This Doctor is Great

Chapter 6: Director's rounds...

afternoon,

The instructor, Senior Brother Chen Bing, brought Zhou Mo and Huang Yiming to the room, and went through all the seven patients in his hands.

Brother Chen Bing is a very enthusiastic person, and he has imparted a lot of experience, which has made Zhou Mo and Huang Yiming gain a lot.

Then go back to the duty room and adjust the medical records.

At 4 o'clock in the afternoon, the laboratory report of the blood drawn in the morning finally came out.

Brother Chen Bing began to analyze the laboratory report for Zhou Mo and Huang Yiming, and then adjusted the patient's doctor's order (medication, etc.) according to the results of the laboratory report.

After all this was done, it was already 20:00 in the evening.

this day,

Several other Mengxin medical students did not leave work according to the time of 17:00, but worked overtime until eight or nine in the evening. After all the teachers and residents left the hospital, they breathed a sigh of relief and dared to leave work.

They finally felt the hard work of the doctor.

…

Zhou Mo didn't get off work with other medical students because he had to take care of the beds 28 and 29.

He came to bed 29 (the 60-year-old grandma with refractory hypertension).

"Grandma..."

Zhou Mo walked to the bed.

At this time, Grandma was half-lying on the bed, chatting with her relatives via video, and she was so happy that she laughed, and her daughter was washing clothes in the bathroom.

"Hello, Dr. Zhou..." Grandma saw Zhou Mo come in, and quickly ended the video chat, showing a cautious smile to Zhou Mo.

Zhou Mo: "Are you ready to sleep?"

Grandma: "It's almost there... Doctor Zhou hasn't gotten off work yet?"

"After seeing you, I'll get off work."

"Thank you so much. Your doctors have worked really hard. From morning to now..." Grandma said sincerely.

Zhou Mo smiled: "It's alright... Grandma, did the nurse tell you that you should wear a respiration monitor at night?"

Grandma said again and again: "I said it, the nurse said that she will come over at 9 o'clock and put it on for me..."

Zhou Mo nodded: "Okay... put it on, and then take a look at your sleep condition at night..."

Grandma quickly asked, "Doctor, does my high blood pressure have found the cause?"

Zhou Mo shook his head and said conservatively, "We will not be able to analyze it further until the results come out..."

As a result, there are two possibilities:

The first type: Grandma's refractory hypertension, the main cause is sleep apnea... That's easy to do, just wear a portable ventilator to sleep, and then further investigate why there is apnea.

The second type: If it weren't for sleep apnea, it would be difficult, because there are many reasons for refractory hypertension.

I chatted with my grandma again.

Finish.

Then I came to the 28th bed, which is the old man with the arterial stent, and had a simple chat.

get it done,

get off work!

Not long after, the nurse girl took the sleep respiration monitor and put it on her aunt.

…

After an hour's ride on the subway,

On the subway, Zhou Mo found several papers and guidelines on sleep apnea.

"Sleep Apnea AHI Index"

"Obstructive Sleep Apnea (OSA

"Central Sleep Apnea Syndrome (CSAS

"Mixed Apnea Syndrome (MSAS

After reading,

The harvest is not small.

…

The next day, 6 o'clock in the morning.

The genius just dawned.

Zhou Mo continued to sit in the place for more than an hour, crowding the collapsed Death Metro Line 3.

Halfway through, I watched:

"The relationship between essential hypertension and obstructive sleep apnea syndrome"

"Relationship between nocturnal hypoxemia and ambulatory blood pressure in patients with hypertension and snoring"

7:30, arrived at the hospital, cardiology department.

"Good morning…"

People say hello.

Zhou Mo glanced at it and found that most of the medical students had already come, but they all had dark circles under their eyes, so they must have slept well last night.

but,

Zhou Mo clearly felt that the duty room was busy.

All the bedside doctors are in full swing.

Senior Brother Chen Bing held the document deck and shouted, his voice was much higher than yesterday: "Zhou Mo, go check the room first to see the situation... Then wait for the director (team leader) to come to the room, you have to report..."

"Okay, Senior Brother!"

Zhou Mo couldn't help but get nervous.

Open an vacant computer, log in with Brother Chen Bing's account, and then open the information of the 29-bed patient grandma.

Sure enough,

Yesterday, the data from the night sleep respiration monitor that Grandma wore had been uploaded to the system by the nurse girl for the doctor to read.

"It turns out that there is really apnea!"

Zhou Mo glanced at the monitoring data from last night.

The AHI value is 25 times/hour,

In addition, the minimum blood oxygen saturation at night is 80%.

This is already considered "moderate"!

Based on last night and this morning, Zhou Mo has read the relevant materials of "Apnea Syndrome" and has a certain understanding of this patient.

There is a spectrum in my heart.

Then I looked at the other data of the 29 beds.

This morning, the girl's blood pressure for the patient's grandmother was 179/111...

She quickly brought her notebook and came to the ward.

First 29 beds…

"Grandma, I'm here..."

At this time, Grandma was still lying on the bed, not long after she woke up.

"Morning Doctor Zhou..."

"Grandma, how are you feeling now?"

"It's still the same, I feel so tired, and my head still hurts..." Grandma said with a sleepy look.

The grandmother's daughter next to her said, "Doctor, I paid special attention to my mother yesterday. She snores when she sleeps, and sometimes she suddenly becomes silent, and after a few times she suddenly gasps loudly..."

Zhou Mo: "This is apnea... I just watched my grandma's sleep breathing monitoring last night, and there is indeed a problem, so I am going to add a non-invasive ventilator when you sleep at night to check the blood pressure the next day. Is there any change, will you feel better in the morning..."

"Okay, okay, thank you doctor!" Grandma felt hopeful for her recovery.

Zhou Mo did another physical examination and the like, and then ended the ward round.

Then came to bed 28 (angina pectoris, coronary stenting).

"Abo, good morning..."

"Hello Doctor Zhou..."

It took 5 minutes of consultation and physical examination, but there was nothing special.

Zhou Mo looked at the examination schedule: "Abo, wait more than 10 o'clock, you have a coronary angiography to review the heart. You don't need to go to other departments, just do it in our cardiology department..."

Coronary angiography is to inject contrast agent into the coronary arteries, and then develop the coronary arteries to check the specific situation.

It is a kind of "gold standard" for coronary heart disease examination. It has a very good effect on the diagnosis of angina pectoris in 28-bed patients and the current specific situation of the stent after the last stent operation.

…

The quick ward round is over,

8:00…

Zhou Mo walked out of the ward and saw that there were many middle-aged and elderly doctors in the Cardiology Department.

Needless to say, it was the chief and deputy chief physicians.

Today is not a big round, but a small round, that is, a round in a small group.

When Chen Bing saw Zhou Mo, he ran over quickly and said in a low voice, "How is it? Have you memorized the data of the ward round?"

Zhou Mo knew that Senior Brother Chen Bing was really nervous: "Don't worry, take it down."

Chen Bing asked again, "How was the sleep apnea monitoring last night?"

Zhou Mo nodded: "I read the numbers, and it's definitely apnea, moderate..."

Chen Bing was overjoyed when he heard the words, UU Reading www.uukanshu.com patted Zhou Mo's shoulder: "You really exist, but you found out, I didn't even pay attention... After the ward round, the director may ask you, behave well ...Our director is good, don't be nervous..."

Zhou Mo was grateful: "Thank you, Senior Brother!"

I have to say that Senior Brother Chen Bing is a really good teacher!

at this time,

The fifth group, gather!

9 people.

The team leader, Director Niu, is 60 years old and ready to retire.

He has white hair and a kind smile on his face, but he still has majesty. The deputy chief physician and the attending physicians in the group are all standing up, daring not to violate his majesty.

Zhou Mo and Huang Yiming shivered and hid behind the crowd, like huskies hiding among wolves.

It was my first time to lead a ward round and I was a little nervous.

Zhou Mo knew that he was fully prepared, but he still couldn't help being nervous.

At this time, Director Niu spoke.

"Zhou Mo, come out for a moment..."

"..."

Zhou Mo was startled.

calls me?

Zhou Mo bravely walked out of the crowd.

"director!"

"Are you Zhou Mo?"

"Yes!"