My medical skills add experience

Chapter 479 Strange pregnant woman with fetal heartbeat but no image

"Doctor Zhou, does my brother need a thoracotomy?"

The patient's younger sister could only half-understand it, and she was full of worries about her brother's treatment.

The family background is not good, she has just graduated and is an intern in a company.

The probationary period has not even passed, and the salary received in one month is pitifully low.Most of the bosses who are a little bit unscrupulous now set up an internship period of more than three months.The longest can even reach more than one year.

There is no bonus for interns, and only the minimum basic salary every month, which is basically a consensus.

Just because the labor cost is much lower than regular employees, no matter the hospital or other units, they especially like to have a long internship period.

The darkest should be the hospital, where you will do a one-year internship and do free white labor.

It even needs to pay back money to the hospital.

For the next three years of regular training, there is only the minimum basic salary.

A large number of undergraduates and graduate students have been used as cheap labor for more than four years.

"Judging from the patient's current postoperative performance, he should be quite optimistic. But no one can predict what the final result will be." Zhou Can's answer is basically a doctor's standard speech.

Give hope to patients and family members first, and then tell family members and patients that the final result is unknown.

……

After seeing the patient from the cardiothoracic surgery department, he returned to the emergency department. He had just arrived in the lobby when he was stopped by Dr. Xie at the triage desk.

"Doctor Zhou, Doctor Zhou, this pregnant woman was unfortunately involved in a car accident and was seriously injured. Please help me find out what to do!"

Zhou Can raised his eyes to look over, and found that he went to the cardiothoracic surgery department for a while, and unexpectedly sent several victims of car accidents.In the emergency room, doctors and nurses rushed in and out, and the seriously injured patients may have been sent in first for rescue.

Pregnant women are injured and very tricky.

The pregnant woman seemed to be seriously injured, with blood on her body and her belly swollen high.At least eight or nine months of fetus.

Zhou Can is not good at obstetrics.

Whether the child needs to be cut out first must be evaluated by a specialist in obstetrics and gynecology.

"Have you checked your basic signs?"

"The body temperature, blood pressure, heart rate, and respiration have all been measured. The blood pressure is a bit high, the heart rate is too fast, shortness of breath, and everything else is normal. After preliminary examination, her right leg is probably broken, and there is bleeding in the lower body. There were abrasions to varying degrees on the right shoulder and right arm. There were obvious bruises and hematoma on the forehead."

Dr. Xie only did the most preliminary examination.

This is also a common problem of many novice doctors, who only follow the textbook procedures.

Experienced old doctors will have clear and targeted questions when asking patients and performing various examinations.

"Has the fetal heart rate been measured?"

"No! But I listened to it with a stethoscope, and it seemed normal."

Doctor Xie said after hesitating for a few seconds.

"Let's do an abdominal ultrasound first! Now give her a blood test! The right leg will definitely need an X-ray. If there is dizziness, headache, or loss of consciousness, it is best to have a head CT."

Zhou Can gave Dr. Xie some guidance.

"Her lower body is bleeding, let's just ignore it?"

When Dr. Xie asked this question, he was worried about the child in the pregnant woman's womb.

"We must first do a B-ultrasound to clarify the situation in the abdominal cavity before proceeding to the next step of diagnosis and treatment. The blood test must be done quickly. In the future, when such patients are admitted, the first thing to do is to do a blood test. In case it is Xiaomei or the like, we can promptly Find out. In addition, the wounded is bleeding, and her blood type can be known in time if she needs a blood transfusion."

Zhou Can's Xiaomei was syphilis.

Clinical front-line nurses should be most afraid of people infected with syphilis and AIDS.

In front of the patients, the doctors and nurses spoke in code words.

The main purpose is to avoid arousing resentment from patients and to avoid disputes between doctors and patients.

"By the way, quickly invite a specialist in obstetrics and gynecology for consultation."

After speaking, Zhou Can walked directly towards the operating room.

With his director-level hemostasis, when he observed the patient just now, he could basically conclude that the bleeding was not as serious as imagined.It should not be life-threatening for a short time.

There is another thing that makes him particularly puzzled.

When looking at the face of this pregnant woman, there is no pregnancy appearance.Usually, after a woman is pregnant, she will be affected by estrogen in her body and her appearance will become ugly.Thus, the unique appearance of pregnancy appears.

But this female patient did not have such characteristics.

Also, he asked Dr. Xie to check the blood routine of the pregnant woman first, because he always felt that the patient was not like an ordinary patient with the director-level hemostasis technique and the fifth-level pathological diagnosis technique.

Various special patients are often encountered clinically.

Among them, patients with syphilis and AIDS are the most common.

Even if such people are professional doctors and nurses, sometimes it is difficult to tell from their appearance that they have an infectious disease.

……

In the operating room, Zhou Can had just finished three operations. Dr. Xie came here to send a message to Ma Xiaolan, asking her to tell Zhou Can that the pregnant woman was indeed a carrier of both syphilis and AIDS after examination.

Three of the wounded who were brought in with the pregnant woman were later found to be infected with both viruses.

The doctors and nurses in the emergency room were frightened into a cold sweat.

Because the wounded they rescued was one of the three.

Blood transmission is one of the most dangerous routes of infection.

When rescuing the patient, the doctors and nurses didn't think too much about it. At that time, various first aid operations inevitably came into contact with the patient's blood.No one was wearing any protective equipment, not even the simplest pair of rubber gloves.

The other three infected people are all men, they are the boss of the pregnant woman, her current boyfriend, and a male colleague.

It is said that the pregnant woman's current boyfriend turned green on the spot when he heard the news.

What made him angry was not that he was infected with syphilis and AIDS, but that his boss and male colleagues were also infected.You know, whether it is syphilis or AIDS, ordinary physical contact will not cause infection at all.

Often only contact with the patient's body fluids is prone to infection.

Moreover, when the body surface skin such as hands comes into contact with the patient's body fluids, as long as the skin is not broken, infection will not occur.The skin is the first line of defense in our human immune system, and it is much more powerful than imagined.

Almost 99.9% of bacteria and viruses can be kept out of the body by this barrier.

Therefore, it cannot be a coincidence that the pregnant woman's boss and another male colleague were also infected with syphilis and AIDS.It must have been infected by pregnant women.

As long as you are not a fool, you will understand how it is infected.

After a few minutes, a message came in from outside, asking Zhou Can to go out and help with the consultation.

Zhou Can quickly debrided and stopped the bleeding of the surgical patient on the stage, and then handed it over to medical assistant Yang Zhi to suture the patient.

In many operations, he will deliberately leave some opportunities for surgical training to Yang Zhi.

Sometimes it will guide Yang Zhi's deficiencies in the operation and make mistakes in the operation.Of course, this kind of thing is usually said by the patient after leaving the operating room.

Yang Zhi lived up to his high expectations, growing very fast, coupled with his already good surgical skills, he is now able to relieve Zhou Can's worries in many situations.

After Zhou Can handed the patient over to Yang Zhi, he went outside to help consult the patient with peace of mind.

"Where is the patient? What is the condition?"

As he walked, he asked the nurse who had come to fetch him.

"It's the pregnant woman infected with Xiaomei and Xiaoai. Her abdominal B-ultrasound is abnormal. Dr. Yang from the Obstetrics and Gynecology Department would like to ask you to help with the consultation."

While talking, the two had arrived at the emergency room.

Zhou Can saw a pretty figure standing there, it was none other than his college classmate Yang Chan.

Like Zhou Can, she is now a full-time resident doctor.

"Hello squad leader!"

Zhou Can bit the bullet and stepped forward to say hello.

He is actually a little scared to see Yang Chan now.Because the look in her eyes when she looked at Zhou Can was very hot.

This is not a good thing.

If Zhou Can doesn't have a girlfriend, that's okay.

Yang Chan's appearance is beautiful, and her medical skills are also quite outstanding.I heard that she has passed the postgraduate entrance examination and is currently a postgraduate student.

She is already ahead of Zhou Can in terms of education improvement.

"Zhou Can, this pregnant woman's B-ultrasound is very strange, please help me with my advice!"

She basically calls Zhou Can by his first name.

Compared with others calling him Dr. Zhou, calling him by his name seems more closely related.

After receiving the patient's checklist, Zhou Can was stunned.

Only a large fuzzy gestational sac can be seen on the B-ultrasound sheet, but the fetus cannot be seen at all.It stands to reason that with such a big belly of a pregnant woman, even the rotten ultrasound equipment can detect the fetus and show the specific appearance of the fetus.

When Zhou Can saw the pregnant woman for the first time, he felt that the pregnant woman did not look pregnant.

Visible stretch marks can be seen on her belly though.

As for whether there are stretch marks on the thighs and groin, Zhou Can did not check.

Be especially careful when examining female patients.

Watching indiscriminately is easy to be beaten by family members.

"Can you hear me clearly?"

Zhou Can asked about the pregnant woman.

"can!"

The voice of a pregnant woman is sweet and waxy, which can touch a man's heart.

Zhou Can thought to herself, no wonder her boss and her male colleagues are getting tricked.If it is not a man with strong willpower, if he gets in touch with her more at work and she is more casual, few people can clean themselves up.

"How long have you been pregnant?"

"Uh... probably more than eight months!"

"It should be nine months and more than two days." A middle-aged man with an angry expression next to him was lying on a flat bed. It seemed that his lumbar spine had been injured and he was unable to move.

"Who are you from her?"

"Boy friend!"

It turned out that this man was the pregnant woman's wronged boyfriend.

"You remember it very clearly! Your lumbar spine seems to be seriously injured. You need to get someone to send you to orthopedic surgery."

Zhou Can sympathized with this man.

He can clearly remember the pregnant woman's pregnancy time, which shows that he cares about the relationship between the two very much.

It's just that the top of the head is green at the moment, I'm afraid it's uncomfortable.

"We have contacted the orthopedic surgery department for him, but he refuses to go there and wants to stay here with his girlfriend." The nurse explained beside him.

"The lumbar spine injury needs to be treated quickly. What if it takes too long and becomes paralyzed?"

Zhou Can persuaded this wronged man.

"I have to see that she and the baby in my stomach are safe before I go to the orthopedic department for treatment. Don't worry about me, please help her treat quickly!"

The man is an infatuated species.

Zhou Can stopped persuading her, and turned her gaze back to the pregnant woman.

"Squad leader, have you measured her fetal heart rate?"

Zhou Can asked Yang Chan.

Although Dr. Xie has measured the fetal heart rate of the patient, he is not professional.

For the novice doctor, Zhou Can is not at ease.

In particular, the situation of this pregnant woman is extremely strange. A large gestational sac can be seen, but the fetus cannot be seen.

"This is exactly what puzzled me the most. The fetal heart rate was clear and normal."

Yang Chan probably also encountered such a wicked thing for the first time.

The hairs on Zhou Can's back stand on end. He is an atheist.Such a bizarre thing is enough to make him wonder if there really are 'ghost fetuses' in this world?
Nezha fetus appeared in ancient myths and novels.

B-ultrasound can't see the fetus, but it can detect the fetal heart rate, and the pregnant woman's belly is no different from that of eight or nine months old.

"Ms. Lu, give me a pair of rubber gloves."

"Give!"

It's already prepared by the side.

After all, everyone already knows that this pregnant woman is infected with syphilis and AIDS, so we must take precautions.

To be honest, if you are infected with one of the two viruses alone, it is also possible that the patient is unfortunately infected by the other half.Or when you are stealing fish outside, you are unfortunately caught.

Infected with two viruses at the same time like this, this woman must have a bad life style.

Adults' private lives are chaotic, and no one can control them.But for men and women who do not love themselves, syphilis and AIDS are definitely their nightmares.

Zhou Can put on the rubber gloves, and lifted up the pregnant woman's blouse, revealing her round belly.

Then touch the belly with your hands.

There are two purposes of doing this, to see if the fetus can be touched, and to check whether there is fetal movement.

"Well……"

When he tried to touch the pregnant woman's abdomen for further examination, he felt an obvious fetal passage.It looks like a mouse is swimming past under the palm.

Fetal movement and fetal heart rate were present, but the fetus could not be seen by B-ultrasound.

Could it be that B is out of question?
This possibility cannot be ruled out.

But Tuya's ultrasound examination department has a strict inspection system. If something goes wrong with the B-ultrasound machine, it would have been discovered long ago during the examination of other patients.

Where will the problem be?

Zhou Can didn't know how to judge for a while.

When the pregnant woman's belly is slightly pressed, it is quite soft, and there is no sign of the fetus at all.

The belly in the third trimester feels very leathery, and you can even feel the outline of the fetus.

"What is the fetal heart rate?"

He asked Yang Chan.

"109 beats/min."

Hearing this result, Zhou Can was slightly taken aback, and then took the patient's medical record.When Dr. Xie received the consultation, the heart rate measured for the pregnant woman was 110 beats per minute.Now the fetal heart rate is almost the same value.

Is it a coincidence or is there a close relationship between the two?

A normal heart rate for an adult should be between 60 and 100 beats per minute.Some eminent monks and Taoist priests who have been meditating for a long time have a much slower heart rate than ordinary people.

The pregnant woman's heart rate reaches 110 beats per minute, which is obviously too fast.

The normal heart rate of a fetus is generally between 110 and 160 beats per minute.The pregnant woman's fetal heart rate was 109, barely qualified.

"Squad leader, measure her fetal heart rate again, and I will measure the pregnant woman's heart rate! We will do it at the same time. Teacher Lu, please help us start."

"Ah... ok, ok, no problem."

Nurse Lu was stunned for a moment, then agreed.

Yang Chan didn't understand Zhou Can's intention at first, but she still instinctively agreed.

"start!"

After the two were ready, Nurse Lu waved her hands and gave orders.

Those who didn't know thought that a competition was being held here.

While measuring the fetal heart rate, Yang Chan was thinking about Zhou Can's intentions.Immediately, his eyes brightened slightly, as if he understood a little.

Soon, the measurement is over.

The pregnant woman's fetal heart rate is 112 beats per minute, and the fetal heart rate is also 112 beats per minute.

Seeing this result, the doctors and nurses present were shocked.

(End of this chapter)