Chapter 222 Outpatient Chest Pain Patient
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The next day, the news that Zhang Lide, the director of the Department of Internal Medicine brought an intern, quickly spread throughout the Department of Internal Medicine, and even other departments also heard about it. Many people were surprised by this incident, and some Many people are extremely skeptical about this matter.
Because trainees are generally assigned an attending doctor to teach at most, and it can be said that it is very rare for a deputy chief physician to teach.
As for the situation where the head of a department brings interns, in the attached one, it has never happened before, let alone a head of a major department.
So after the news got out, many people didn't believe it; but several physicians who were on duty yesterday in the internal medicine department all swore that Director Zhang had indeed brought an intern to the department to see the patient. And it's not rounds, it's simply taking interns to see patients.
Moreover, these doctors also said mysteriously: "The reputation of this trainee is also very famous in Fuyi recently, that is, the one who used the knife to perform tracheotomy on patients..."
What the doctors said was so vivid, and there were doctors in several departments who said so, naturally no one would not believe it.
So the doctors and nurses in Attached One are also curious. Who is this Xu Ze? It is really curious enough to be able to teach Zhang Lide, the director of the Department of Internal Medicine, who has always been high-spirited.
However, most of the people who knew Xu Ze's real situation were the directors of various internal medicine departments. The impact of the subject competition incident is still there. It was a matter of the face of the internal medicine department, so they would not reveal Xu Ze's situation to the public.
Director Qu and a small number of doctors in the emergency department are the only ones who know Xu Ze's real situation, except for the internal medicine department. At the beginning, Xu Ze worked in the emergency department with the brand of a doctor in the round; but now Xu Ze His identity is a trainee who has not yet graduated from Star University.
Who dares to disclose the details of Xu Ze, otherwise, if it is revealed that the emergency department actually let an ungraduated student get the brand name of Lun doctor, even Director Qu will be in trouble.
Therefore, student Xu Ze is extremely well-known among the medical staff in the First Affiliated University of Star University. Many people want to see who this kid surnamed Xu is. It made Zhang Lide, the director of internal medicine, so favored.
Even on the campus of Xingda University, those students who saw Xu Ze teaching one-on-one with Zhang Lide behind their own eyes, passed it on.
This incident also caused quite a stir in the Xingda Clinical Medical School.
Especially these senior students who are also on probation, they naturally know what it is like to be taught by the director of Internal Medicine of the First Affiliated University of Star University, and they can't help but admire Xu Ze more and more at the moment.
This person at the top of the Billboard is really extraordinary, no matter where he goes, he will be extremely noticeable...
Xu Ze, who was in the center of the storm, naturally didn't know much about it, because at this moment, he was following Zhang Lide in the internal medicine consulting room of the outpatient building.
Zhang Lide, as the director of the Department of Internal Medicine of the First Attached University of Star University, is naturally well-known in the Star City area. He sits in the outpatient clinic of cardiovascular medicine specialists, and he will sit in the outpatient clinic for two afternoons every week. And at this time, there will be a long queue at the door of his consulting room, and hundreds of patients are waiting for him to see a doctor or follow up every day...
Xu Ze, who was sitting next to Comrade Zhang Lide, was helping to see patients. Of course, sitting there is not just helping hands, measuring blood pressure and so on. These nurses who have their own entrances have checked each of them. All he has to do is wait for Zhang Lide to show the patient after reading the medical records Finished, and then he continued to take a look. As the name suggests: learning...
Xu Ze was also very puzzled that Zhang Lide could see more than one hundred patients every afternoon, but he soon understood why Zhang Lide had such a speed.
When a patient comes in, after Zhang Lide briefly asks about the situation, he will listen to it for a few seconds at most, and then he will issue the relevant test sheet to the patient, and ask the patient to do the test . I went on to see the next patient, so the efficiency is naturally extremely high.
However, since Xu Ze came to study by name. Naturally, he would still take a serious look at it. Whenever a patient had an examination and brought back the results, and Zhang Lide was examining another patient, Xu Ze would take a good look at it first.
At this time, Xu Ze was frowning while holding a patient's examination report. This patient was suffering from chest pain. He had had chest pain for two days, and the chest pain was very severe.
And Zhang Lide had already given the patient electrocardiogram and chest X-ray and other examinations. These examination reports of the patient showed that the electrocardiogram showed myocardial ischemia, and coronary heart disease was considered; while the chest X-ray showed no abnormalities.
But when Xu Ze looked at the patient's condition, he always felt that something was wrong. Although the patient had chest pain, which was very similar to angina pectoris caused by impatient ischemia, this patient's chest pain was continuous, sometimes mild and sometimes severe, not serious. Like pure myocardial ischemia.
I looked at the patient's blood pressure just now, and it seemed to be normal.
Looking at the pale face of the patient, Xu Ze frowned. After thinking about it, he was still worried. Then he took another blood pressure monitor and measured the patient's blood pressure.
The blood pressure of the patient's left arm was basically the same as the blood pressure recorded by the nurse in the medical record, both mmhg, which was normal; but after the test, Xu Ze always felt that something was wrong, and then his mind moved. Instead, the patient was asked to stretch out his right arm and take another measurement.
At this time, the patient was always looking at Zhang Lide, waiting for Zhang Lide to see him, but he was extremely impatient with Xu Ze always checking here and there. However, it is limited to the fact that one of the patients in Zhang Lide's hand has not been finished, and it is not his turn yet, so he has to be patient and let Xu Ze examine him.
He helped the impatient patient to roll up his sleeves, and then checked carefully again. Hearing the blood pressure he measured this time, Xu Ze couldn't help raising his eyebrows. It was really wrong... The blood pressure of the patient's right arm was actually the same as that of the left arm. There is a huge difference between the arms. The blood pressure of the right arm is only mmhg, and the pulse pressure difference is 20 mmHg.
Thinking of this difference in pulse pressure, Xu Ze had a flash of inspiration, as if he felt that there was a big problem in the middle, but he couldn't think of any disease that had this symptom, but it seemed to be mild or severe, he was not sure …
At this time, Zhang Lide just finished finishing the patient in hand, and the patient that Xu Ze was seeing had long been a little impatient, and Zhang Lide had already finished dealing with that patient. When it was my turn, I quickly grabbed the medical records and examination results in Xu Ze's hand, sat down with Zhang Lide, and said enthusiastically: "Director Zhang...my results have come out, please help me to see..."
Xu Ze looked at the patient sitting next to Zhang Lide, hesitant to speak, because although he felt that there was a problem, he didn't know what the problem was with the patient. So I had to watch Zhang Lide examine the patient to see if he would see any problems.
Zhang Lide took the patient's medical records and test results, flipped through them quickly, and then listened to the patient again. He nodded and said: "You should have coronary heart disease, myocardial ischemia... Now you still have chest pains, so I suggest you be hospitalized..."
"It's really coronary heart disease..." The patient was taken aback for a while, and after thinking about it, he said to Zhang Lide: "Director Zhang... It's really inconvenient to live here with you, I wonder if you can give me a prescription?" Some medicine, I will go back to our local area for treatment, don’t know if it’s okay?”
Zhang Lide was not at all surprised by the patient's request. After all, there are many patients from other places and subordinate counties who come to the Affiliated University of Xingda for medical treatment. Nearly 50 to 60% of the patients do not want to be treated in the Affiliated One after confirming their illness. Instead, I want to go back to the local area.
Zhang Lide was very experienced, so he nodded immediately and said: "Your illness is quite serious, it is best to be treated in our hospital, and some related examinations are also required... It is okay to go back to your local area for treatment. , but relatively speaking, it is naturally not that safe..."
The patient thought about it for a while, and continued to insist: "Director Zhang, I still want to go back to our place for treatment. The People's Hospital near us is more convenient. As long as the diagnosis is clear, I think it should not be a big problem to go there for treatment..."
"Okay then...it's up to you..." For such a patient, Zhang Lide naturally wouldn't force it, so he swiped his pen and wrote a few notes in the medical record book, and then handed it over to the patient to let him leave Go, see the next patient.
The patient took the medical record, thanked Zhang Lide a few words, and then planned to leave. At this time, Xu Ze thought for a long time, but finally remembered that this patient's situation fits some extreme conditions. Manifestations of serious disease. And Zhang Lide just looked at the blood pressure measured by the nurse in the medical record, so he probably didn't notice the difference in pulse pressure between the patient's arms.
Thinking of this, Xu Ze hurriedly and anxiously faced the patient who stood up and was about to leave. Said: "Wait a minute..."
The patient was stunned when he heard Xu Ze's cry. He was inspected by Xu Ze for a long time, but he was already impatient with Xu Ze, and now he was stopped by this kid, but he was very impatient. Looking at Xu Ze, he said, "Little doctor, what else can you do?"
Seeing that the patient had stopped, Xu Ze hurried to Zhang Lide's ear and said, "Director Zhang, this patient has a pulse pressure difference in both hands...the blood pressure in the right arm is only mmhg, I think he may have other problems..."
"A difference of twenty?" Zhang Lide frowned, but then said with a smile: "Coronary heart patients, some people will have a little difference in pulse pressure, this is normal..."
"But..." Hearing Zhang Lide's words, Xu Ze felt a little relieved. There was indeed such a situation, but he was still a little uneasy. After thinking about it, he hurriedly stood up there. The patient in front of him looked at his heart, and at the same time ordered to the automatic response system: "Start the color B-mode ultrasound, and perform a cardiac color ultrasound examination..."
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