NovelTags Chapter 532
Chapter 532
Lin Feng was speechless: "I don't charge technical fees, okay, only equipment and medicine, okay?" Probably more than 100..."
The patient nodded repeatedly: "That's it!" "
Lin Feng: "But what I want to explain is that because there is no CT verification, maybe your feet do not have foreign bodies, but just simple bacteria, viral infections... So maybe you'll be stabbed in vain..."
The patient hurriedly said: "White, I am not afraid, as long as it is cheap..."
Die for money!
Poor!
Lin Feng was helpless...
Only CT can be skipped and the patient is directly incised to re-debride.
Lin Feng quickly cut the worker's wound and debrided.
Really!
Inside the wound, a small piece of plastic was found.
This plastic, according to the patient, was the sole of the shoe worn when the nail was worn.
Obviously, when stepping on the nail, the head of the nail with a fragment of glue was inserted into the sole of the patient's foot.
And the patient because of the casual manipulation of the co-workers, the debridement was unprofessional, and did not get this glue out, resulting in repeated suppuration and inflammation.
As for why X-rays can't be taken?
It is estimated that it is a material problem.
Lin Feng estimates that this material, even CT, may not be able to see it.
To some extent, the patient successfully saved himself 700 yuan in CT examination fees.
Laugh and cry·jpg.
......
......
Next patient,
A patient walked in.
Not long after I first asked about the condition,
The nurse from the nurse's station ran in.
"Dr. Lin, a doctor from the Department of Neurology, call you for a consultation, may I ask if you are free now..."
"Consultation? I know, when I finish diagnosing this patient, I'll go over..."
"Okay, okay, I'll go back to neurology now."
The nurse leaves.
Lin Feng spent about 10 minutes to diagnose the patient.
End the patient,
There were more than thirty patients waiting for him outside, and Lin Feng's pace quickened a lot, otherwise he would have to work overtime at noon.
......
Department of Neurology.
At this point,
A special patient who stumped the Department of Inner Medicine.
thereupon
Wang Zhen, the attending doctor, invited several doctors from other departments to come to consult.
Among them, Lin Feng is one of the invitees.
Patient, Zhou Xiaodong, male, 45 years old
Sudden limb weakness for 1 day.
The patient had weakness in the limbs without obvious cause 1 day ago, and found that his feet were numb, so that he could not walk, and his hands were numb...
Have a history of high pressure, do not regularly take high-pressure drugs, self-measured blood pressure and found high blood pressure, so they took oral antihypertensive drugs on their own, but the symptoms continued to not be relieved...
Because the condition seems serious,
So the patient was a little panicked and hurried to the hospital to see the neurology.
Wang Zhen, deputy chief physician of the Department of Neurology, received the consultation.
Physical examination:
Blood pressure 129/81mmHg, clear consciousness, bilateral pupils and other large circles, sensitive to light, frontal lines, nasolabial folds symmetrical
Low muscle tone of bilateral limbs, weak muscle strength of both upper limbs and grade 3 muscle strength of both lower limbs.
Other than that
Check blood sugar: normal...
Then Dr. Wang Zhen asked the patient Zhou Xiaodong to do "head CT".
· CT Results: No abnormalities!
After Dr. Wang Zhen got this result, he arranged for the patient Zhou Xiaodong to be admitted to the hospital.
After admission,
The patient's electrolytes were checked and it was found that the blood potassium was 2.8mmol/L.
It is hypokalemia.
Considering hypokalemic periodic paralysis? (Written in chapters 532-533)
thereupon
Doctors prescribe drugs and give oral, intravenous potassium supplementation, and symptomatic supportive care.
(ps: If book lovers can understand the above disease information, it means that the meaning of this book has reached (manual dog head). ）
......
But!!
After potassium supplementation,
Something unexpected happened!
But the patient's condition has not improved, but has worsened!
The skin of the lower extremities is obviously tender!
Numbness of hands!
At this time, you can confuse the tube bed and the attending doctor!
So
The previous "low potassium cause" is not established!
thereupon
Further examination begins.
Repeat head MRI (hypertension) and lumbar spine MRI (tumor compression, etc.), thyroid function, ultrasound (hormone secretion, resulting in low potassium).
Outcome:
Brain MRI: no abnormalities.
MRI of the lumbar spine: no abnormalities.
A gong, B ultrasound: normal.
Attending doctor Wang Zhen: ".................."
Tube bed doctor: ".................."
"Hypokalemia was complicated on admission, and the patient's limb muscle strength still rapidly worsened after the correction of hypokalemia, what is the disease?"
Confused!!
Even more troubling:
At this time, the patient has not been able to treat the cause in time because he has not found the cause in time, and has begun to become very serious.
The patient's limbs are sluggish, numb, and weak, which continue to worsen.
It has even spread to the face, causing facial paralysis.
It became difficult to speak, strenuous coughing appeared, and the heart began to be more loaded.
And what about the families?
At this time, the attitude is not as enthusiastic as before, but a little complaining that the doctor is not effective, worried that the patient will die in the hospital.
No way
The attending doctor, Wang Zhen, could only call, and Hua Renqing found a doctor to come for consultation.
......
Lin Feng came to the Department of Inner Medicine,
Other doctors have arrived.
"Sorry, it's late, just now there was a patient who couldn't leave..."
Other doctors have come and gone,
"It's okay, we just arrived..."
"The emergency department is a little busier than us, understand and understand..."
After some pleasantries,
The doctors came to the patient's bed.
The family is happy.
Wife: "Dr. Lin is here, my husband has been saved!" "
Dr. Wang Zhen: "..........................."
I feel that my medical skills are underestimated by patients ~~~~
Holding his head and crying · JPG
Dr. Wang Zhen began to talk about the patient's condition...
Lin Feng and other consulting doctors listened carefully.
5 minutes,
Finish speaking.
Dr. Wang Zhen: "Do you have any ideas?" "
Lin Feng was not polite because he wanted to fight quickly.
"After potassium supplementation, have you rechecked your blood potassium?"
"No..."
"Did you check blood magnesium in the first place?"
。