My medical skills add experience

Chapter 441 Beware of neonatal sepsis, there is no real fairness at all
"It's better to let the nurse call the number directly in order!"

After Zhou Can finished speaking, he ignored the woman and went directly into the consulting room.

The guiding nurse was still Zhou Yanqing, who was an old acquaintance with Zhou Can.

It's not been a day or two since the two of them cooperated. She could understand it with just one look from Zhou Can.

"Number 1, Tang Juxiang!"

"It's us, it's us!"

A young woman resting on a bench hurriedly picked up her child and entered the No. 17 outpatient room.

At this moment, none of the family members would speak up for that shrew who scolded the street.The common people have a good reputation in their hearts. Although everyone doesn't say it, they can see it in their eyes and keep it in their hearts.

Everyone's sympathy is not so easy to use.

"Doctor Zhou, please help me find out, the child suddenly stopped taking milk for some reason."

The woman's husband and family members were not accompanied.

Judging by her attire, her economic conditions should not be bad.

"The child looks quite small, isn't it not long after birth?"

Zhou Can began to observe the condition of the child.

I saw the child's pale complexion, cyanosis around the mouth, and irregular breathing. This symptom is very similar to neonatal jaundice.The disease itself is also a high incidence.

"Today is exactly 21 days old, and it's not yet full moon! Since yesterday, he hasn't been breastfeeding much, and he seems very restless, crying all the time, and has a very bad temper."

The woman described the child's condition.

"Is it breastfeeding or feeding milk?"

"I have been breastfeeding since I was born. At the beginning, I was worried about the lack of milk. The confinement lady who hired seemed to be very professional. She made me some food such as pig's trotter soup and boiled eggs with rice wine. The milk became more and more abundant. My child After eating, sometimes there is still some leftover, and I feel bloated and painful. But since yesterday morning, when breastfeeding, the baby seemed a little resistant. The confinement sister told me to take the baby to the hospital for an examination."

The woman looked at the baby in her arms, full of the radiance of maternal love.

The greatness of a mother's love begins from the moment she conceives a child.After the tenth month of pregnancy, the burden of maternal love will not only not be relieved, but will also increase.Need to put the baby to sleep, breastfeed, clean up the poop...

This woman can afford a confinement wife, which shows that her economic conditions are good.

Because the confinement sister-in-law these days starts at least five thousand.Better yet, the gimmick of a gold-medal confinement lady is very common, asking for more than [-] yuan.

"Do you and the confinement wife take care of the children together?"

"Yup!"

"Does your family help take care of it together? Such as parents, mother-in-law, husband."

"Why do you ask this? It doesn't seem to have anything to do with the illness!"

Her words flickered and she refused to answer.

"Don't get me wrong, I just want to rule out possible problems in the process of raising the child." Since the family members were unwilling to answer, Zhou Can didn't question them any more.

These days, some women give birth to a child, maybe she is just a mistress.

An illegitimate child cannot see the light, and the identity of the child's father must be tightly covered.

"I don't think the child's spirit is very good. Even if he hasn't eaten for a day, it shouldn't be like this. Is there any water?" Zhou Can asked.

"There is water, but he doesn't drink much."

"While breastfeeding, does the baby have a strong suck?"

"It's much weaker than usual and looks weak."

"Have you had a bowel movement? Have you had diarrhea?"

"I have diarrhea. It seems that I have been having diarrhea since the third day of birth. The confinement wife told me that this is a normal phenomenon. When the child is a little older and the stomach is full, it will no longer have diarrhea."

"How is the baby's sleep?"

"Especially easy to wake up. Crying at every turn, especially at night. Last night, almost every once in a while, there was a fuss, punching and kicking, and crying hard. No matter how coaxed, I couldn't coax her."

"Is it like this before?"

"No, it's from the night before yesterday. But the night before yesterday was fine."

……

After Zhou Can asked about the basic situation and medical history of the child, he took the child's temperature, which was normal.

When the child's abdomen is examined, the abdomen is obviously hard.

Indicates the presence of abdominal distension.

"Let's do two tests first! If the child has urination or stool, you can take some for laboratory tests. For the time being, first check the three major routines. After the results come out, you can come to the outpatient room to see me for further diagnosis."

Zhou Can quickly opened the inspection application.

The three major routines are sometimes basically mandatory items.

"Doctor Zhou, I heard from a friend that your medical skills are very good, your medical ethics are noble, and you are very responsible for the patient's condition, so I specifically registered your number. Is my son's condition serious? Could it be that he was injured at night? A minor problem like a cold?"

When the woman said this, she naturally wanted to get closer to Zhou Can.

"Well... It's hard to say for the time being. But according to some of the child's current symptoms, it may not be optimistic, and you must not delay. In fact, you should take the child to the hospital as soon as possible yesterday. Babies are not like adults. They The progress of the disease is particularly rapid, and the tolerance is much weaker. The various systems of the body are not fully developed, and they will be relatively more vulnerable."

Zhou Can was originally unwilling to say these serious words.

Seeing that the young mother didn't seem to pay too much attention to the child's condition, he had to remind her.

"It's all right? What can I do? I was hesitating whether to come to the hospital yesterday. It's all my fault. What can I do!" After hearing this, the woman really became anxious.

"Go for an examination first! You are in the first place, and the blood test results should be available within two hours at most. If it's just neonatal jaundice, it's better to treat it. I'm afraid it's troublesome if it's neonatal sepsis. Therefore, blood After the test results come out, you must come to me in time without delay. In addition, try not to feed your child other food except breastfeeding and water feeding."

According to Zhou Can's personal diagnosis experience, he highly suspected that this child was likely to have neonatal sepsis.

The disease is usually most susceptible to infants within three days to half a month.

It took 21 days for the child to develop the disease, so the resistance should be considered good.Or the disease has already occurred, but the mother of the child is not alert.

Neonatal sepsis is a systemic infectious disease caused by bacteria invading the blood circulation.

Because the central nervous system of newborns is immature, the body’s reaction is low and weak, the skin, mucous membrane and gastrointestinal tract defense ability is low, and the local lymph nodes are highly permeable to bacteria, the infection focus cannot be confined to a relatively small range.

Instead, it spreads rapidly and eventually becomes sepsis.

At present, the child's mental state is very poor, coupled with the lack of food all day and night, Zhou Can is very worried.

In the face of a terrible disease, a fresh life is very easy to lose.

According to Zhou Can's instructions, the woman hurriedly took the child for an examination.

Zhou Can really wanted to ask why the child's father didn't come?
Because this woman has just given birth 21 days ago, and her body is still in the recovery period. Running around with the baby in her arms is very likely to have some adverse effects on her body.Even leaving the so-called confinement disease.

Since ancient times, Huaxia has had the habit of confinement to recuperate.

This is by no means the squeamishness of Chinese women, but the medical wisdom of the nation.It is also a manifestation of the heritage of traditional Chinese medicine.

Foreign women do not have these rules.

They think that there is no need for confinement, and they dare to bathe in various ways after giving birth, eat and drink without taboos, etc.It is even popular to give birth in water now.It can only be said that the benevolent see benevolence, and the wise see wisdom.

The puerpera who has just given birth is deficient in both qi and blood. Even though foreign women and Chinese women have different immune mechanisms, such a tossing of the body will leave confinement disease, which is often accompanied for life.

The pain and bitterness in it can only be experienced by themselves.

One patient after another, Zhou Can's processing speed is faster.When encountering some difficult cases, he often needs to spend a long time on careful investigation and comprehensive research and judgment.It is even necessary to consult with pediatric experts to discuss the condition.

Generally speaking, his recovery rate is very high, whether it is a common disease or a difficult and miscellaneous disease, the cure rate has always been high.

At present, he has been in pediatrics for about two years. In the first year, his CMI value reached 3.2.

You should know that the CMI value of many chief physicians in pediatrics is only about 1.5.

The powerful ones are naturally very powerful, and some even reached above 6.0.

The Cmi value refers to the case mix index, which is internationally recognized to represent the technical difficulty of the hospital in treating diseases and the comprehensive ability to treat difficult and severe diseases. The higher the Cmi value, the more serious the disease and it is not easy to cure.

This is even directly linked to the amount of prepaid medical insurance that the hospital can obtain.

Moreover, the country is currently paying more and more attention to the CMI value of doctors, which directly reflects the level of a doctor's medical skills.

If ordinary doctors usually treat ordinary cases, the CMI value will naturally be very low.

This year's CMI value has not yet come out, and Zhou Can estimates that it will be no problem to reach above 4.0 this year.

This is also because he participated in the treatment of many diseases, especially when performing major operations, as a medical assistant.If he is directly asked to complete the consultation as the chief surgeon, as well as the consultation of some difficult cases, if he is the chief physician, the CMI value will be frighteningly high.

In terms of real strength, he should not be inferior to some of the 'big bulls' in this academy.

Of course, this is not to say that his medical skills have reached the top level, but a more objective evaluation.

His medical skills still have a lot of room for improvement.

Whether it is academically or clinically, it is far from reaching its peak.

Most first-level directors and top experts say that medicine is never-ending.The more I learn, the more I feel that medicine is boundless.

Human cognition and research on the human body are at best superficial.

The woman with the child's broken left arm was soon in the consulting room.

Because Zhou Can didn't agree to let her jump in the queue and give priority to seeing a doctor, she could feel a hint of hostility in her.

After entering, the woman put on a pitiful face again.

"Doctor Zhou, my family's economic conditions are not good. I have three children. Your medical skills are so good and your heart is kind. Can you try to save some medical expenses for my children?"

As she spoke, the woman squeezed out two tears and began to wipe them away.

If you were a novice doctor, seeing this situation, most of them would be overwhelmed with sympathy and try their best to meet this person's requirements.

Especially in pediatrics, many doctors are women.

They are more likely to soften their hearts than male doctors.

"It's really not easy to raise three children. Don't worry, I will help you save what you can."

Zhou Can is now considered an old fritter.

The answer was watertight.

He has rich experience in dealing with all kinds of difficult family members.

In case he really encounters the kind of family members who cry, make trouble, hang themselves, hob meat, and play tricks, sometimes he can't stand it.

But it doesn't matter, Director Tang Fei of the Department of Pediatrics has a good relationship with the Security Department.

Several times, when encountering family members who deliberately caused trouble, the security department quickly dispatched and directly controlled the person.

It must be said that the security guards in the security department belong to the employees recruited by the hospital, not the police, and they have no law enforcement power.

But when in danger, people can be controlled.

Security security, security is the safety of one side.On one-third of an acre of land in the hospital, security guards have great freedom to act freely.The family members are carrying sharp knives in the hospital to kill people. In this case, the most capable people from the security department will usually be dispatched.

They are also known as riot squads.

Armed with steel forks, shields, electric batons and other weapons, they greeted the assailants directly.

In this case, as long as people are not killed, basically they will not keep their hands.

Another point is that if a certain department or a certain doctor or nurse offends the head of the security department, when something happens, they will often wait until the angry family members beat the doctor or nurse before they come forward.

And even if they arrived at the scene in time, they would still watch the show with their sleeves rolled up.

Therefore, the water in the hospital is very deep.

The logistics staff should try their best not to offend if they can.There are quite a few support staff, most likely related households, and you never know who is standing behind them.

One more thing, Zhou Can has heard a colleague complain that most of the hospital's staffing is provided by logistics or other related parties.

At that time, he didn't understand that the educational background of the support staff was generally low, and their contribution to the hospital was beyond words.

Why are these people able to snatch the extremely limited number of establishments?

Later, when I inquired about it, it was an eye-opener.

An unemployed youth in society, commonly known as street sneaker, he has a beautiful younger sister.One day, his younger sister fell in love with a rich young man.The two talked about love.

Not long after, his younger sister revealed that the son-in-law she was in love with was the son-in-law of the vice president of a certain hospital.

After hearing this, the brother of the homeless man immediately became active.

I've been wandering around on the street every day, and even keeping warm is a problem.I heard that the big hospital is a money-absorbing monster, and there are millions or tens of millions of accounts every day.If you get a job in the hospital, isn't it like picking up money every day?
Ever since, the elder brother begged his younger sister to help him find a way.

The younger sister sees her brother fooling around in society with a bunch of cronies all day long, and her parents can't control her at all. She's already in her thirties and hasn't married yet.She thinks it is a good thing to help her brother find a decent job.

It can also save parents from worrying a little bit.

At the same time, the deputy dean's brother was chasing her passionately and was fascinated by her, so she took the opportunity to talk about it.

In order to win the heart of a beautiful woman, the son-in-law is very forthright.

The future uncle wants to find a job in the hospital, isn't that difficult?
Just go to the vice president's father directly.

After questioning, my uncle is really 'excellent', basically a product of the social three nos.If you want education but no education, you need ability but no ability, you are too lazy.

These days, hospital recruitment basically starts with undergraduates.

If you are applying for a doctor, you should start with a master's degree.

How did this kind of "three no products" get into such a high-ranking unit as a doctor?
This can't trouble the son's father.The deputy dean has a big brain.

Firstly, the "three non-products" were brought into the hospital into the security department as security guards by way of business outsourcing.After working for two years, I became a personnel agency and had an official status.

Finally, divide the establishment into one for this 'three no products'.

After some coquettish manipulations, a street slut became a full-time employee of the hospital directly, and obtained a quota of establishments that made countless postgraduates, masters and even doctoral students overwhelmed.

Just to ask, is it not sad to see a street guy who has not graduated from elementary school and get a solid job in the hospital, while those doctors who have worked hard for more than 20 years and worked hard in the clinical frontline are not as good as a street guy?

Although this kind of thing is only a case in Tuya Hospital, it is basically a common phenomenon in various hospitals.

(End of this chapter)