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Published at 7th of November 2021 08:42:13 AM


Chapter 314: 314

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With the sound of the system prompt, Chen Cang was hungry and thirsty, but he calmly took the task and looked at Meng Xi lightly.

"Okay."

Meng Xi raised her eyes and handed the electrocardiogram: "Come, let's analyze the patient's condition."

Dongda First Hospital and Provincial Second Hospital are not at the same level. There are many students here. After all, it is the first affiliated hospital of Dongyang Medical University. There are many interns and postgraduates.

The emergency department is a special necessary transfer room, so several people around him looked at Cang Curiously.

Chen Cang took an ECG first glance, um, just a glance, walked directly to the patient, looked at the stethoscope on the neck in front of the patient's chest, then looked at the patient and asked: "Uncle, do you feel How long has your chest been tight? "

The man was also very cooperative. He was relieved not to hear my heart attack.

"Three days, I feel inexplicable. I just attended a colleague's son's wedding a few days ago. When I came back, I caught a cold, got a fever, took some medicine, and the next day I felt a faint uncomfortable chest. Fever, I thought it was a tired cold, so I didn't care. "

"But ... I feel suddenly terrible today. I was worried about a heart attack, so I came here, chest pain, chest tightness, and now I feel a little strenuous even breathing."

After listening to the game, Cang Cang: "You lie down, I'll knock you."

The man was very cooperative. Lying on the bed, Chen Cang began to percussion.

Asking if it hurts.

After two minutes, Chen Cang said after the percussion in the heart area, "Take a deep breath, right ... inhale ... exhale ..."

The man suddenly hesitated: "Oh, it hurts!"

After a little slowing, he slowly said, "No, no, it hurts as soon as I inhale!"

Chen Cang looked at the intern next to him: "Where is the test sheet, blood routine, myocardial enzyme."

Ji Peisheng paused, and looked at Chen Cang just like a teacher. He was very respectful and quickly handed it over.

"Teacher, here!"

Chen Cang didn't pay attention to these details. After opening, he looked carefully.

Take the chest radiograph and take another look, everything is clear in the chest.

As a doctor, the most important thing is diagnosis. Chen Cang now has perfect interpretation of chest images, perfect electrocardiogram, and perfect clinical interpretation of physiological and biochemical indicators!

At this moment, Chen Cang estimates that no one knows the patient's condition better than him.

Chen Cang said directly: "The patient has an acute onset, accompanied by fever, chills, chest pain, dyspnea and other symptoms. The pericardial friction sound is obvious, the blood routine white blood cells are increased, and the nuclear is shifted left. I looked at the chest radiograph and the x-ray examination showed that the patient's normal contour of the heart disappeared and the pulse was weak! "

"So, I am now 90% sure that the patient is acute bacterial pericarditis, and that the heart may now have purulent fluid. My percussion just now felt that the dullness zone was changed."

"Heartbeats and breathing difficulties, this is a sign of cardiac tamponade!"

In a word, I said everyone!

Justified!

Every sentence makes sense!

And most importantly, every student here can understand, Chen Cang's words are easy to understand, and every conclusion is based on evidence.

It makes people feel that diagnosis is like investigating a case. Every clue points to a cause, and what kind of result it leads to.

Looking at a group of medical students who could not help but applaud!

Too great!

Gangster 666!

A group of medical students are really agitated and bloody.

Is Meng Xi niubi?

Absolutely cow!

It can be seen that it is an acute pericarditis.

But everyone just feels great.

But Chen Cang is different. The explanations are thorough and thorough. For students, this is what they can learn.

This is clinical knowledge.

In fact, what this group of students did not know was that this was intentional by Meng Xi.

After Chen Cang finished speaking, Ge Huai was also a little hesitant. He could also see pericarditis, but ... maybe not as clear as Chen Cang's diagnosis.

but!

Ge Huai thinks that Chen Cang can do this because he Meng Xi has said it is pericarditis, and Chen Cang is a student, and the book knowledge is firmly remembered. This is the case. It is the same as the original suture. A little faster than myself, but ... not as tight as my own sewing.

Meng Xi looked at Chen Cang's performance just now and was very satisfied. Basically, Chen Cang used all the diagnostic methods of acute pericarditis.

Even bacterial acute pericarditis may have a pericardial tamponade.

The eyes of a group of students around Chen Cang were already full of worship!

However, Meng Xi suddenly asked: "How do you think the patient should be treated now?"

During this time, Chen Cang made bad foundations and was very well equipped with theoretical knowledge.

"First, the first step is to relieve cardiac tamponade. Patients now have more fluid in the heart cavity. The first step should be pericardial aspiration."

"At the same time, the nature of the pericardial effusion is tested and blood cultured to find pathogenic bacteria and use sensitive antibiotics based on the pathogenic bacteria."

"Finally, if there is no relief, use a pericardiotomy!"

Instead of praising Chen Cang too much, Meng Xi asked lightly, "Can you succeed if you pierce you?"

【Ding! Pass the mentor Meng Xi's test and get a favor rating of +3, Ding! Trigger the second loop of the test task to perform a pericardial puncture on the patient. 】

As soon as Chen Cang's eyes brightened, it was still a series of tasks, what would be the last link?

"Yes!"

At this time, Wu Peng, the emergency doctor, came back, and the doctor with the ultrasound room pushed in the car.

"Director Meng, here it is!" Wu Peng said in a hurry.

The doctor in the ultrasound room, because he often deals with internal medicine, has a good relationship with Meng Xi, and also knows Meng Xi's character.

So after seeing Meng Xi, instead of talking nonsense, he nodded and asked, "Director Meng, what about the patient?"

Meng Xi said, "I suspect it is bacterial acute pericarditis ~ www.novelhall.com ~ the patient still has some signs of cardiac tamponade."

b When the super doctor heard it, his face changed slightly and his heart became congested?

This disease is not a joke!

With that in mind, I hurriedly started.

Color ultrasound is still very good for this check.

It didn't take long before the results came out!

There is a lot of pericardial effusion, which has oppressed the lungs and bronchi, which has caused certain effects on breathing, and also has some oppression on the heart.

Under the echocardiogram of the heart, the ejection fraction seen by the heart has begun to decrease.

Doctor B Chao frowned: "Director Meng, puncture as soon as possible!"

Meng Xi nodded: "Xiao Chen, come on!"




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