When doctors have a simulated operating room

The man held his stomach and wailed all the way from the door to the emergency room.

The nurse at the reception desk saw that he was in so much pain and immediately pushed a wheelchair for him.

As a result, he not only did not say thank you but also cursed loudly:

"Are you stupid? Why are you pushing a wheelchair for me? What I want is a doctor! I want a doctor to see me and give me a painkiller!"

The nurse held back her anger and advised him: "I saw that you were in so much pain, so I pushed a wheelchair for you so that you don't have to walk by yourself. I can push you directly to the clinic!"

At this time, his wife said beside him: "Then sit down, people will push you to see the doctor for free."

"Okay!"

The man sat down with a pale face while holding his stomach.

He was domineering but also had a self-righteous look.

The nurse rolled her eyes inwardly!!

Humph! You deserve your stomachache!

——

Zhang Yi, who was preparing to take over the shift to welcome the night work, suddenly heard a nurse outside the door shouting:

"Doctor Zhang, there is a patient with abdominal pain here, please take a look."

"Okay."

Zhang Yi asked Wang Yufei to take over and then walked in front of the young couple.

Before Zhang Yi asked about the medical history, the man said anxiously:

"Doctor, please give me a painkiller quickly. I have stones. Just give me a shot. I did this the day before yesterday."

Zhang Yi frowned slightly: "Stones? I got a painkiller the day before yesterday?"

"Yes, yes, yes, hurry up, don't waste time, I'm in so much pain!"

The man was a little irritable.

But you can't say what disease you have when you come to the hospital.

Doctors are not allowed to check?

"Then did you bring the examination sheet that confirmed the stones the day before yesterday?"

"I brought it." His wife quickly handed the bag in her hand to Zhang Yi, and then explained:

"He has urinary stones. We just had an examination at the Men's Hospital a few days ago. The doctor said that the stones were small and did not require surgery. He asked us to take some medicine, drink more water, and exercise more to let it pass out on its own. He was in great pain at the time, so the doctor gave him an injection of painkiller, which worked quite well. The pain went away after a while."

"But who knew that the pain would come back after just two days? Today, I happened to come to my dad's house for dinner, but he died before we got there, so we came to your Union Hospital. If it was a men's hospital, we would have probably given him the painkiller injection by now."

From the meaning of the family member's words, it seems that they are still reflecting that Union Hospital is too slow? ?

Zhang Yi said calmly while looking at the check list in his hand and observing the patient's physical condition:

"First of all, I'm not sure whether the men's hospital you mentioned is more professional than Union Hospital. Secondly, just because you come to our hospital doesn't mean we will believe what disease you have. We have to confirm whether you have stones first, and if the stones cannot be discharged by themselves, you have to undergo surgery. Your repeated pain means that the stones are in a bad position or have become larger. Painkillers are only a temporary solution."

"Ouch... I'm in so much pain! Who cares if it's professional or not! As long as it can relieve my pain right now, it's a good hospital, better than your Union Hospital!" The man in the wheelchair covered his right lower abdomen and stared at Zhang Yi.

Zhang Yi ignored him and observed silently.

When his eyes touched the patient's ureter, he did find a problem.

It's really a stone.

But this stone is too small, right?

It stands to reason that this person is in so much pain that the stone is too large to block the ureter.

But in Zhang Yi's sight, the stone was too small.

As long as this person drinks more water and exercises more, the small stone can be discharged along with the urinary catheter.

It can't be so painful!

Zhang Yi frowned slightly.

Something is wrong.

Is this person not a simple urinary tract stone?

Then, Zhang Yi took the opportunity to examine the patient again while doing a full-body examination.

There is no problem around the bladder, no stones.

There are no stones around the renal tubules and renal pedicles.

Even the genitals were checked!

There are no problems with the testicles, vas deferens, vas deferens, spermatic cord, etc.!

It's really strange!

Could it be that he is in so much pain because of a small stone? ?

"Oh, doctor, are you done? I just want a painkiller, why are you so slow!"

The patient lying on the bed looked painful and kept wailing.

Zhang Yi also knew that he was anxious, but he couldn't go to random doctors when he was in a hurry.

His pain is really strange, so he can't just give him a painkiller.

What if he ignores the real cause of the disease just because he wants to relieve the pain?

.

Who is responsible if something goes wrong?

At this moment, Zhang Yi's eyes suddenly fixed on the patient's heart.

Immediately, his eyelids couldn't help but jump!

Damn it! !

It turned out to be this! !

Aortic dissection! !

He is only in his thirties, how could he have an aortic dissection? ?

Immediately, Zhang Yi didn't dare to delay any longer and said immediately:

"I listened to your heart sounds with a stethoscope and found that there were some murmurs when the heart contracted and relaxed. I suggest you do a cardiac ultrasound or electrocardiogram as soon as possible, or you can do a CT scan directly! In short, the sooner the better!"

Aortic dissection does have systolic and diastolic murmurs when auscultating.

Zhang Yi has already told them what the disease is very straightforwardly using professional terms.

Unexpectedly, this person didn't appreciate it!

"What? What ECG and color Doppler ultrasound? Why are there so many tests at once? Didn't I say I have stones? Isn't it clearly written on the examination form? I have urinary stones. Just give me a painkiller injection. I will go back and exercise more and drink more water to try to get the stone out as soon as possible, okay? Oh my, why is it so troublesome to give a painkiller injection at Union Hospital!"

The patient was very unhappy when he saw Zhang Yi wrote so many orders.

He thought Zhang Yi wanted to get kickbacks by ordering more tests.

Zhang Yi then advised:

"You do have stones, but the stones are too small and shouldn't make you so painful. I suspect that the cause of your illness is not stones. I suggest you go for a cardiac color Doppler ultrasound or CT scan as soon as possible. I'm doing this for your own good!"

Aortic dissection is a very dangerous type of heart disease in clinical practice.

The mortality rate is very high.

Arteries have three layers, namely the middle layer, the inner layer and the outer layer.

The inner layer of the blood vessel wall is overwhelmed by long-term high pressure, causing cracks in the blood vessel wall.

But the crack was not completely opened, so the blood slowly flowed from the inner layer into the middle layer.

The blood vessel wall itself is very thin, and the blood pressure remains high for a long time, so more and more blood will flow into the middle layer of the blood vessel wall.

The range and area of ​​the arterial dissection are much larger than that of the aneurysm.

Just like the patient in front of me.

He is only in his thirties, but the dissection actually occupies half of the area of ​​the ascending aorta in the front of the heart!

Such a large area of ​​"bomb" is really too dangerous!

In simple terms, the entire side of the blood vessel, which is about ten centimeters long, has an arterial dissection.

This kind of "bomb" that grows on the artery and may be detonated at any time, most doctors will be terrified when they see it.