I Can See Health

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Lu Chen continued to read books on ECG interpretation.

He still had no clue about the abnormal electrocardiogram of the 12-bed patient this morning.

Do we really have to wait until Sun Guoguo answers tomorrow morning?

Lu Chen was a little unwilling.

"Lu Chen, let's eat chicken together. Four are short of one, are you coming?"

Battle royale games are pretty good these days, and the other three people in the dormitory are playing games on their phones.

Lu Chen smiled and shook his head, "No, just play, I'm not very good at it."

"Hey, that's okay."

The roommates were having fun while Lu Chen kept flipping through the electrocardiogram manual.

Start reviewing the principles of electrocardiogram, look at the specific meaning of each waveform change, and then find various examples to interpret...

At eleven o'clock at night, the moon and stars were sparse.

The night was already very dark.

The lights in the dormitory were turned off, and only the lamp in front of Lu Chen's desk was on.

The halo of the desk lamp shone on Lu Chen's face.

He slowly began to have some clues about the abnormal electrocardiogram in bed 12.

The electrocardiogram characteristics of the 12-bed patient were: sinus bradycardia, premature atrial contractions, as well as downward slope depression of the ST segment, flat T wave and shortened QT interval, with a measured value of 280 ms.

Isn't this a "fishhook-like" change?

Lu Chen's eyes lit up, but then he became confused again.

"Fishhook-like" changes in the electrocardiogram are usually caused by the digitalis effect caused by overdose of "digital" drugs, resulting in poisoning.

But according to the patient's own description, she is not taking any medicine at all.

What's more, it's "digitalis" cardiotonic drugs!

This drug is only used by patients with heart disease and heart failure.

Now that the possible cause of the patient's illness has been identified, another dilemma arises.

Time passed by minute by minute.

After all, Lu Chen couldn't resist the heavy sleepiness and slowly fell asleep.

…

A night of silence.

The next day.

Lu Chen came to the department at seven o'clock and took the blood pressure of the four patients in his charge.

The mental state of the 10-bed old man was much better than the previous day.

He lay flat on the bed, breathing steadily, not feeling agitated at all, and he could even take the initiative to say hello to Lu Chen.

"Dr. Lu, are you here for ward rounds so early?"

"It's late. Dad, did you still cough up red phlegm last night?"

The old man shook his head, "No, it's white sticky phlegm."

Lu Chen nodded, then took the mercury blood pressure meter and measured his blood pressure.

The blood pressure is around 140/80mmHg, which has dropped a little compared to yesterday morning.

After measuring the blood pressure, the lungs are auscultated.

Auscultation of the lungs is mainly to determine whether the wet and dry rales in the lungs have decreased.

Especially for patients with heart failure and pulmonary infection, it is extremely important to auscultate changes in rales in the lungs!

The 10-bed old man can still hear crackles in both lungs, but compared with yesterday, it has reduced a lot!

This shows that the old man's condition is gradually improving.

…

And the aunt in bed 12 was wandering in the corridor early in the morning.

When he saw Lu Chen coming, he pulled him over and asked him again.

"Doctor Lu, how is my condition now?"

It's strange to say that she has always been alone, and Lu Chen has never met her family members.

"Auntie, please don't be impatient." Lu Chen said, "We will make a decision after our superior doctor checks the room this morning."

Lu Chen once again asked the 12-bed patients whether they had taken any "digitalis" drugs.

The 12-bed patient still denied it continuously.

"Doctor Lu, I haven't been sick before, why should I take medicine?"

The way Lu Chen looked at her, she shouldn't be lying.

Then this is a little strange!

There is absolutely no way to ingest digitalis!

The conditions of the patients in the other two beds are stable and no special treatment is required.

…

Half past seven in the morning.

Everyone else in the group showed up, including two interns.

"Junior brother, do you see what that electrocardiogram is?"

Sun Guoguo walked into the doctor's office and said to Lu Chen with a smile.

"Senior sister, is this a fishhook-like change?" Lu Chen replied tentatively.

Sun Guoguo nodded happily.

"Yes, the electrocardiogram of the patient in bed 12 has a very typical fishhook-like change! It is also the effect of excessive digitalis!"

"Senior sister, this patient denies taking any medicine!" Lu Chen said doubtfully.

For patients with digitalis poisoning, it is very important to take this type of drug for a long time, which will cause a kind of accumulated toxicity. It is not toxic when used in small doses.

If it is really considered to be digitalis poisoning, the patient will definitely ingest digitalis through the gastrointestinal tract.

But now it seems that this possibility does not seem to be true.

"So this is what I'm confused about." Sun Guoguo pondered, "But what we need to do now is to improve the measurement of serum digitalis to determine whether there is a possibility of digitalis poisoning, then treat it, and finally find the The cause!”

When the cause of the disease is unknown, the most important thing is to treat the symptoms, stabilize the patient's condition, and then slowly find the cause.

Others in the same group were also attracted by the discussion between Lu Chen and Sun Guoguo, and several people picked up the electrocardiograms of the 12-bed patients to watch.

…

Eight in the morning. UU reading www.uukanshu.net

After the shift handover, Li Yao still didn't come to the department today.

Sun Guoguo led everyone to start checking the ward.

Came to bed No. 10.

The old woman took out a small bamboo basket from the bedside table in the ward. There were more than a dozen eggs in the basket.

The eggs looked very big, with some dirt still stuck to them.

"Doctor Sun, I asked someone from my hometown to bring this to you."

The old woman was holding the bamboo basket tremblingly, holding the bottom of her hand in one hand to protect the basket tightly.

"No, thank you, mother-in-law." Sun Guoguo quickly refused, waved her hand and said, "You can take it back and eat it yourself."

"Dr. Sun, don't worry, these eggs don't look good, but they are our own local eggs." The old woman handed the bamboo basket to Sun Guoguo's hand, "Oil eggs are very nutritious!"

Sun Guoguo saw that her refusal was fruitless, so she had no choice but to accept the bamboo basket and hand it to Lu Chen.

"Junior brother, you can take it back to the department and keep it there. Anyone in the group who wants it can go and get it."

Clinically, red envelopes from patients must not be accepted!

However, we cannot refuse the local products and fruits brought by some patients, and we can accept a small portion as appropriate.

"Mother-in-law, daddy's condition is stable now, but you can't give him so much water in the future." Sun Guoguo pointed to the 500ML large water cup on the bedside table.

Patients with heart failure must strictly control their fluid intake.

Many patients drink too much water, which increases the load on the heart and induces heart failure.

"Thank you Dr. Sun, when can we be discharged from the hospital?" the old woman asked.

"Not yet, probably in four or five days." Sun Guoguo pondered for a moment and said.