When a doctor opened a plug-in

Chen Cang's regulations are very clear!

First, deduce the cause of the patient based on the symptoms, signs and other clues.

Then go according to the current medical history and past history, and jointly promote the possibility!

Then begin to verify your judgment through physiological and biochemical tests.

Chen Cang's simple rescue and the process used allowed many students to form a logical thinking framework.

Chen Cang smiled: "This is clinical thinking!"

Everyone was taken aback.

In fact, as a doctor, the most important thing is the formation of clinical thinking.

At this time, Xu Dongdong's words made everyone more curious.

"That's right! Teacher Chen, the serum electrolyte hasn't come out yet, how did you guess the blood potassium level! Is it judged by experience?"

"Yes! Teacher Chen, you were too handsome just now, how do you judge, is there a secret?"

...

Looking at a group of students, Chen Cang smiled: "Of course there is a secret!"

When everyone heard it, their eyes lit up, and one by one quickly took out pens and papers. This was "dry goods"!

Real dry goods!

Chen Cang was also happy to share when he saw it.

What does that sentence say?

Correct!Knowledge is not one's own, but only the user and disseminator of knowledge.

As more people get this knowledge, more people can be saved.

"Actually, did you notice that I did an electrocardiogram just now."

Everyone nodded: "Well, I saw it, but... the ECG is just a waveform, what does it have to do with blood potassium?"

Chen Cang said to Xiao Lin at this time: "Xiao Lin, I just had an extra ECG. You can help me get it."

Just to be on the safe side, Chen Cang produced an extra electrocardiogram, which now comes in handy.

Xiaolin was anxious and took it and handed it to Chen Cang.

Chen Cang took the electrocardiogram and said to everyone: "Don't underestimate any of the tests, as small as a thermometer, a blood pressure monitor, a heart auscultation, or an electrocardiogram, x-rays, etc..."

"These checks can tell us a lot of clues!"

"As for hyperkalemia and abnormal electrocardiogram, it is even a typical example. I hope everyone will remember what I said next!"

When everyone heard it, they quickly prepared their notebooks and pens and listened carefully.

"When serum potassium increases, it increases the permeability of the cell membrane to potassium ions during the repolarization phase, which makes the action potential steeper and shortens the time. The first ECG manifestation of high potassium is the towering T wave and the shortened QT, so I see the ECG. At the time, it was basically determined that the patient was hyperkalemia."

"Everyone knows that patients with hyperkalemia come and go in a hurry."

Chen Cang's words "come and go in a hurry" made everyone laugh, but everyone knows that it is true that hyperkalemia can cause cardiac arrest at any time and endanger life!

Chen Cang continued: "It is true that the serum electrolyte test is the gold standard for hyperkalemia, but after the biochemical test is found, the patient has passed one or two hours, and the person is long gone. Why do I want this gold standard?"

"So, at this time, if you suspect hyperkalemia, you must do an electrocardiogram. This is a clinical trick!"

"Moreover, with the increase of blood potassium, different concentrations, there will be different performance, start to remember!" Chen Cang reminded.

"When serum potassium is greater than 6.5mmolL, QRS will be uniformly widened, and ventricular muscle block may occur at this time;

When serum potassium is greater than 7.0mmolL, P wave may decrease and time will increase;

When blood potassium is about 8.5mmolL, P wave disappears, forming sinus conduction."

These are all officially reported and can be used clinically, so when Chen Cang said, he did not hesitate.

If it was only Chen Cang's personal experience, he would say it is very conservative!

After everyone heard it one by one, their eyes flashed green and they kept recording.

A lot of knowledge will shine brightly only when combined with clinical practice.

At this moment, Chen Cang in their eyes has a halo effect!

All were hungry and thirsty.

They can imagine that the difference in electrocardiogram can actually reflect the abnormal signal of human blood potassium.

This is something they never thought of.

Just like Chen Cang said, if you wait for the serum electrolytes to come and the patients are gone, you don't know why!

As a doctor, you must continuously improve your skills.

This technology includes diagnostic technology, treatment technology, surgical technology, and technology for communicating with patients.

Learning is everywhere in life.

At this time, a student couldn't help asking: "Ms. Chen, will he die immediately after his blood potassium reaches 10?"

Chen Cang: "The blood potassium concentration further increased. When it reached 10 mmolL, the QRS progressed and widened, and even merged with the T wave into a sine wave, and finally died of ventricular arrest or ventricular fibrillation."

Having said that, Chen Cang looked at everyone.

"So, the most taboo thing in clinical practice is experience, especially in emergency. Don't use your usual experience to treat others, let alone persuade or encourage others to do it in your life."

"In the case that you don't fully understand the patient, any word you say is wrong, and any suggestion you make is fatal!"

Chen Cang took a deep breath: "If you follow the usual electrolyte disorder just now, you vomit and diarrhea! Isn't it just rehydration to adjust electrolytes? Replenish sodium, potassium, calcium, iron, zinc, selenium, vitamins... If this is the case, what kind of patients are you! Think carefully."

"Medicine, you can't tolerate the slightest sloppy. In the emergency department for these two months, I don't say how much I hope you can learn, but you must learn a little!

"That is danger and caution."

In a word, let all the students who were present to accompany them to calm down.

There is no lack of such examples in life. A method that may be applied to oneself may become the real culprit of the death of others.

and so!

The most appropriate persuasion and suggestion may be: go see the doctor!

Chen Cang smiled: "So, you know: What is the difference between a doctor and a butcher?"

Everyone was taken aback and looked up at Chen Cang.

Chen Cang said earnestly: "The doctor is more courageous, the butcher is more courageous!"

The words were very humorous, and everyone couldn't help but smile after hearing it.

But... but I can't laugh inside!

The more you laugh, the heavier you feel.

Chen Cang looked at everyone, got up and left, and walked towards the office. He didn't expect this group of people to remember everything, but he must remember one thing: When treating patients, he must:

careful!

careful!

careful!

At this time, in the crowd, a man was sweating profusely!

He has lingering fears and dare not lift his head.

Thinking of his own abilities, he felt very naive...

If this old man really handled it in his own hands...

What will the result be?

This is a living life, and he is only in his early 30s. If something goes wrong, who can be held responsible?

Who is responsible for the elderly!

Only one life?

Who can let you try?

...

...

ps: For this story, what I want to tell you is that the kind suggestions made by others may not be suitable for others.

The disease is so!

Why is life not like this?

Without sufficient knowledge of the disease, seemingly well-intentioned suggestions lead to misdiagnosis or mistreatment.

Without sufficient knowledge of the situation of others, what would seemingly well-meaning suggestions lead to?

Chinese medicine believes that medicine is Tao. In fact, life and medicine have many things in common. I hope this story will give you a little bit of inspiration.