medical road high rise

Chapter 18 I'll Give You the Qualifications of Regular Trainee
Chapter 18 I will give you the qualification of regular trainee
"Pay attention to the elevated blood pressure of the patient, and be ready to inject antihypertensive drugs at any time." Lu Ming reminded the injection nurse.

This drug is a cardiotonic agent. High blood pressure is a good thing for ordinary patients, but it is somewhat fatal for hypertensive patients.

Failure to use antihypertensive drugs in time will lead to intracranial hemorrhage and the possibility of cerebral blood vessel rupture.

As the drug was injected slowly, the values ​​on the ECG monitor continued to rise.

"Are the other directors here?" Lu Ming asked.

This patient is no longer able to perform surgery in the emergency department. In Lu Ming's view, this patient must be transferred to the ICU, mainly because the patient has already developed decompensated shock and his life is in danger at any time.

However, the patient is too old, and his hematopoietic function is not as good as that of a young person. He needs blood perfusion of the whole body's organs and tissues, which cannot be done in the emergency department.

Lu Ming took out his mobile phone and called the director of the ICU. He told the patient's situation that he needed to transfer the patient directly to the ICU.

"It just so happens that there is a vacant bed here in the ICU. Let's send the patient over directly, and let the family members of the patient pay the fee." The director of the ICU didn't talk nonsense.

Entering the ICU is like entering a gold-selling cave, where money is being burned every minute and every second.

"The patient's condition is a bit critical, and he needs to be transferred to the ICU for further treatment." Lu Ming glanced at the ECG monitor. There is another bed that can be transferred in time.”

The high consumption of ICU, unless the consent of the patient's family is obtained, the general doctor will not take the initiative to contact the ICU to transfer to the ward.

Otherwise, if you transfer the patient without going through the patient's family, who will pay for it if the patient's family does not pay?
The patient's family members said without any hesitation: "Transfer directly and I will pay the fee."

Lu Ming glanced at the patient's family members. Since he was wearing pajamas, Lu Ming could not judge the financial situation of the patient's family members.

However, the patient's family members agreed, so Lu Ming asked people to go to bed directly, and at the same time asked a nurse to bring the patient's family members to pay the bill.

Enter the ICU locker room, put on a sterile suit, and walk into the ward.

The sound of ticking instruments in the ICU was like a countdown.

"How is the patient's condition?" The director of the ICU and the director of endocrinology arrived separately.

"The patient has some abdominal pain. The pain has been going on for a while. No matter whether it is an injection or taking medicine, it has no effect." Lu Ming said with self-understanding, "I have used the treatment of lowering blood sugar and rehydration, but the patient's abdominal pain still has not improved."

"What about the patient's routine blood test?" the director of the ICU asked with a frown.

Lu Ming handed the checklist to the director of the ICU, and the director of endocrinology stood aside and watched. The director of endocrinology soon saw what he wanted.

"The patient's ketone body is high. Could it be the abdominal pain caused by diabetic ketoacidosis?" asked the endocrinologist.

As soon as these words came out, both Lu Ming and the director of the ICU looked unhappy. If so, the patient would need hemodialysis. The patient is so old, and the difficulty and risk of hemodialysis are too great.

"Could it be renal colic caused by kidney stones?" Lu Ming also proposed his own diagnosis.

The endocrine director shook his head and said, "Renal colic is unlikely. The patient's abdominal ultrasound and abdominal plain film are all here. There is no major abnormality. If it is a kidney stone, we cannot see it on the ultrasound."

"Gastric perforation is possible. The patient's abdominal plain X-ray can show free air under the diaphragm, and the patient has obvious abdominal pain."

The director of the ICU came forward and checked the patient for tenderness and rebound pain, and found that the patient's two tests were not obvious.

"I agree with Lao Zhao's diagnosis. The percussion pain in the gallbladder and liver areas of the patient is negative, and the percussion pain in the kidney area and ureter area is also negative. The acute abdomen is not established." said the director of the ICU.

Lu Ming's expression didn't change at all. He just raised all the possible situations and then screened them to avoid misdiagnosis and missed diagnosis.

Doctors should not be afraid of mistakes in diagnosis, especially in the case of consultation, that is, a group of doctors put forward their own diagnosis, and then everyone agrees on it one by one, so that misdiagnosis and missed diagnosis will be avoided as much as possible.

After all, one person's thoughts cannot be compared with three or four people, especially the thoughts of different departments. This is the importance of consultation.

"However, the patient's condition still needs to be observed for a day, and the diagnosis of ketoacidosis should be treated first to see the effect." The endocrinologist said.

The director of the ICU nodded and said: "Then treat according to ketoacidosis first."

Seeing the results of the consultation, Lu Ming remembered what happened to Qin Feng, so he greeted the director of ICU and the director of endocrinology and left.

Then the two stayed and made a further treatment plan for the patient's treatment.

Lu Ming walked out of the ICU and took out his mobile phone to call Qin Feng.

After a while, Qin Feng came to the gate of the hospital again from his residence and got into Lu Ming's car.

"Director Lu."

"Don't call me Director Lu, just call me Brother Lu from now on, I'm only 35 this year." Lu Ming laughed.

Lu Ming who left the hospital was completely different from Lu Ming who was inside the hospital, and Lu Ming who was outside the hospital was more humane.

Qin Feng couldn't believe that Lu Ming was such a young, 35-year-old chief physician. This is something that many medical students dare not think about.

Generally, if you want to reach the level of chief physician, it takes three years and three years, and you must be at least 30 years old to have the opportunity to take the exam.

You know, Lu Ming was already the chief physician before Qin Feng entered Taoshi No. 30 Hospital as an intern, that is to say, Lu Ming reached the rank of chief physician before he was [-] years old.

This ability is beyond the reach of ordinary doctors.

"Lord Lu... Brother Lu, you are amazing, if only I could be like you." Qin Feng sighed.

Although Qin Feng has a system, the main function of the system is training. Qin Feng also needs time to improve. You must know that a chief physician is not only a practical examination, but also has corresponding qualifications, such as how many years it takes to be an attending physician.

"I'm nothing. There are a large number of better existences than me in Kyoto and Shanghai. Don't set your goal in Taoshi. With your surgical skills, it's only a matter of time before you go out." Lu Ming looked at Looking at the rearview mirror, he turned the steering wheel and said, "After you go to the Second Hospital to hone your skills for a while, I'll apply for you to be qualified as a regular trainee in a provincial third-level hospital."

"What are the qualifications for trainees from provincial tertiary hospitals?" Qin Feng exclaimed.

This is not a qualification that can be obtained with money. You must know that there are so many municipal hospitals. Although there may not seem to be many medical students across the country, there are many in the tertiary hospitals.

If one wants to obtain the qualification of a provincial third-class hospital as a regular trainee through normal channels, he must pass at least five tests and pass the regular trainee test.

There are hundreds of people who take the exam every year, but only five people can pass.

(End of this chapter)