I Can See Health

Just when Lu Chen was thinking about how to get a wave of gratitude points from his junior brothers and sisters.

Sun Guoguo led a group of trainees in white coats into the doctor's office in District 8.

There are about ten people in this group of trainees.

Sun Guoguo walked towards Lu Chen and said with a smile: "Junior brother, are you busy now?"

Lu Chen shook his head: "Fortunately, the doctor's orders and disease history records have been processed."

Sun Guoguo smiled and said, "That's just right. I will go to the teaching building to hand in some materials later. There are more than ten trainees here. You will take them to the ward to see patients later, mainly heart failure and coronary heart disease. patient."

"You want me to take care of the trainees?" Lu Chen looked behind Sun Guoguo.

This is a group of young trainees with curiosity and thirst for knowledge shining in their eyes.

A traineeship is not the same as an internship.

In their senior year, medical students will come to the hospital for clinical study. At this time, they only come a few times temporarily, so it is called internship.

When medical students are in their fifth year, they will be stationed in the hospital and rotate in various clinical departments, which is called internship.

"Well, just take them around the hospital bed and tell them about the diagnosis and treatment of heart failure and coronary heart disease." Sun Guoguo said with a smile, "They are still trainees, so they don't make too many demands. The main thing is Familiarize them with the workings of the hospital and then teach them to take medical history.”

"In that case, fine." Lu Chen nodded.

It was his first time to give a lecture in front of so many trainees.

But if you can teach the class well, you should be able to earn a lot of thank you points!

…

After seeing Lu Chen's agreement, Sun Guoguo handed over the trainee and rescued him from the ward.

"Do you have a team leader?" Lu Chen stood up and looked at the group of trainees in front of him.

A thin boy wearing glasses walked out.

"Teacher, I am the group leader."

"My name is Lu Chen. I just started graduate school. You can just call me senior brother." Lu Chen smiled.

"Okay, senior brother."

Lu Chen selected two patients who were in charge of their own beds.

A patient with heart failure and coronary heart disease.

Before taking the trainee for ward rounds, Lu Chen first communicated with the patient and his family.

After obtaining permission, Lu Chen led everyone to the ward.

"This is a patient with heart failure..." After Lu Chen briefly introduced the patient's situation, "The first step in receiving a patient is consultation. Who wants to try a consultation?"

There were more than ten trainees, but not one of them said anything.

"Then let the team leader give it a try." Lu Chen said to the thin boy.

The team leader hesitated for a moment, then stood up, hesitated for a moment, and then began to inquire with the patient.

Lu Chen was not in a hurry.

He also came here from this time.

Although the medical certificate states how to conduct a consultation, it is still knowledge in the book!

This is a huge leap from knowledge in books to clinical skills in reality.

This is a big challenge for trainees who are going to clinical practice for the first time.

The group leader began to ask: "Auntie, what makes you uncomfortable?"

"Chest tightness." The patient was very cooperative. "In addition to chest tightness, I also have dizziness, headache, and recently I have developed a loss of appetite."

"..."

The team leader's initial consultation was relatively organized.

But after a few questions, he began to let himself go and ask questions about whatever he caught.

Seeing this, Lu Chen quickly interrupted the team leader's consultation.

"The team leader has already asked a good question." Lu Chen smiled, "Is there anyone else who wants to ask?"

I looked around, but no one came forward.

Lu Chen had no choice but to explain it in person.

"When asking about the medical history, you should ask about the patient's main symptoms, accompanying symptoms, triggers, location, nature, aggravation or relief of the symptoms...you can't just ask as you like!"

…

In about half an hour, Lu Chen led more than a dozen trainees to see the two patients, and then brought them to the demonstration classroom in the eighth district of Xin Nei.

Next, he will start to explain the pathophysiology of coronary heart disease and heart failure.

After talking for a long time, Lu Chen felt a little dry.

The trainee sitting below still had a confused look on his face.

"If you have any questions now, you can ask me." Lu Chen could only say.

The students present were silent for a long time.

Finally a girl said: "Brother, can I ask any questions?"

Lu Chen nodded: "As long as I know about medical and clinical matters, I will try my best to answer them."

The girl paused and then said: "Brother, I just looked through the patient's medical record. I saw that the medical record contains a history of travel. What is a history of travel? Is it a travel experience?"

Lu Chen was stunned.

This problem has nothing to do with heart failure or coronary heart disease!

"Ahem." Lu Chen cleared his throat, "It's an inappropriate relationship between a man and a woman."

The girl's face turned red, "I understand, thank you, senior brother."

Lu Chen thought that was the end of it, but he didn't expect that one of the boys present shouted something.

"Senior brother, can you be more specific?"

Lu Chen's face darkened: "He just slept with other women besides his wife."

The boy present replied again: "Senior brother, if you sleep with a mistress, does this count as history?"

"It probably doesn't count..." Lu Chen paused.

"What does that mean?"

Lu Chen thought for a while and said, "If you go to sleep in heaven and earth, you will be considered a traveler."

As soon as he finished speaking, all the trainees burst into laughter.

Lu Chen felt something was wrong and was almost led astray by these boys below!

He quickly said: "Everyone, please mention issues related to coronary heart disease and heart failure!"

Lu Chen looked around. Everyone was quiet, but no one answered.

"If you don't ask, then I'll ask one." Lu Chen smiled.

His smile looked a little creepy to all the trainees.

Everyone lowered their heads slightly, not daring to look at Lu Chen.

"We just saw a patient with right heart failure. Compared with right heart failure and left heart failure, what are the more characteristic signs?"

As soon as Lu Chen's question came out, there were whispers below.

After a while, the team leader slowly stood up and said: "Brother, is the hepatojugular reflux sign positive?"

Lu Chen smiled: "Yes, UU reading www.uukanshu.net do you know how to do it?"

The team leader nodded.

"Instruct the patient to lie in bed, put his head on a high pillow, and breathe through his mouth. The examiner's right palm will be placed lightly on the liver area, and the pressure will be gradually increased for 10 seconds. At the same time, the degree of jugular vein distension will be observed."

"What is the principle of this examination?"

"The compression of the congested liver increases the amount of blood returning to the heart. The congested right atrium cannot accept the blood returning to the heart, forcing the jugular venous pressure to rise..."

Lu Chen nodded slightly, and the team leader answered well.

However, Lu Chen's next question made everyone look at each other in confusion.

"Why is the patient in a semi-recumbent position at 30-40° when performing the hepatojugular reflux sign? It cannot be in a recumbent position at 60° or other angles?"

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