I Can See Health

   Chapter 615 It's not that you can't do it yourself, it's the other party who opened the hook

   At this time, a woman in her forties, with an anxious look on her face, hurried into the emergency room.

   "The patient is here."

   Before the woman waited for the woman to say anything, Wang Xiaodong pointed to the drunken man's bed.

   "Thank you, doctor." The woman looked at what Wang Xiaodong was pointing at, her expression tightened, and she trotted over quickly.

  Wang Xiaodong sighed helplessly.

  In the emergency department, he really sees this kind of scene a lot.

   Being able to lie down on the street drunk in such a cold weather, life must have encountered great difficulties.

  The woman ran to the hospital bed and shouted softly, but there was no response.

   "Doctor, what happened to my husband?"

   "He was sent to the hospital by the police..." Wang Xiaodong briefly described the patient's condition, "He is still in a coma."

  The woman's face was covered with tears.

   "It's all my fault, I shouldn't quarrel with him at night."

   "He worked well during the day and was scolded by the boss. I shouldn't argue with him."

   "Doctor, you must save him!"

   said, the woman was about to kneel down to Wang Xiaodong.

  Wang Xiaodong saw that there were many such things, so he quickly supported the woman.

   "We will try our best, but the patient's condition is unstable now, you still have to be mentally prepared."

   "Thank you, thank you doctor." The woman wiped her tears and returned to the bedside.

  …

  Because of the special condition of the drunk, Wang Xiaodong promptly reported it to the superior doctor and Lu Jianjun, the director of the emergency department.

   "Xiaodong, you are the patient's doctor, what do you think?" Lu Jianjun asked after learning about the patient's condition.

   "The cause of the coma is yet to be investigated. It may be caused by hypothermia, but the most important thing now is that his electrocardiogram is abnormal. We haven't found any cause." Wang Xiaodong said.

   "Yes." Director Lu Jianjun nodded slowly, then looked at the others in the office, "Do you have any other opinions?"

   "Could it be myocardial infarction? Cardiomyopathy? Or congenital heart disease?" said an attending doctor in the emergency department.

  Wang Xiaodong immediately replied: "The echocardiography is normal, there is no abnormal change, and myocardial enzymes and BNP are normal."

   "We also asked the patient's family members. The patient has no previous history of heart disease."

   "Cardiomyopathy and congenital heart disease were tentatively ruled out."

  Wang Xiaodong ruled out several diagnoses one after another, and the doctors fell into deep thought.

   At this moment, a voice suddenly sounded from the corner of the office.

   "I think, should the patient have a cardiac MRI?"

  Everyone looked at the sound.

   The one who made this opinion was a doctor named Xu Yiwen who just came to the emergency department.

   He is currently a doctoral student, and his advantage lies in scientific research.

  Xu's translation continued: "Cardiac ultrasound is not the gold standard for diagnosing cardiomyopathy, cardiac magnetic resonance is."

   "Perhaps we recommend the patient's anterior cardiac MRI to further confirm or exclude."

  Lu Jianjun nodded slowly when he heard the words, "However, the technology of cardiac magnetic resonance is relatively new. Has our hospital developed it yet?"

"Yes." Xu Yiwen smiled, "I recently had a topic about cardiac magnetic resonance. I asked the CT department of the hospital before, and their director has sent people to higher-level hospitals for further study, and now they can independently complete the diagnosis and treatment of cardiac magnetic resonance. process."

   Director Lu Jianjun of the Emergency Department is still very satisfied with this new doctor.

   You must know that it is not easy to recruit a doctor in a department like the emergency department.

   Even for a provincial leading hospital like Jinghua Second Hospital.

  If someone engages in scientific research, then there are topics.

  If there is a subject, then there is a fund.

   "Okay, then follow your ideas." Lu Jianjun nodded slightly.

   "Okay." Xu Yiwen grinned and suddenly saw Lu Chen next to Wang Xiaodong, "By the way, it seems that Junior Brother Lu Chen hasn't expressed his opinion yet."

   The current Lu Chen is in the second hospital of Jinghua, which is very beautiful.

   Everyone may not know who the director of the department is, but they all know the name Lu Chen.

   Even though Lu Chen is only a graduate student.

  Wang Xiaodong and Lu Chen didn't have much grudges, they just thought about what Lu Chen thought about this patient.

  Lu Jianjun also looked at Lu Chen curiously.

   Lu Chen, a student, knew something about him two years ago.

   Of course, there was an explosion in Jinghua, and Lu Chen was the first student to come to the emergency department for support.

  A variety of skilled clinical skills have left a deep impression on Lu Jianjun.

Seeing everyone looking at him, Lu Chen smiled slightly, and said, "I think my brother's idea is very good, and he can further diagnose cardiomyopathy. The current gold standard for cardiomyopathy is also the Lake Louise standard for cardiac magnetic resonance. If conditions permit, this inspection can be improved.”

  The examination of cardiac magnetic resonance is good, but the cost is still quite expensive, it costs thousands of dollars.

  Xu Yiwen was very relieved to hear Lu Chen say this.

"but……"

   Lu Chen's next words caught everyone's attention.

   "This patient is also my first consultation. After the emergency rescue in the morning, the patient's vital signs have improved." Lu Chen said, "The patient will most likely wake up tomorrow."

   "What treatments did you mainly use?" Xu Yiwen asked curiously.

   "That's the main point I want to say." Lu Chen smiled, "We didn't give any other special treatment except warming up and rehydration."

In the    office, everyone still couldn't believe it, and opened the patient's doctor's order form one after another.

   One look, and sure enough, there is no other treatment except warming up and rehydration.

   "So, I was thinking just now that all these abnormal performances of the patient may only be related to hypothermia."

   The voice just fell, and everyone below remembered whispering.

  Xu Yiwen frowned and said, "Can hypothermia make the patient's ECG image look like plastic surgery?"

Lu Chen picked up the patient's electrocardiogram from the table and explained, "The principle of the electrocardiogram is the electrical conduction of the heart, which is simply the current passing through the heart. Electrocardiographic changes in potassiumemia, such as QT prolongation and prominent U waves."

  Lu Chen marked several locations on the electrocardiogram, which just corresponded to what he said.

   "Looking at it like this, it seems to be true." Wang Xiaodong said in surprise.

   However, Xu Yiwen frowned, "How can I confirm my own thinking there? What check?"

  Lu Chen smiled, "It's actually very simple."

   is easy?

   When everyone heard this, the corners of their mouths twitched.

   They didn't have a clue yet, but Lu Chen actually said something very simple...

   Just listen to Lu Chen continue: "As long as the patient's body temperature has completely recovered, review the electrocardiogram and other indicators."

   "Comparing the results before and after, if the ECG returns to normal, it can be basically confirmed that the abnormality of the patient's ECG is related to hypothermia!"

   When the answer was not revealed, everyone was at a loss.

   But once the answer to the mystery was clarified, everyone made an "oh" sound, and it suddenly dawned on me.

   In fact, this is also a more classic clinical laboratory diagnosis method.

   For example, some patients with pulmonary nodules to be investigated will often undergo experimental anti-tuberculosis treatment without any pathogenic bacteria being examined.

   If the patient's symptoms are relieved, then it can be reversed that the patient is a tuberculosis infection.

   "Lu Chen is right!" Lu Jianjun showed a satisfied smile.

   He really wanted to keep such an excellent student by his side.

   But it's just a thought...

  Xu translation did not continue to ask questions at this time, bowed his head and remained silent.

   Obviously, compared to his cardiac MRI, Lu Chen's diagnosis and treatment method may be simpler.

"Actually, Senior Brother Xu's idea is also very good." Lu Chen added with a smile, "Maybe because I am the patient's first doctor, I understand the patient's condition better. Otherwise, I would also support the patient's cardiac MRI examination. ."

   Hearing Lu Chen's words, Xu Yiwen felt a little better.

   It's not that I can't do it myself!

   It's like the other party is hanging up...

   (end of this chapter)