Come on, Dr. Wu

Chapter 405 is coming to an end
After all, it is an invasive operation and the procedure must be followed.

Ask the patient to lie on his left side, bend his neck, knees and hips, and puncture L3-L4.

The four major punctures are different, but they also have similarities, such as positioning, which is their essence.

Sharpening the knife does not delay the chopping of wood. After careful exploration and repeated confirmation, Chao Yuan selected the best puncture point.

Although Chao Yuan had performed the operation countless times before, in the practice operation room and on humans during internship, this time felt particularly different.

The success of each operation is the result of careful attention to details and countless failures.

Chao Yuan's eyes gradually became sharper, and he laid the towel, put on gloves and performed anesthesia in one go.

The sword is pointed out, the needle is slowly inserted, and 2cm3cm4cm is being explored carefully.

Suddenly, the long-lost and familiar "break" feeling came from the fingertips.

From here, the operation is actually over. The subsequent operations are sequential operations, which are not difficult and are as simple as throwing a stone into the sea.
Connect the pressure tube, cerebrospinal fluid rushes to the sky, intracranial pressure>330mmH2O
It was confirmed that it was meningitis.

I asked the nurse to help me and dye the smear.

At this time, a figure also walked over.

He is slightly fat, with a yellow face, a little gray on his temples, and a pair of wise eyes that seem to be able to see through people's hearts. His hands, which are a little rough due to the wear and tear of time, are flexible and precise.

Although he is over 40 years old and has been through many hardships, he still looks energetic. As the old saying goes, "The old horse on the stable neighs at the drums and horns, and the old general in front of the gate knows the wind and clouds." Isn't this Mr. Lin Dongping, Chao Yuan's rescuer?

"How about it?"

"Teacher, it has been taken out. You see the pressure is more than 330. It is definitely meningitis. It's up to you now. I'll have the patient do a head CT scan again."

Lin Dongping nodded.

The results came out very quickly, just as Chao Yuan had expected. Chao Yuan was even more excited at this time, because the final result was what he had expected.

The diagnosis has been made clear: intracranial infection of viral meningoencephalitis, all that remains is treatment.

Then it won't be difficult.

For this type of patients, the main treatment is mannitol to reduce intracranial pressure, and the rest is symptomatic treatment such as fluid replacement, antipyretic and analgesic.

Chao Yuan can be said to be familiar with the route.

After emergency treatment, the patient will be transferred to the Department of Neurology to see the effectiveness. Although he still has to be transferred to the Department of Neurology, this transfer is completely different from the previous transfer for Chao Yuan who is under assessment.

Later, Chao Yuan also added acyclovir to the patient, which can reduce the mortality or incidence of complications of some viral infections.

I also gave her glucocorticoids to improve inflammation and edema. I also gave her calamine lotion to treat herpes. Finally, I took profenofibrate to relieve pain and treat the symptoms.

“我记起来了！100减9等于91呀，再减9等于82！……”

This was the first sentence the patient spoke the next morning.

At this time, the patient could no longer remember who saved him... It seemed like he was alone, or it seemed like there were five or six people, or rather, it was "those people" who helped him at the most critical moment.

This is what patients think when they are discharged from the hospital.

Of course, these are all things for the future. At this time, the assessment of Chao Yuan and the other eight people is still going on.

Of course, Chao Yuan wasn’t the only one who performed well.

Jiang Bei also encountered a rare case at this time.

Standing opposite Wu Xiaofu is a female patient, who is considered an elderly woman in medical terms, but according to modern theories, 60 years old is still considered young.

This patient also discovered by chance that emphysema occurred below the thyroid cartilage when he breathed and spoke.

At first, the patient thought it was just a temporary problem and maybe it would be fine in a few days, but soon he found out that he was wrong. His symptoms became more and more obvious, and the local pulsation in the jugular vein increased again and again.

The patient was no longer careless and rushed to the hospital. However, it was very difficult to get an appointment at the First Affiliated Hospital. He should have been admitted to the Department of Thyroid and Breast Surgery.

However, all the appointments for the thyroid and breast surgery department are fully booked, and the patients cannot wait to see the doctor until an appointment becomes available.

After searching on Baidu, I found that the patient had already seen the extent of the tumor.

The more he looked, the more frightened he became. The more he thought about it, the more terrified he became. How could the patient dare to delay any longer? He rushed to the hospital. Since the thyroid and breast surgery department was not available, he went to the emergency department.

This patient has been to the hospital before, and the doctors in the emergency department are all good. Moreover, the emergency department can mobilize people, and when the time comes, we can ask the emergency department to call a consultation with the thyroid and breast surgery department.

However, she did not expect that after arriving at the emergency room, she met a young female doctor who did a lot of examinations, including blood drawing and color Doppler ultrasound, but did not call for a consultation with the thyroid and breast surgery department as she wished.

They did a lot of tests but still didn't give her a straight answer as to what the disease was.

Seeing that the patient was about to get nervous, Jiang Bei finally spoke.

hernia?

The patient was a little confused. After all this time, it turned out that it was not a tumor but a hernia.

This patient is a retired worker. He has a wealth of knowledge about health preservation and has some general understanding of some diseases.

This includes hernias.

It's not just what I read in books, but also among the old friends I danced with. Many of them had hernias.

It doesn't seem to be a big problem, just something came out, just send it back.

Some serious cases can be cured with a minor surgery.

However, can this hernia also occur in the neck?
How come she had only seen it in the groin, on the stomach, etc.

There doesn't seem to be any above the chest.

"I think you have a lung-cervical hernia."

After Jiang Bei told her diagnosis, she couldn't help but feel surprised. It was the first time she had seen a hernia in the neck.

The reason why he dared to make this diagnosis was because Wu Xiaofu gave them a lot of knowledge after seeing a hernia patient in the outpatient clinic last time.

Among them are a variety of hernias.

Not only cervical hernia, Wu Xiaofu also told them about lung hernia, brain hernia and so on.

It can be said that hernias can occur anywhere, but some hernias are more likely to occur, while others are rare.

This patient suffered from a rare hernia.

"But I don't feel any discomfort. I saw my old friends get hernias and they felt it. It was only after I discovered it suddenly that I felt something was different.

But I don’t think it’s a psychological effect.”

Jiang Bei nodded. When the cervical lung hernia is small, there is usually no obvious discomfort. Only when coughing and wheezing, signs similar to emphysema can be seen in the neck.

This type of emphysema appears and disappears, and the soft tissue mass is particularly obvious when holding your breath and exerting force, but this type of tissue mass generally does not cause any discomfort to the patient unless it is discovered. No one can see their neck like this and not feel anything.

Of course, when there is a lot of lung tissue herniation, there will be a local feeling of distension, discomfort when turning the head, and a few people will have difficulty breathing, and even compression of the carotid artery will cause corresponding symptoms.

The patient in front of us actually has a mild case and the symptoms are not too obvious. It was only after he discovered that there was a problem with his neck that he felt uncomfortable all over due to psychological suggestion.

When the patient came, he underwent a CT scan first. Generally speaking, if it is a hernia, you can see that the hernia is hard.

However, the patient only had a mild case, and it was not obvious when he was breathing calmly, so the previous CT scan did not show any abnormalities.

After a color ultrasound, the patient's thyroid gland was found to be normal.

If it is really a cervical hernia, for this mild case, it is actually recommended to hold your breath during further examination, which will help to clarify the diagnosis.

But the patient has already had a CT scan, so we can’t do another one.

Especially seeing that the patient was already showing signs of trouble, no matter how fierce Jiang Bei was, she didn't dare to speak directly. If she was complained about or something, her assessment for today would be reset to zero.

But Jiang Bei was unwilling to follow the patient's wishes and seek consultation from the thyroid and breast surgery department. There was no clear diagnosis yet. Although you can call anyone you want in the emergency room, it is your right.

But that is only after a clear diagnosis, especially in a hospital like the First Affiliated Hospital. If you can't even make a clear diagnosis and ask for a consultation, you will be looked down upon.

Because if a wrong judgment is made, it will waste the time and energy of the other department.

Now is Jiang Bei's assessment time. Asking for a consultation will only result in Jiang Bei failing the assessment.

Therefore, even if she had to bite the bullet, Jiang Bei had to let the patient do another CT scan.

However, the methods and approaches still have to be sophisticated, such as taking the initiative. Although cervical lung hernia has not been clearly diagnosed, Jiang Bei is 90% sure that the patient has cervical lung hernia.

All that's missing now is evidence.

That doesn't stop her from throwing out this diagnosis first to gain the patient's trust.

Sure enough, just as Jiang Bei thought, after this diagnosis was made, the patient's mood immediately shifted.

All the pent-up emotions from the long examination disappeared, and my attention was completely attracted by the diagnosis Jiang Bei made.

Of course, it doesn’t mean that the patient will believe everything Jiang Bei says. After all, in her eyes, this diagnosis is somewhat outrageous.

But none of this matters. What matters is that Jiang Bei said the diagnosis that the patient hoped for. You know, the patient had previously thought that he had a tumor and had no appetite.

When doing these tests, the reason why patients' emotions swell so quickly is that fear is the catalyst.

Every time a patient undergoes a test, he or she will wonder whether this test will detect a tumor.

The more she thought about it, the more frightened the patient became, and the more she rejected the examination. Naturally, she had no good feelings towards Jiang Bei, who ordered the examination for her.

To be honest, the fact that the patients have been able to hold on until now is due to their good Qi-cultivation skills.

But now it’s different after hearing Jiang Bei’s diagnosis.

All the fear disappeared in an instant. The emotion changed so quickly from fear to anticipation. Unlike the previous examinations which were to detect tumors, this examination was to help her rule out tumors.

Even repeated inspections didn't seem that difficult to accept.

"Check, hurry up and make a list, I'll check it right away."

Wu Xiaofu and the others who were watching from behind also smiled. This is how medical treatment is done. It is really important to guide the patient's emotions, and it is even more important to take the initiative.

It is obviously for the good of the patient, but if the patient still reports it, then the doctor is unqualified. You have to let the patient know that this is for her good and make her willing to cooperate with you.

Just like Jiang Bei.

To be honest, young doctors rarely achieve this. The reason why older doctors rarely have conflicts with patients is because they know what patients want and doctor-patient communication is their strong point.

They have seen all kinds of patients, know what they like to hear and what they need, but it is different for young doctors.

They have too much willpower and persistence.

Many young doctors feel that they cannot easily say anything before the diagnosis is made, but this is really not that important.

Ninety percent of the time, it can actually be said verbally, as long as it is not written on paper.

As long as the final result is good, everything you say is good. Even if there are problems, there will be no risk.

"Director Wu, you taught me well. Cervical hernia is not common. Even if we saw it, we might not be able to recognize it, let alone a young doctor like Jiang Bei.

The fact that she dared to make this diagnosis without a gold standard actually makes her better than most people.”

"Yes, as doctors, we may never see such a rare patient in our lifetime. Has Jiang Bei seen one before?"

"Maybe it was when I was doing outpatient work before and I encountered a lung hernia. I told them a few words and Jiang Bei remembered it."

Just a few words? You dare?
You know, this is not a matter of just a few words. They have attended five years of university, three years of master's degree, and three years of doctoral degree. How many classes have they attended? Do they really remember and understand them?
It has to be Teacher Wu Xiaofu who teaches well.

"Don't praise me so much, this kid really works hard."

Lin Dongping and the others nodded. This was indeed a true story. Jiang Bei actually worked very hard, and they could all see her effort.

It's not just Jiang Bei, there's also Xun Qi and Zhong Beibei, all eight of them work very hard.

"Director Wu, I estimate that even if Jiang Bei performs well this time, it will be difficult for her to enter the top three. Are you really willing to let this female disciple leave?"

This was asked by Miao Qingyan. As a female doctor, Miao Qingyan really admired Jiang Bei. However, she couldn't keep Jiang Bei. Although it was very infuriating, as the director of the cardiology department, she really didn't have the ability to keep anyone in the general surgery department.

It’s not that I don’t have the ability, it’s just that I have to pay too much, and the most I can get is just a scientific employment contract.

But Wu Xiaofu is different. As long as Wu Xiaofu is willing, let alone keeping Jiang Bei, it is not impossible to get her a contract with the hospital or even a position there.

Wu Xiaofu now has energy beyond imagination.

"I can't bear to let go of this person. I have nurtured him with all my heart, how can I let him go like this?"

As soon as these words were spoken, they immediately understood.

Chao Yuan and his team performed well, but this kind of performance was almost the norm for Xun Qi and Cheng Shi.

In terms of both quality and quantity, Xun Qi and Cheng Shi are ahead of others, and Song Tiantian is not bad either.

The strong will always be strong. Xun Qi and the others seemed to be saying that their ranking would only continue and their scores would only rise again and again, leaving no chance for others to overtake.

Time passed. Just six hours was really nothing for a busy emergency room.

It's not just slipping away from your fingertips, it's being blown away by the wind.

The assessment is over, which means offer 2 is also over.

(End of this chapter)