On the way, Zheng Ren called Zhou Litao.
He briefly talked about the situation of the patients sent there, and told Zhou Litao that if he had no other judgment, he would give him a shot of diazepam first.
Under normal circumstances, when encountering similar patients, doctors would not dare to directly inject a shot of Diazepam.
Patients who had been agitated by hypoglycemia before calmed down for a while and stopped moving, but their blood sugar continued to decrease.
If blood sugar falls below a certain limit, it may endanger the patient's life.
Similar to this, for patients with abdominal pain, it is contraindicated to take analgesics in order to avoid pain.
Zheng Ren explained, and Zhou Litao took the order and left.
One injection of diazepam can basically confirm the diagnosis. The only thing left is to wait for the EMG side to do a more detailed examination after returning to work.
"Boss, if it wasn't for his illness, he would be so good at mechanical dancing!" Su Yun was still sighing.
"It's impossible. There are several movements that obviously go against the common sense of biokinesiology and can't be mastered through practice." Zheng Rendao.
"Tsk, tsk, I still feel it's a pity."
The two of them went to the community hospital to take a look while talking.
The patients here are very stable and the doctors who are training are diligent and conscientious.
The lecture fee has been mentioned as 800,000 euros, and they all know it. Besides, it’s just the lecture fee, and it doesn’t involve Boss Zheng’s step-by-step instruction.
Even in class, it is said that Brother Yun is the one doing the talking, and Boss Zheng doesn't even show his face.
Although they were still on duty in the imperial capital, they did not dare to complain.
Even most doctors think that after helping here for half a year, it is already a blessing to be able to perform an operation on Boss Zheng when he leaves.
After leaving the community hospital, Zheng Ren and Su Yun discussed the matter of doctors taking turns going to 912.
Zheng Ren was not interested in routine work. After a few words, he pushed all these tasks to Su Yun without any interest.
Su Yun didn't care, he was still immersed in the strange and bizarre "dance" of his friend just now, and from time to time he would make certain movements as if having a convulsion.
It's a pity that even he can't imitate it at all.
The two of them went directly to the 912 emergency room from the community hospital. Seeing Zhou Litao standing in front of the bed in the emergency room observing, they walked in.
"Boss Zheng and Brother Yun are here." Zhou Litao said with a smile, "The patient has fallen asleep and the muscle spasm has disappeared."
"Well, let's do the check-up after work." Zheng Ren was relieved when he saw that the patient had begun to snore while sleeping, and his limbs were limp, like a normal person.
"What tests are you doing?"
"It's the inpatient department for examination, and I didn't let you do it." Su Yundao said, "Sending rheumatism immunization."
"..." Zhou Litao also remembered that Su Yun said that those who couldn't understand would be given rheumatism immunity.
He had no idea about stiff-man syndrome, but when Boss Zheng arrived, he refused to miss any chance and quickly took Boss Zheng to his duty room.
Taking out a box of 95 Supreme from the cabinet, Zhou Litao handed it to Zheng Ren and Su Yun.
"Hey, Mr. Zhou, are you corrupt?" Su Yun smiled and held a cigarette in his mouth.
"There's nowhere to go." Zhou Litao waved his hands repeatedly, "This thing is too expensive for me to enjoy. I saw that Brother Yun and you were all smoking these cigarettes, so I bought a box specially for you two."
Zhou Litao was reluctant to smoke a cigarette, put the cigarette back, took out his own cigarette, lit it for Zheng Ren and Su Yun, and then asked: "Boss Zheng, how did you judge?"
"If I didn't call, how would you judge?" Zheng Ren didn't answer, but asked.
"I ruled out the possibility of tetanus at first glance. Judging from the patient's condition, it was probably not a problem with the central nervous system. After all, he was conscious. He was just scared to death and his speech was a bit unclear." Zhou Litao tried hard to recall the patient he had just seen. Case.
Because Boss Zheng had already called, the first reaction was Boss Zheng's, not his own.
Looking back now, Zhou Litao felt that if this patient fell into his hands, it would probably take a long time to get a correct diagnosis.
"Do CT, MRI, and check little by little." Zhou Litao then said, "It may also be Isas syndrome."
"Don't talk nonsense. Isas syndrome is also called myotonia-dwarfism-diffuse bone disease. When you see muscle tremors and rigidity, you lean on it? Your pupils are dilated on both sides. Where did you see dwarfism?"
Su Yun sprayed it directly without hesitation.
"Actually, I interfered with Mr. Zhou's judgment." Zheng Ren said with a smile, "I guess the patient was sent directly. Mr. Zhou's first judgment should be that it was organophosphorus poisoning."
Only then did Zhou Litao suddenly realize.
Looking back on the situation at that time, if there had not been a call from Boss Zheng, I would definitely have thought it was organophosphorus poisoning.
Excessive accumulation and stimulation of acetylcholine at the neuromuscular junction of striated muscles can cause myofiber fibrillation in the face, eyelids, tongue, limbs and striated muscles of the whole body, and even tonic spasm of the whole body muscles.
This nicotine-like symptom is so obvious. Although the patient cannot smell it, there is such a hurdle in his heart that it always takes a lot of time to get a clear diagnosis.
Although it won't delay anything, it's just a case-by-case investigation, but it's still not as smooth as Boss Zheng's direct diagnosis.
"It's okay. If you push in a drop of atropine, you'll know it's not right." Zheng Ren smiled, "It won't delay the patient's diagnosis and treatment, don't worry."
Boss Zheng was still considerate and gave me a step down.
"Brother Yun, does the patient really need to be vaccinated against rheumatism?" Zhou Litao asked.
The work of the emergency department is difficult. If the patient is sent to an unrelated department, even though the inpatient doctor will have a consultation at the end, the patient's diagnosis and treatment will not be delayed. But in the minds of others, it will leave the impression that you don't know how to treat a doctor.
"Well, under normal circumstances, patients can get better by taking diazepam every day and gradually reducing the dose. Treatment with benzodiazepines is the first choice in clinical practice."
"If that doesn't work, just give him a chloral hydrate enema. Send the patient there after he sleeps for a while." Su Yundao said, "It's okay to sleep here with you."
"But..." Zhou Litao said hesitantly, "It seems that the treatment has nothing to do with rheumatism and immunity, but more like a neurological disease."
"They are almost the same." Su Yun laughed, "For example, for the patients who were consulted by the whole hospital yesterday, the boss gave a shock dose of cyclophosphamide 1.0g. Stiff person syndrome is also effective with cyclophosphamide. You said it is not a rheumatism-immune disease. Or some kind of disease."
“…”
This is too simple and crude, and a bit unreasonable.
However, the clinical classification of many diseases is unclear, especially some rare diseases.
According to Zhou Litao's idea, this patient should be sent to the Department of Neurology, but Brother Yun thought that he should be sent to the Department of Rheumatology and Immunology, so just send him there and don't have any other ideas.
If you don’t know how to see a doctor, it’s also Brother Yun who doesn’t know how to see a doctor.