This Doctor is Great

afternoon,

The teacher, Senior Brother Chen Bing, led Zhou Mo and Huang Yiming to continue the ward rounds, going through all the 7 patients in his hands.

Senior brother Chen Bing is a very enthusiastic person, and he has imparted a lot of experience, which has greatly benefited Zhou Mo and Huang Yiming.

Then go back to the duty room and adjust the medical records.

At 4 o'clock in the afternoon, the test report of the morning blood test finally came out.

Senior brother Chen Bing began to analyze the laboratory report for Zhou Mo and Huang Yiming, and then adjusted the patient's doctor's order (medication, etc.) according to the results of the laboratory report.

After all this work, it was already 20:00 in the evening.

this day,

Several other new medical students did not get off work according to the time of 17:00, but worked overtime until eight or nine o'clock in the evening. After all the teachers and residents left the hospital, they breathed a sigh of relief and dared to leave work.

They finally felt the doctor's hard work.

...

Because Zhou Mo had to manage the two beds of 28 and 29, he didn't get off work with other medical students.

He came to bed 29 (the 60-year-old grandmother with refractory hypertension).

"Grandma..."

Zhou Mo walked to the bed.

At this time, the grandmother was half lying on the bed, video chatting with her relatives, and she was so happy that she was wrinkled. Her daughter who accompanied the bed was washing clothes in the bathroom.

"Hello, Doctor Zhou..." Grandma saw Zhou Mo coming in, and quickly ended the video chat, showing a cautious smile to Zhou Mo.

Zhou Mo: "Are you ready for bed?"

Grandma: "It's almost... Dr. Zhou hasn't got off work yet?"

"After seeing you, I'm off work."

"Thank you so much, you doctors have worked so hard from morning till now..." Grandma said sincerely.

Zhou Mo smiled: "It's okay...Grandma, did the nurse tell you to wear a respiratory monitor at night?"

Grandma said again and again: "I've said it, the nurse said that she will come over and put it on for me at 9 o'clock..."

Zhou Mo nodded: "Okay... put it on, and then take a look at your sleep at night..."

Grandma quickly asked: "Doctor, do I have found the cause of my high blood pressure?"

Zhou Mo shook his head, and said conservatively: "We can't analyze it further until the results come out..."

As a result, two possibilities:

The first type: Grandma’s refractory hypertension, the main cause is sleep apnea... Then it’s easy to handle, just wear a portable ventilator while sleeping, and then further investigate why the apnea occurs.

The second type: If it is not sleep apnea, it is difficult to deal with, because there are many reasons for refractory hypertension.

Talked to grandma again.

Finish.

Then I came to bed 28, that is, the old man with the arterial stent, and had a brief chat.

get it done

get off work!

Not long after, the nurse girl took the sleep breathing monitor and put it on for the aunt.

...

I took the subway for an hour,

Zhou Mo found several papers and guides on sleep apnea on the subway.

"Sleep Apnea AHI Index"

Obstructive Sleep Apnea (OSA)

"Central Sleep Apnea Syndrome (CSAS)"

"Mixed Apnea Syndrome (MSAS)"

After reading,

The harvest is not small.

...

...

The next day, at 6 o'clock in the morning.

Genius just came to light.

Zhou Mo continued to sit on the place for more than an hour, squeezing the crashing death subway line 3.

Halfway through:

"The relationship between essential hypertension and obstructive sleep apnea syndrome"

"Study on the relationship between nocturnal hypoxemia and ambulatory blood pressure in hypertensive patients with snoring"

7:30, arrived at the hospital, cardiology department.

"Good morning……"

"Good morning……"

Everyone greeted.

Zhou Mo glanced and found that most of the medical students had already arrived, but they all had dark circles under their eyes, so they must have slept very well last night.

but,

Zhou Mo obviously felt that the duty room was busy.

All the bed doctors are in a hurry.

Brother Chen Bing held the file deck and shouted, his voice was much louder than yesterday: "Zhou Mo, you go to check the room first to see the situation... and then the director (team leader) will come to check the room, you have to report... "

"Okay, brother!!"

Zhou Mo couldn't help becoming nervous.

Turn on a vacant computer, log in with the account of senior brother Chen Bing, and open the information of the 29-bed patient grandma.

really,

Yesterday, the data of the night sleep breathing monitor worn by the grandmother has been uploaded to the system by the nurse girl for the doctor to read.

"There is really apnea!"

Zhou Mo glanced at the monitoring data from last night.

AHI value is 25 times/hour,

In addition, the minimum blood oxygen saturation at night is 80%.

This is considered "moderate"! !

Combining last night and this morning, Zhou Mo has read the relevant materials of "Apnea Syndrome", and has already gained a certain understanding of this patient.

There is a spectrum in my heart.

Then I looked at the other data of 29 beds.

This morning, the girl measured the patient's grandma's blood pressure at 179/111...

Quickly took the notebook and came to the ward.

First 29 beds...

"Grandma, I'm here..."

At this time, grandma was still lying on the bed and had just woken up not long ago.

"Morning Doctor Zhou..."

"Grandma, how do you feel now?"

"It's still the same, I feel so tired, and my head still hurts..." Grandma said sleepily.

The grandma and daughter next to her said: "Doctor, I paid special attention to my mother yesterday. She snores when she sleeps, and sometimes she will suddenly become silent, and then suddenly gasp loudly after a few times..."

Zhou Mo: "This is apnea... I just watched grandma's sleep apnea monitoring last night, and there is indeed a problem, so I am going to add a non-invasive ventilator to you when you are sleeping at night, and see what the next day's breathing is. Is there any change in blood pressure, will you feel better when you wake up in the morning..."

"Okay, okay, thank you doctor!" Grandma felt hopeful that she would recover.

Zhou Mo did other physical examinations and the like, and then ended the rounds.

Then came to bed 28 (angina pectoris, coronary artery stent).

"Abbe, good morning..."

"Hi Doctor Zhou..."

It took 5 minutes for consultation and physical examination, but there was nothing special.

Zhou Mo looked at the examination schedule: "Abbe, you will have a coronary angiography after 10 o'clock to re-examine the heart. You don't need to go to other departments, just do it in our cardiology department..."

Coronary angiography is to inject a contrast agent into the coronary arteries, and then develop the coronary arteries to check the specific conditions.

It is a "gold standard" for coronary heart disease examination, and it has a very good effect on the diagnosis of angina pectoris in 28-bed patients and the current specific situation of the stent after the last stent operation.

...

The quick check is over,

8:00...

Zhou Mo walked out of the ward, and then saw that there were many middle-aged and elderly doctors in the Cardiology Department.

Needless to say, it is those chief and deputy chief physicians.

Today is not a big ward round, but a small ward round, that is, a ward round within the group.

When Chen Bing saw Zhou Mo, he ran over quickly, and said in a low voice, "How is it? Have you memorized all the data from the rounds?"

Zhou Mo knew that Senior Brother Chen Bing was really nervous about himself: "Don't worry, I've memorized it."

Chen Bing asked again: "How was the sleep apnea monitoring last night?"

Zhou Mo nodded: "I checked the value, and it's definitely apnea, moderate..."

Chen Bing was overjoyed when he heard the words, and patted Zhou Mo on the shoulder: "It's really you, but you discovered it, and I didn't pay attention... After the ward rounds, the director may ask you, behave well... Our director is a good person , don't be nervous..."

Zhou Mo was grateful: "Thank you, brother!"

I have to say that Senior Brother Chen Bing, the teacher, is indeed a nice person!

at this time,

Group five, assemble! !

9 people.

The team leader is Director Niu, who is 60 years old and is about to retire.

He has white hair and a kind smile on his face, but he is still majestic. The deputy chief physicians and attending physicians in the group stood upright, not daring to offend his majesty.

Zhou Mo and Huang Yiming shivered and hid behind the crowd, like huskies hiding among wolves.

It was the first time to lead the ward rounds, and I was a little nervous.

Zhou Mo knew that he was well prepared, but he still couldn't help being nervous.

At this time, Director Niu spoke

"Zhou Mo, come out..."

"..."

Zhou Mo was startled.

calls me?

Zhou Mo bit the bullet and walked out of the crowd.

"director!"

"You are Zhou Mo?"

"yes!"

"Don't be nervous... I heard from Chen Bing that you did a good job and even took care of two patients...so I'm a little curious..."

Not only Director Niu was curious, but several other deputy directors and attendings looked at Zhou Mo curiously.

Look up and down, explore.

Zhou Mo stabilized his mind: "Thank you, Director, for your attention..."

Director Niu looked around the crowd: "Then let's start the rounds, the first patient will start from Zhou Mo..."

Zhou Mo: "!!!!!!"

Worth!

.