Chapter 21 The first ward round
Chen Xia bowed to everyone amid everyone's applause and said modestly:
"I'm just here for the first time. Please take care of all the uncles and aunts, brothers and sisters. Before getting off work in the evening, I'll invite everyone to have popsicles."
Such self-introduction made everyone feel very funny, and the applause became a little warmer.
Gu Lin now likes Chen Xia because she likes sweets the most and loves popsicle cakes. However, the old man in her family doesn't let her eat too much, saying that eating it will make you gain weight easily.
This time someone invited me to have popsicle, so of course she would have to support her. She also planned to use her little charm to influence the recruit and let him treat more in the future.
Zhang Li was indeed a magical assist and asked,
"Chen Xia, you are born in 1962, right? Then you and Gu Lin are the two youngest comrades in our department. Gu Lin, what month do you have for your birthday?"
"Oh, I was born on August 16, 1962."
Chen Xia stretched his head and looked at Gu Lin not far away, "Coincidentally, I was born on August 13, so I was scared to death. Finally, I don't have to be at the bottom. I have a little sister."
Everyone burst into laughter again, Gu Lin glared at Chen Xia and waved her fists again.
Ren Yuanfei was very happy to see Chen Xia get along with everyone soon, so he clapped his hands and said:
"Then let's start today's rounds. Chen Xia and me are in the same group, Dr. Zhang is in the same group, and Dr. Liu is in the same group."
Chen Xia is not a real doctor now, so he has no prescription rights. His identity is similar to an intern doctor, which makes him funny.
I remember that he was the instructor in the department back then, and he was called by someone else wherever he went. Unexpectedly, after he was reborn, he became the lowest-level intern.
Interns must have the awareness of interns. Chen Xia followed a group of doctors with a thick hospitalization record.
The responsibility is that the doctor will go to, Chen Xia must take out the patient's medical record in time, and at the same time be familiar with the patient's current medical history, examination results, treatment medication, course records, etc. in advance. For the superior doctor to answer at any time when inquiring.
Chen Xia is still an "old doctor" for more than ten years and has solid basic skills. So every time he takes advantage of Ren Yuanfei's inquiries about his condition or changes, he quickly browses the situation of the next bed patient.
Fortunately, the hospitalization records of this era are simple and clear at a glance, allowing Chen Xia to remember them in the shortest time.
After Ren Yuanfei entered the work state, he forgot that Chen Xia was not a professional. He still habitually walked to a patient and asked:
"What's going on with this patient?"
Chen Xia will answer soon:
"The patient, 20 years old, was admitted to the hospital for three days due to high fever, accompanied by coughing and sputum, occasionally chest pain, limb pain and fatigue. The blood was routinely shown to be normal when admitted to the hospital, and the X-ray chest radio showed thickening of the texture of the lungs.
He was admitted to the hospital with an influenza. After admission, he was given anthelmintic acid to reduce fever and vitamin C potassium chloride intravenous fluid. To prevent infection, penicillin was dripped twice a day."
Everyone looked at Chen Xia, and everyone was surprised. This kid was really the first time he came to the infectious ward?
No matter how medical records are introduced, they can be clearly explained. They can understand each set of them more clearly than the residents.
Ren Yuan didn't think so much, so he lifted the patient's clothes and sounded with a stethoscope. Then several residents also went to listen and finally asked Chen Xia to auscultivate.
When Chen Xia heard this, his lungs were obviously covered with wet rhymes, and frowned and said, "There are complications, pneumonia."
Ren Yuanfei asked with a smile: "You can hear it?"
"It's obvious that you should take another X-ray now to make a clear diagnosis, and then have a blood routine. Influenza and pneumonia, and there will often be difficulty breathing and continuous high fever, so..."
Due to the presence of the patient and his family, Chen Xia did not dare to say it, but the doctors present understood the meaning of this.
Ren Yuanfei was surprised. He now believed that Chen Xia had really taught relevant medical knowledge by Chen Bingkun at home. Otherwise, it would be very clear. Even if he had a poor prognosis of pneumonia flu and a high mortality rate, he knew that he had a poor prognosis of pneumonia flu and a high mortality rate.
Gu Lin followed the head nurse and happened to come here to clean the hospital bed. When she heard Chen Xia talking there, she couldn't help but be a little surprised.
When Nurse Ding saw Gu Lin's surprised look, he hit her shoulder and joked:
"How is it? Comrade Xiao Chen is good. Do you want your sister to help you take it off?"
Gu Lin was not embarrassed, but just smacked her lips and said, "It's not bad, it's far from being outstanding. The girl is going to marry a great hero."
"You just be so pretty. It's too late to cry when you become an old girl."
Chen Xia and several doctors have not finished their conversation here. Several doctors have come out of the ward and Ren Yuanfei has started to study again:
"Then tell me, what is the pathogenesis of influenza? What are the sources of infection and transmission routes?"
"Influenza is essentially a viral infection, belonging to the family Orthomyxovirus family, and is an RNA virus. The source of infection is mainly influenza patients or hidden infected people, and it is contagious even in the incubation period.
The transmission route is mainly transmitted directly by droplets between people, and can also be transmitted indirectly through contaminated hands, daily tools, etc. In general, influenza A and abortion B are more common."
"What do you think about the treatment and prognosis for the patient just now?"
"I think the effect of adamantane may not be good, and the side effects are great. The most important thing for this patient is antiviral treatment, and oseltamivir must be used.
At the same time, it is supplemented with antibiotics to fight infection, supplement liquids and electrolytes, and reduce fever, etc.."
"Your treatment plan is OK, but what medicine is oseltamivir? Why haven't I heard of it?"
Ren Yuanfei asked curiously, and several hospitalized doctors next to him also focused their attention on Chen Xia.
Chen Xia was speechless for a moment and was almost inseparable from all over the world. Oseltavir must have not been invented in this era, and now he has a numb claw.
(Oseltamivir did not obtain a US patent until 1998, and it is only 1980 now, so it is weird if you can get it out.)
"This is the medicine, this medicine is available abroad. I also saw it in an American medical journal of my sister Zhijiang Medical University, so I wrote it down."
"Oh, can you understand foreign languages? Which journal?"
"I'm good at English, and basic reading and dialogue are not a problem. I forgot which journal is specific. At that time, there were a lot of them on the table. I picked one and read it casually, and then threw it away and read it for another one."
Ren Yuanfei rolled his eyes when he heard this.
He is a doctor trained in an army hospital. Because of this special reason, the learning environment is relatively closed and he does not know much about the latest medical news abroad. The key is that he does not understand English and only understands Russian.
"You, you, such a good learning opportunity, I missed it in vain. Oh, let alone oseltamivir, I can't even get adamantamantine, and this patient seems to be in danger."
Chen Xia remembered the patient who had been drowsy at a young age and his breathing rate had increased significantly. All this shows that the condition is increasing.
The only one who can save him now is oseltamivir, which is also the familiar "Duffy" in later generations. It has it in the hospital of my own space, but how can I take it out and not be suspected?
This made Chen Xia feel embarrassed.
During the rounds this morning, Ren Yuanfei's group was mainly composed of flu patients. It is now the end of August. It is logical that influenza is more common in winter and spring, but this year's flu broke out in summer.
What if someone doesn’t play by the virus?
Patients with mild flu are generally treated outpatiently, and those who are admitted to the hospital are often in serious condition.
The treatment plan is mainly based on symptomatic treatment, and the symptoms are not the root cause. The family members were very anxious and held Ren Yuanfei's hand several times to beg him for help, which made all the doctors on the scene feel very heavy.
When they returned to the office, the residents were busy making medical advice and writing records of the disease course. Ren Yuanfei pulled Chen Xia to continue talking about the topic of influenza just now.
"Xiao Xia, tell me about this oseltamivir in detail."
"I probably remember some, for example, this drug is a specific inhibitor that acts on neuraminidase. It inhibits the effect of neuraminidase and can inhibit the separation of mature influenza viruses from the host cells, thereby inhibiting the spread of influenza viruses in the human body to play a therapeutic role."
Ren Yuanfei felt a little dizzy when he heard this.
"The target of the drug is neuraminidase distributed on the surface of influenza viruses. This thing can catalyze sialic acid hydrolysis, undo the connection between mature virus particles and host cells, and allow them to move freely to invade other healthy host cells. Inhibition of neuraminidase activity can prevent the release of viral particles, thereby cutting off the spread chain of the virus."
OK, Ren Yuanfei felt that the doctors who had been doing it for decades was useless. Chen Xia introduced this for a long time, but he could only understand it at all.
This made him a little uneasy. Has he lost his aggressiveness from retirement from the army and lived a life of silence?
This made him secretly make up his mind to pick up the book again and take the initiative to learn the latest medical knowledge. Otherwise, if he is compared by his little apprentice, he will be embarrassed to throw it to his grandma's house.
"Ahem, Xiaoxia, you have such a great enthusiasm for learning. Keep it up. Judging from your performance today, I am very satisfied. The tiger father has no dog son. Your father is amazing and your sister is amazing. I didn't expect you to be so powerful too."
Generally speaking, when a leader says this, it means that the conversation is over.
After Chen Xia came out of the director's office, she was so tired that she was sweating. "Oh my God, I have to weave so many words every day to hide myself. When will it be the end?"
But he didn't want to pretend that he was a novice who didn't know anything. The medical training period would take at least 3 years. He really couldn't stand such a long time of training. He thought in his mind that the sooner he graduated, the better.
Intern Chen couldn't help but miss the happy years of being a grain merchant.
Chapter completed!