medical treatment

Chapter 76

After working until 06:30 in the evening, Yu Zhiming finished diagnosing the last patient assigned to him.

Fifty!
For a whole day, Yu Zhiming received a total of [-] patients, and felt that he was going to be exhausted and paralyzed.

This deep tiredness does not come from the body, but mainly from the spirit.

Not to mention that he has to maintain a high degree of physical and mental attention during auscultation and percussion, and he has to work hard to mobilize what he knows and learn, and carefully verify the patient's symptoms.

The purpose is to make the diagnostic conclusions as accurate as possible.

Unlike in the outpatient clinic of the county hospital, most of the patients who see a doctor are minor ailments such as headaches and brain fever, and it doesn't take much effort.

But the patients here are different. Yu Zhiming needs to check carefully, for fear of misdiagnosis or missed diagnosis due to an oversight.

After working continuously for a day with such high intensity, Yu Zhiming was really tired and stupid.

Even though he worked so hard, he started work nearly half an hour earlier at noon, and managed to diagnose [-] patients in one day.

Yu Zhiming learned about it from nurse Wang Li.

Most of the outpatient visits completed by other clinics today are 100+, [-]+, and even more than [-].

His outpatient volume is considered to be at the bottom.

"However, the quality of my work is high." Yu Zhiming, who was slightly shocked, encouraged himself like this.

He did not dare to say that there must be no mistakes or omissions in his diagnosis, but the error rate must be very small.

Doctors with more than 100 outpatient visits still need to spend a lot of time reviewing the examination results or images that outpatients have just completed.

Sometimes, the same patient is reviewed more than once.

In this case, the average time spent on each patient is only three to five minutes?
With such a short diagnosis time, unless he has sharp eyes, superb medical skills, a sense of responsibility and a high degree of concentration, the chances of mistakes and omissions will not be low.

From time to time on the Internet, there are some misdiagnosed cases in large hospitals that make many people feel ridiculous...

As a participant, Yu Zhiming understands in his heart, but he is also a little helpless. Sometimes such problems are inevitable.

Doctors are people too, not machines.

It is difficult for a doctor to maintain a high degree of physical and mental concentration throughout the day in the face of continuous patients like a revolving lantern.

Quantity and quality are always contradictory...

Among the patients Yu Zhiming received in the afternoon, another patient was transferred to the center.

The patient is a 16-year-old boy with lethargy and can fall asleep anytime and anywhere.

The teenager not only fell asleep unknowingly during class, but even fell asleep inadvertently while eating.

This ability to fall asleep quickly made Yu Zhiming, a patient with difficulty falling asleep, a little envious.

For a teenager, his narcolepsy seriously affected his studies, especially when he was in the second year of high school after the summer vacation.

His symptoms, which Yu Zhiming judged to be neurological problems, also belonged to Teacher Qi's treatment category.

Yu Zhiming decided to take the boy into the center...

He dragged his heavy body back to the big office of the center, and unexpectedly found that Teacher Qi hadn't left yet.

Yu Zhiming knocked on the door and entered the director's office, and saw Mr. Qi looking through a stack of heart examination materials.

"Teacher, is that patient's in the morning?"

"Confirmed?"

Qi Yue nodded and said, "In the afternoon, Dr. Wang and I gave him a stress test."

"Let him do overloaded high-intensity exercise, and within two or three minutes of exercising, he found signs of ventricular fibrillation and ventricular tachycardia in his heart."

Qi Yue sighed, "If we hadn't called a stop immediately and treated him, we would have suffered a cardiac arrest on the spot."

"His condition is indeed serious."

Yu Zhiming groaned, and asked with concern: "The cause?"

Qi Yue shook his head and said, "It's hard to find out exactly."

"We have dissected the hearts of more than one deceased victim of cardiac arrest, and found that the hearts of several deceased patients were obviously healthy, but stopped beating for no reason."

"A lot of sudden cardiac deaths are actually caused by systemic reasons, and the heart is just an organ of stress."

Qi Yue said with a smile: "It seems that the brain has received alarm messages from all over the body, saying that it is too tired and needs to take a rest."

"The brain synthesized the information and decided to quit, so it notified the heart as the power source."

"You stopped for me."

Yu Zhiming laughed a few times and said, "If we can't find the exact cause, it can only be maintenance and prevention?"

Qi Yue nodded and said: "One is to adjust the work and life conditions, reduce stress and tension, and change the way of life."

"The second is to implant an ICD, just in case."

An ICD is a small cardiac pacemaker, technically known as an Implantable Cardioverter-Defibrillator.

Its working principle is just like that seen in film and television dramas. Medical workers use a defibrillator to put a brick-sized electrode on the patient's chest, and then perform electric shock rescue with a bang.

The ICD is small in size and can be implanted subcutaneously in the patient's chest and abdomen.

Its electrode leads placed in the heart can automatically sense the occurrence of ventricular fibrillation and ventricular tachycardia in patients at any time, and the pulse generator is charged rapidly and generates electric shock energy.

The whole process is only about 15 seconds, so that ventricular fibrillation can be terminated in time and life can be saved.

The advantage is that the shock success rate is almost 100%, and the patient's heart rate can be monitored around the clock.

If the patient has a fatal arrhythmia, it can be automatically identified and treated with electrical discharge to restore the heart to a normal state.

Yu Zhiming thought of another question, and asked with concern: "Teacher, what is the total cost of this ICD implant?"

Qi Yue said casually: "Using the best ICD, using minimally invasive implantation surgery, the total cost is about 15."

"It's not cheap." Yu Zhiming sighed softly.

Qi Yue smiled lightly and said, "This is something that can save lives at a critical moment. Besides, once it is implanted, it can be used for ten years, and an average of [-] a year is not too high."

Pausing for a moment, Qi Yue then turned to say: "The boy who was transferred in the afternoon is not narcolepsy, but narcolepsy."

"This is a genetic mutation disease that causes the hypothalamus to secrete too many neuropeptides, causing the patient's sleep switch to malfunction and produce irresistible short-term sleep."

"This disease cannot be cured, it can only be controlled."

When Yu Zhiming heard that it was a genetic mutation disease, he knew that this disease was difficult to cure.

I heard Teacher Qi continue: "I have seen dozens of cases of this disease, and I have rich experience in treatment."

"Observe for two days, do a few drug tests, let the teenagers perform willpower resistance sleep exercises, and then take the medicine I prescribed for a long time to maintain a normal life, it can still be done."

Yu Zhiming said with deep emotion: "This disease of a teenager will make life and work inconvenient."

"At least driving is out of the question, and I can't think of a way to turn the bad into the good."

Qi Yue nodded and said, "Not only driving, but all high-altitude work and dangerous work are prohibited."

Yu Zhiming's heart suddenly moved, and he asked, "Teacher, is there any equipment similar to ICD?"

"When this kind of sleeping sickness occurs, give him an electric shock directly, and he will be full of energy immediately."

Qi Yue was slightly taken aback, and said, "I haven't seen any similar equipment yet."

He pondered for a moment and said, "Although this narcolepsy is a rare disease, based on the population base of our country, there are 70 million patients, and there are quite a few new cases every year."

"If there is such a device..."

Qi Yue thought about it and said: "I can ask domestic companies that make medical equipment, whether there is such a thing in the world, and whether it has research and development value."

"It might be worth a try."

Qi Yue looked at Yu Zhiming, hesitated for a moment, and asked, "Zhiming, did you have lunch with Zhou Mo at noon?"

Yu Zhiming's heart skipped a beat, and he hastily explained: "She brought her special lunch as a thank you for her mother's physical examination. I wanted to refuse."

"It's just that Zhou Mo is too enthusiastic..."

Qi Yue snorted, and continued: "I know Zhou Mo is very good, and it's inevitable that you have some ideas."

"It's just that Zhou Mo's mother has said something beforehand, and she is determined not to allow Zhou Mo to associate with the doctor..."

Yu Zhiming thought to himself, since she doesn't consider the doctor, why let her work in the hospital? It's a typical contradiction.

Teacher Qi said that because there is no 300 taels of silver here, he used Zhou Mo's mother's words as a shield.

Yu Zhiming expressed his tactfully and quickly.

"Teacher, don't worry, I will never have any thoughts about Zhou Mo."

"I concentrate on improving my medical skills, and I will never consider personal issues for at least a year!"

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(End of this chapter)