When a doctor opened a plug-in

Wu Yushu was quickly admitted to the 19th bed of the Department of Cardiac Surgery. The bed doctor was Zhang Wenfu, a senior physician.

Tao Mi intends to teach everyone with the patient as a case.

Many students do not understand constrictive pericarditis very well. Most cardiac surgery patients have cardiovascular diseases, and most of them are heart valve diseases. This kind of chronic persistent pericarditis is still relatively rare.

Therefore, Tao Mi thought about it again and regarded it as a teaching round.

...

Qian Lin followed the graduate students around him and looked at the patient curiously, took out the paper and pen, and started taking notes.

Clinical teaching is to cultivate a clinical thinking ability for the diagnosis and treatment of diseases.

Other doctors and students surrounded him, while Zhang Wenfu stood in front asking for medical history.

Zhang Wen is a little nervous!

After all, there were scripts for teaching ward rounds in the past, and the patients’ conditions were memorized and kept in mind.

But this time it was a real job.

Give everyone a panic.

What's more, it is a patient with constrictive pericarditis that is rare in clinical practice!

Thinking of this, Zhang Wenfu whispered, don't be ashamed...

Behind him was the entire Corey doctor and a group of students...The most important thing was that Director Tao Mi was still staring behind him.

If...it would be a tragedy!

Thinking of this, Zhang Wenfu began a detailed medical history collection.

I have to say that Zhang Wenfu is indeed an experienced veteran. He collected patient information very comprehensively and quickly got some meaningful clues.

but!

After inquiring about the medical history, Zhang Wenfu became even more nervous...

Because this symptom is more like COPD!(Chronic obstructive pulmonary disease).

Zhang Wen is a little flustered. It is still quite difficult to detect constrictive pericarditis through physical examination. It will test a clinical doctor's grasp of the signs of this disease.

Could it be... the emergency doctor made a diagnosis error?

Thinking of this, Zhang Wenfu's eyes lit up. After all, there are many such cases in clinical practice. After all, the emergency department is a transit department, and it is not uncommon for the diagnosis to be unclear.

However, this call to the director personally, it should be diagnosed as constrictive pericarditis!

Forget it, just push it according to constrictive pericarditis.

All the signs of constrictive pericarditis continued to surface in his mind, calmed his mind, and proceeded step by step.

He won't push backwards, or retreat?

Thinking of this, Zhang Wenfu picked up his stethoscope and listened. After hearing this, um, the heart sound was a little abnormal.

After that was the percussion of the heart, which seemed wrong, um, the dullness world is a bit big!

Then there is the physical examination...

Until the end, Zhang Wenfu suddenly understood that this should be a constrictive pericarditis!

At this moment, Zhang Wenfu had to admire the doctor in the emergency department.

It is difficult for him to push down with this constrictive pericarditis, but how difficult is it for others to diagnose it?

Thinking of this, Zhang Wenfu couldn't help but wonder, who is it?

Is it director Li Baoshan?

Zhang Wenfu asked curiously: "Do you know any illness before?"

Wu Yushu shook his head: "I don't know, just as Dr. Chen said, I may have this old problem before, but I haven't paid attention to it. I didn't react until Dr. Chen diagnosed me as having constrictive pericarditis."

Tao Mi is a little curious, how did Xiao Chen diagnose it?

Thinking of this, Tao Mi asked: "How did the emergency doctor diagnose you?"

Wu Yushu thought for a while: "In the morning, there are many patients. Then Dr. Chen listened to the heart, then checked the blood pressure, touched my stomach and said that I might have constrictive pericarditis... Five or six minutes."

Everyone around was blinded.

Tao Mi swallowed, what is Meng Xi's ability to make a person progress so fast?

Tao Mi: "I haven't done one ECG?"

Wu Yushu nodded: "Well, no, Dr. Chen said he asked me to come to the hospital for a comprehensive examination after I was hospitalized."

Tao Mi hummed: "Xiao Zhang, give your doctor's order, complete the relevant examination as soon as possible, and continue to discuss this case tomorrow morning."

Zhang Wenfu nodded and gave the patient relevant examinations, chest X-ray, heart color Doppler ultrasound, abdominal B-ultrasound, electrocardiogram... and various physiological and biochemical examinations.

...

...

At the shift of the next day, Tao Mi looked at Wu Yushu's inspection reports, and all the signs indicated that the patient was a constrictive pericarditis.

Tao Mi sighed and looked at the crowd and said, "Bed 19 Wu Yushu has been diagnosed with constrictive pericarditis, but... this is a wake-up call for us."

"Other emergency doctors can make a clear diagnosis of the patient without passing the auxiliary examination, but everyone asks yourself, Wu Yushu, can you be sure by physical examination and consultation alone?"

In a word, everyone was silent to ask.

Zhang Wenfu couldn't help but blush for a while. To be honest, if he didn't know in advance that it was constrictive pericarditis, could he diagnose it himself?

Not only Zhang Wenfu, but even the people around him couldn't help but reflect.

Maybe...?

Tao Mi looked serious, and said seriously: "As a clinical doctor, if you go to the grassroots level and go to the countryside, let alone CT and NMR, even if you don’t even have a B-ultrasound X-ray or even an electrocardiograph, one will come. Patient, you only have a sphygmomanometer and stethoscope. Can you make a judgment? Can you give the patient a relatively accurate answer?"

Speaking of this, Tao Mi even felt a little disappointed.

Many doctors nowadays have lost the ability to think independently and rely on instruments and examinations to see a doctor. Who can't see a doctor like this?

"I am not saying that everyone is not good enough. I think that every doctor, since you are engaged in clinical practice, you must improve yourself. Instrumental inspection is a good thing and can help us make a better diagnosis. However, you must not forget some Basic clinical operation."

"Otherwise, the patients will laugh at us and leave the instrument. Will you see a doctor?"

When speaking the last sentence, Tao Mi's voice was obviously raised a few points!

This sentence echoed in everyone's mind, and it took a long time to let go.

"Leaving the instrument, will you see a doctor?"

The doctors couldn't help clenching their fists. This sentence really pierced their hearts like a needle.

The whole office was silent.

Tao Mi looked around and suddenly said loudly, "Starting next week, we will have a small round every week. Starting from the auscultation of the heart, I need you to remember the auscultation sounds of every disease!

A stethoscope can tell us many clues. This is all experience. Now look at yourself. How many stethoscopes do you wear every day?Some people don't wear stethoscopes for ward rounds. Do you still look like an outsider doctor?"

After speaking, Tao Mi blackened his face and said, "Okay, the meeting is over!"

Regardless of everyone, get up and leave.