Great doctor starts with adding points
Chapter 18 Do you regard Qingda as a magic medicine? (For collection, for follow-up)
"Wait, Dad!" Wu Xie quickly chased after him.
"What did you talk to Jinping about? Why did he agree?"
Wu Xie was afraid that Wu Guonan would conflict with the other party because of himself, which was unnecessary.
Doctors don't knock on doors.
"Where, your mother and I just arrived at the hospital, and your grandpa (grandfather) went directly to the ward and scolded Jinping, and even called Cousin Jinyinshan in front of Jinping, asking if you want them to come together Give Jinping some money for medical treatment."
"You also know that Jin Ping and your grandfather are cousins, the same generation." Wu Guonan said.
"The old people are saving face, let's take a breath."
All right!
Wu Xie didn't know what to say. No wonder, when he was at the county hospital, the director and the dean said that if he returned to Shazhen, his work would go smoothly. It turned out to be the reason.
"I'll call Mr. Ga (grandpa) tomorrow. Dad, go to bed early." Wu Xie smiled.
"If we have the ability, we will still try to get the medical treatment of uncle Jin Ping, your cousin Gagong (grandpa) well. His family is a bit difficult and it is not easy to earn money."
"The main reason is that my son is not up to date. He can change money, but he likes to gamble, so the old man is very frugal." Wu Guonan confessed in this way.
"I'll try my best, dad, infection is still troublesome." Wu Xie dared not express his opinion in private in front of his dad.
There is nothing 100% in medicine, let alone such a small hospital, many tests cannot be done.
...
the next day.
When Wu Xie rushed to the department, no one was there yet.
However, Director Lu Junyin has arrived and is communicating with Liu Chengshan and He Ling.
He Ling was always on duty in the department. He asked Lu Junyin, "Director Lu, that Lin Hua said that he was going to be transferred from Dr. Xiong in the town to our hospital. Would you accept it or not?"
"I refused yesterday."
Lu Junyin frowned when he heard this: "What is he doing in our department? He is suffering from hemiplegic sequelae of cerebral hemorrhage. If he wants to go, he will also go to the internal medicine department?"
Wu Xie happened to be in the office at this moment, so He Ling looked at Wu Xie.
"That is to say, when I heard Xiao Wu from our department came from the big hospital, I wanted to ask Ha Xiaoxie if there was anything I could do. Qin Dahe's condition has improved a lot now. The news spread in the town."
Hearing this, Liu Chengshan looked at Wu Xie.
In the case of Qin Dahe, to be honest, Wu Xie was really ruthless when he dared to attack him. After all, the case was transferred from the state hospital, and the provincial hospital refused to transfer it.
In the end, he got a turning point in Shazhen, which really gave Wu Xie a wave of fame.
can also? Pros and cons go hand in hand.
Wu Xie immediately shook his head and expressed his opinion: "Director Lu, this is still not acceptable."
The sequelae of hemiplegia after stroke and cerebral hemorrhage are a worldwide problem. Not to mention Wu Xie, no one in the country or even in the world dares to take on this job. It's better not to think about it.
Of course Lu Junyin knew: "This Lin Hua is not to be accepted, absolutely not. When he and his family come to ask, they tell him to go to the county, state, or province. We cannot accept him here."
The town hospital didn't have a special official shift, so Lu Junyin asked Wu Xie about Jinping's treatment plan: "Xiao Wu, don't worry about this Lin Hua thing, is it this Jinping's infection?"
"Although he's relaxed now and agrees to take the medicine, it's still troublesome. Do you have any suggestions?"
Jinping, he was in charge before, and Fang Hao was in charge of patients.
The admission diagnosis was plantar trauma, standard debridement, postoperative anti-infection treatment with antibiotics, cephalosporin was used, but it did not work.
Such infected patients, who do not agree with the medication, are part of it. After standard diagnosis and treatment, they are still infected, which is a big trouble in the town.
Without too many auxiliary examinations, even if the drug is agreed to, it is still difficult to determine what the situation is and what drug to switch to, and there is no bacterial culture.
If you want to send the bacterial culture to the county hospital and wait for the results, I don't know how long it will take to go back and forth. At least five days from now.
"Don't be nervous. Although you are in charge of this patient now, we will definitely help you deal with it." Lu Junyin continued.
Jinping is different from Qin Dahe before, Qin Dahe is a dead horse as a living horse doctor.
Jin Ping was the original case, and it was transferred from Lu Junyin to Wu Xie. The director Lu Junyin took over the first diagnosis and treatment. Now it is Wu Xie who can remedy it.
Of course, it was Jinping who requested it on his own initiative.
"Director Lu, I want to try gentamicin instead." Wu Xie directly expressed his thoughts.
Wu Xie's words froze the expressions of Lu Junyin, He Ling and others.
"Gentamicin again?" Liu Chengshan even blurted out.
But he immediately explained: "Xiao Xie, you continue to talk."
Qin Dahe, it was Wu Xie who used gentamicin to treat it effectively, and now Jinping has also changed to Qingda, do you use gentamicin as a magic medicine?
Wu Xie heard the words and said, "Director Lu, Dr. He, Dr. Liu. I have some ideas here, but I don't know if it's right?"
"Generally speaking, Staphylococcus aureus, Enterobacter, Pseudomonas aeruginosa, Klebsiella, etc., are the main pathogenic bacteria for postoperative infection."
"Of course, fungi and Vibrio cholerae are not ruled out."
"We have no way to be sure, and the conditions are limited, so I called the Epidemic Prevention Office and learned about the common postoperative infections in our county. Staphylococcus aureus, Enterococcus, and Escherichia coli."
"These common types of infections, if the bacteria in the initial infection do not mutate, should be sensitive to cephalosporins, that is, most of our debridements are treated with cephalosporins, which is effective."
"Jumping is an exception, so it may be the first infection, and the bacteria develop resistance, resulting in limited effect of antibiotics, or it may be a rare disease infection."
"Fungi, Vibrio cholerae true, anaerobes, or atypical pathogens such as mycoplasma and rickettsiae."
"Based on the comprehensive consideration of Jinping's current local symptoms and systemic symptoms, I think the probability of Rickettsia infection is the greatest."
"In the sensitive antibiotics of Rickettsia, there are no cephalosporin antibiotics. Among the sensitive antibiotics of Rickettsia, tetracycline antibiotics such as doxycycline are the current first-line treatment antibiotics, but their antibacterial spectrum is relatively narrow."
"Quinolone antibiotics: such as ciprofloxacin, moxifloxacin, etc., have a wider antibacterial spectrum. But compared with aminoglycosamine antibiotics, their price will be relatively more expensive."
"The aminoglycosamine antibiotic, gentamicin, is relatively cheap and effective against rickettsia. If I were to advocate changing the drug, I would choose gentamicin plus intravenous injection. Topical rinse treatment."
"Director Lu, do you think it's okay to think about it this way?" Wu Xie was still quite polite.
The difficulty in the treatment of infection lies in the diagnosis. When a diagnosis cannot be made, it is necessary to speculate on the diagnosis. There are many ways to speculate on the diagnosis. Obviously, Wu Xie chose the one that is down-to-earth.
Moreover, Wu Xie's choice, in addition to the targeted treatment of rickettsia, gentamicin has other broad-spectrum antibacterial effects, so even if it is not rickettsia, it is still effective, and the point is that it is cheap.
The diagnosis is speculated from the county's epidemiological survey.
The consideration of medication also takes into account the feelings of individual patients, and the theory is sufficient. Does Lu Junyin have anything to add?
Wu Xie's way of thinking is not the usual way of diagnosis and treatment in their hospital.
"I think gentamicin is a good modification. What do you think?" Lu Junyin nodded immediately without hesitation.
"Very good." Liu Chengshan and He Ling were still rumbling in their heads at the moment, and they hadn't fully woken up from Wu Xie's frantic bombardment.
I thought that Wu Xie used gentamicin to give off the feeling that it was a magic medicine, but Wu Xie was able to list such a meticulous diagnosis and treatment ideas.
What a fart!
"Okay, that's the decision. In addition, I will go to the nurse station and tell the nurse that no matter who is on duty, this Lin Hua cannot be transferred to the department." Lu Junyin made a final decision and ended the shift.
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