The system takes me for surgery

"Then you come." Li Zhengping pointed to the girl.

Sure enough, the gun hit the head, Liang Yi took a step back quietly, taking advantage of this gap, and continued to doze off.

"Let's have a quick question and answer, and if we don't know, we will answer next." Li Zhengping said.

He asked: "How much mmol/L can 1 U of insulin lower blood sugar?"

The girl replied: "2.7 mmol/L, good answer very quickly!"

"Come to a simple question, can nitrates be used for right ventricular myocardial infarction?"

"No. The next classmate hurried to answer, be careful not to be snatched away.

"What is the drug of choice for children's fever?"

"Ibuprofen and acetaminophen."

"What is the general principle of rehydration? This is very important. If you can't answer it, you can't even count as a medical student."

"Salt before sugar, see urine potassium supplementation."

"This is a bit more difficult. Let me tell you which drugs should be avoided for patients with atrial fibrillation and pre-excitation."

"Adenosine, verapamil." Classmate Lan smiled awkwardly, but couldn't remember.

"Anyone else have anything to add?"

Someone relayed: "Beta blockers and digoxin."

"How can the course of empyema be divided into acute and chronic?"

"Within 3 months, it is acute empyema, and if it exceeds 3 months, it is chronic empyema and acute empyema."

"Not bad, not bad, the theory is good."

Li Zhengping glanced at Liang Yi, saw him dozing off, and joked with a smile: "It's because I didn't teach well, or it was too dark to be on duty last night."

Zhong Yubo quickly explained: "Last night's shift was too dark, so he didn't sleep much."

Liang Yi smiled awkwardly.

"You have to be like this in clinical practice. There is no way. This is a clinical question. Liang Yi, please answer it."

Liang Yi shook his head to wake himself up, and said, "Okay."

He asked, "What are the surgeries that require emergency thoracotomy?"

Liang Yi's mind immediately jumped to the medical textbook he had memorized, and he replied: "[-]. Progressive hemorrhage in the pleural cavity; [-]. Cardiovascular injury; [-]. Severe lung laceration or tracheobronchial injury; [-]. Esophageal rupture; [-]. Pectoral muscle injury; A large defect in the sixth chest wall; a large foreign body remained in the seventh chest.”

"It's very complete. To be honest, it's more complete than me. Sometimes I forget things, and I'm missing one or two points." Li Zhengping said.

Now Zhong Yubo's view of Liang Yi has also changed. In all fairness, if he answers this question by himself, he can answer it, but like Director Li, there may be gaps.

He had heard that Liang Yi's theory was very good from a doctor who was also a regular trainer before. He didn't believe it at first. He thought that doctors in grassroots hospitals had never seen the world. When he met one or two doctors with solid basic skills, he felt that he had met a master. .

However, after getting along with Liang Yi in the past two days, and the calm and composed state when dealing with the patients yesterday, it can be seen that Liang Yi's level is actually far more than that.

After checking the ward,

Another tall black-faced doctor Guipei, his face is very rough, almost like the surface of the moon, he approached Liang Yi and said, "Brother, I heard from Brother Zhong in the morning that you did an amazing job last night. Operation."

Right now, Liang Yi's whole mind is confused, and he can't understand any serious surgery at all, so he asks, "What kind of surgery are you talking about?"

"Didn't a drunkard come here last night? I heard that the artery was cut and the blood kept rushing. It was supposed to be sent to the vascular surgery department, but then the blood was stopped by you. It's awesome!" He looked excited Said.

"Are you a resident doctor or a research doctor?" Liang Yi asked.

"Brother, I am a graduate student this year."

"It's not difficult to suture blood vessels. Next time I meet, I'll call you again. Let's go to school together. After a few times, you'll be fine." Liang Yi glanced at his badge that read: Qian Futing.

Qian Futing immediately said excitedly: "Is it really possible?"

"Of course I can, but I can't do it today. I'm really sleepy. I have to go back and catch up on sleep."

"Hey, you can tell by the expression on the senior brother's face. I was really tired yesterday, so go back to sleep quickly." Qian Futing said.

Just when Liang Yi was about to take off his white coat and go back to his residence to rest, the ambulance brought another patient.Moreover, the patient's family members named Zhong Yubo to handle it.

Even his own teachers couldn't go back, Liang Yi was naturally embarrassed to go back early, because both of them were in the same class, and if they were tired, Zhong Yubo was actually under more pressure, so he should be even more tired.

"This is my classmate's father. I'll take care of it before I go back. Why don't you go back first." Zhong Yubo looked at his haggard look and said, "Look at you so tired."

"It's okay, just take it easy." Liang Yi said.

A man in his sixties pushed in with a flat cart. This man's son and Zhong Yubo were classmates in high school.

This is a man in his 62s who usually lives in a nursing home and was sent by his other sons when he came.

When he was pushed in by the flat car of the hospital, his consciousness was not clear, he was lethargic, his lips were pale and dry, his tongue coating was white, and his tongue was chapped.When he came here, he drank a lot of water and hadn’t eaten recently. He reported pain in the lower stomach area under the xiphoid process, tenderness under the bilateral costal arches, chest and back pain, and low back pain. The vomit was normal gastric juice.

The condition was quite complicated, and he had almost half of the medical symptoms. Zhong Yubo frowned, and kept stroking the stubble that had just protruded from his chin.

Myocardial infarction?Insufficient intake?Hypovolume shock?Electrolyte disturbance?intestinal obstruction?

But all subsequent inspections shattered Zhong Yubo's pre-judgment.

Liang Yi thought of a patient in his forties who had been treated before. When this patient came to see the doctor, he kept saying that he was very thirsty. He held a bottle of 5L mineral water in his arms and drank it with a straw when he was thirsty. .

When Zhong Yubo was in a state of desperation, Liang Yi whispered in his ear, "Test your blood sugar, it might be DKA."

DKA called diabetic ketoacidosis refers to diabetic patients under the action of various incentives, insulin is obviously insufficient, and the glycogen hormone is inappropriately increased, resulting in hyperglycemia, hyperketone, ketonuria, dehydration, electrolyte disturbance, metabolic acidity Symptoms of pathological changes such as poisoning.

Zhong Yubo frowned, and said, "He said he basically hasn't eaten recently." Although he was puzzled, measuring blood sugar is very simple, so he immediately got up to get the blood glucose meter.

A blood sugar test turned out to be 29!

Seeing such a high blood sugar, Zhong Yubo was shocked!
The reason why Liang Yi suspected the patient's high blood sugar after the family member said that he had hardly eaten recently was that he began to doubt the key information that the patient had been living in a nursing home.

The word "nursing home" also means that the statement of relatives is worthy of scrutiny. "Not eating" is not necessarily what relatives saw with their own eyes, but it may be learned from nursing staff in nursing homes.

Once there is suspicion, it should be ruled out by examination, and DKA with abdominal pain can be easily overlooked.