Siheyuan: living in a prosperous era

Chapter 32
After Director Yang finished the introduction, Yang Shuning followed the team leader Yuan Xingguo to start the ward rounds.

Team leader Yuan Xingguo introduced the team members, including Yang Shuning, a total of seven people, team leader Yuan Xingguo, deputy team leader Zhang Jing, and team members Wang Song, Shao Jun, Li Zhan, and You Weiguo.

Among them, Li Zhan entered last year. He is 23 years old and graduated from the Second Military Medical University last year. He is the youngest except Yang Shuning.

However, the overall area of ​​the department is not large. Except for the two directors, they are both born in their 20s and have not yet reached the golden age of cardiology!

"Shu Ning, from now on you will be the little brother in our group, and I am finally no longer the youngest."

Li Zhan patted Yang Shuning's shoulder, thankful that he was no longer the youngest.

However, two colleagues in the team, Wang Song and Shao Jun, went to support grassroots hospitals today, and You Weiguo was off today, so the four of them made rounds.

Team leader Yuan introduced the situation in the group. There are [-] beds in the entire department, and each group is assigned one to twenty beds.

The nurse who usually works with one group more often is one group of nurses.

There are 35 nurses in the department. In addition to the head nurse Zhang Xiaojing and deputy head nurse Wang Meihua, there are 33 nurses, also divided into three groups.

Among the doctors in one group, except for the two team leaders and You Weiguo, who has a high professional title, the remaining four have to participate in the mid-night and night shifts of the department.4 people from the entire department participated.Group leaders and others will also participate, but less frequently.

In this way, Yang Shuning participated in two out of ten days, one day working in the evening shift and one day working in the night shift.Doctors working the night shift have the next day off.

There are currently 13 patients in one group, all of whom are middle-aged officers or above. They were transferred here from lower-level hospitals due to limited medical capacity at the army station.

After Yang Shuning calculated it, it was okay. There were not many mid-day and evening shifts and night shifts, and there were also compensatory days off, which was pretty good.

I was planning to work night shift every week before, but now I only have one every two weeks, so I missed it.Make a lot of money.

Thanks to the 301 Hospital for its sufficient medical strength.

After introducing the situation, deputy team leader Zhang Jing went to the outpatient clinic, and team leader Yuan took Yang Shuning and Li Zhan to start the ward rounds.

The three of them were wearing military uniforms and white coats.He carried a small notebook and pen in his pocket.

There are two patients in each room, and there is also a separate toilet in the ward.

"One patient, Wu Guozhu, was found to have coronary heart disease four years ago. Because his army was on the front line, he had not received formal treatment for a long time. He began to have angina pectoris at the beginning of the year and was transferred to our hospital for treatment the day before yesterday. This is a perfect examination result."

Team leader Yuan asked Li Zhan to briefly introduce his condition, and carefully checked Wu Guozhu's physical signs. Then he gave Yang Shuning's medical records and asked him to take a look and understand Yang Shuning's strength.

"Xiao Yang, come and take a look at the medical records. Do you think there is any better treatment method?"

Yang Shuning read the medical records, then carefully looked at the various examinations done in the 301 Hospital, such as blood routine, listened to Captain Wu's heart sounds with a stethoscope, performed a simple physical examination, such as blood pressure, heart rate, etc., and asked some questions , and then said:
"Captain Wu's coronary heart disease is stable angina pectoris, and the proximal segment of the right coronary artery is almost completely occluded. Because it has formed a rich collateral circulation, it is considered a chronic disease."

"Captain Wu has already started antiplatelet treatment with aspirin tablets, but I looked at his electrocardiogram and found that he had obvious ST-segment elevation myocardial infarction (STEMI). I think he should take beta-receptor antagonists. Metoprolol can be used for symptomatic treatment.”

“Moreover, Captain Wu’s triglycerides and cholesterol are too high, which are high risk factors for coronary heart disease. I think we should use atorvastatin calcium tablets and ezetimibe tablets to lower cholesterol, and fenofibrate tablets to lower triglycerides. ester."

"Captain Wu's heart rate is quite good and can be controlled without taking medication."

"At the same time, Commander Wu should quit smoking. I smelled a distinct smell of smoke when I approached Commander Wu. Cigarettes are really harmful to Commander Wu's condition and will aggravate the formation of thrombosis."

"I'm right, Captain Wu." After Yang Shuning finished speaking, he looked at Wu Guozhu who was lying on the hospital bed.

Wu Guozhu smiled brightly. Once he entered the hospital, he had to take responsibility for his own life.I am still smoking in the hospital even though I have coronary heart disease. This is irresponsible to me.

"What you said is very good, Xiao Yang. Your treatment plan is good. It seems that your electrocardiogram skills are also good."

Team leader Yuan appreciates it very much. After all, there are too few electrocardiograms now, and even fewer people understand them. Unlike in later generations, electrocardiograms were widely popularized, and reading electrocardiograms has become a required course for doctors.

"I don't dare to take it seriously. I just did too many electrocardiograms in college. How can I be afraid?"

It is a pity that B-ultrasound was only invented a few years ago, and we will not know until it is introduced into our country.Otherwise, if you have a B-ultrasound, especially a color Doppler ultrasound, many conditions will be clear at a glance.

Where it is needed now, diagnosis can only be made by relying on rich clinical experience and simple examination data.

What Yang Shuning lacks is rich clinical experience.In my previous life, when I was in a township health center, patients who were diagnosed with heart problems after an examination basically went to a higher-level hospital.

At most, after making a treatment plan at the higher-level hospital, he came to him for further observation because of the shortage of beds.

However, Yang Shuning can also learn from it, such as looking at medical records, learning the treatment plans of senior doctors, understanding why he treats him in this way, which drug combination is more reasonable, etc.

This also laid the foundation for Yang Shuning to go to the provincial hospital for further training. After one year of training, he was able to basically handle patients independently.

As Team Leader Yuan continued to check the wards, almost two hours had passed since the three of them had checked 13 people.

Internal medicine ward rounds are slow, especially in the current situation where there is a lack of various instruments. Doctors must carefully examine each patient one by one to perfect the treatment plan.

It's not like surgery. Every day, you just check how the wound is healing, notify the patient on the day for surgery, etc. The cardiology department visits a patient, and the surgeon has almost finished checking his own group.

Yang Shuning expressed his envy of the surgical ward rounds.

After the ward rounds, Yang Shuning and Li Zhan started writing course records for a group of 13 patients, especially Wu Guozhu, whose treatment plan had just been completed, and filled three pages of medical records.

A few people ate in the canteen at noon. The food in the canteen was eaten in various ways. Yang Shuning ate more in the steel rolling mill. The taste was so-so. It was a big pot dish, but I still want it to taste good.

I continued to write down the course of my illness in the afternoon, and by the time I finished writing the course of my illness, it was already three o'clock.

"Team leader, Brother Zhan, let's have dinner together after get off work. I'll treat you."

Yang Shuning thought that as a newcomer, he should treat him to show his sincerity.

"Farewell, it's not easy for everyone. Let's go home and eat after get off work. Xiao Yang, you are far away from home, so go back early later."

"is it okay?"

"It's alright, let's go."

"Thank you, Captain."

(End of this chapter)