I'm really an intern

Chapter 268 Can't think of the title, wish you a good old age

"I just want you to call me master."

"What are you thinking?"

Is he that kind of person?

Zhang Tianyang straightened his face, waved his hand, and followed the rounds.

It's a joke, but in the process of leading Lin Ke'an to do the waist piercing, he really felt a sense of being a teacher.

Kind of novel.

After all, it is a new experience in life.

During the attending rounds on Wednesday, the atmosphere was surprisingly harmonious.

There were no fancy things like asking questions to make things difficult, and the overall process was very calm, which reassured those little doctors who were not ready.

The five patients directly and indirectly managed by Zhang Tianyang are all in stable condition.

The old lady in bed 76 had just had a lumbar puncture, and the effect was very good. During the rounds, Zhang Tianyang consulted with the attending doctor, and decided to observe for another day and officially remove the old lady's intracranial drainage tube tomorrow.

While the attending doctor was going to check the next bed, Zhang Tianyang and Song Changkong called the fans to assign tasks.

"Tomorrow's waist piercing will still be made by Lin Ke'an, I will watch from the side."

"Brother, please call the neurosurgery department later. We can't remove this drainage tube. It needs to be removed by the doctors who perform the surgery."

"Teacher Song, what do you think?"

"I think it's very good. Let me write the medical records."

Once this life-threatening tube is pulled out, the old lady's follow-up condition should be stabilized.

It can be regarded as an explanation to the uncle who has been looking forward to day and night outside the ward and copied several A4 papers.

When we talked in the morning, the uncle had already started copying and writing outside.

I don't know if I'm still here, have I sat down and rested for a while.

The young man in bed 78 was still in a coma, with strong salivation and periodic tremors all over his body.

However, judging from the results of the lumbar puncture and the latest blood test results, the infection was clearly under control.

The attending doctor, Song Changkong, and Zhang Tianyang had a discussion beside the hospital bed.

In the end, it was decided to use the treatment plan of Meiping Wangu combination for another two days. If the infection index does not rebound after two days, it will be downgraded and a weaker drug will be used.

Of course, before the hospital bed, I was told again that the enteral nutrition preparations must be replaced in time.

Zhang Tianyang didn't deal with this patient much.

It's just that I had an idea and noticed the possible source of infection.

He was very happy to see the patient's condition improved.

"How many days has he lived with us?"

The attending doctor also sighed a little.

Compared with Zhang Tianyang, who has just been here for three days, he has been "getting along" with this patient for more than a month, and he touches the patient's whole body every day in rounds

No matter what, I feel a little bit emotional!

"The patient came on the 8th of last month."

Song Changkong seriously answered the random questions asked by the attending doctor, while recording the treatment plan after the discussion between the attending doctor and Zhang Tianyang in his notebook.

The attending doctor sighed, "Hey, it's been so long. It seems that the patient has lost a lot of weight."

"That's right, come to our ward to sleep for a month or two, and you can lose weight."

The head nurse who was passing by responded casually, echoing her jokes.

The attending doctor seems to be in a good mood now, and after the physical examination, he even took a look at the tattoo of the young man in bed 78.

"Look at this tattoo, you can't quite figure out what this pattern is, but the word, when the patient first came here, looked like 'Xiaoqing', but now it looks like 'Qing'."

The white coat who was closer couldn't hold back his curiosity, and tiptoed his head to take a look.

It really is!

Although the word "love" still looks a little fatter, it can be seen anyway.

As one by one the white coat probed to see, the hospital bed was filled with a cheerful atmosphere.

Zhang Tianyang turned his head subconsciously and glanced in the direction of the window.

Thick curtains block the glass from the inside, and also separate the ICU ward from the outside world.

But he knew that every afternoon, after the curtains were opened, there would be a middle-aged man who looked a bit vicissitudes and sloppy standing there unshakably.

Hurry up.

The 80-bed uncle is still shaking his head from side to side from time to time and insisting on what he thinks is "rehabilitation exercise".

The attending doctor will say during the rounds every day, "Shaking your head won't help you recover substantially."

But the uncle still went his own way.

The doctors and nurses who come and go are also used to it.

His condition is also improving. During the physical examination today, he found that his right hand can move in parallel on the bed.

Although it only moved a short distance, it was a huge improvement for the uncle.

"Congratulations! Getting better!"

Song Changkong encouraged the uncle on the bedside, which made the uncle start to shake his head from side to side in excitement.

"creak creak, creak creak"

The director checked the new patients first, and the attending doctor simply put them at the end.

When standing in front of bed 69 again, Zhang Tianyang made up his mind, this is the third time he came here today.

The 69-bed uncle's breathing is much faster than that of ordinary patients.

The respiratory rate of a normal adult is around 12-20 times per minute. When a patient is put on a ventilator, this value is generally set between 18-20.

The same is true for the 69-bed uncle.

But the uncle held his endotracheal tube and breathed heavily, stunned that the breathing rate on the monitor was 1-40 times per minute.

"Doctor, the patient's breathing rate is too fast."

The little nurse in charge of the bed looked worried, calling for a doctor, and looking in Zhang Tianyang's direction.

Song Changkong noticed this, but lowered his head calmly.

Zhang Tianyang and the doctor in charge simply didn't notice this detail at all.

"Have you done a blood gas analysis?"

As soon as the attending doctor asked, Zhang Tianyang had already handed over the result list that the little nurse had stuffed in during the ward round.

"Blood gas analysis uses arterial blood. The partial pressure of arterial blood pressure is lower than 60mmHg, and the partial pressure of carbon dioxide is higher than 50mmHg, which meets the diagnostic criteria for type [-] respiratory failure."

The attending doctor took the list, looked at it twice, nodded, then looked at the patient on the hospital bed who was breathing hard, and shook his head again.

He looked at Zhang Tianyang, "Do you have any good ideas?"

Now, asking Zhang Tianyang has become his instinctive reaction.

But Zhang Tianyang could only shake his head.

"White lung" indicates that all lungs of the patient have lesions.

The respiratory failure shown by the patient is essentially due to hypoxia and carbon dioxide retention caused by alveolar hypoventilation.

Equivalent to inhaling this breath, the amount that the patient can use is only a fraction of what a normal person can use.

Otherwise, if this breathing rate was placed on a normal person, something would have happened long ago.

You can feel dizzy and dizzy after keeping fast and deep breathing for half a minute. If you don't believe me, you can try it.

For the patient, such a breathing rate is enough to maintain the oxygen consumption needed for his survival.

"If you want to relieve the symptoms, you can only wait for the lung disease to improve."

Zhang Tianyang shook his head silently, "At most, I will teach the patient breathing techniques to make him feel better. I still have to wait for the medicine to take effect."

The attending doctor was silent.

The patient felt very uncomfortable, and he also felt uncomfortable looking at it, but there was nothing he could do.

"Okay, get off the bed."

Zhang Tianyang's last patient was the middle-aged female patient transferred from Yanling Hospital for the third time.

The attending doctor conducted a physical examination as usual, and the result was similar to that of Zhang Tianyang's own physical examination yesterday.

All the indicators are almost up to now. Although they are still outside the normal range, compared with the indicators of the patient's previous admissions, they are obviously better.

"There is no need to adjust the medicine for the time being. Observe for two days to see if the situation is stable and downgrade it. If it is possible, it will be transferred to continue treatment."

There is nothing special about this patient.

The attending doctor put away the stethoscope, glanced at the pale female patient lying quietly on the bed, and asked a casual question.

"Did the patient's family members come yesterday? Have you signed a consent form or something? I don't seem to have seen her family members."

"teacher!"

Song Changkong's always simple and honest expression suddenly changed, but it was too late to stop it.

"Ho! Ho Ho!"

On the hospital bed, the patient who had been quiet all this time suddenly twitched.

(End of this chapter)