"Mr. Cui is boiling a frog in warm water. He will first ask you to see patients, and then if you can't wipe your face, he will give you benefits and let you work in the emergency department." Su Yundao.
Zheng Ren also thought of the little idea behind this. But with a Nobel Prize project in hand, who would work in a busy, tiring and unprofitable place like the emergency department
Zheng Ren just smiled and did not answer Su Yun's words.
Both of them knew in their hearts that just like Director Pan, Mr. Cui was unwilling to give in.
There are no new people in the emergency department, but they must still exist. They just desperately burned the little life they had left to barely survive.
After working hard, you can only die in the end.
But is personal power useful
It's completely useless. Even if Mr. Cui, at the age of 70 or 80, insists on giving lectures across the country, he will gain very little.
But issues such as improving the remuneration of emergency doctors will cause a chain reaction. This kind of thing is not something that an academician of the Academy of Engineering can decide.
It sounds noble and academician, but it's just a sign. If you say it is useful, then it is useful. It's useless to say it's useless.
Let hospitals and society adjust themselves? So how much does it cost to improve
A while ago, the matter of beating and scolding bus drivers was taken seriously, and now those who beat and scolded bus drivers have begun to be sentenced for endangering public safety.
But when it comes to medical care, the situation is more complicated.
Forget it, he is just a little doctor, Zheng Ren sneered.
All the way to the emergency department, the chief resident, Zhou Litao, was already waiting in the corridor.
He was short in stature and his face was pockmarked. His dark face was in sharp contrast to Su Yun's.
"Boss Zheng, there is a patient with inconsistent symptoms. Mr. Cui happens to be visiting the clinic today and wants to see you." Zhou Litao greeted him and said politely.
"Don't dare, don't dare." Zheng Ren immediately replied: "Mr. Cui fell in love with me by mistake, I don't dare take it seriously."
Zhou Litao smiled and said a few polite words, and took Zheng Ren to Mr. Cui's consulting room.
After entering the door, Zheng Ren saw an old man with white hair and beard sitting in the consulting room, asking for a consultation.
"Hello, Mr. Cui." Zheng Ren bowed deeply and expressed his respect first.
"Well, Xiao Zheng, come and see this patient." Mr. Cui nodded, "Litao, tell Xiao Zheng about the patient's condition."
Zhou Litao immediately said: "The patient came to our hospital for treatment due to intermittent upper abdominal pain for one day, nausea, and vomiting once. The patient had a history of smoking for more than 30 years and a history of hypertension for 10 years. He was treated with Norvax and his blood pressure was well controlled. "
"The patient's abdomen had no distension, no intestinal pattern or peristaltic waves, no skin scars and no abdominal wall varicose veins.
Deep tenderness in the upper abdomen without rebound pain and muscle tension. The liver and spleen were not reached under the ribs, Murphy's sign was negative, and no obvious masses were palpable. Abdominal percussion showed tympani, no percussion pain in the liver and spleen areas, and no percussion pain in the kidney areas. Moving dullness was negative, bowel sounds were about 3 times/min, and no abnormal vascular murmurs were heard. "
"The B-ultrasound report showed mild fatty liver and was negative. However, the patient complained of severe pain. Mr. Cui judged that it might be aortic or mesenteric artery dissection, and was preparing for an emergency 64-slice vascular CTA."
Zheng Ren understood that there were probably patients in row 64 waiting for a call, so he took a look at himself during the break.
This must be what Mr. Cui meant.
While listening to Zhou Litao's narration of the patient's medical history and looking at the patient, Zheng Ren saw that the system panel was bright red.
Several diagnoses such as isolated superior mesenteric artery dissection type 2b and hypertension came to mind.
It's quite a troublesome disease, Zheng Ren thought to himself.
Vascular dissection is very troublesome. From Cui Heming's aortic dissection to the patient in front of him, a lower-level hospital would have admitted him to the hospital or outpatient clinic with abdominal pain pending investigation.
If the diagnosis cannot be made promptly, once the dissection ruptures, death awaits the patient.
Especially in small and medium-sized hospitals, the misdiagnosis rate is quite high when encountering this disease.
As for Mr. Cui, he was able to basically confirm the diagnosis of the disease with just a physical examination. His level and experience are not something to be boasted about.
Zheng Ren nodded and began to examine his body.
As Zhou Litao said, the patient's abdominal tenderness is not obvious, there is some deep tenderness, but it is not serious.
The physical examination showed very mild tenderness, but the patient was pale and sweating profusely from the pain. This was considered a case of severe self-reported symptoms.
This is what the so-called physical symptoms do not match.
After Zheng Ren finished the physical examination, he took another look at the emergency ultrasound and test sheets. The patient can be said to be very healthy, with few positive indicators other than severe pain.
"Mr. Cui, I think it is more likely that it is mesenteric artery dissection." Zheng Rendao: "You can choose to do a 64-slice CTA examination or an interventional angiography to confirm the diagnosis and undergo surgery."
"What about conservative treatment?"
"Hmm... Conservative treatment depends on the opinions of the patient's family. I am a surgeon, and I am not in favor of conservative treatment. Because whether it is isolated mesenteric artery dissection or concurrent aortic dissection, once treated conservatively, it is assumed that the dissection will occur at night. Rupture will cause greater damage to the patient." Zheng Rendao.
He also knows that his attitude is relatively radical.
Surgeons are generally more aggressive. If a problem can be solved with surgery, why should we keep a hidden problem around
Of course, the recovery rate of isolated superior mesenteric artery dissection with conservative treatment is also very high, and Zheng Ren knows this.
However, Mr. Cui only asked for his opinion, and Zheng Ren expressed his inner thoughts.
Mr. Cui looked at Zheng Ren, and then said calmly: "Can you do the patient's surgery?"
"I have no problem coordinating the surgery with the general surgery department." Zheng Rendao said, "I will try my best to minimize the patient's injuries."
"Okay, you and Litao will take the patient for examination. Let me know when it's done." After Mr. Cui finished speaking, he waved his hand and motioned for them to push the patient for a 64-row vascular CTA.
The old man was full of momentum. Zheng Ren recalled the scene yesterday of Mr. Cui pointing at Director Kong's nose, and then smiled bitterly.
People who deal with emergencies cannot be impatient. Even if you are a chronic patient, you will soon be worn out in the emergency department.
Mr. Cui in front of him was very kind. He told him to pay attention to the patient's blood pressure and personally checked the concentration and speed of the antihypertensive drugs pumped by the micropump before letting Zheng Ren and the others push the patient away.
"Boss Zheng, do you think the patient has an isolated dissection or a concurrent aortic dissection?" Zhou Litao asked in a low voice as he walked.
The patient's family members are all around him. Without objective evidence, everything is just a hypothesis. If you can lower your voice, please do so.
"From what I see, the patient's physical signs seem to be isolated." Zheng Ren replied: "The pain point is wandering, not like the pain point of aortic dissection is fixed with radiating pain."
This is reverse inference, based on the inverse inference of the system panel.
Zheng Ren thought it was normal. The physical examination was consistent with the diagnosis on the system panel. He estimated that Big Pig Hoof was right this time.
He thought it was normal, but to others, it was a different story.