact, these 'few companies' are often only two or three.

Even many provinces are dominated by one company.

After reading the cause of the boy's illness, Li Jingsheng looked at a nutritional support plan form sent by Lian Tao.

It is a nutritional treatment plan formulated by Muyin.

Regarding the patient's hyponatremia, she assessed that she had too much water, and the supportive measures were to replace the patient with a new nutritional formula and limit fluid input.

However, patients have diarrhea symptoms and are prone to dehydration.

She restricted fluid infusion, which was very unfriendly to the patient's reduced blood volume, potential risk of secondary myocardial infarction, cerebral infarction, etc.

After all, she is a talented student at Harvard and a professional nutritionist. I believe she will definitely have a way to break this cycle.

For the patient's hypokalemia, she mainly corrected K deficiency and also provided a set of nutritional support and treatment plans to reduce diarrhea.The main focus is nutritional support, supplemented by treatment.

Combined with the previous support plan for hyponatremia, they echo each other and form a powerful combination.

It also successfully broke the endless loop.

……

After reading the enteral nutrition support plan given by Muyin, Li Jingsheng felt very impressed.

If there is a chance, I would like to introduce Lian Tao to her, not because I want to make friends with her, but because I want to learn her superb nutrition skills.

Nutrition is considered an unpopular major in China.

At present, many people's impressions of nutritionists are still based on the past bad impressions of pyramid schemes, money fraud, and health food.

In fact, there is also a shortage of skilled nutritionists in the country.

But in the nursing industry, nutritionists are an extremely important profession.

How important is it?
Whether an operation is successful or not depends on the surgeon.Nutritionists have the final say on when a post-surgery patient will recover and whether he or she can survive the life-and-death crisis.

Perhaps this is a bit exaggerated. After all, nutritional support is one aspect of postoperative care, and infection control is equally important.

Monitoring of physical signs and input and output after surgery is also very important.

For example, if a patient does not urinate after surgery, this is a big problem.

You need to find a doctor quickly to diagnose and treat the problem, identify the problem, and then provide a treatment plan.

Li Jingsheng has a great ideal, which is to make Sunshine Clinic stronger.He needs to recruit top talents from all aspects.

Top nutritionists are hard to find.

This Muyin's performance is very good. He really wants to get in touch with her and get to know her better, and then slowly win over her.

Just like wooing Lian Tao, Luo Binggang, Wang Weiwei and others, slowly penetrate and cultivate feelings.Instead of simply trying to beat people unconscious with money.

Throwing money at them works for most second-rate doctors, but less so for top doctors and nurses.

It’s not that they don’t love money, but it’s hard to give them a price they’re satisfied with.

If the premium is too high to poach people, the clinic will collapse if it cannot bear it.

After reviewing the complete nutritional support plan provided by Muyin, Li Jingsheng couldn't help but admire her strength even more.

The basic core of parenteral nutrition support is to inject nutrients through the vein.

The nutrition plan she gave included peripheral intravenous nutrition and central intravenous nutrition.

What nutrients are supported through peripheral veins, which tissues and parts are affected, and what major nutrients are supported through central veins are all formulated in great detail.

From this we can also see her level.

It is many times better than those crude and crude nutrition programs.

Li Jingsheng is really not belittling the nurses of the Second Hospital. Even the chief nurses of the departments of respiratory medicine, gastroenterology, and cardiothoracic surgery, the nutritional support plans they prepare for patients are nothing more than a few rough ones.

Among them, glucose is the most used, followed by amino acids and vitamins.

Those who can use minerals well can basically be called the masters among masters.

Use fat emulsion, and sometimes it looks very awesome.

In addition, the Second Hospital has many senior nurses who secretly sell some nutritional solutions to wealthy patients.

Many of these nutrient solutions are imported and prepared from abroad.

They just earn an intermediary fee, and their technical content is almost zero.

There was even a joke two years ago: a nurse sold a family member an expensive nutrient solution worth 800 yuan per bottle, which was eventually found to be glucose and a small amount of vitamins.It is a 'nutritional formula' that an unemployed young man put together using his own brain.

It is a complete three-no product.

It was just carefully packaged and the benefits were guaranteed. Eventually, many nurses sold his homemade nutritional solution.

The euphemistic name is that it was smuggled in through special channels from abroad.

After the unemployed young man was arrested, he honestly confessed that he dropped out of school before finishing his third year of junior high school.

Later, I washed dishes, moved bricks, and carried cement on the construction site, but I felt it was too hard.

By chance, I met a clinic nurse as my girlfriend.After reading my girlfriend’s nursing books, I once heard her talk about how expensive imported nutritional solutions are now.He had a sudden idea that he could make his own nutrient solution, package it and pretend it was imported from abroad.

Maybe make a lot of money.

He also went out of his way to work as a pharmaceutical salesman for more than a year and suffered a lot.

However, thanks to my thick skin, sweet mouth, and quick mind, I became familiar with the nurses in some big hospitals.

After that, he gradually began to sell homemade nutritional solutions.

This young man was worried about killing people, so he specially prepared it and experimented on animals.

Nothing unusual happened, so he asked his girlfriend to give him another bottle.

I feel the effect is good and I haven't noticed any side effects.So sell boldly.

When he was caught, he bought his girlfriend a large flat in the city center and a BMW worth more than 30 yuan.

I also gave my girlfriend multiple luxury bags and two luxury watches.

One carat high clarity D color diamond ring.

His girlfriend praised him for his ability.

Even if her boyfriend is arrested, she still expresses her willingness to wait until her boyfriend is released from prison to get married.

She was originally just a clinic nurse with a monthly salary of more than 3000 yuan. Since falling in love with this young man, she has lived the wealthy life she dreamed of.

It is worth mentioning that the young man was sentenced to three years and fined 50.

But because the young man was very smart, most of the dirty money could no longer be recovered.

The 50 fine may be only a small part of the money he earned.

After coming out, the little life should be very nourishing.

Of course, the premise is that his girlfriend did not cheat on him during the three years he was in prison.

Otherwise, he would just cry and faint in the toilet.

This also shows that academic qualifications are not always decisive.A person like him who is quick-minded, thick-skinned and sweet-tongued can still make a lot of money even if he has little education.

The only pity is that I didn't take the right path.

From the case of this young man, we can also see how scarce senior nutritionists are in China.

Muyin's parenteral nutritional support is not only specific to the maintenance of the function of each organ, but also uses various minerals, vitamins, and trace elements to an astonishing level.

She listed which nutrients the patient was currently lacking and which ones were urgently needed to be supplemented.

Then what nutrients can be supplemented through food supplements or slowly.

Looking at her nutritional plan table, it really feels like there are rows separated by rows.

Li Jingsheng is a complete layman in front of this nutrition.

"With the help of a nutritionist like her, and the patient's belief in writing a book, I believe he will be able to survive."

All that can be done now is to wait and see whether the old man's physical condition worsens or improves after he gets a new treatment plan.

Li Jingsheng finished reading these things and basically finished breakfast.

Another day of busy work has to start.

One patient after another is waiting for his treatment.

At this time, Li Jingsheng's cell phone rang.

It's an unknown phone number.

"Hello there!"

Li Jingsheng thought to himself, could it be the call from the blackmailer?
What should I say in a while?
Just two words to send him out?
"Is this Dr. Li Jingsheng?"

"Yes, I am Li Jingsheng, what do you want?"

"I am Shang Fu, Chief Physician of Cardiothoracic Surgery of the People's Hospital. I have a patient who was transferred from the Department of Gastroenterology. Now it is found that the esophagus is ruptured and there are remains of duck bones inside. Because the patient's condition is critical, we are going to arrange arrangements immediately. Surgery. But when deciding on the surgical plan, I still have a question I would like to ask Dr. Li."

Director Shang is quite famous in the Cardiothoracic Surgery Department of People's Hospital.

Specializes in extracardiac surgery.

Especially good at some delicate surgeries.

"Oh, by the way, it was introduced by Director Lian. He said that the cause of this patient's disease was almost all diagnosed by you alone. Time is urgent now, so I took the liberty to disturb Dr. Li."

When Director Shang heard that Li Jingsheng didn't answer, he quickly added a few words.

He thought Li Jingsheng was not willing to take care of this matter.

"If you have any questions, feel free to ask, but don't take it seriously! I was just recalling the patient's condition, so I didn't answer you right away."

Li Jingsheng explained to the other party.

When dealing with people, the first impression is particularly important.

He didn't want to leave a bad impression of arrogance and indifference in Director Shang's mind.

"Judging from the drainage situation of this patient, I think there should be the possibility of heart cell suppuration. At present, it is certain that the surface of both lungs of the patient has been covered with purulent material. There is effusion in the pleural cavities on both sides. Dr. Li believes that both cavities are Is there purulent effusion present?”

"Uh... I can only infer this based on the patient's condition, which may not be accurate. The possibility of pleural effusion on the patient's right side should be relatively small, and the possibility of thick fluid effusion on the left side of the pleural cavity is very high. Even the patient's pericardium There is also the possibility of pus in the cavity, or it may be eroded by pus. If the patient is undergoing thoracotomy, I suggest focusing on the location of the anterior mediastinum near the right upper lobe bronchus.

The patient now has obvious lung problems, and I suspect that there may be pus in this location and that it may be one of the sources. "

Li Jingsheng explained his analysis.

This patient should not have waited so long. Now, multiple organs in the chest may be infected, and the difficulty of the operation has increased more than ten times.

The risk is extremely high.

To be honest, it is basically impossible for such patients to go to the operating table if they are in the cardiothoracic surgery department of the Second Hospital.

Either the patient is advised to transfer to another hospital or treated conservatively.

It’s not that doctors are ruthless, the current medical environment and procedures are like this.

Even if the patient dies under conservative treatment, it will be due to ineffective rescue, and the doctor and hospital will not be held responsible.If an operation is performed and the patient dies on the operating table, it will be very troublesome for the family to sue the hospital.

The People's Hospital dares to take this hard nut, dares to take risks, race against time to formulate surgical plans for patients first, and arrange surgeries urgently. This is a kind of responsibility.

Perhaps, it is its medical spirit and high sense of responsibility that dares to take risks to treat patients that make people support it from the bottom of their hearts.

Trust it.

"Dr. Li's opinion is very valuable. Thank you for your support. Goodbye."

Director Shang really didn't say any unnecessary nonsense.

After listening to Li Jingsheng's opinions, he ended the call directly.

Now let’s see how the surgery turns out.

Although modern medical instruments are very advanced and can perform many examinations non-invasively, some lesions are still difficult to identify.

It's like gambling on a stone. No one knows what's going on inside unless it's cut open.

Experience also makes mistakes.

Li Jingsheng also stood up and went to the reception hall to start the consultation.

As soon as I arrived at the reception hall, I saw a female patient being carried and placed in front of the consultation table.

To be honest, it gave people a very bad impression. I thought the clinic had treated people badly.

(End of this chapter)