My medical skills add experience

Chapter 193 The patient who vomits blood.Back to the emergency department, close to the hometown

Most modern women are highly educated, and their knowledge and ability are not inferior to men.They are fully capable of earning money to support themselves.

This greatly improved their social and family status, and made them more independent.

It is no longer necessary to be a vassal of men like in the old society.

"It's not good to think like this. Men should get married at university, and women should marry at university. This is a good lesson left by our ancestors through the ages. Not all men in the world are unreliable. Most men are responsible and good men. When you meet the right one, don’t miss out on a good match. Find a husband who loves you and start a family, and you will feel the happiness you have never had before.”

Director Jia told her how to live a correct life based on the experience of those who have experienced it.

Only when a woman is married to a man can she enjoy the wonderful feeling of being protected and loved by a man, can she conceive and have children, and enjoy the joy of a family.

After listening to Director Jia's advice, Qiu Hong turned to look at Zhou Can.

"Junior Brother Zhou, do you have a girlfriend?"

Zhou Can was terrified by her sudden question.

"Yes, I have! Senior Sister Qiu is so outstanding and beautiful, I am absolutely not worthy of you."

Zhou Can was very worried about this beautiful senior sister, and suddenly fell in love with him on a whim.

"Hey, what are you thinking? Look at your bear, am I so scary and hate to marry? I just want to ask, how are you treating your girlfriend?" After hearing Zhou Can's answer, she couldn't help being a little ashamed angry.

After realizing that Zhou Can was wrong, he hastily explained clearly.

"Oh, so that's the case! I can't say that I treat my girlfriend very well, I can only say that it's okay!"

Zhou Can's answer was quite modest.

"Is your girlfriend happy with you?" she asked again.

"You have to ask my girlfriend to get a more accurate answer. Judging from her reaction, she should be considered relatively happy! She will come to see me often, give me some gifts, and read books with me. We are in When we are together, her smile will be very bright. I can feel that she is very happy inside."

Zhou Can thought for a while before seriously answering.

"Senior Sister Qiu asked me this, don't you have any good female friends around you?"

"My circle is relatively simple. There are only two female friends who are about the same age. One of them has been divorced twice, and one of them often complains to me that after marriage, her husband does not do housework, is not self-motivated, and even occasionally She would quarrel and once broke her mobile phone. So, I am quite afraid of love and marriage."

No wonder she is so beautiful, has a stable job, and has not found a partner in her late thirties.

"Qiu Hong, let me tell you from the experience of someone who has been here before, that the female friend who told you about her husband's bad things was actually just telling you the grievances and bad things she suffered when getting along with her husband. The next time you chat , you can ask her to let her leave her husband, do you think she will agree? Marriage and love are not as good as you young people think, nor are they so bad. "

Director Jia smiled and shook his head.

What she received happened to be bad information about love and marriage, so she developed marriage and love phobia.

"You're right. I'll ask her another day."

Qiu Hong nodded thoughtfully.

Then he looked at Zhou Can again.

"Do you think being in love is happy?"

"Of course I am happy! When you are with the one you love, you will feel very sweet, peaceful and joyful. Love is one of the most beautiful things in the world, so try it boldly!"

Zhou Can persuaded this highly educated senior sister.

The three chatted for a while, and another patient came in.

An elderly couple walked in with a thin middle-aged man.

The middle-aged man staggered when he walked, his eyes were blurred, his eyes and face were red, and there were traces of blood at the corner of his mouth.

Most of the patients who came to Director Jia for consultation were intractable diseases.

There are very few such emergencies.

"vomit!"

The middle-aged man opened his mouth, and blood spit out from his mouth.

The situation was frightening.

The outpatient clinic can receive all kinds of patients, and both Director Jia and Qiu Hong seem very calm.Only Zhou Can, a novice, felt a little scared.

Hematemesis may indicate upper gastrointestinal bleeding.

Before the man came in, he must have started vomiting blood.No wonder there are traces of blood on the mouth.

The strong smell of alcohol hits the nostrils.

It appears that the middle-aged man vomited blood due to drinking.

Most likely the stomach is bleeding.

Drinking alcohol on an empty stomach, or drinking a lot of hard alcohol, is prone to stomach bleeding.

In addition, drinking alcohol can damage the liver.

In the process of alcohol metabolism, a large amount of reduced coenzyme I can be produced, which can change the redox state in liver cells, inhibit protein, glucose synthesis and gluconeogenesis, and also cause triglycerides to accumulate in the liver, thereby increasing the risk of fatty liver. morbidity.

In addition, a large amount of acetaldehyde can be produced in the process of alcohol metabolism, which can combine with various proteins to form acetaldehyde-protein adducts, which not only directly damages liver cells, but also causes liver cells to be attacked by immune responses , affect the function of liver cells, and then lead to fatty degeneration of liver cells.

In addition to causing serious damage to the liver, drinking alcohol can also damage the brain.

People who often get drunk are prone to various lesions in their brains.

"Director Jia, I beg you to save my son! He drank alone as usual today, and started to vomit blood while drinking. We are just a single seedling, you must find a way Save him."

The old couple are very close to this son's baby.

It is roughly estimated that their son is at least 37 or [-] years old, but they still spoil him like a child of two or three years old.

Habit is like killing a child.

Their son's turn into a drunk had a lot to do with their connivance.

"Have you been checked?"

Director Jia did not dare to be careless when he saw the patient vomiting blood.

Mainly afraid of accidents.

"I haven't done it. We were planning to go to the emergency room. We heard that your medical skills are very good, so we bought a number from the scalper, thinking that we will be more confident in asking you for treatment."

Judging by the clothes of the old couple, they must be from the city.

In order to save their son, they are willing to spend money.

They even asked scalpers to buy Director Jia's consultation number for the day, just to have a doctor with better medical skills to treat their son.

Of course, it is also possible that the scalper deliberately fooled the old couple in order to sell the clinic number in his hand.

"Oh my god, I'm vomiting blood! The condition is so serious, I have to seek medical treatment immediately! Ordinary doctors may not be good at it. If you seek Director Jia from the Department of Digestive Surgery, you will definitely be able to save your son..."

Number dealers are the best at observing words and demeanor.

The mouth is also good at speaking.

After bluffing and frightening, they flattered Director Jia, and the old couple, eager to save their son, obediently paid for the number dealer's scalper number.

Scalpers hoard expert consultation numbers, and sometimes there is a certain risk.

If you don't sell it, won't it be in bad hands?
A special needs expert number is several hundred.

So in the outpatient hall of the hospital and the front door of the hospital, you can always see some number traffickers wandering around looking for targets.

These people are very smart.

Knowing that the hospital cracked down on scalpers, they solicited customers around the hospital entrance under the banner of "accommodation and meals".These people have a specialized way of surviving.

In addition to secretly giving some benefits to hospital security and building good relationships, they will also engage in businesses such as providing temporary accommodation, meals, and car rental for patients and their families.

It is generally difficult to get an expert account in a large hospital.

Especially for patients who come to see a doctor from other places, if they wait an extra day, the various expenses will increase a lot.The illness itself can't afford it.

It became the only choice to obediently find an account dealer to buy a scalper account.

Zhou Can saw with his own eyes a number dealer selling a plus note signed by an expert.With the plus note, the family members of the patient were successfully registered to the expert account of the day.

It can only be said that these people have great supernatural powers.

It is not ruled out that the experts themselves are also involved.

Director Jia briefly asked about the patient's condition, and then did a physical examination.

"He should be bleeding from the upper gastrointestinal tract. I will prescribe five tests for him, blood routine, stool test, liver function, coagulation function and gastroscopy. Take the time to take him to do it. This disease cannot be delayed."

In the patient's condition, the possibility of hospitalization and surgical treatment is extremely high.

Doing these necessary routine checks is also a preparation for hospitalization.

The old couple took their precious son for an examination.

"This patient, I think his disease is not difficult to cure, but the difficulty is to make him stop drinking. This time he is cured, and he will drink again next time."

"If you want to blame, you can only blame his parents. They spoil their children too much."

Qiu Hong answered.

"Isn't it! Being a child is like killing a child. As a parent, relying on your child for everything is tantamount to killing your child."

Because Director Jia is famous, the patient who vomited blood had just left, and a new patient came in.It was the first time for Zhou Can to experience a consultation with an expert, and he felt what it means to be busy.

Every patient comes with different demands. Some of the causes are complicated, while others are more clear.

Director Jia treats every patient very seriously.

Not only can I learn a lot of useful practical knowledge, broaden my horizons, and increase my knowledge by attending the consultation with Director Jia, but also under his influence, I will be more serious and responsible for the diagnosis and treatment work.

Near noon, the patient who had been vomiting blood due to drinking came back from his examination.

The examination results were esophageal and gastric varices and ruptured bleeding.

Director Jia took a gastroscope and checked the results.

"Oh, your blood vessels are already ruptured! Fortunately, the rupture is not too big, so you can try a more conservative treatment method first. First, let him fast for a period of time. Second, reduce the portal pressure treatment, and at the same time give him Appropriate nutritional support can improve liver function. Third, use drugs to increase blood coagulation function. For example, use thrombin or vasopressin."

The patient's symptoms seemed serious, but after the examination, it turned out to be better than expected.

"Doctor, we all listen to you, please treat my son quickly!"

the patient's father urged.

Director Jia had a troubled expression on his face.

"It's safe for him to be hospitalized for this disease. We don't have any beds here! He can't wait for his condition. Why don't you take the diagnosis results to other hospitals that don't have enough beds?"

This patient should actually see a gastroenterologist.

The beds on the surgical side are too tight.

Many surgical patients are waiting for beds to come out. As a non-surgical patient, it is difficult to arrange beds.

This is basically the case in well-known large hospitals.

The beds are seriously tight, and some minor illnesses can only be pushed to the outer courtyard.

"Director Jia, please help me find a solution! My son has been vomiting blood until now, and we have to register and wait for him to go to another hospital. We are afraid of accidents!"

The patient's mother was about to kneel down.

Zhou Can's eyes were quick and his hands were quick, so he quickly helped her up.

"Let me ask you first! If it is really not possible, the beds in the Provincial People's Hospital are not so tight, and the medical skills there are also very good. You can go there for hospitalization."

After Director Jia finished speaking, he asked Qiuhong to call the inpatient department.

Qiu Hong called, "Hi, may I ask, can the inpatient department arrange a bed now? Here is a patient who vomits blood and needs to be hospitalized urgently."

There should be an answer that there are no beds.

Qiu Hong continued, "Can you help me find a solution? The patient's condition is very urgent."

Soon, she ended the call with some disappointment.

"There are no beds in the inpatient department right now. If it is really urgent, they suggest that patients wait to see if there are any beds available tomorrow. Then call to inform."

This is also the most common practice.

There are only so many beds in the Department of Gastroenterology, and they are already full of patients. Only when the patients are discharged, will there be beds vacant.

Hospitals generally let these patients who need hospital treatment leave their phone numbers, and then wait in line for beds.

It is usually in the morning to go through the discharge procedures.

That's why patients are asked to wait until tomorrow to see.

"He's been vomiting blood. It's too risky to wait until tomorrow morning." Director Jia looked embarrassed.

In many cases, what makes doctors difficult is not how to treat the disease, but the lack of beds.

"Director Jia, do you think it is possible to let him go directly to the emergency department for treatment? He can stay in the observation area of ​​the emergency department for one night." Zhou Can has been trained in the emergency department for three months and has a better understanding of the situation there.

In fact, this patient should not be registered as an expert with special needs.It is just a common disease in itself, and even an ordinary attending physician in gastroenterology or surgery can take care of this disease.

Also, for an emergency like his, he can often receive treatment in the shortest time by going to the emergency room.

If you go to the outpatient clinic, just queuing up for the examination is already exhausting.

The patient was able to complete the examination so quickly, it is estimated that his parents did not cut the queue with him.

After all, vomiting blood is really scary to look at, which is a good excuse to jump in line.

"Yes, yes, it is a good way to go to the emergency room."

After listening to Director Jia, he felt that Zhou Can's suggestion was quite good.

"Zhou Can, are you familiar with the emergency department?"

Director Jia knew that Zhou Can was from the emergency department.

"I should be able to get this done by taking them there!"

Zhou Can didn't dare to talk too much.

It has been more than a year since he came out of the emergency department. Because he was too busy, he almost never went back to the emergency department.

The only way to do this is to call or send messages to Dr. Xu, Director Lou, Qiao Yu and others during the holidays to say greetings and blessings.

Director Lou, Chief Physician Han Changqing, Dr. Xu and others will definitely buy him.

Ordinary doctors and nurses are not so easy to say.

Because they have been away for too long, and they don't know about Zhou Can's brilliant achievements in other departments.It is inevitable that people will leave the tea to cool down.

When the family members of the patient heard that Zhou Can was able to help their son get the hospitalization, it was as if they had grasped the life-saving straw, and thanked Zhou Can a thousand times.

Zhou Can led them to the emergency department.

Arriving in the waiting corridor outside the emergency department, Zhou Can felt a little 'nearly homely'.

Once, here are all familiar people and things.

More than a year ago, he embarked on a journey to study surgical training with the high hopes of Director Lou, Deputy Director Han, Dr. Xu and others.

Originally, he planned to return from his studies in two years and nine months, and start a drastic career in the emergency department.

Now it is only half of the regular training, and even the surgical training has not been completed. In fact, he does not want to go back to the emergency department at this time.

Even if he just came here and left soon, he was unwilling.

Deep in his bones, Zhou Can is a person with very strong self-esteem.

He promised Director Lou, Dr. Xu and others at the beginning, and he hoped to come back after finishing his studies.

"Wow, Doctor Zhou, it's really you! I haven't seen you for more than a year! I don't usually come back to sit around."

Ye Tingting is literally everywhere.

Her eyes were also sharp, and she spotted Zhou Can at a glance.

"Hello, Miss Ting! I'm busy, I don't have time to come back and sit around! I haven't seen you for more than a year, and you are still so beautiful, you haven't changed at all."

Zhou Can responded with a smile.

Back in the emergency department, Ye Tingting had a good relationship with him.

"You brought them this is?"

Ye Tingting looked at the patients and their families behind Zhou Can.

"There is no bed in the digestive surgery department. I will bring the patient here to see if he can be treated first in the emergency observation area." Zhou Can explained with a smile.

"Are you relative or acquaintance?"

Ye Tingting felt that if Zhou Can could bring her here for treatment in person, it must be the kind of treatment that only relatives or acquaintances would have.

"No, it's just an ordinary patient in the Department of Digestive Surgery. He caused esophageal and gastric varices and their rupture and bleeding due to alcohol. There is no way to wait for this disease. I volunteered to bring them here."

"Understood. Give me the information, and I will talk to Dr. Ai Li who is in the clinic."

Ye Tingting is quite enthusiastic.

She is only a nurse in the observation area, and has no right to decide whether patients should be observed for treatment.This has to be done with a doctor.

At this time, Dr. Lin in the operating room should have just returned from the cafeteria after lunch.

Seeing Zhou Can, he hurried over to say hello.

"Zhou Can, Dr. Zhou! But I haven't seen you for a while, how is it going? Is it going well?" Dr. Lin enthusiastically asked about Zhou Can's recent situation.

"Thank you for your concern. My regular training is going well. How about you, after more than a year of development, it must be good!"

Zhou Can remembered that when he left, the operating room of the emergency department started a competition mechanism.

Dr. Lin, who is mediocrely talented, and Dr. Lu, who is just dawdling, are at risk of being eliminated.

"Oh, don't mention it. It's not that you don't know my talent. I haven't slept before one o'clock in the morning this year. I've been practicing the basic skills of surgery every day, and I've stayed here for the time being."

When Dr. Lin talked about this, his stomach was full of bitterness.

"Hehe, if you stay, you will have a chance. I believe you will definitely develop better and better."

Zhou Can was really happy for him.

Although Dr. Lin has various flaws, no one is perfect. We have been together for so long, and there must be some feelings.

"Dr. Xu should miss you very much. Whenever our operation is not making obvious progress or making mistakes, he will often say how good Zhou Can is in front of us. I will go and tell Dr. Xu, and it happens to be time for him to go to dinner. .”

After Dr. Lin finished speaking, he walked quickly to the operating room without waiting for Zhou Can to agree.

　Thank you book friend Echo for your support!

　　
　
(End of this chapter)