"Examination of the bladder, how full is it?" Zheng Ren asked.
"Where is it? Bladder..." Lingzi was a little surprised. She didn't understand what Zheng Ren meant.
"Sight, touch and listen, eldest sister. To judge urinary retention, you need to percuss and clearly understand the boundary of the bladder." Su Yundao said.
"Oh." Reiko immediately responded sheepishly, then thought for a long time and scratched her head sheepishly, "I forgot."
Zheng Ren sighed inwardly, if this was his doctor, he would kick her to the community hospital to write medical records. Let Chang Yue wait for a few months before talking, otherwise he wouldn't be a doctor if he didn't even do such an important physical examination.
I also got used to it in 912. During the consultation in the hospital, all the talk was dry. If the resident general who reported the medical history said nonsense, he would be scolded by the director and professor who came for the consultation.
Since the lady was sitting across from him, Su Yun was embarrassed to spray the naive little doctor hard. He just smiled, his smile full of ridicule and ridicule.
Reiko was obviously nervous and stammered when speaking. “There were three radial incisions on the anal verge, with a lot of secretions, obvious edema, and anal canal skin defects. Microscopic examination showed that the ligatures at 3, 7, and 11 o’clock had not fallen off, and the surrounding tissue had not fallen off. Congestion, edema…”
"Well, it shouldn't be a problem with the surgery. Have you done any other tests?" Zheng Ren asked.
"I did it, and everything is normal. Blood sugar, ions, kidney function, and urine routine." Lingzi took out her mobile phone and showed the test sheets to Zheng Ren and Su Yun.
There is indeed nothing wrong with the laboratory indicators. They are normal and clean. There is not even a plus or minus sign for the standard ones.
Su Yun frowned, "It shouldn't be."
"It looks like there's something wrong with it."
"You two, what's wrong?" Reiko fell into a state of confusion. How could there be a problem with the normal test results
"Oh, it's nothing. It's just that the test report looks too clean and makes me uncomfortable." Zheng Ren smiled, "It's okay, I'll think about it."
"Boss, you are too polite." Su Yun said disdainfully, "Let's put it this way, I looked at the date and it was yesterday's urine routine. The patient has been using continuous catheterization for three days."
Reiko counted for 2 seconds and nodded.
"The urinary catheter will cause irritation and friction in the urethra. Normally, the occult blood in the urine should be ±, which is correct." Su Yundao, "Red blood cells can be seen, but it is not to the level of diagnosing urinary occult blood. This is normal. There’s nothing wrong with the test sheets for urinary catheter patients, but the one you brought me doesn’t look serious at all.”
"Speak carefully." Zheng Ren took Lingzi's mobile phone and muttered, "Does the patient have other symptoms?"
"She doesn't want to talk to me." Reiko said worriedly. "Every time I go to the ward to see her, she closes her eyes and says we cut off her bladder."
"Ha, does this happen in private hospitals too?" Su Yun said with a smile, making it clear that he was watching the fun.
"Uh, it shouldn't be. How is the patient's expression? Indifferent or excited?" Zheng Ren asked.
"Apathetic? Excited?" Reiko was obviously confused about this clinical judgment.
In fact, this is also a relatively idealistic judgment standard. It is difficult to calculate with quantitative data if the patient's expression is indifferent. What is important here is the clinical skills and the control of various details of the patient.
Obviously, Yiren's classmate has nothing, and is still a clinical rookie.
"Have you had a neurological examination?" Zheng Ren asked.
The answer was confusion again, and this time the girl's eyes became confused.
Zheng Ren was also very helpless. She thought countless times that if she was asked to go to a public hospital for consultation, and she didn't know anything about it, the medical records would definitely be thrown in her face.
"Are you familiar with the doctor on duty at the hospital?" Su Yun asked.
"We are familiar, we are all colleagues."
"Let the doctor on duty do a physical examination." Su Yun said, "See if the patient's expression is indifferent or normal. If you don't know the criteria, check the book first. Then do an ECG to see if there is any decrease in myocardial irritability or signs of symptoms. Various cardiac arrhythmias and conduction blocks.”
"I also want to ask about the exhaust situation." Zheng Ren added, "Is there less exhaust, or no exhaust for a long time? By the way, your glucose tolerance... is wrong."
Zheng Ren said, hesitated for a moment, and seemed to have grasped the key point of the problem.
"Boss, are you still thinking that there is something wrong with the laboratory test?" Su Yun asked, "I just said there is something wrong with this laboratory test sheet!"
"Yeah." Zheng Ren nodded.
"Lingzi, let the patient be discharged from the hospital. Come to 912 and I'll find a bed for her." Su Yun said, looking at Lingzi opposite who was already distracted.
He casually agreed to find a bed in 912. This was a huge favor.
But Reiko didn't seem to understand the rules in these circles. She still hesitated a little, her eyes flickered, and then she lowered her head without saying a word.
When Zheng Ren saw this situation, he immediately knew that his guess was right. He smiled and said warmly, "How long have you been practicing clinical practice?"
"One and a half years, 6 months to get the practicing certificate."
It is common for many hospitals to work without a license. Some public hospitals really have no one available, so they are testing the boundaries of the rules. Private hospitals are because unlicensed people are paid less and can at least be used for personal use.
Zheng Ren actually didn't understand why there were so few thunderstorms in this wave of cool operations.
After seeing it for too long, he didn't think it was strange. He frowned and asked, "The... error in the laboratory test, do you think it is possible?"
"Well… "
"Lingzi, you may have relatively little clinical experience, but you have always heard of the words "human life is at stake", Zheng Ren said in a deep voice, "Every laboratory value is important, and you can't just look at it and ignore it." If there is no problem, just throw it aside. There should be some problems with the occult blood in the urine of patients who have been wearing urinary catheters for a long time, but if you look at the test report, it is too clean."
"..." Lingzi said nothing.
"Furthermore, you said that the patient's condition is not right. I don't think the patient has a problem with you, but that he has entered a very bad situation." Zheng Rendao, "I don't know what it is specifically. If there is an error in the test sheet, , one has kidney failure, and it’s too late for treatment.”
Reiko's face was a little pale, so pale that her blush didn't cover the white color.
"Suppose something really happens, or only the last examination is true, all the blame will fall on the clinician. This blame is too big, are you sure you can handle it?"
"We just went to a hospital in Jinhai City for a medical evaluation a few days ago. The doctor's medical license was revoked for life. It's hard to say the specific amount of compensation, and we didn't ask in detail."
"Boss, she won't tell you, why are you talking so much?" Su Yundao said, "For laboratory tests, if you are interested, go to a large public hospital to check and compare the values. I think we can find the problem right away."