Doctor's Life Simulator

Chapter 234 Doctor Dismissed?Save Liu Peichun
After completing this operation, Professor Shen Xi had other arrangements, so he left first.

Of course, Director Han is also very busy. After a few words of encouragement and appreciation to Qin Lang, he is also busy with his own affairs.

Qin Lang looked at the time, he wasn't tired anyway, so he drove back to the city's first hospital, and it wasn't too late when he arrived at the hospital.

After Qin Lang changed his clothes, he walked towards the duty room of the emergency department. He had just arrived at the door of the consultation room. In the corridor, he saw a female patient, leaning on the corridor, facing the trash can, retching, wanting to vomit but unable to vomit. When he came out, he covered his abdomen with his whole body, panting.

[Ding, new task, find the real cause of the patient through single case simulation.To prevent Dr. Liu Peichun from being dismissed due to misdiagnosis and subsequent death of the patient, resulting in harassment by family doctors.Task reward: 1.1 life simulation points. 】

Qin Lang's face changed slightly. This patient died because of being misdiagnosed by Dr. Liu.

The first time it consumed 1 life simulation point, Qin Lang soon learned the real cause of the patient:

[Patient: Hu Jie, female, 34 years old

Symptoms: Abdominal pain for 4 days, aggravated with wheezing for 3 hours
Sudden abdominal pain with no obvious cause 4 days ago, accompanied by nausea, poor appetite, no diarrhea and fever, no pre-emphasis, 3 hours ago, abdominal pain aggravated with wheezing, sweating, no chest pain, syncope, etc.

Past: found numerous gallbladder stones more than 10 years, no cholecystitis occurred.Hyperlipidemia for 5 years, usually taking statin drugs.

The mind is clear, the heart and lung examination is unremarkable, Mo's sign is positive, and the lower extremities are not swollen.

The real cause of the disease: acute cholecystitis, acute myocardial infarction.

The patient suffered from myocardial infarction due to prolonged cholecystitis inflammatory response, prolonged hypotension, and hypoxia damage to the myocardium.It needs to be diagnosed and treated as soon as possible, otherwise it will cause shock and death. 】

Hu Jie retched for a while, and went back to the consulting room, accompanied by her husband, his face full of worry.

Qin Lang looked at the hidden cause of the patient and sighed, no wonder it happened like this.

With Dr. Liu's level, acute cholecystitis can still be detected, but acute myocardial infarction is not so easy, so he followed the patient in.

Liu Peichun, who was treating patients, was a little surprised to see Qin Lang, and said hello: "Doctor Qin, didn't you go to Zijingang No. [-] Hospital for a postgraduate course today, and you came back so soon."

The patient also turned his head to look at Qin Lang, but because he was really uncomfortable, and he heard that Qin Lang was still a postgraduate student, he was in no mood to pay attention to this little doctor.

"Doctor, I'm dying of pain, please give me an infusion as soon as possible. Since cholecystitis has been diagnosed, it's time for surgery. I'm really sick to death."

Hu Jie held his stomach weakly.

Liu Peichun nodded slightly: "Okay, you have gallbladder stones for more than ten years, and this time you have acute cholecystitis, coupled with vomiting, which leads to water shortage in your body. Infection, acid suppression, of course, the best cure is gallbladder removal.”

The patient nodded: "Then trouble Dr. Liu."

Qin Lang on the side looked at Liu Peichun's diagnosis and really ignored the acute myocardial infarction, so he said to Dr. Liu:
"Doctor Liu, the patient's vomiting is so severe, he has hyperlipidemia, and he is wheezing. Have you done an electrocardiogram, myocardial enzyme check, and echocardiography for him?"

In the past, with Qin Lang's qualifications, he would naturally ignore his comments on his diagnosis, but after a series of recent incidents, Liu Peichun immediately looked at the patient's medical records.

"That's not done. Do you suspect that the patient has other complications besides acute cholecystitis?"

"But the patient didn't have chest pain or fainting, just abdominal pain and nausea, and according to the patient's past medical history, gallbladder stones for more than 10 years, plus these abdominal films, it is basically determined to be acute cholecystitis."

According to conventional deduction, Dr. Liu felt that Qin Lang was a little too cautious.

"The patient's long-term cholecystitis inflammation, long-term hypotension, and hypoxia may damage the myocardium. I suggest to do an echocardiogram and an electrocardiogram."

Qin Lang looked at Liu Peichun with conviction in his tone.

Looking at Qin Lang's serious expression, Liu Peichun thought for a while, then looked at the patient, and discussed: "Doctor Qin, what you said is also reasonable, I should go for a heart color Doppler ultrasound and an electrocardiogram. After that, I will arrange rehydration and so on. "

After all, it is just Qin Lang's guess now, and the addition of additional examinations still requires the patient's consent.

She was already going to go for treatment, but when she heard that a bunch of tests were going to be done, Hu Jie frowned.

She looked at Qin Lang unkindly. She was not convinced by such a young doctor who was still a postgraduate student.

"Doctor Liu, I'm dying of pain, you'd better let me go for rehydration treatment."

Hu Jie clutched her abdomen, a little impatient, and instinctively rejected the thought of going to the queue to do an electrocardiogram and a heart color Doppler ultrasound.

Hu Jie's husband was on the side, and he couldn't stand it any longer: "Doctor, is there any mistake? My wife has cholecystitis, so it can't be wrong. Hurry up and arrange treatment, check the electrocardiogram and heart color Doppler ultrasound, she just has abdominal pain, It's not a heartache."

"It's an electrocardiogram and a color Doppler ultrasound. Are you trying to cheat us of money? What does this little doctor know? We don't do these unnecessary tests."

The patient's husband yelled a few words, Hu Jie thought for a while, clutched his abdomen, and became impatient:
"That's right. I know my own illness. I just have abdominal pain. I have an old problem. Cholecystitis. Why do you have a heart check? It costs money to do the checkup, hundreds of dollars. If we don't do it, we won't do it."

"Ma'am, I still suggest you to have an electrocardiogram and a color Doppler ultrasound of the heart. Gallbladder-heart syndrome caused by cholecystitis is not uncommon, so it's better to have a comprehensive examination soon."

Qin Lang continued to console her, after all, acute myocardial infarction could be life-threatening if it is not handled properly.

Hu Jie glanced at Qin Lang, then at Liu Peichun, and sneered: "I think you just want to do random checks and cheat us of money. You are young and incapable of diagnosing the cause, so you know how to ask patients for various checks. Spent a lot of money and ended up doing exactly the same thing as not doing it.”

The patient's husband also threatened: "Hurry up, let us check this, check that, and I will report you. My wife has cholecystitis, and she has an old problem. Do you need an electrocardiogram or a heart ultrasound."

Seeing the patient's attitude, Liu Peichun's face turned cold:

"Although Dr. Qin is young, his medical skills are still very good. It is also for your benefit. Only by doing a comprehensive examination can you give your wife the best treatment. Otherwise, if the examination is not careful and something is missed, the treatment process will happen. If it was an accident, it can only be regarded as your own failure to cooperate with the treatment, and we are irresponsible."

Liu Peichun directly took out the medical record and wrote on it that the patient refused to undergo two kinds of examinations.

"Don't scare me, my wife has cholecystitis, gallstones have been repeated for many years, and this time I still have abdominal pain, could it be as serious as you said?"

The patient's husband despised Qin Lang and Liu Peichun, just you two young doctors, don't try to trick him into spending money.

Although I have already seen the results once in the simulated world, in the real world, Qin Lang is also very helpless when encountering patients who are so determined and do not cooperate with the treatment.

Qin Lang thought for a while and asked again: "Then, do you suddenly feel uncomfortable in the heart area, or feel dizzy when you wake up suddenly?"

"When you get up suddenly from squatting, sometimes you will feel dizzy, and occasionally you will exercise a lot, and your heart will feel a little uncomfortable, but this is not normal. Many people are like this, so don't fool me."

Hu Jie rolled her eyes, she had been cheated on by Du Niang, and any small symptom said that she was about to die, and when she went to the hospital for an examination, there was nothing wrong with her.

Seeing that the patient refused to eat oil and salt, Qin Lang was also very helpless, and looked at Liu Peichun.

"Let's do this first, let them treat cholecystitis first. At that time, it will really cause discomfort due to unknown cause, and let the patient take responsibility."

After all, Liu Peichun is more experienced, and has seen many patients who are difficult to communicate with.

If the patient is more polite to the doctor, then the doctor will say more and spend more thought. If you encounter this kind of patient who only doubts you, the doctor will not bother to say more.

In order to avoid becoming a scapegoat in the future, Liu Peichun clearly wrote that the patient refused to accept the examination, and asked the patient to sign and agree.

With Qin Lang's reminder, Liu Peichun finally avoided the original tragic fate.

Hu Jie and her husband signed with disdain, and left the consultation room cursing.

Qin Lang shook his head watching the two people leaving, and waited.

In less than 10 minutes, there was a scream from the infusion room.

"Help, help, my wife has passed out, come quickly!"

Hu Jie's husband yelled in the infusion room.

"Save my wife, I don't know why she passed out all of a sudden"

Qin Lang had been waiting by the side for a long time, and sure enough, acute myocardial infarction occurred.

Sighing, Qin Lang quickly ran towards the infusion room.

Two nurses were already frantically lifting the unconscious Hu Jie onto the flat car.

Liu Peichun also rushed over from the consulting room very quickly. When he saw Hu Jie lying on the flat car, he broke out in a cold sweat. Qin Lang really guessed it. Fortunately, he asked the patient to sign a contract to refuse the examination.

"What's the situation?"

Liu Peichun ran to Qin Lang's side and asked nervously.

"Shock caused by cardiac arrest should be myocardial infarction caused by cholecystitis."

Qin Lang said in a deep voice.

"Quick, send it over, and immediately perform CPR."

Qin Lang and Liu Peichun rushed over quickly, pushing the flat cart and directing the nurses to rescue them.

After being sent to the emergency room, the nurses had skillfully installed various instruments on the patient, and Liu Peichun immediately started cardiopulmonary resuscitation on the patient.

The principle of treatment for the dying myocardium: reduce the infarct size, protect the heart function, and deal with various complications.

"Perform perfusion therapy."

"Low molecular weight heparin, blockers, renin-angiotensin transaminase inhibitor (ACEI)."

Qin Lang had experienced it in the simulated world, and he calmly gave instructions from the side, and the nurse followed suit non-stop.

Simultaneously, Liu Peichun also completed two sets of cardiopulmonary resuscitation. Looking at the instrument, the patient's heart rate finally fluctuated from a straight line.

"so close."

Liu Peichun was already sweating profusely, but he was relieved to see the patient's heartbeat resumed.

After all, the success rate of cardiopulmonary resuscitation in the hospital is very high, which is why Qin Lang did not choose to forcefully let the patient be examined. However, the life is saved, and there is still some suffering.

Wiping the sweat off his brow, Liu Peichun leaned against Qin Lang: "This time, it's thanks to you, otherwise I wouldn't be able to explain clearly."

"Nurse, give the patient an electrocardiogram, an echocardiogram, and check the myocardial enzymes."

Qin Lang first arranged the next treatment, then looked at Liu Peichun, smiled faintly: "Let's go, the next step will be handed over to the cardiothoracic surgery department."

At this time, the patient's husband chased after him aggressively: "Doctor Liu, what happened to my wife?"

"Acute myocardial infarction is out of danger."

When Liu Peichun saw the patient's husband, his complexion was not very good, and his tone was a little indifferent.

"Myocardial infarction? My wife is so young, how could she have a myocardial infarction? Did you misdiagnose my wife and cause a problem with the fluid replacement?"

The patient's husband suddenly became suspicious, and looked at Liu Peichun very unkindly.

(End of this chapter)