(Thanks to my friends for their emptiness, loneliness, and coldness 671112, ziluo134, Zhifeng Love, Ty~ Wu Yuepiao for encouragement)

For the eight newcomers who just reported today, the experience on the first day was quite happy. At least it was very relaxing, and I even ate with chicken legs. Other friends were envious because they started work directly after the first day of reporting.

The emergency department is also calm. Except for the technician incident under Qiao Qiao yesterday, there are no patients who need to be admitted to the hospital.

First, I went to the anorectal department to change the medicine for Qiu Huaiyuan and Doudou, and then went to the ward on the second floor to patrol the room, and the morning work was done smoothly.

"Brother Liu, Han Miao is discharged from the hospital today. I will help you with it later." Qiu Mingyuan ran over.

"Go and help me as much as possible." Liu Banxia glanced at Xiao Yue who was chatting with Xu Dan and said.

It was so depressed that Brother Liu was very good, but he was a little unreasonable.

"Even if you are officially on duty today, Dr. Wei and Dr. Wang are not here today. Liu Yiqing, Miao Rui and Su Wenhao will follow me first." Liu Banxia said.

"Teacher Liu, do you always go to 24 off after the emergency department?" Liu Yiqing asked curiously.

"It's only temporary now. When there are too many doctors moving to the new building, you can get the shifts. There are only so many clinics now, and there are too many doctors and they can't be separated." Liu Banxia said.

"You can also adapt to the working rhythm of the emergency department in advance. I have no requirements for your night shift for the time being. Anyone who wants to go to can apply. If you want to go to night shifts in the future, you will need to evaluate it."

"Teacher Liu, what about us? Teacher Shi had surgery today." Xu Yinuo asked.

"I'll take you to the operating room if there's nothing wrong in a while. I'll take you around to the operating room. Pay attention to the discipline of the operating room. If anyone makes a mistake, it's not sure when the next time you go in." Liu Banxia said.

I was very excited to give these people, and it was of course good to be able to enter the operating room. I had also been in during my internship before, but I just took a look from a distance.

"There is another thing. The nurses are responsible for the triage work now. In the future, it will be left to you to take care of, and each person will take turns taking turns." Liu Banxia continued.

"After you go back, you can discuss it yourself and arrange the duty schedule. This is also an assessment item for your training. If the triage accuracy is very high, you will get extra points."

After hearing this, these people were a little disappointed. If they really took this job, they would have to be on the triage desk all day long. Even if there were patients who needed first aid, they would not be able to participate.

"Hey? Why are you here again?" Liu Banxia was about to lead them to the operating room for a walk when she saw the TV reporter who interviewed him yesterday led someone in again.

"Hello, Dr. Liu. After our discussion, we decided to make a special program about emergency doctors. From today on, we need to shoot here and collect materials." Qu Feng said with a smile.

Liu Banxia frowned, "I've finished asking our leader for instructions?"

Qu Feng nodded with a smile.

"Then you guys can take pictures, but I have a requirement. Don't occupy the main route, and you can't go to the rescue room or clinic to shoot." Liu Banxia thought for a while and said.

"The emergency department is still a little different from other departments. Usually, there are not many patients, but some patients need rescue as long as they come."

"Doctor Liu, don't worry, we will abide by these things and will not affect your work." Qu Feng promised.

Liu Banxia nodded, "That's fine, you can do whatever you want."

But he still doesn't understand. If the TV station wants to collect materials, wouldn't it be better to go to the affiliated hospital to collect them? There are many patients and many cases there.

If I can’t figure it out, don’t think about it first. Then he was like an old hen, squatting in the emergency room with a bunch of chicks.

"Doctor Liu, there is a patient with abdominal pain, and Dr. Qi is treating other patients." Xu Dan shouted.

"You cheer up, every patient with abdominal pain in the emergency department should be given priority attention," said Liu Banxia.

"There are many causes of abdominal pain. If we don't think about it carefully, it may worsen the patient's condition and may even threaten life."

The patient who came to the hospital was a woman in her forties. She should have suffered a lot of pain, her face was pale, and her head was sweating.

"How long has it been hurt? Can you tell me where it hurts?" Liu Banxia asked.

"I felt my stomach hurt after eating last night. At that time, I thought I had my stomach hurt. Then the pain became more and more severe. It didn't work after taking painkillers. However, it didn't hurt all the time, and it hurts one after another." The patient said.

"Lying down first, let's check it out. Is the place where you are holding your hands the most painful now?" Liu Banxia asked.

"No, the right side hurts, I dare not cover it." said the patient.

Liu Banxia frowned. It was easy to deal with the pain on the left side. If it hurts on the right side, it might be acute abdominal pain caused by appendicitis. If it is really appendicitis, the patient's tolerance is also very strong. Many people can't help but come to see a doctor for an hour or two.

"Qingkeva takes blood pressure and body temperature." Liu Banxia ordered, then reached out and pressed the patient's Mai point.

"Oh."

As Liu Banxia pressed her fingers down, the patient shivered in pain and curled up.

"Blood pressure is 80/120, body temperature is 38.6 degrees Celsius." said Sekova.

Liu Banxia nodded and touched the patient's abdomen again. He could feel that the patient's abdominal muscles were a little nervous, but not very serious, and it made him feel more at ease.

If it is a slab-abdominal shape, maybe it is the perforation of the appendix that causes peritonitis, which is too dangerous. This is also one of the reasons why acute abdominal disease is terrible. Now there is only a little nervousness, which only means that inflammation in the abdominal cavity affects the abdominal wall or peritoneum.

"I'll draw blood for you first, then do a B-ultrasound to see the abdominal condition. If it's acute appendicitis, surgical intervention is required. Otherwise, it will be very dangerous after the appendicle ulcer." Liu Banxia said.

Hearing Liu Banxia's words, the patient was obviously startled, "Doctor, can't you just take medicine? Is it a lot of money to do the surgery?"

"Should you wait a while to check the results. Are you from Binhai City or where are you from? Do you have medical insurance?" Liu Banxia asked.

"I came to Binhai to work and do cleaning. I don't have medical insurance and I have rural cooperative medical care." said the patient.

"The agricultural cooperative medical care is fine, and it can be reimbursed in proportion. Yours is an emergency department, and it is OK as long as it is in the province. Let's take a look at the situation first." Liu Banxia said.

"Although appendicitis can also be considered conservatively treated, it is very dangerous. If you really speak seriously, it may cause perforation, necrosis and some complications."

After hearing Liu Banxia say this, the patient's heart is a little more solid, otherwise the salary for two or three months would not be enough to be hit by this.

Xu Dan collected blood, and the mobile ultrasound was pushed over, and Liu Banxia also began to operate directly.

But looking at the images on the screen, Liu Banxia was stunned. The appendix looked intact and had no obvious swelling. How could this be possible?

The symptoms of appendicitis are too obvious. The pain in the lower right abdomen and the pain in Mai's backlash is not appendicitis. Could it be that there is a problem with the gallbladder?

He applied some coupling agent and scanned the patient's upper right abdomen. Judging from the image, the gallbladder was indeed a little inflamed and some gallstones.

But he did not make a diagnosis immediately because the patient's clear pain location was the lower right abdomen. If it was really acute cholecystitis or gallbladder stones, it should be pain in the upper right abdomen.

Although one is above and the other is below, the distance is not very pleasant, but in medical judgment, this is a clear indication.

Ding! Mission release: Strange abdominal pain

Open task: Because there are conflicting indications of abdominal pain in patients, it is difficult for the host to determine the condition. The host needs to apply the knowledge learned to give the patient appropriate medical treatment. The task reward is related to the host diagnosis process and results.

Looking at the task prompt, Liu Banxia frowned, and the system has indeed changed. Now the assessment is not only the final result, but also requires the process.

Just like answering questions, you not only need to give the correct answer, but also need to give the steps and ideas for solving the problem. The simplification is, the higher the reward you will receive.

After hesitating for a moment, Liu Banxia percussed the patient's gallbladder position again, but the patient did not react strongly. If it was really acute cholecystitis and hit the gallbladder while percussing himself, the patient's reaction would be stronger than the tenderness at Mai's point just now.

In order to be more cautious, Liu Banxia swept the patient's kidneys and ureters to see if it was abdominal pain caused by kidney stones.

Although there are stones in the kidneys, there is no stasis, and the ureteral examination is also very clean.

"Through the B-ultrasound examination just now, there should be no problem with your appendix. However, there are some stones in your gallbladder. If you want to have further diagnosis, you need to take another CT scan." Liu Banxia said to the patient.

"Doctor, can't I give me some useful painkillers to stop the pain? It really hurts too much," said the patient.

"It's really not possible now. If you are given analgesic drugs, you may ignore many symptoms in the next examination. If you do a CT scan, the CT examination will be more accurate." Liu Banxia said.

"Can you also contact your family? If surgery is really needed, we need to be accompanied by a family member, and you also need someone to take care of you."

"My family is not in Binhai City. I come here to work. Doctor, am I very sick?" the patient asked.

Liu Banxia shook her head, "Don't be nervous, we just asked you this way by following the process. Take a CT scan and you can see it more clearly."

The patient may have been tortured by abdominal pain. Although he felt a little sorry for the money, he still nodded in agreement.

Liu Banxia was not in such a relaxed mood, and this complicated abdominal pain really stumped him.

The same reason is still the case. If the cause is not found, it may delay the treatment of the patient, leading to more serious complications and life-threatening.
Chapter completed!