The system takes me for surgery

Chapter 316: Grapes Choked Throat

Tan Aizhu turned around and said to the old lady: "Grandma, if you need anything today, you can call him, can you?"

Being rejected by her like this, the old lady just didn't want to: she had no choice but to nod helplessly.

In Liang Yi's opinion, as a medical staff, one should not be like Tan Aizhu, the ability to control emotions is a basic professional quality, and he also believes that doctors like Tan Aizhu will definitely not have great breakthroughs in technology.

In fact, Liang Yi was following the teacher Zhong Yubo, but Tan Aizhu spoke up. As a low-level training doctor, he could only obey unconditionally.

After being assigned to Liang Yi, Liang Yi treated the old lady as a newly admitted patient, and began to ask the doctor and do a physical examination from the beginning.

He took a look, emergency routine laboratory examination: blood routine is normal.Urine routine showed ketone body 3.9mmol/L, others were normal.

He thought:

The old lady provided a clear history of dysphagia after eating grapes, but because grapes are soft and smooth, the chance of incarceration is very small, and esophageal foreign bodies caused by grapes are quite rare in clinical practice.And the patient is an elderly woman who is prone to mental stress and has a history of Parkinson's disease. Therefore, she has visited many hospitals successively, all of which are considered to be caused by psychological factors.

What makes Liang Yi wonder is why there is no gastroscope. If you want to know whether there is a foreign body, you only need to open a gastroscope to solve it.

Liang Yi came to the doctor's office and saw that Tan Aizhu was still busy. When she had some free time, he said, "Teacher Tan, the old lady in bed 14, do you want to prescribe a gastroscope for her?"

Tan Aizhu gave him a sideways look and said, "Sometimes Parkinson's patients feel uncomfortable everywhere, so ignore her."

"But……"

"Are you idle? Then copy my meeting minutes."

Liang Yi was speechless for a while.

This woman really doesn't have the basic qualities a doctor should have.

Liang Yi does not have his own job number, and if he wants to prescribe a prescription, he must obtain the consent of the superior doctor.

He risked the workplace taboo of leapfrogging,

I found Director Li Zhengping. Today is his outpatient day, and there are fifty or sixty patients lined up outside.

He had a lot of patients all the time, and when he came back from the toilet, Liang Yi said pretentiously, "Director, please take a look at this medical record."

Li Zhengping frowned and said, "What do you think?"

Liang Yi said, "I think it's better to have a gastroscopy."

Director Li Zhengping thought about it again and said, "Then prescribe one for her."

Using the director's job number, Liang Yi gave the old lady a gastroscopy checklist.

Check the gastroscope.

Tip: An oval foreign body can be seen at the first stricture of the esophagus

Afterwards, it was taken out by gastroscopy, and it was confirmed to be Xinjiang mare's milk grape.

Li Zhengping didn't dare to scold his subordinate doctors either. He took care of this patient himself and always thought it was Parkinson's or psychological factors that caused dysphagia.

However, he has a new understanding of Liang Yi's ability.

After seeing the outpatient clinic, Li Zhengping worked hard all day, which made him a little tired, but he still deliberately turned back from the outpatient department and came to the inpatient department.

Seeing that Liang Yi was writing the medical records, Li Zhengping said, "Xiao Liang, how is bed 14 doing now?"

Liang Yi got up quickly, and said with a smile: "The 14-bed old lady is much better now, and won't feel uncomfortable."

"Yeah, it's the grape that choked my throat and made it uncomfortable. Just take it off. I really didn't expect soft grapes to choke. I have been a doctor for so many years, and I have seen fish bones, bones, fruit cores, needles, coins, and blades. Yeah, they are usually hard objects. Accidentally swallowing a whole grape can enter the trachea and cause suffocation, and foreign bodies in the esophagus caused by embedding in the esophagus are really rare in clinical practice,” Li Zhengping said.

This is obviously a cliché to find a step down for himself.

Liang Yi will definitely not let the director down, he hurriedly said: "Yes, once other factors are added to this simple disease, the information provided by the patient and family members will become unreliable information, and the original single-point information will become complicated. Woke up."

"Yes, it is like this clinically. When you hear about Parkinson's, you will get into the horns. You are very good. Everyone is drunk and you are sober. This is very rare in clinical practice. Work hard and have the opportunity to take you. Surgery." Li Zhengping said.

"Okay." Liang Yi replied happily?

This case also made Liang Yi reflect a lot. I have encountered cases of foreign body infarction in the affiliated hospital before, and they were all mistaken for mental illness. In fact, the diagnosis process of the disease is very simple and fast, but the foreign body caused by grapes in the It is rare clinically, and doctors are prone to subjective assumptions, leading to missed diagnoses in many hospitals. This is really worth learning in clinical practice.

When he got off work, Liang Yi was driving a car. When he just left the gate of the hospital, he happened to meet a white Mercedes-Benz E300 in the parking garage on the right, and then walked in the opposite direction.

Isn't this Liang Yi?

Driving a white Mercedes-Benz E300 is Xu Bowen, No. 1 General Surgery Department of the Provincial People's Hospital, am I wrong?There should be no mistake, he seemed to be nodding to himself in greeting.

This kid really came to save the people, and he didn't even say hello to me.

After the "flying knife" operation at the affiliated hospital that time, he was deeply impressed by Liang Yi's "God", and he kept it in his heart. The people who came to the province went to study.

Xu Bowen said to himself: "I have to go and see which department this kid is studying in in two days."

In the emergency department, after the morning meeting, the department director Xie Tianmu and the director Li Zhengping sat on the side alone.

The regular trainees and interns are sitting in the back row.

Dr. Gong Zhengnan took out the projector, put it on the table, and said to everyone: "Today we will conduct a case discussion and let the two directors evaluate how we should deal with this patient.

Dr. Gong Zhengnan reported the case: Today we are discussing this patient, male, 18 years old, the main cause is "fever for 2 weeks"

Two weeks ago, the patient developed high fever after taking a bath, with a body temperature of up to 2Y, accompanied by cough and a small amount of white sputum, without chills.

As soon as they heard the fever, everyone's heart immediately became tense, because among the difficult and miscellaneous diseases, fever of unknown cause is the most troublesome.

Dr. Gong Zhengnan continued: The white blood cell count in the blood test in another hospital showed an increase, and the chest X-ray showed no abnormalities. He was treated with antiviral drugs, but the effect was not good, so he was transferred to our hospital.

Previously healthy, no history of drug allergy.

Emergency examination in our hospital: blood routine leukocytes were not high, chest X-ray showed pneumonia in the lower lobe of the left lung, and abdominal B-ultrasound showed splenomegaly.

Liang Yi drew the key points in the notebook. From no abnormality to pneumonia in the chest X-ray, it means that the patient is progressing.

Director Xie looked at the above medical records and frowned, feeling that it was still a little tricky.