Since 1981 Health School

  Chapter 510 Small fishbone is also very dangerous

  Lan Lijuan saw that Director Tang had a positive attitude and was willing to get closer to her husband, so she quickly flattered the old director:

   "Director Tang is on the job, we are absolutely assured, thank you so much."

  Director Tang was also very satisfied with the polite and respectful attitude of the young couple, so he worked very seriously.

  After putting on the reflector on the head, take out the special dental tools from the box and check them carefully.

   At this time, all the people around gathered around, the answer to the mystery was about to be revealed, and even the family members of the patient were eager to know the final answer.

   About 3 minutes later, Director Tang picked up the tool and said cheerfully:

"Dean Chen, this is really a tooth problem. You see, the patient's tooth is a little loose, accompanied by continuous bleeding from the gums, and local redness, swelling and oozing blood. If all the bleeding is swallowed, black stools will also appear. .”

  The onlookers made a voice of sudden realization at the same time: "Oh~~~"

  Chen Qi looked at the middle-aged woman patient and asked:

   "Sister, did your teeth bleed a few days ago?"

  The patient nodded in embarrassment:

   "I have been bleeding for the past few days. Sometimes I spit out the blood when there is too much blood, and sometimes I just swallow it before I have time to vomit. Doctor, am I okay?"

  As soon as the patient said this, the little doctors and interns next to him played the role of Xiaomengxin again, talking all of a sudden

"OMG."

   "Is the patient vomiting blood caused by bleeding gums?"

   "We always thought it was gastrointestinal bleeding. After a long period of gastroscopy, we couldn't find the problem. The more we did it, the more nervous we became."

  Qi Damin's heart skipped a beat, wondering if there would be such a **** thing? Gastrointestinal bleeding for a long time is bleeding gums?

  Liu Huichun breathed a long sigh of relief, and at the same time glanced at Qi Damin, who was beside him with a livid face, and snorted coldly in his heart:

   "The dean didn't cooperate on the first day of work, so you just wait to wear small shoes."

   After Chen Qi pulled out the gastroscope completely, he handed it over to the head nurse at the side. After regaining his confidence, he straightened his back again.

   "Combined with the previous colonoscopy and gastroscopy examinations, all were normal. Now we can preliminarily confirm that the black stools and hematemesis caused by bleeding gums are not actually hematemesis. It should be called hematemesis, right?

   You see, this shows that when we usually do physical examinations and laboratory examinations, we must be careful and conscientious, and we can’t just stare at the lesion you think of. What if it is not? Then we were in a hurry, so our vision and pattern had to be enlarged.

  Finally, we still want to thank Director Tang for his wonderful action. Look at the old director who took the initiative and solved the disease that we could not solve in two days in three minutes. This shows that we still need to learn more from the old director. "

  Everyone nodded to Director Tang.

  Director Tang waved his hands again and again: "Our dentistry is a small department, unlike your gastroenterology department, which is a trump card of our People's Hospital. We learn from each other and learn from each other."

  The ward rounds will continue. Director Wang signed the consultation form at this time and went back happily.

  Some people are happy, some people are not. Wang Fang stood there almost crying.

  Because she is a doctor in charge of the bed, she also performed the first gastroscopy, and now she is the first person responsible for the "misdiagnosis".

   Moreover, she also judged a simple "vomiting blood" as "vomiting blood", which misled the direction of follow-up treatment and examination.

   Then what Dean Chen said just now, to her ears, came from the dean's beating, and it was the dean's dissatisfaction with her clinical level.

  The key point is that this kind of oolong happened on the first day of the new dean's tenure. Thinking of this, Wang Fang has a sense of frustration about the gloomy future.

  At this time, Chen Qi also saw the little girl with a mournful face and a red nose, and couldn't bear it, so he said a few more words of comfort:

"As doctors, we are not always right. Mistakes are inevitable. But if we make mistakes, we can find the correct cause of the disease immediately and help patients solve the disease in time. This is the most important thing. Don't blame yourself. I am the dean. I didn't criticize you, why did you cry first?"

  Hehehe, there was a burst of light laughter in the ward.

   A dean like Chen Qi is really rare. If you meet other deans or department heads, you will definitely be scolded bloody.

   If you don’t believe me, ask the students of Professor Wu Mengchao how they spend their days.

  The atmosphere in the ward suddenly relaxed, the cause of the disease was found, and the patient and family members were quite satisfied, thanking Chen Qi in a hurry.

   "Thank you, Dean, yo, after all, the dean's level is high, and he found out our bleeding point at once."

  Chen Qi was quite contemptuous in his heart, and he slandered in his heart: Who was calling the dean a back door just now? Now it's leveled up again?

   But on the surface, Dean Chen is still very personable:

   "Okay, you guys take good care of your illness. Since it's not gastrointestinal bleeding, you can be discharged from the hospital. Just go to the dentist for a check-up."

  A "misdiagnosis" was finally resolved peacefully, which made Chen Qi feel relieved. Although he was smiling on the surface, in fact, his mother had already approved it in his heart.

  When turning around to leave No. 1 hospital bed, Chen Qi whispered in Lan Lijuan's ear with lingering fear:

   "Oh my god, I was scared to death. I thought I was going to make a fool of myself on the first day I came to the People's Hospital. Fortunately, you are careful."

  Generally, doctors pull out the tube directly after the gastroscopy, and they don’t pay attention to what else they can see halfway. Fortunately, Lan Lijuan is careful and has quick eyes and hands.

  Lan Lijuan also covered her mouth and joked:

   "I can't let Dean Chen overturn in the sixth department, otherwise the leader will wear small shoes in the future."

  Chen Qi became excited when he heard it, bit his ear and said:

   "That's right, otherwise Dean Chen got angry in the hospital, and when he went home to bed, he wouldn't take it out on the director of the department..."

  Lan Lijuan blushed when she heard this, and squeezed the fat on Chen Qi's waist, causing Chen Qi to almost cry out in pain.

  The ward is so small. Everyone can see the two parents-in-law whispering their ears. Others pretend not to see it. Ma Xiaona, an old classmate, can't stand it anymore, so she joked:

   "Okay, okay, if a dean and a department head flirt openly in front of the public in the hall, you are not afraid of spreading gossip and being known by your family members?"

Um? Got gossip?

  The patients and companions in the ward pricked up their ears. They didn't know what the relationship between the two was. They thought they had heard the shocking scandal, and they all looked at Chen Qi and Lan Lijuan with strange eyes.

  The other doctors and nurses knew the inside story, and all of them chuckled lightly, not taking it seriously.

  Lan Lijuan pursed her lips: "Okay, let's be more serious. It's the ward rounds. Dean Chen, you should also pay attention."

   "Oh yes, serious, serious!"

  I don’t know, I thought Lan Lijuan was the dean.

  Lan Lijuan turned around and looked at Wang Fang again: "Doctor Wang, continue to introduce the situation of the second bed patient to President Chen."

  The little doctor Wang Fang quickly cheered up, wiped away the tears she just shed, changed the iron clip of the medical record in her hand, and continued to introduce:

"President Chen, a 2-bed patient, male, 72 years old, was admitted to the hospital yesterday evening because he was stuck by a fishbone after eating fish at noon yesterday. At present, the patient's fishbone is very troublesome. We have already done a gastroscopy and a CT. It can be determined that the fishbone is stuck at the upper end of the esophagus.

The trouble is that this fishbone is relatively thick, and it is stuck on the esophagus horizontally. If you can't go down, you can only take surgery to remove the thorns. "

  Chen Qi glanced at the elderly patients on the hospital bed and felt a little strange:

   "No, a fishbone is stuck, why does this old man look dehydrated and weak? Are there other underlying diseases?"

   It’s no wonder Chen Qi is surprised, because the old man is lying on the bed now, his whole body is as limp as a paralyzed noodle, as if he has no strength at all, only groans from time to time.

  When a doctor sees a doctor, what he is most afraid of is encountering such a patient with an extremely poor mental state.

   At this time, the patient’s son next to him was in a hurry:

   "Doctor, my dad never likes to chew slowly when eating. It happened that a relative came to visit yesterday at noon. At that time, my dad ate a big mouthful of fish, but the fishbone stuck in his throat all at once.

At that time, we tried a lot of methods, such as swallowing rice and vegetables without chewing, and trying to smooth out the fishbone but failed. Later, we tried drinking vinegar, coughing hard, picking with hands, etc. Good guy, not only did we not see it. The fishbone, on the contrary, made the pain in the throat worse and worse.

We just sent it to the hospital to see if there are other ways to remove the fishbone. Well, can this operation be stopped? My dad is so old that he has to have his stomach cut open, and he can’t stand it . "

  Chen Qi heard the problem:

   "Wait a minute, what did you guys do when you said the fishbone first started getting stuck?"

  The patient’s son was a little unclear, but he answered honestly:

   "It's just swallowing rice, swallowing a whole vegetable, inducing vomiting, and drinking vinegar. By the way, it's just such a big bottle of vinegar. We drank a full 3 catties, but it didn't work at all, and then my dad was completely wilted."

   "Oh my god, I drank three catties of vinegar, so I can't stand it. Even the fellow villagers from Shanxi can't stand it."

  Drinking vinegar to soften the fishbone after it gets stuck in the throat is also a common error handling method, and it is also a method that everyone usually uses.

  Many people think that drinking vinegar can soften the fishbone in the throat, because the acetic acid contained in vinegar can chemically react with the calcium contained in the fishbone, which will soften the fishbone and relieve the jam.

  In fact, this is not the case, because the throat cannot accumulate liquid. After drinking vinegar, the vinegar will quickly flow from the throat into the esophagus, and will not stay in the fishbone for a long time.

  So it can't soften the fishbone at all, it just flows the vinegar through the fishbone.

  In addition, if the fishbone is large, drinking a lot of vinegar will not only not soften the fishbone, but will also cause aggravated damage to the mucous membrane of the throat, which will aggravate the symptoms of mucosal edema, but will increase the discomfort of the fishbone stuck in the throat.

   Another wrong way to deal with it is to eat a big mouthful of rice or steamed buns after the fishbone gets stuck in the throat, or swallow the whole vegetables without chewing.

   It is a big mistake to think that in this way, the fishbone can be wrapped and brought to the stomach by the way.

  Because eating too much may not only cause choking, but also cause the fishbone to penetrate deep into the throat under the pressure of food, which increases the difficulty of pulling out the fishbone.

  Originally, the fishbone was in the throat, and the doctor could see it with a flashlight, and it could be removed with a smooth tool.

   But your fishbone is deep, and the doctor can't see it with naked eyes. You need to use tools, spend money and suffer, and you may not be able to find it.

  Another mistake is to try to take out the fishbone by yourself or with a tool after the fishbone gets stuck in the throat. This method is very dangerous

  Because you can’t clearly see where the fishbone gets stuck, it’s easy to accidentally injure your throat, and it may cause nausea or vomiting, and it may also deepen the position of the fishbone, which will aggravate the symptoms of throat stuck.

  All wrong methods not only fail to remove the fishbone, but also cause anxiety and panic, and cause dehydration of the patient due to wrong methods such as severe vomiting or vinegar filling, leading to electrolyte imbalance and other adverse consequences.

  Mucosa injury, inflammation and other side effects are still mild.

   More seriously, if the fishbone gets stuck deep in the throat, it may induce muscle spasm in the throat, and may also cause edema of the throat to block the airway, causing suffocation, which will pose a greater threat to the patient's life.

  As for the most serious situation, fishbone may also cause blood vessels to rupture.

  Because there is a large neck artery near the esophagus, it would be terrible if the fishbone pierced the artery and caused the blood vessel to rupture and cause massive bleeding. This kind of hemorrhage may cause the patient to die of hemorrhagic shock before being sent to the hospital in time.

  So when a fishbone is stuck in the throat, the most sensible choice for the patient should be to go to the otolaryngology department of the hospital for electronic laryngoscopy.

  After the fishbone is found, the doctor can use tweezers or foreign body forceps to remove the fishbone, so as to avoid serious consequences.

  But many ordinary people don't care about it, thinking that their own local method is the most effective.

  Why go to the hospital to pick fishbone? The hospital is dark, you can get in and you can't get out.

   Decades later, if you call a fishbone, the registration fee + diagnosis and treatment fee + surgery fee will not be paid without 100 yuan.

  If you use an electronic laryngoscope or a fiber laryngoscope, you won’t be able to leave without 500 yuan, which is a waste of money.

  Even in the 1980s, no matter how cheap your registration fee and surgery fee were, it was at least 2 or 3 yuan for rooting a fishbone.

   It costs 2 or 3 yuan, and a catty of pork is only 1.8 yuan. The two catties of pork are gone, so ordinary people are even more reluctant to go to the hospital.

  Of course, most of the patients with fishbone got stuck like this twice, ah, well, I don’t feel much anymore, and I saved 3 yuan.

   But there are always some people who not only can’t solve the fishbone problem, but the problem is getting worse and worse. Good guy, this person is sent to the hospital for hospitalization and surgery, and they can’t afford it without a few hundred dollars.

   It’s better for those who have public medical treatment, anyway, the factory reimburses them.

  If this is a self-funded patient with a small family, it will be nothing for a year.

  If it was Huangtan Town where Chen Qi lived, ordinary people in the mountains would consider themselves unlucky if they encountered such a thing.

  So small fishbone can easily cause big troubles, and you have to spend money when you should spend it. Don’t spend small money or big money.

  (end of this chapter)