Chapter 369 After Leaving the Instrument, Will You See a Doctor?

Wu Yushu was soon given 19 beds in cardiac surgery. The doctor in charge of the beds was Zhang Wenfu, a senior attending physician.

Tao Mi intends to use the patient as a case to teach everyone.

Many students do not know much about constrictive pericarditis. Most cardiac surgery patients have cardiovascular disease, and most of them have heart valve disease. This chronic protracted pericarditis is still relatively rare.

Therefore, Tao Mi thought about it, and regarded it as a teaching round.

...

Qian Lin followed the graduate student beside him and looked at the patient curiously, took out a pen and paper, and started taking notes.

Clinical teaching is to cultivate a clinical thinking ability for the diagnosis and treatment of diseases.

The other doctors and students gathered behind him, while Zhang Wenfu stood in front and asked about his medical history.

Zhang Wenfu is a little nervous!

After all, there was a script for teaching ward rounds in the past, and the patient's situation was memorized and kept in mind.

And this time, it's the real deal.

It's a little frustrating for everyone.

What's more, a patient with constrictive pericarditis, which is rare in clinical practice!

Thinking of this, Zhang Wenfu murmured, but don't be ashamed...

Behind him are the doctors of the entire Corey, as well as a group of students... The most important thing is that Director Tao Mi is still watching from behind.

It would be tragic if...

Thinking of this, Zhang Wenfu began to collect detailed medical history.

I have to say that Zhang Wenfu is indeed an experienced doctor. He is very comprehensive in collecting patient information, and he quickly got some meaningful clues.

but!

After inquiring about his medical history, Zhang Wenfu became even more uneasy...

Because this symptom is more like COPD! (chronic obstructive pulmonary disease).

Zhang Wenfu was a little flustered. It is quite difficult to detect constrictive pericarditis with a simple physical examination. It is a test of a clinical doctor's grasp of the signs of this disease.

Could it be... an ER physician misdiagnosed?

Thinking of this, Zhang Wenfu's eyes lit up. After all, there are not a few such cases in the clinic. After all, the emergency department is a transit department, and it is not uncommon for the diagnosis to be unclear.

However, this phone call to the director in person should be diagnosed as constrictive pericarditis!

Forget it, push it according to constrictive pericarditis.

All the signs of constrictive pericarditis kept appearing in his mind, and he made up his mind and proceeded step by step.

He won't push backwards, and he won't go backwards?

Thinking of this, Zhang Wenfu picked up the stethoscope and listened. After listening, um, the heart sounds were indeed a little abnormal.

Then there is the percussion of the heart, which doesn't seem right, um, the voiced world is a bit big!

And then there's the physical exam...

Until the end, Zhang Wenfu suddenly realized that this should be a constrictive pericarditis!

At this moment, Zhang Wenfu had to admire the doctor in the emergency room.

It is difficult for him to push down this constrictive pericarditis, but how difficult is it to diagnose?

Thinking of this, Zhang Wenfu couldn't help but wonder, who is the great man?

Could it be Director Li Baoshan?

Zhang Wenfu asked curiously, "Do you know what illness you had in the past?"

Wu Yushu shook his head: "I don't know, just as Dr. Chen said, I may have had this old problem before, but I didn't pay attention until Dr. Chen diagnosed me with constrictive pericarditis."

Tao Mi was a little curious, how did Xiao Chen diagnose it?

Thinking of this, Tao Mi asked, "How did the emergency doctor diagnose you?"

Wu Yushu thought for a while: "In the morning, there are more patients, so Dr. Chen listened to the heart, then checked the blood pressure, and when he touched his stomach, he said that I might have constrictive pericarditis... Five or six minutes."

The people around were stunned.

Tao Mi swallowed, what kind of ability does Meng Xi have to make a person progress so fast?

Tao Mi: "Don't have an ECG?"

Wu Yushu nodded: "Well, no, Dr. Chen told me to come here for a comprehensive examination after being hospitalized."

Tao Mi snorted: "Xiao Zhang, give a doctor's order to complete the relevant examinations as soon as possible, and continue to discuss this case tomorrow morning."

Zhang Wenfu nodded and gave the patient relevant examinations, such as chest X-ray, cardiac ultrasound, abdominal B-ultrasound, electrocardiogram... and various physiological and biochemical examinations.

...

...

When the shift was over the next day, Tao Mi looked at Wu Yushu's examination report sheets, and all the signs indicated that the patient had constrictive pericarditis.

Tao Mi was a little emotional, looked at the crowd and said, "Wu Yushu has been diagnosed with constrictive pericarditis on the 19th bed, but... this is a wake-up call for us."

"Emergency doctors can make a clear diagnosis of patients without passing auxiliary examinations, but please ask yourselves, Wu Yushu, can you be sure just by physical examination and consultation?"

In a word, everyone was silent.

Zhang Wenfu couldn't help blushing for a while. To be honest, if he hadn't known in advance that it was constrictive pericarditis, would he have been able to diagnose it clearly?

Not only Zhang Wenfu, but even the people around couldn't help but reflect.

Maybe...?

Tao Mi looked serious and said seriously: "As a clinical doctor, if you go to the grassroots level or go to the countryside, let alone CT, MRI, even B-ultrasound X-rays or even electrocardiographs are not available. Patient, you only have a sphygmomanometer and stethoscope, can you make a judgment? Can you give the patient a relatively accurate answer?"

Speaking of which, Tao Mi even felt a little disappointed.

Many doctors today have lost the ability to think independently, relying on instruments and examinations to see a doctor. Who can’t see a doctor in this way?

"I'm not saying that everyone is not good enough, I think that every doctor, since you have done clinical work, you must improve yourself. Instrument examination is a good thing, and it can help us make a better diagnosis. However, you must not forget some Basic clinical operations."

"Otherwise, other patients will laugh at us. If you leave the instrument, will you see a doctor?"

When he said the last sentence, Tao Mi's voice increased significantly!

This sentence echoed in everyone's mind, and they couldn't let go for a long time.

"If you leave the instrument, will you see a doctor?"

The doctors couldn't help clenching their fists. This sentence really pierced into their hearts like a needle.

The entire office was silent.

Tao Mi looked around and suddenly said loudly: "Starting from next week, there will be a small round of wards every week, starting with the auscultation of the heart, I need you to remember the auscultation sound of each disease!

A stethoscope can tell us a lot of clues. This is all experience. Look at yourself now. How many of you wear a stethoscope every day? Some people don't even bring stethoscopes for rounds. Do you still look like an extracardiac doctor? "

After finishing speaking, Tao Mi said with a dark face, "Okay, let's end the meeting!"

Regardless of the crowd, get up and go.