: Nothing small in clinical practice

It is absolutely honorable to complete a major heart surgery.

It is a shame to be beaten as a doctor who treats diseases and saves people.

Tension in the relationship between doctor and patient is a real social problem.

During the treatment of patients, it is common for doctors to have conflicts between their views.

There may be many reasons for conflicts between doctors and patients, such as the patient is in an extraordinary period, is in a relatively irritable mood, and may lack trust in the doctor. Doctors will feel stressed when facing a large number of patients every day.

If both doctors and patients can think from the perspective of others, tolerate and understand each other, and can rationally realize that quarrels will not only not solve the problem, but will also intensify the relationship and hurt more people. If both doctors and patients can abide by social moral constraints and think from the perspective of others when encountering problems, this contradiction can be avoided.

However, the conflict encountered by Gu Feng and Yan Xinyue is basically inevitable. Therefore, in addition to claiming to be unlucky, we can only blame ourselves for not being good at learning skills. However, it is even more helpless when talking about this. Patients are humans, doctors are humans, and doctors are not gods, and they cannot calculate in advance what kind of ability they will be in the future.

No matter how much impact and shock this operation brought to other doctors and nurses of the provincial affiliated doctors, or whether people will feel the same way for the medical staff of the Fifth Department of Emergency Surgery after this operation, this matter is over!

After that, there is no need to discuss or confuse again. So the fifth department of surgery has returned to its original state, so everyone should do what they should do.

As for Gu Feng, there is no excuse to be lazy anymore and he honestly goes to and from get off work from 8 am to 6 pm.

When I was free, the work in the emergency department was still not too busy. When I was busy, Gu Feng was still so busy that his legs were cramped.

For example, now, just as Gu Feng got out of a surgery, the nurse immediately came to tell me, "Doctor Gu, the new patient is breathing very fast. Should you come and see me!"

As an emergency department doctor, you should be able to come when you come, fight when you come, and win when you fight. However, in the fifth department of emergency surgery, there are not many doctors who have such a responsibility, and Gu Feng is the most outstanding among the few, so now when doctors and nurses in the fifth department of emergency surgery have something to do, they almost immediately look for him.

When Gu Feng heard the nurse's anxiety, he didn't care about the fatigue after the operation. Without saying a word, he took his full-time nurse Liu Shiya over!

At this time, it was already 5:40 in the evening. At this time, the doctors and nurses who were working on the day shift had basically got off work, but the special department of the emergency department did not get off work just after get off work. Sometimes the condition was dangerous. If you walk one step late and go one second later, it would probably be a life.

Gu Feng rushed to the bedside of the patient, immediately picked up the stethoscope, and a blood pressure monitor to check the patient.

Under Yan Xinyue's oppression, Gu Feng has become accustomed to using Western medicine to check first, and finally supplemented by traditional Chinese medicine's vision, hearing, and questioning. This dual-combination examination method can reduce the possibility of misdiagnosis and missed diagnosis! You should know that diseases are sometimes quite cunning.

The patient is an elderly male, 88 years old.

At this time, it is a semi-lying position, with a blood pressure of 110/70mmhg, which is still a normal value, but he is breathing like a sigh and is inappropriate!

The pupil diameter on both sides is about 3mm, it is slow to reflect light, cyanosis of the lips, and the breathing sound of both lungs is reduced, dry and wet rales can be heard, heart rhythm is irregular, abdominal abdomen, and swelling of both lower limbs.

This is a critical and complicated patient. Gu Feng did not dare to claim to be a big deal, so he quickly asked about his family.

After asking, I found out that the patient had a history of copd and diabetes and used insulin to control blood sugar.

This time the patient came due to the acute aggravation of chronic obstructive pulmonary disease. When Gu Feng asked about his medical history, his family repeatedly told Gu Feng that if the condition is not good, in order to relieve the patient's pain, they refused to invasive treatment such as tracheal intubation and ventilator-assisted ventilation before death. At the same time, they also refused blood biochemistry, chest CT and other related examinations and signed.

Although Gu Feng was a doctor in his past and present lives, this was the first time he encountered such a requirement. However, seeing that the patient was too old and the failure of various systems in his body was extremely serious, he had to reluctantly respond!

Although the family members have obviously given up treatment, Gu Feng, as a doctor, must do his own duties and diagnose the patient after careful examination. Considering that type ii respiratory failure may lead to pulmonary encephalopathy, he immediately gave him intravenous respiratory stimulants. At the same time, he also informed the patient's family that he was in critical condition and could die at any time. The family also understood the patient's condition and prognosis.

After Liu Shiya gave the doctor's advice and after he went to execute it, Gu Feng was about to leave, but he looked at the old man lying on the bed again, feeling a little unbearable, because breathing stimulants may not wake him up, so he couldn't help but talk to his family again, "How is his diet these days?"

This is an unnecessary, insignificant, or even redundant sentence. However, it is this sentence that brings a turning point in the patient's situation.

The family reported that the patient's appetite was extremely poor these two days, and said that after subcutaneous insulin injection at around 10 a.m., he ate a few tablespoons of porridge.

This detail made Gu Feng's thoughts suddenly open up, and a noun "low blood sugar coma" passed through his mind!

Gu Feng quickly stopped Liu Shiya, who was about to perform the respiratory doping doctor's instructions, and asked her to immediately check the blood sugar level.

The test of the portable blood sugar machine is very convenient. In less than two minutes, the result is out. The blood sugar value of the finger is: 0.6mmol/l!

This result surprised all the doctors and nurses present. Not to mention that this is a diabetic patient, even a normal person, the fasting blood sugar must be at least 6.1mmol/1, while the fasting diabetes patients should be 7.0mmol/1.

This is the lowest blood sugar that the doctors and nurses present have seen, and it also confirms Gu Feng’s judgment!

Since the diagnosis has been confirmed, the treatment is much simpler. Intravenous injection of 50% of glucose content and 80 ml of glucose content, and at the same time, the infusion of 10% of glucose content is maintained.

Thirty minutes later, it was amazing that the patient's consciousness gradually became clear. Not only did he wake up, he could also say his name and the names of his relatives present. What was even more surprising was that the patient could actually write down his recent blood sugar values ​​word for word.

It is indeed gratifying that the treatment effect is so magical. Perhaps in terms of coma caused by many causes, the treatment of hypoglycemia coma may be the most immediate. Just a little bit of common glucose can awaken the severe coma.

As a doctor, Gu Feng felt that he had achieved success and was also shocked.

Because when he diagnosed the patient, he first thought of pulmonary encephalopathy caused by respiratory failure. At the same time, considering that the patient has diabetes, he habitually thought about dropping normal saline and respiratory stimulants in silence. Just think about it, if he didn't ask too much and then check the blood sugar, the blood sugar of only 0.6mmol/l will disappear quickly. Even if he actively treats it, the efficacy will be greatly reduced, and it will even lead to the death of the patient, and the consequences will be unimaginable.

After the patient woke up, he transferred to the endocrinology department. It is said that the patient was relieved and discharged from the hospital within a few days. However, this incident left many insights to Gu Feng and the doctors under him. When diagnosing the disease, don’t just take it for granted. Grasp every clue. Perhaps the patient’s condition will be improved at the corner of his thinking, and the prognosis will be completely different. Each step of treatment will directly or indirectly affect the patient’s condition. There is no small matter in clinical practice and it will continue to improve. It is worthy of the sacred responsibility of the doctor, and every doctor’s advice and clinical decision.

After dealing with this patient, Gu Feng saw that nothing happened, so he returned to his office. After a while, Liu Shiya actually followed her in...
Chapter completed!