Dr. Lin was so angry that he snatched the medical record from the nurse and complained: "You didn't say it!"
"Doctor Zhang didn't tell you when he handed over the shift, Dr. Lin? We asked Dr. Zhang before if the patient had any family members. She said she went to ask, but later she didn't tell us what the situation was." The nurse replied, not planning to take the blame.
Zhu Huicang held up his glasses, first identified Xie Wanying's facial features, and recalled the meeting more than three years ago: Was it the girl who made Cao Yong see the lost soul?
"Have she studied in our hospital now?" Zhu Huicang asked his old classmate Ren Chongda.
"Isn't I following Huang Zhilei when I go to the neurosurgery department?" Ren Chongda said.
"Oh." Zhu Huicang thought: Could someone be so happy that he was so happy because his junior sister came to his department for internship.
Dr. Lin looked through the electrocardiogram that Liu's father had done before: "This, this-"
Zhu Huicang followed his head and looked over, then glanced at Dr. Lin: "The patient you are seeing?"
"No, it's not me!" Dr. Lin denied it with all his strength. "She didn't say that his ECG had changed. What she said was that the ECG seemed nothing, and blood test for myocardial infarction is normal."
If such a big thing happened, he couldn't bear the blame!
"Isn't this a problem? Didn't the st section be lowered?" Zhu Huicang pointed out the problem at once, "Isn't this a typical sign of myocardial ischemia?"
Of course, Dr. Lin saw the same thing, otherwise why did he desperately deny it: "Yes, yes, it's myocardial ischemia."
"It's not just myocardial ischemia, right? The patient's main complaint is that chest pain seems to have vaguely since the morning, and it has been pain for at least several hours before being admitted to the hospital. ACS must be true. If it is ACS, you must be vigilant. You have to go to surveillance for at least eight hours. How long has it been since he entered the emergency room of our hospital?" Zhu Huicang asked and looked at the table on his hand to calculate the time.
acs refers to acute coronary syndrome.
First of all, normal myocardial enzyme examination does not mean that there is no myocardial infarction.
Standard diagnosis of myocardial infarction does not rely solely on myocardial enzyme examination, but is an electrocardiogram, myocardial enzyme or clinical symptoms. Two of the three are consistent with the diagnosis.
Secondly, pseudo-normal manifestations may occur on the electrocardiogram.
For example, some patients with myocardial infarction may happen to have an electrocardiogram performed by a doctor on the patient during the ultra-acute period. At this time, the patient is in the ST-T abnormality during the acute myocardial injury period and before the full development period, the electrocardiogram just returns to normal state. Needless to say, the normal at this time is pseudo-normal.
Therefore, the electrocardiogram produced during this period is very likely to cause doctors to misjudgment of patients. Liu's father may be such a typical case.
Experienced hospitals will definitely provide guidance and requirements for clinicians in the diagnosis and treatment of myocardial infarction.
For example, the National Association stipulates that it is the first electrocardiogram test if it is roughly normal, but Liu's father complains that it is acs. As Zhu Huicang said, he needs to be under custody for more than eight hours.
Chapter completed!