"Ma Chu... President Ma, I''m really sorry." Director Song stood up and said when he saw Ma Xiude coming in.
"It''s all right. This is Zhou Guohui, director of the Department of Neurology of DIDU hospital." Matthew said.
"I know." Director Song said quickly. "Director Zhou, who held the academic meeting, gave a lecture."
Zhou Guohui nodded slightly as a greeting. He doesn''t care much about doctors in "Grass-roots" hospitals. They should know themselves, but they don''t have to know them at all.
"Tell me about the patient. You were rescuing just now."
"The patient is now diagnosed with upper gastrointestinal bleeding and has given symptomatic treatment. The situation is not very serious," Song Yabin said.
Upper gastrointestinal bleeding? This one is more bizarre than the other. The patient was a 21-year-old young man with stroke and gastric bleeding.
Zhou Guohui sat down seriously and asked, "let me see the medical record."
A little doctor immediately came up and called out the patient''s medical record page.
The patient was a 21-year-old male who was hospitalized due to sudden dysarthria, mild left limb weakness and ataxia. The NIHSS score at admission was 6, and there were no obvious vascular risk factors.
Previously, the patient had a history of psychotic depression and asthma, and took sertraline and risperidone to treat depression.
The patient was initially diagnosed as posterior circulation stroke, and the right posterior cerebral artery dense shadow was seen on brain CT scan.
It is clear that ischemic stroke is accompanied by cerebral infarction.
Zhou Guohui looked through the doctor''s orders again. The doctors of the second hospital gave the patient a single dose of aspirin 300mg, and then gave clopidogrel 75mg orally once a day.
Because anticoagulant drugs were given, the possibility of upper gastrointestinal bleeding was observed during hospitalization.
Unexpectedly, the patient who had been recovering well during hospitalization had an accident when going through the discharge formalities.
Zhou Guohui turned to the last page and asked, "how is the patient now?"
"Vital signs are stable, blood oxygen saturation is low, 92%," Director Song said. "The blood gas analysis report of urgent investigation shows that the partial pressure of oxygen is 10.7, the partial pressure of carbon dioxide is 5.0, and the pH value is 7.38. It is confirmed that the patient has anoxia."
Zhou Guohui looked at the computer screen and thought about the specific situation in his mind.
After thinking for two minutes, Zhou Guohui said in a deep voice, "look at the patient first."
"Director Zhou, please come here." Song Yabin politely opened the door and bowed down to let Zhou Guohui go out first. Then she walked quickly to Zhou Guohui and led the way straight to the ward.
Zhou Guohui looked at the neurology ward of the second hospital of Medical University and saw that the layout should be a ward that can accommodate about 50 patients. There was no extra bed in the corridor.
He knew that it was not that there were no patients, but that the third class hospital did not allow extra beds, and many patients lined up outside to be hospitalized.
In fact, the patient in front of us should be observed for another two days, but it involves assessment indicators such as bed turnover rate
These are non-medical factors. Zhou Guohui doesn''t care very much. It''s just a habitual flash of thought.
When he came to the ward, director Song opened the door and introduced Zhou Guohui, "this is a patient."
Later, she and the patient''s family said, "this is director Zhou of the Department of Neurology of DIDU hospital. We invited him to consult the patient."
Zhou Guohui looked at the patient and frowned.
The patient is weird.
His pale face may have something to do with the blood loss. Generally speaking, it is normal to have pale lips and eyelids after blood loss.
But the patient''s lips were "crawling" with several capillaries, as if several small insects were lying on his mouth.
"Does the patient have telangiectasia?" Zhou Guohui asked.
"Er..." Director Song Yabin was stunned and nodded.
Zhou Guohui didn''t say much in the ward. After all, he just came for consultation. In particular, He taboo scolding other doctors in the ward.
Not only that, even in their own hospitals, reprimanding lower level doctors in wards will have an extremely bad impact. This involves the patient''s trust in subordinate doctors, which will have a very bad negative effect.
Zhou Guohui inquired about the medical history in detail, and then checked the body. It took a full 20 minutes.
Returning to the office, Zhou Guohui said slightly sternly, "why is telangiectasia not reflected in the medical record? Have you checked your body carefully?"
"..." Song Yabin concluded.
"I just asked the patient. The patient has a history of nosebleed since childhood, which is not reflected in the medical record." Zhou Guohui talked about the patient and the medical record, and the Qi field was all open. "Director Song, I don''t think the physical examination can be careless."
"Yes, yes," Song Yabin replied.
"Give me the imaging data."
A little doctor immediately brought the film, including CT and MRI.
Zhou Guohui watched the film one by one in front of the film reader in chronological order. He watched it very carefully. It took him thirty minutes to "pass" the film.
Director Song and his doctors waited for Zhou Guohui to give a conclusion, but he didn''t expect him to pick up two of them and insert them into the film reader to look at them carefully.
It''s chest CT. One is lung window and the other is mediastinal window.
The little doctors looked at Zhou Guohui in surprise. They didn''t understand why a patient with ischemic stroke should look at lung CT if he didn''t look at head film, color Doppler of cervical blood vessels and vertebral artery blood supply image.
Zhou Guohui did not explain, but reviewed the lung CT film bit by bit, as if there were any treasure in it.
He watched the two films for twenty minutes.
The office was silent, and everyone seemed to feel dark clouds hanging over their heads, increased humidity and difficulty breathing.
The silence was finally broken by Zhou Guohui.
"Horse yard, please ask when Mr. Wu will come."
"Director Zhou, have you found anything?" President Ma asked.
"There is something wrong with lung CT. My level is not enough. I think the patient should do 64 row enhanced CT. It''s better to take a look at the film after Mr. Wu comes." Zhou Guohui freely admits that his level is not enough and is not embarrassed.
"OK, I''ll hurry Mr. Wu again," said Matthew.
Although he also did not understand why Zhou Guohui wanted to see a chest film of an ischemic stroke patient, this was clearly a different analysis. However, Matthew has long been refined. Naturally, he won''t ask at this stall. Director Zhou must have his reason.
"Hello, Mr. Wu. Director Zhou Guohui said there was something wrong with the patient''s lung CT. There is no diagnosis for the time being. I''d like you to have a look at the film."
"OK, OK, I''ll contact you right away."
Hang up, Matthew said, "Mr. Wu can arrive in about an hour. He said to do 64 row 3D CT of the chest for the patient."
"...." Song Yabin was dumbfounded. It was really simple and rude.