Gou is practicing medicine in the clinic

Chapter 402: Directly administering medicine without examination
Since Rong Xuekai, the chief physician, had already said this, Li Jingsheng naturally would not say anything more.

This is people's territory.

However, Li Jingsheng still believes that the patient is just calm on the surface, and the longer it is delayed, the higher the possibility of problems.

Just now he checked some real-time physical data of the patient.

There was an obvious slow decrease in blood oxygen saturation.

The partial pressure of carbon dioxide is also falling, and these are warning signs.

"Xiao Li, it's a rare occasion for you to come over. Let me take you to visit the intensive care unit of our hospital. Some of the equipment should be among the most advanced in the country, and many of the management models are imported from the top intensive care unit of an island country abroad and some developed countries in the West. I learned from it.”

A certain island country has indeed done very well in medicine and precision instruments.

Although it has never dared to be ranked first in the world, its average life expectancy, five-year survival rate of cancer patients, critical illness rescue success rate and other data are basically in the world's leading position.

There are technological blockades in island countries, but there are still some cracks that people can get through.

It was already night, but the intensive care unit was busy day and night.The sound of alarms from various instruments kept coming and going, and medical staff were running around like whack-a-mole.

Wherever there is a situation, support is provided.

Under normal circumstances, there are usually one doctor and two nurses in charge of three beds.

But because the people living here are all critically ill patients, sometimes there is a situation that requires rescue. Just one doctor and two nurses are definitely not enough.At this time, basically all the doctors and nurses who are free will run over to provide support.

Li Jingsheng was fortunate enough to spend a month in the Department of Critical Care Medicine of the First Hospital.

Although the time was short, he learned a lot of rescue knowledge and experience.Many of them cannot be learned in textbooks.

It was also the most united place he had ever stayed.

There is little intrigue or office politics.

We are all close comrades-in-arms.

As long as the seniors have time, they are very happy to give guidance to this newcomer.

Looking at the busy scene in the intensive care unit at this moment, he seemed to have returned to six years ago.But the difference from six years ago is that he is no longer what he used to be.

What we are visiting now is the intensive care unit of the People's Hospital, accompanied by two chief physicians Rong Xuekai and Lian Tao.

This kind of treatment is more than just dignity.

"These are the three critical medical wards that our People's Hospital has built so far. Their software and hardware have reached the first-class domestic level. The only thing missing is talent. Although we work hard to cultivate and tap talents every year, we can not only endure hardships but also have the ability to It is difficult to find doctors with high medical literacy. When we recruit people, we find a very serious problem. Many capable young people choose to go abroad for development.

Large hospitals in the country are facing serious polarization.

In the top hospital, ordinary people simply can't get in.

It is difficult for a second-rate hospital like ours to recruit truly cutting-edge talents. "

The opening of Rongxue School is also a rare experience.

"Sigh, the domestic medical environment does have a lot of room for improvement. Four out of ten of my classmates are developing abroad. When asked why they don't stay in China, the answers are almost surprisingly consistent.

The treatment at home is not as good as abroad.

Large hospitals in China are very serious about interpersonal relationships, and do not look at abilities but connections.Also, the slightly larger hospitals in China have special admission requirements.

Then there is the poor doctor-patient relationship in China, where patients hate doctors, making them feel like they have to go to work every day with their heads in their belts.No one can tell when they will encounter an unreasonable family member or a patient with a bad temper who will directly attack the doctor.

Dr. Li was stabbed this time, which is the best example. "

Lian Tao sighed and complained about some medical problems in China.

There is currently a shortage of medical talents in the country, and on the other hand, there is a serious loss of talents due to the inability to retain them.

Many high-end talents never come back after studying abroad.

"Xiao Li was stabbed?"

Rong Xuekai asked in surprise.

"I met a mentally ill patient during a consultation. Without saying a word, he drew his knife and stabbed him. Fortunately, a doctor hugged the crazy patient desperately. I only hurt my hand." Li Jingsheng now talks about this matter in a much calmer tone. .

"I have been beaten and stabbed with a knife by patients and family members. Once, I was stabbed in the abdomen, and the abdominal aorta was just a little bit pierced. I was very scared at the time. Especially the first time I was stabbed by a family member. I felt particularly angry when the chair hit my head and caused bleeding. I didn’t go to the hospital to work for half a month.

When I was stabbed by the patient for the third time, because the aorta would be punctured just a little further, I would definitely die.

My wife advised me to change my career and stop being a doctor.

She said she was scared when she saw me going to work in the hospital every day and worried that she would never see me again.

My mother was still alive at the time.

She said a few words to me that strengthened my belief in continuing to practice medicine.She held my hand and said, "Kaiyazi, there are two professions in the world that are the most respected, and they are a good thing for future generations."One is a teacher and the other is a doctor.

Teachers impart knowledge to future generations and everyone will respect them.

Doctors save lives and heal countless lives, and are equally respected by everyone.

As long as you act with a clear conscience, I believe everyone will think of you well.In the future, your children will be proud to talk about their father.

She also said that those who are sick are the most sinful. Their bodies are suffering from illness day and night, so they sometimes behave irrationally.Let me follow their wishes when dealing with patients and family members in the future.

It’s just that I’m a straightforward person by nature and don’t like to play tricks and twists and turns, but it’s still easy for me to offend patients and their families.

Later, I began to change my career plan and specialize in critical care medicine. "

Rong Xue spoke earnestly about his medical experience.

"Xiao Li, one thing is for sure, our practice of medicine is the right thing. As long as we do it rightly, we have a clear conscience. Not everyone in this world can be reasonable people, and there are only a handful of people who hurt doctors. Like If talented doctors like you quit this industry, it will not only be a loss for the hospital, but also a loss for all patients.

99% of patients are innocent.

I have learned about your bone-setting techniques, and they are practical medical techniques that can really bring huge benefits to patients.It can significantly reduce their treatment costs, make them suffer less, have better recovery than surgery, and have lower risks.

I hope you will pass on such good medical skills even if you encounter big setbacks in the future.

Just like the critical care medicine I am currently studying, some particularly young patients are already dead when they are sent in.However, after rescue, the person finally survived, was transferred back to the general ward, recovered and discharged.I think it's very meaningful.

As long as you want to learn someday, I will be happy to teach you all the knowledge and experience I have at any time.From you, I can feel the compassionate heart of a doctor, which is very precious.

Especially after you were assassinated by a patient, you still maintained this kind heart, which is really good. "

Rongxuekai has his own set of rules for recognizing people.

He likes Li Jingsheng not only because of his extraordinary potential and solid medical skills, but also because Li Jingsheng has a benevolent heart as a doctor.

Benevolence is the most important quality of a doctor.

Doctors with evil intentions are a great danger to all patients.

"Director Rong, the patient in bed 76 has convulsions and his blood pressure has dropped!"

A nurse ran over in panic to report.

"I'll take a look right away!"

After Rong Xuekai listened, he seemed very calm and collected.

"It was fine just now. It's less than half an hour now. Why did something suddenly go wrong?"

Lian Tao's heart became heavy.Li Jingsheng just reminded that the patient's physical condition seems to be stable, but he is very dangerous.

It's just that he didn't take it seriously. Rong Xuekai was completely confident in his medical skills, so he didn't take it seriously either.

Moreover, based on the rich experience of Lian Tao and Rong Xuekai, they determined that even if something happened to the patient, it would definitely happen slowly.

Especially since a pulmonary embolism had just occurred not long ago and was resolved.

There is almost no possibility of other changes.

The three of them rushed to the patient's bedside, where two doctors and a nurse were already rescuing him.

"Did the patient suddenly develop convulsions?"

Rong Xuekai asked in a deep voice.

"Correct."

The doctor in charge of the bed frowned as he looked at the patient's declining blood pressure.

"Director Rong, do you want to increase his pressure immediately?"

"Don't worry yet."

Rong Xuekai has experienced thousands of battles and has seen all kinds of critical cases.

In his eyes, the patient's symptoms at the moment were just pediatrics.

He opened the patient's eyelids and looked at them, then examined the patient's fingers.

"It should be cerebral thrombosis, and the blockage is probably a cerebral artery. Try drug thrombolysis immediately."

There is no room for negotiation throughout the entire process.

Not a single word of nonsense.

By simply looking at the patient's eyes and fingers, it was concluded that it was cerebral thrombosis, and rescue was carried out directly based on this diagnosis.Li Jingsheng was beside him, which opened his eyes.

Ordinary doctors are afraid of taking responsibility and would never dare to behave like Rong Xuekai.

At least an imaging examination is required before targeted treatment can be carried out.

But Rong Xuekai dared to do this.

Just like Li Jingsheng's manipulation of bones, if the patient trusts the doctor and does not cause trouble.Almost the vast majority of patients do not need to take X-rays when they come to him, they can be treated directly by touching the bones.

After thrombolysis and anticoagulation were given to the patient, the symptoms improved quickly.

The falling blood pressure also slowly recovered, and the patient no longer convulsed.

Breathing is still a little short.

"Director Rong is so awesome!"

Li Jingsheng felt yearning for it. Who wouldn't want to learn such a powerful skill?
This clinical diagnosis ability is summed up from countless rescue experiences.

After a series of rescue operations, the patient's physical condition temporarily stabilized.

But this time, Director Rong's brows furrowed instead, and his face became slightly solemn.

"With the current treatment, the patient still suffered from cerebral thrombosis, which shows that the problem is more serious than imagined." After speaking, he looked up at Li Jingsheng. "Xiao Li, maybe your reminder is right."

"Let's go outside and talk."

Rong Xuekai signaled to the two of them.

Then he turned to the doctor in charge of the bed and told him, "Add 25 units of streptokinase and complete the intravenous infusion within half an hour."

"clear."

The doctor in charge nodded in agreement.

The three of them walked out of the intensive care unit, but instead of going out, they entered the adjacent lounge.

There are several computers here and some card slots.

It can be used for doctors to rest and prescribe, apply for examinations, access patient medical record information, etc.

"I just had a pulmonary embolism treated this morning, why did I have a cerebral embolism again? Jingsheng, I found that you have a crow's mouth, and your diagnosis always comes true." Lian Tao is the doctor in charge of this patient.

Now that the patient is admitted to the ICU, he is already very annoyed.

One wave just calmed down, and another wave came up, making him a little unable to resist.

"Xiao Li, if you think this patient is in danger, please tell me where does his danger come from?"

"The main danger definitely comes from the heart. But the pathological mechanism of the patient cannot be determined from a single organ. I still think that the liver problem should be detected immediately and solved from the source, and then the lung problem should be solved. In fact, solve After the liver problem is solved, the lung problem only needs to be solved by heart failure.”

These organs are intertwined, almost forming a dead knot.

Both Rong Xuekai and Lian Tao tried various treatment methods, and the facts proved that Li Jingsheng's analysis was correct.

Because their treatments failed to achieve the expected results.

If nothing else, it will definitely get worse with more treatment.

Both of them have rich experience and naturally understand that if the treatment continues like this, the patient will probably die in the end if the rescue is ineffective.

"Director Lian, what's your opinion?"

After hearing Li Jingsheng's treatment strategy, Rong Xuekai probably agreed.

However, he did not immediately comment.

This patient belongs to Lian Tao, and Lian Tao's opinion must be asked for major decisions.

"I agree with Jingsheng's analysis and strategy. If this continues, the patient may have another condition." Lian Tao has now clearly understood the situation and has a high degree of trust in Li Jingsheng's diagnosis. "You have also seen the patient's current condition. It is actually very difficult to do an examination. Jingsheng, I know you are the best at diagnosing such difficult and complicated diseases. Just tell me, what kind of problem is the patient's liver most likely to have?"

"Tumor is the most likely! Judging from the existing examination results and the patient's actual condition, I think his problem is probably a liver tumor. However, a chest X-ray did not find any obvious tumor, so there is only one situation. , should we check the bile duct?"

Li Jingsheng has been thinking about the cause of the patient's liver.

After repeated elimination methods, he believed that liver tumors were the most likely cause.

And it's vicious.

Some malignant tumors grow slowly and can last for seven to eight years, or even more than ten years.

So far, the patient has not lost much weight in a short period of time, which shows that the tumor is not large.

It is very likely that it is still in an early stage of liver cancer.

Some malignant tumors can grow very large in a month or two, and some may behave like benign tumors overall.

They grow slowly, as if suppressed by something.

This is related to personal constitution and the nature of the tumor.

In general, some adenomas have a higher risk of malignant transformation.

(End of this chapter)