【1215】Common diseases should be excluded one by one
"He is my grandson." The sick boy's grandmother reported the incident to the doctor. "The school teacher said he had a cold and fever. I only found out from the teacher when I went to pick him up. He was fine when we sent him to school in the morning.
Yes, he doesn’t have a fever. I don’t know what happened to him at school. It’s not convenient for his parents to go to work, so I asked me to take him to the hospital to prescribe medicine first.”
After listening to the family members' description of the situation, Xie Wanying squatted down and was level with the child's head so that she could easily observe the child's face and breathing.
The boy had some mucus coming out of his nostrils, as if he was sneezing, his eyes were red, his voice was hoarse, he had a fever and had no strength, it was like a cold.
For patients with fever, the triage nurse must first take a thermometer to measure the temperature. Xie Wanying turned to the elderly and asked: "Have you taken out the thermometer?"
"Thermometer? Oops, I forgot." The patient's grandmother hit her forehead with her hand.
Elderly people who accompany their children to see a doctor tend to forget things as they get older and cannot remember the details given by the doctors and nurses. The thermometer under the child's arm is expected to have exceeded the ten-minute limit given by the nurse.
We can’t blame the nurses on this matter. Emergency nurses in tertiary hospitals are very busy. The nurse in charge of sitting at the triage table needs to help other colleagues give injections to patients when they have time. The latter situation is more urgent than watching the patient take the temperature.
Anyway, when the doctor sees the child, he will ask about his temperature and will not completely forget about it.
"It's okay." Xie Wanying comforted her grandma. She reached out and gently touched the thermometer from the child's armpit, took it out, and read the mercury degree on it under the fluorescent lamp: thirty-nine degrees six.
You can re-measure it, but the value should not deviate much. In short, do not burn the temperature above 40 degrees.
Thirty-nine degrees six is close to forty degrees, which has an impact on human brain activity. As a result, the boy suffered from headaches and dizziness, and was unable to answer the doctor's questions.
Without asking the child to rest more, Xie Wanying took out a stethoscope from her pocket and listened to the child's lungs to rule out pneumonia.
The most feared complication of viral colds is pneumonia. Once pneumonia is diagnosed, needless to say, you will definitely need to be hospitalized. Which department you stay in does not necessarily mean you go to pediatrics. Because the National Association does not have a pediatric internal medicine department, you may be admitted to their respiratory internal medicine department.
For example, when she was in the second year of general surgery, if there was no transfer to pediatric treatment, these departments would admit some children to the hospital based on the scope of specialist disease treatment.
After listening to the boy's lungs, it was found that the child's lungs were in good condition. The child's cough was not serious, there was no wheezing, and there was no chest pain.
Xie Wanying took out two magic weapons for doctors to see a doctor from the pocket of her white coat: cotton swabs and a flashlight.
"Classmate Wei Wei, come on, open your mouth."
When he heard someone calling his name, the boy raised his head and saw the smiling and beautiful eyes of the doctor sister in front of him. He seemed to be mentally comforted.
The ten-year-old child is able to cooperate with the doctor. The boy opens his mouth wide.
There was no tongue depressor, so Xie Wanying used two cotton swabs instead of the tongue depressor to press the child's tongue. The area pressed by one cotton swab was not enough, so two cotton swabs were needed.
Hold up the flashlight with the other hand and use the light of the flashlight to look inside the child's mouth.
Don't think that the doctor only looks at the throat. A good doctor will focus on observing the patient's oral mucosa. For children, fever caused by acute pharyngitis is much less common than in adults. Acute tonsillitis in children is common among children, so it needs to be focused
Excluded. Others, some diseases that may appear relatively rarely in today’s society, also require doctors’ vigilance and attention, such as measles.