Chapter 368： : Without the instrument, will you see a doctor?

Wu Yushu was soon received 19 beds in cardiac surgery. The doctor in charge of the bed was Zhang Wenfu, a senior physician.

Tao Kun intends to teach everyone a case using patients as a case.

Many students with constrictive pericarditis do not know very well. Most of the patients in cardiac surgery are cardiovascular disease and heart valve disease. Most of the chronic prolonged pericarditis is relatively rare.

Therefore, Tao Yan thought for a while that it was a teaching round.

...

Qian Lin followed the graduate students looking curiously at the patient, took out the paper and pen, and began to take notes.

Clinical teaching is to cultivate a clinical thinking ability for the diagnosis and treatment of diseases.

Other doctors and students were behind him, while Zhang Wenfu stood in front of him and asked about his medical history.

Zhang Wen is a little nervous!

After all, there was a script for teaching rounds in the past, and the patient's situation was memorized.

This time it was a real gun.

Dim panic for everyone.

Not to mention a patient with constrictive pericarditis that is rare in clinical practice!

Thinking of this, Zhang Wenfu muttered, but don't be ashamed ...

Behind this is the doctor of the entire Cory, and a group of students ... The most important thing is that Director Tao Yan is still staring behind him.

If ... it would be tragedy!

Thinking of this, Zhang Wenfu began to collect a detailed medical history.

I have to say that Zhang Wenfu is indeed an experienced doctor. He has very comprehensive collection of patient information and soon got some meaningful clues.

but!

After asking about his medical history, Zhang Wenfu was even more stunned ...

Because this symptom is more like copd! (Chronic obstructive pulmonary disease).

Zhang Wen is a little bit flustered. It is very difficult for a simple physical examination to detect constrictive pericarditis. It is a test for a clinical doctor to grasp the signs of this disease.

Could it be ... an emergency physician's diagnosis error?

Thinking of this, Zhang Wenfu's eyes brightened. After all, there are not a few such cases in the clinic. After all, the emergency department is a transfer department. It is not uncommon to have an unclear diagnosis.

However, the call to the director in person should confirm that the diagnosis is constrictive pericarditis!

Forget it, just follow the constrictive pericarditis.

All the signs of constrictive pericarditis kept appearing in his mind. He set his mind and proceeded step by step.

He will not push backwards, will he not retreat?

Thinking of this, Zhang Wenfu picked up his stethoscope and listened. This sound, uh, my heart sounds really abnormal.

After that, there was a percussion of the heart. It didn't seem right, um, the voiced sound world was a bit big!

Then there is the physical examination ...

Until the end, Zhang Wenfu suddenly opened up, this should be a constrictive pericarditis!

At this moment, Zhang Wenfu had to admire the doctor in the emergency department.

He had some difficulty pushing this constrictive pericarditis down, but how difficult was it to diagnose it?

Thinking of this, Zhang Wenfu couldn't help wondering, which cow was it?

Is it Li Baoshan?

Zhang Wenfu asked curiously, "Do you know what was wrong before?"

Wu Yushu shook his head: "I don't know, just like what Dr. Chen said, I may have this old problem before, but I haven't noticed it until Dr. Chen diagnosed what my constrictive pericarditis was.

Tao Yan was curious. How did Xiao Chen diagnose?

Thinking of this, Tao Yan asked, "How did the emergency doctor give you a diagnosis?"

Wu Yushu thought for a while: "In the morning, there are more patients, then Dr. Chen listened to the heart, then checked his blood pressure, and touched his belly and said that I might be constrictive pericarditis ... Five or six minutes. "

The people around were blinded.

Tao Yan swallowed saliva. What kind of patience does Meng Xi have that can make a person progress so fast?

Tao Yan: "Did you make an electrocardiogram?"

Wu Yushu nodded: "Well, no, Doctor Chen said that he would come here for a comprehensive examination after being hospitalized."

Tao Yan said, "Xiao Zhang, you give a doctor's order, improve the relevant examination as soon as possible, and continue to discuss this case tomorrow morning."

Zhang Wenfu nodded and gave the patient relevant examinations, chest radiographs, cardiac ultrasound, abdominal ultrasound, electrocardiogram ... and various physiological and biochemical examinations.

...

...

When he was handed over the next day, Tao Yan looked at Wu Yushu's examination report sheets. All signs showed that the patient was a constrictive pericarditis.

Tao Yan was a little bit emotional and looked at the crowd and said, "Nineteen beds of Wu Yushu have been diagnosed, which is constrictive pericarditis, but ... this is a wake-up call for us.

"Everyone's emergency doctor can make a clear diagnosis of the patient without auxiliary examinations, and everyone asks himself, Wu Yushu, can you be sure by physical examination and consultation alone?"

In a word, everyone asked to be silent.

Zhang Wenfu couldn't help but blush for a while. To be honest, if he didn't know in advance that it was constrictive pericarditis, could he diagnose it himself?

Not only Zhang Wenfu, but even the people around him couldn't help thinking about it.

Maybe ...

Tao Yan looked serious and said seriously: "As a clinical doctor, if you have arrived at the grassroots level, you have to go to the countryside, let alone ct, nuclear magnetic resonance, even if there is no b-x-ray or even an electrocardiograph, you come here. Patient, you only have a sphygmomanometer stethoscope. Can you make a judgment? Can you give the patient a relatively accurate answer? "

Having said that, Tao Yan even felt a little disappointed.

Many doctors today have lost the ability to think independently, relying on instruments and inspections to see a doctor. Who can see a doctor like this?

"I'm not saying that everyone is not good enough. I think that every doctor, since you have done clinical work, you must improve yourself. Instrumental inspection is a good thing and can help us to make a better diagnosis. Basic clinical operations. "

"Otherwise, patients would laugh at us and leave the device. Will you see a doctor?"

When I said the last word ~ ​​www.novelhall.com ~ Tao Yan's voice was obviously improved!

Everyone's mind echoed this sentence, unable to let go for a long time.

"Leave the instrument, will you see a doctor?"

The doctors couldn't help but clenched their fists. This sentence really looked like a needle and pierced their hearts.

The whole office was silent.

Tao Yan looked around and suddenly said loudly: "Starting next week, a small round of inspection every week, starting from the auscultation of the heart, I need you to remember the auscultation sounds of each disease!

A stethoscope can tell us a lot of clues. This is all experience. Now look at yourself. How many days are you wearing a stethoscope? Some people do n’t have a stethoscope for the rounds, do you still look like an extracardiac doctor? "

After speaking, Tao Yan was dark-faced and said, "Well, let's end the meeting!"

Regardless of everyone, get up and leave.