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【118】Overcrowded emergency room 5

The nurse was free, so she brought the lathe and transported the dead car accident patient to the hospital morgue.

Father Liu glanced at the dead patient and his breathing became tight. But it seemed strange that the heart rate number on the monitor did not change much for the time being.

"Are there no beds in the cardiac surgery department?" Xie Wanying asked her senior brother because she was worried about her little friend.

Cardiac surgery? Upon hearing her question, both Huang Zhilei and Dr. Jiang were a little surprised.

"He is a patient with angina pectoris. He may have suspected myocardial infarction, so he was put on a monitor." Dr. Jiang said, "The internal medicine department may receive a diagnosis and may require an interventional stent, but there are no beds in the cardiology department."

When answering, Dr. Jiang estimated that Xie Wanying saw the diagnosis on the bedside card and knew what kind of disease this person had. However, the emergency room was full today, and the emergency nurse could not have time to go to the emergency room to put the bedside card.

After last night, Huang Zhilei got to know his junior sister better, so he lowered his head to look at the bedside card and found that it was not there. In fact, he didn't know what kind of patient it was when he first came here. It was Dr. Jiang who called him, not the emergency medicine doctor.

"How can I get a bed?" Xie Wanying asked her senior brother.

"It's too difficult to get a bed today. We have to wait." Dr. Jiang said the difficulty, "Look at my female patient with gastric bleeding. She can't enter our department since she was lying in bed last night. This belongs to our department.

Patient, it’s even harder to say that there are no doctors from other departments on duty in the emergency room today.”

The attending physician couldn't admit the patient even if he wanted to. Xie Wanying immediately thought of Yue Wentong in front of the nurse station. The patient the monitor picked up was admitted by a professor.

"His condition seems to be fine. We need to wait a few more days or transfer him directly to the emergency observation room for observation." Dr. Jiang said, looking at the heart rate and blood pressure values ​​on Liu's father's monitor.

"But for a patient like this, isn't it more important to determine whether several blood vessels are blocked? It's too late to wait until there is a large area of ​​myocardial necrosis. The gold standard for confirming the diagnosis is coronary angiography. And the monitor is an analog lead, so it doesn't

It's as accurate as an electrocardiograph." Xie Wanying said.

Huang Zhilei was surprised: The junior sister spoke so directly, just like last night. The question was neurosurgery last night, and today it is heart disease. Has the junior sister also reviewed other subjects that are not in the internship plan?

In fact, Xie Wanying directly reported the situation to her clinical seniors like last night because her father Liu's condition was a little urgent.

Dr. Jiang was right after hearing what she said. Some patients with cardiovascular diseases may have a balanced oxygen supply and demand before a myocardial infarction, and their electrocardiogram often has no obvious characteristic changes. When the attack occurs, the disease progresses rapidly and collapses.

Lost. Some patients may not have any symptoms just before death. There is only pain reported by the patient, not even chest pain.

"We need to do coronary angiography first to see if the blood vessels are blocked. If it doesn't work, we will transfer from the cardiology department to cardiac surgery." Dr. Jiang said, no longer insisting on what he said at the beginning, and he started to support Xie Wanying's idea.

Xiaoxiao asked Xie Wanying, "You have learned diagnostics, which chapter of internal medicine and surgery have you learned now?"

I feel that this female trainee can point out the key points of clinical observation of the disease, unlike a new clinical rookie. These are completely invisible in medical textbooks and belong to the doctor's personal clinical experience.

This chapter has been completed!
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