Sleepless Doctor

"The doctor has no sleep(

"Isn't it right?" Han Guangyun said unconvinced.

"Guangyun, you don’t know if you have not undergone surgery. Suddenly on the operating table, the patient has a high fever and stiff body. The first thought must be over. Will the family members of the patient on the death table kill me." Han Guangyun’s senior brother Some said with emotion, "It's rare for people to judge the patient's condition in the shortest time and make the correct diagnosis."

"..."

The more Han Guangyun listened, the more he felt uneasy.

"First, extremely strong psychological qualities are required, and secondly, extremely deep medical knowledge and clinical experience."

"..." Han Guangyun continued to be silent.

"Let me give you two examples. I have encountered similar situations, all of which are rheumatic heart disease. Some have to undergo mitral valve replacement, and some have to undergo aortic valve replacement. It was the first time a friend of mine encountered during surgery. When the patient had a sudden high fever and body stiffness after the establishment of cardiopulmonary bypass, the whole person was stupid."

"This is what he said when he drank too much while eating. At that time, he judged it was a malignant high fever, but they didn't have medicine in the local area, and if they got it, they would die."

"What happened later?" Han Guangyun asked subconsciously.

"He was lucky enough to give an ice pack to cool it down to 38.5 degrees Celsius. At that time, people were invited for consultation on the stage, but the malignant high fever could not be ruled out, but he bit the bullet and finished the operation.

After 7 hours, the patient was awake and the tracheal tube was removed. One hour after extubation, the patient developed irritability and hands tremor, his HR increased to 145 minutes, and T38.8°C. "

"My friend didn't dare to go, and kept looking at the patient again in ICU. When he saw abnormal changes, he had a physical examination immediately. Blood vessel murmurs could be heard in the anterior area of ​​the neck. He was a little suspicious of the diagnosis at this time.

If thyroid crisis is suspected, propylthiouracil 600mg and propranolol 10mg should be taken orally immediately. On the second day, blood was drawn to measure thyroid function T3 and T4, and he was diagnosed with thyroid crisis. "

"Wait..." Han Guangyun heard that there was a problem and said immediately.

"What's wrong?"

"Brother, why can the check be done the next day?"

“Tyroid function testing was not available for emergency department at that time, and there was no way to check it in the middle of the night. I had to wait for the normal check-up the next morning.” Han Guangyun’s brother said, “It’s much better now. We are all preoperative routine screenings. ."

"..." When Han Guangyun heard the words for routine screening, he felt countless flies in his mouth. And some flies are not dead yet, flapping their wings in their mouths.

"Uh, let's not talk about the shortcomings, let's talk about the awesome place first." Han Guangyun's senior said, "If you encounter an abnormal situation during the operation, you can judge it in the shortest time and investigate the rare thyroid crisis. This person is a talent."

"..." Han Guangyun choked silently.

He felt that his stomach was full of flies, and he was disgusting. But I can't refute it. After all, I have something to ask my brother.

"The abnormality was discovered, and the treatment during the operation was very timely, and the medicine given was very accurate." Han Guangyun's senior brother also continued, "The patient is taken to ICU now."

"Yes."

"It's okay. If you pull out the tube after two days, it's all over. Maybe you can come out in one day in less than two days."

"Brother, it's just hyperthyroidism...it's not a big problem, right." Han Guangyun said unconvinced.

"Hahaha, Guangyun, how do you learn to be humble now?"

"Uh... I'm humble?" Han Guangyun whimpered, with a lot of flies in his mouth already emerging from another plane.

"Hyperthyroidism. Many people have this problem. Generally speaking, they will ask before the operation. This is a past history. However, some patients and their family members do not know that they are sick. Once on the operating table, a thyroid crisis is induced by surgical stimulation... just now What I told you is a successful case, and there are also failures."

"When I was flying a knife, I heard a doctor from a prefecture-level city talk about a similar case. It was a 22-year-old female patient who was hospitalized for surgery due to rheumatic heart disease. There was no preoperative examination of thyroid function, and neither the patient nor the patient’s family knew about it. There was a problem in this area, so something went wrong during the operation."

"They were of average level, thought it was normal during the operation, and didn't pay attention. The postoperative high temperature continued with convulsions. After reading the book for a day, it finally felt like a thyroid crisis and other problems.

I checked Jia Gong early the next morning and found out that something went wrong. The medication was already 48 hours after the operation. As a result, the patient's condition became more and more serious. The IABP had no effect. Two days later, the family gave up the rescue and died clinically. "

Han Guangyun knew that his senior was just talking about cases like gossip, but every word was like an invisible slap in the face, slapped on his face.

"The problem in your hospital is also quite big. I don't know if it is the bravery of Yigao or the carelessness of the tube bed doctor. The preoperative examination could have avoided rescue and accidents on the operating table, but there were a lot of screening items missing before the operation. Xiao Han Ah, this kind of...Let's put it this way, it's called self-righteousness, thinking that the level is high, and the preoperative examination is just..."

Han Guangyun was silent, his brother kept nagging.

"It shouldn’t be supposed to~www.wuxiaspot.com~ How could a superior doctor who saw a thyroid crisis at a glance... I guess they didn’t see it before the operation. Guangyun, you have to tell them more. Don’t be self-righteous. You don’t look at the patient or check up before the operation. Even though your level is high, you still need to focus on it.”

"Brother..." Han Guangyun wanted to say countless words in his heart, but he didn't know what to say when the words came to his lips.

"Hahaha, Guangyun, can't you suppress such an awesome doctor?" Han Guangyun's brother smiled, "I tell you, you can't suppress it. To have a good relationship with them, you are the director of medical affairs. , No matter how much they have to give you a bit of face, isn't it."

"Brother, what I mean is that there are so many diseases to be screened before surgery, and everything is checked, isn't that adding to the burden on the patient."

"Huh?" Han Guangyun's senior was stunned for a moment, his tone was obviously a little puzzled, "Guangyun, are you all right."

"What's wrong, brother, am I wrong?"

"Why did the patient come to the hospital?" Han Guangyun's senior asked.

"Cure."

"Yes, if you don't cure the disease, what are the costs? If you don't come to the hospital, you will save 100%."

"Moreover, you should save money for the patient. People think it is your responsibility. If something goes wrong, it is your responsibility." said Han Guangyun's senior brother. ."

"But... now the society talks about random inspections..."

"Listen to them, don't even think about doing it in the hospital." Han Guangyun's senior said, "It is true that there are some random examinations, but it has nothing to do with surgery or hospitalization. You think, rheumatic heart disease hospitalization surgery, a doctor who can treat this disease Are you still missing those three melons?"

Han Guangyun listened to the senior brother excitedly talking for half an hour, and he was a little confused after hanging up the phone.