Chapter 429： : Getting timid!

Chen Cang's regulations are clear!

Firstly, the cause of the patient was deduced based on clues such as symptoms and signs.

Then according to the current medical history and past history, jointly launch the possibility!

Then start to verify your judgment through physiological and biochemical tests.

Chen Cang A simple rescue, the process used to form a logical thinking framework for many students.

Chen Cang smiled: "This is clinical thinking!"

Stunned everyone.

In fact, as a doctor, the most important thing is the formation of clinical thinking.

这个 At this time, Xu Dongdong's words made everyone more curious.

Yes! Teacher Chen, the serum electrolytes have not yet come out. How did you guess the blood potassium value! Is it judged by experience?

对 "Yes! Teacher Chen, you were so handsome just now. How do you judge, is there a secret?"

I looked at a group of students, Chen Cang smiled: "Of course there is a secret!"

When everyone listened, their eyes suddenly lighted up, and they quickly drew out pen and paper one by one. This is "dry goods"!

Solid dry goods!

Chen Cang saw this and was happy to share it.

What did you say?

Correct! Knowledge is not its own. It is only the use and dissemination of knowledge.

More people get this knowledge and they can save more people.

其实 "Actually, everyone noticed that I did an electrocardiogram just now."

Everyone nodded: "Well, I saw it, but the ECG is just a waveform. What does it have to do with blood potassium?"

Cang Cang said to Kobayashi at this time: "Kobayashi, I just have an extra electrocardiogram, you can help me get it."

沧 Chen Cang just added an extra electrocardiogram just for insurance purposes, and now it comes in handy.

Xiao Xiaolin took it anxiously and handed it to Chen Cang.

Cang Chen took the electrocardiogram and said to everyone: "Don't underestimate any examination, as small as a thermometer, blood pressure monitor, cardiac auscultation, or electrocardiogram, x-rays, etc."

"These inspections can tell us a lot of clues!"

而 "And the manifestations of hyperkalemia and electrocardiogram abnormalities are even a typical example. I hope everyone will take what I said next and remember!"

After everyone listened, they quickly prepared the book and pen and listened carefully.

"When the blood potassium is increased, the permeability of the cell membrane to potassium ions in the repolarization phase is increased, the action potential gradient is steepened, and the time is shortened. The ECG manifestation of high potassium first appears as a t-wave towering and qt shortening, so I see the ECG At that time, it was basically determined that the patient was hyperkalemia. "

"Everyone knows that patients with hyperkalemia come and go."

沧 Chen Cang's phrase "coming and going in a hurry" made everyone laugh, but everyone knows that this is indeed the case, hyperkalemia can cause cardiac arrest at any time and endanger life!

Cang Chen continued: "It is true that the serum electrolyte test is the gold standard for hyperkalemia, but by the time of the biochemical examination, the patients have passed for an hour or two, and people have long since disappeared. Why do I want this gold standard?"

所以 "So, at this time, if you suspect that hyperkalemia must be done with an electrocardiogram, this is a clinical trick!"

而且 "Also, with the increase of blood potassium, different concentrations will have different performances, start to remember!" Chen Cang reminded.

"When blood potassium is greater than 65ol, qrs uniformly widens, and ventricular muscle block may occur at this time;

When the blood potassium is greater than p wave reduction and time widening;

When blood potassium is left and right, p-waves disappear and sinus ventricular conduction occurs. "

These are all officially reported, and clinically available, so Chen Cang said without hesitation.

If it was just Chen Cang's personal experience, he would say very conservatively!

After everyone heard it, their eyes glowed green and they kept recording.

A lot of knowledge, only when combined with clinical, will dazzle.

At this moment, Chen Cang in their eyes comes with halo effects!

I was hungry and thirsty.

They can think that the difference in the electrocardiogram can reflect the abnormal signal of human potassium.

This is something they never expected.

As Chen Cang said, if the serum electrolytes come, the patient will be gone, and you do n’t know why!

As a doctor, I want to continuously improve my skills.

This technology includes diagnostic technology, therapeutic technology, surgical technology, and technology for communicating with patients.

Life is learned everywhere.

At this time, a student couldn't help but ask, "Ms. Chen, will you die when your blood potassium reaches 10?"

Chen Cang: "The blood potassium concentration increased further. At that time, qrs progressed and widened, even sine wave fusion with t wave, and finally died of ventricular arrest or ventricular fibrillation."

With that said, Chen Cang looked at everyone.

所以 "So, the most taboo in clinical practice is experience, especially in emergency department. Don't use your usual experience to see others for treatment, let alone persuade or encourage others in your life."

"If you don't fully understand the patient, any sentence you say may be wrong, and any suggestion you may give is fatal!"

Chen Cang took a deep breath: "If you just spit up and diarrhea according to the conventional electrolyte disturbances, isn't it just rehydration to adjust the electrolyte? Supplement sodium, potassium, calcium, iron, zinc, selenium and vitamins. If so, what is the patient like! Think about yourself Think. "

"Medicine, you can't afford to be sloppy. I was in the emergency department for the past two months. I don't say how much I hope you can learn, but you must learn a little!"

"That's dangerous and cautious."

In a word, calm down all the attendees present.

There is no lack of such examples in life. A method that may be applicable to oneself may become the real murder of others.

and so!

The most appropriate persuasion and advice may be: go to the doctor!

Chen Cang smiled: "So, you know: What's the difference between a doctor and a butcher?"

Everyone froze and looked up at Chen Cang.

Cang Chen said earnestly: "Doctors are more and more timid, but butchers are more and more daring!"

The speech was humorous. After everyone heard it, they couldn't help smiling.

But I ca n’t laugh inside!

The more he smiles, the more he feels heavy ~ www.novelhall.com ~ Cang Cang looks at everyone, gets up and leaves, walks towards the office. He doesn't expect this group of people to remember everything, but it must be remembered: treat patients Whenever, be sure to:

Careful!

Careful!

Careful!

At this moment, a man in the crowd was sweating profusely!

He had a lingering fear and didn't dare to lift his head.

He felt very naive when he thought of his inability.

If this old man really disposes in his own hands

What will it look like?

This is a living life. I am only in my early 30s. If something goes wrong, who can take responsibility?

Who is responsible for the elderly!

Life is only once?

Who can let you try?

Ps: In this story, I want to tell you that the kind suggestions of others may not be suitable for others.

The disease is so!

Why isn't life like this?

没有 Insufficient understanding of the disease, seemingly well-intentioned advice leads to misdiagnosis or mistreatment.

没有 Insufficient knowledge of the situation of others, what will result from seemingly good advice?

Traditional Chinese medicine believes that medicine is the Tao. In fact, life and medicine have many things in common. I hope this story will give you a little inspiration.