I Can See Health

   Chapter 315 Meet the Vampire Again

   Emergency room on the second floor, observation room.

  Although the hiccupped uncle was sent to CCU, Cheng Peng still couldn't understand it.

  Why does myocardial infarction cause intractable hiccups, and the patient has no obvious symptoms of chest pain?

   "I don't know much either." Although Wang Xiaodong is a doctor at a higher level, in fact, he has just worked for a long time. He has not seen much of this rare case, and naturally he is not very clear about the reason.

  Cheng Peng thought for a while, but still sent a WeChat message to Lu Chen to ask the reason.

   When Lu Chen received the WeChat, he quickly replied.

   "The hiccup caused by myocardial infarction, I guess, this may be because most elderly patients have varying degrees of cerebral arteriosclerosis and autonomic dysfunction (reduced sensitivity to pain)."

   "Especially when the patient has diabetes, both pain and sensory nerves are damaged, causing necrotic myocardium to stimulate the vagus nerve, causing only hiccups without chest pain."

   "That is to say, it is not that there is no chest pain, but that the patient's pain sensation has subsided and no pain is felt."

After reading Lu Chen's explanation, Cheng Peng finally understood.

   "Myocardial infarction manifested as hiccups, this is really rare!" Cheng Peng exclaimed.

Lu Chen said again: "Actually, apart from hiccups, there are other uncommon symptoms, which may also be manifestations of myocardial infarction. For example, toothache, headache, neck pain, frozen shoulder, and even worse , it was a toe headache, and it was finally found to be a heart attack."

   "Anyway, no matter what the main complaint is, a detailed physical examination and a medical history are very important, as well as the electrocardiogram on admission. When all these things are put together, we can finally make an accurate diagnosis."

  …

   After experiencing this somewhat rare patient, the emergency internal medicine clinic ushered in a short window period.

   It's ten o'clock in the evening.

   In the night sky, the stars nodded.

  There are fewer and fewer people on the streets.

   Except for the hospital not far away, the lights were still red, and the surrounding row was pitch black.

  Lu Chen was sitting in the emergency room.

  Although the emergency department is very busy, he feels that he is just a tool person.

   As long as you listen to the doctor's words, you don't need to use your brain at all.

   This is not in line with Lu Chen's style at all.

  He came to the emergency department to exercise.

   If you don’t see patients in person, you can’t get thank you points!

   has always been a tool man, but so many resources were wasted in vain.

   "Mr. Wang, why don't you wait for the patient's physical examination and consultation, and let me come?"

  Lu Chen volunteered.

   "Huh?" Wang Xueyang raised his brows.

   It was the first time she heard such a request from a student!

   Wang Xueyang wished that the students could help replace her.

   But the reality is that most students are not very reliable!

  Let students have a physical examination, and auscultation of the heart and lungs is a problem.

   This is not as fast as it is!

   You must know that the flow of patients in the emergency department is very large.

   Delay for a few minutes, and patients and their families may start to quarrel!

   However, Wang Xueyang thought about it.

  Lu Chen was able to make this kind of request by himself, and considering his previous performance, he should not be that kind of unreliable student.

   "Well, for the next two patients, ask about the medical history and physical examination." Wang Xueyang said, "I'll take a look first."

  Students have this kind of thinking, of course they should be encouraged.

   Besides, if Lu Chen can really replace her, then this night, she will be able to relax a lot!

   "Okay." Lu Chen smiled.

   Finally had the opportunity to contact patients.

   It is only ten o'clock in the evening, if the next patients are all admitted by him.

  Then he earns gratitude points and improves the efficiency of system upgrades, and he will definitely reach a higher level!

  …

   As soon as the two of them finished speaking, a patient with abdominal pain walked into the emergency room.

   Abdominal pain, which is also one of the most common types of patients in the emergency department.

   This time, it was Lu Chen's turn to receive the consultation.

   The patient is a middle-aged man in his thirties.

   His face was flushed, and he smelled of alcohol.

   It's just that the man is covering his stomach now, and his face is full of pain.

  Lu Chen quickly helped the family to move the patient to the bed.

   "Why are you uncomfortable?"

   The middle-aged man pointed to his stomach, "It hurts... it hurts..."

  Lu Chen started a physical examination while asking about his medical history.

  From the causes, incentives, location, nature of abdominal pain, whether there is metastatic pain, radiation pain, and the way of relief, there are no details.

   At the same time, Lu Chen is also checking the patient's abdominal signs, whether there is tenderness, rebound tenderness, etc.

   Wang Xueyang on the side looked at Lu Chen's movements and nodded with a smile.

   This kid is really nice!

   Whether it is a consultation or a physical examination, the performance is extremely perfect.

  This professional skill is not like a graduate student at all.

   For example, consultation, which is one of the simplest clinical skills.

   But many medical students don’t pay much attention to it. They can ask whatever they want, or they don’t have any rules and regulations, so it’s easy to miss a lot of things.

   But Lu Chen was different. From the main symptoms to the accompanying symptoms, as well as the negative signs of differential diagnosis, he was able to ask clearly.

   The most important thing is that there is no unnecessary nonsense.

   In the shortest possible time, he was able to master the first-hand information of the patient.

   "Teacher, the patient has tenderness under the xiphoid process, no rebound tenderness, and the rest of the physical examination is normal."

   "What about auscultation of the heart and lungs?"

   "It's all normal."

  …

   After seeing two patients in a row, Wang Xueyang was relieved.

  Lu Chen can really take her place in the medical examination.

   This is what Wang Xueyang dreamed of.

   With the help of a student, she was able to relax more than half of the night.

   "Lu Chen, next, you continue to see the patient, I will be by your side, and I will give you a hint when you encounter a place you can't."

   "Okay, thank you Teacher Wang." Lu Chen smiled.

  Through his own efforts, he can finally see patients in person.

   However, the next patient changed Lu Chen's expression.

  …

   This is a woman wearing a black hood.

   She was supported by a young man and slowly walked into the consultation room.

   Her face was pale, the expression on her face was extremely painful, and she groaned in pain from time to time.

   "Doctor, my mother has been screaming about stomach pain!" the young man walked into the consultation room and shouted.

   The middle-aged woman beside him covered her stomach.

   "My stomach hurts, give me pain relief!"

  Lu Chen's pupils shrank slightly.

  If he remembered correctly, this woman wearing a black hood seems to be the "vampire" he met when he went to the temple to pray for blessings!

  Wang Xueyang saw that the female patient was in a hurry, and did not plan to ask Lu Chen to come to see the doctor. She wanted to come to see the doctor in person.

   She hurried to the front of the female patient.

   But the first time she saw the patient, she was frightened.

   The whiteness of this woman is not the whiteness of delicate skin, but a kind of morbid whiteness!

   There are large scars on her ears and nose. These scars look like they have been corroded.

   And her teeth are those kind of fangs!

   (end of this chapter)