Chapter 289 Clinical must be "greasy"
Chen Yong didn't ask why. After collecting blood and giving symptomatic treatment in the emergency department, he took the blood collection tube and went straight to the emergency department for examination.
Without wearing a mask, Chen Yong stood in the emergency examination room, laughing and waiting for the test results.
Serum potassium 1.87mmol/L!
Hypokalemia!
No wonder he looked lethargic and there was something wrong with his electrocardiogram. It was indeed caused by hypokalemia!
When I handed the results to the emergency doctor, the emergency doctor looked at Chen Yong in the wrong way.
After being given symptomatic treatment, Chen Yong finally felt relieved.
“Let’s go eat!”
“Brother Yong, why did you remember to call Senior Brother Luo?” Zhuang Yan came over and asked Chen Yong.
"I think something is wrong. I don't know what it is yet, so of course I have to shake people up." Chen Yong replied matter-of-factly.
"The patient has a problem. I have calculated that he may die suddenly in 2 hours. With a confirmed diagnosis, just ask Luo Hao directly."
Chen Yong has already summed up the following: A set of proven “clinical experiences”.
“…”
“…”
Meng Liang and Zhuang Yan sweat.
This method of "confirming diagnosis" sounds extremely strange, and it is the first time I have seen it in clinical practice.
"Brother Yong, are you accurate?"
"Of course, there is no problem with the six-line hexagram except that you don't need Kaiyuan Tongbao. For this little thing, you don't need Kaiyuan Tongbao. Just do the math with your fingers."
"Then you can do the math for me." Zhuang Yan is convinced.
"You can't calculate without hesitation." Chen Yong said with a smile, "Brother Yong, let me do a magic trick for you later."
"Tsk~~~You call this clinical experience? "
"Of course!" Chen Yong eliminated the sarcasm in Zhuang Yan's words and replied matter-of-factly, "It's all taught by Luo Hao. Let's take a look at Xiehe after we go abroad. We happened to encounter an incident of mushroom poisoning.”
Zhuang Yan listened carefully and attentively.
“At that time, I stood behind, no matter what others did, I couldn’t do it. But I believe in Luo Haoxing, and I think this is a good opportunity to show off to others!”
"What happened next?"
"Luo Hao called directly and asked his senior fellow from the Department of Gastroenterology who works in Nanyun Province to come out. Later, an emergency doctor put a mobile phone in front of him, conducted a video consultation, and gave a direct diagnosis."
"It is said that the doctors in Nanyun Province are indeed rich in clinical experience and can administer drugs based on the phantoms seen by patients. Symptomatic treatment. "
"I was dumbfounded. Is this okay? Later, Luo Hao was thick-skinned and told me that this was clinical experience, and he said that various hospitals have their own specialized projects."< br>
“At this time, he stopped talking about his family’s Xiehe, and his expression changed quickly.”
Tsk tsk, Zhuang Yan imagined the scene at that time and felt longing for it for a moment.
“I learned this from Luo Hao. If a patient has a problem, I’ll pinpoint it and figure out if there’s a big problem, then I’ll call him or her. This is all clinical experience, so learn from it.”
With that said, the three of them walked out of the emergency building.
Meng Liangren deeply believed in Chen Yong’s words.
After several months of contact, Meng Liangren has already integrated into the medical team. Even though Luo Hao often goes out, he reports work on WeChat every morning and evening, and Meng Liangren does not dare to neglect at all.
The medical team was operating so smoothly, which made Meng Liangren feel unreal.
Even in the infectious disease hospital, the patients admitted are not seriously ill, but they still have some problems every now and then.
But Professor Luo's medical team is so smooth that it makes people feel trance-like and unreal.
Later Meng Liangren figured it out. Many difficult diagnoses were given by Professor Luo immediately.
With targeted treatment, it is strange that it is not stable.
What Dr. Chen Yongchen said makes sense. If you have anything to ask, just ask, even if it’s just to “calculate with your fingers.”
The three of them had dinner nearby. Halfway through the meal, Luo Hao hurried back.
"Can I get you some extra bowls and chopsticks?" Chen Yong asked.
"No, I just finished eating." Luo Hao asked for a bottle of Centennial Mountain, opened it and took a sip.
"Luo Hao, how do you judge?"
"Chen Yong, how did you judge?"
Luo Hao and Chen Yong asked in unison.
“You speak first.”
“You speak first.”
The two paused for a moment, then said in unison.
Meng Liangren lowered his head and picked up the rice in the bowl.
This is so synchronized, so annoying. Although Meng Liangren did not have this hobby, he knew that Zhuang Yan did.
There are some things that Zhuang Yan can do but he cannot, so he tries to concentrate on eating, as if he has no impression of everything around him and can't see it at all.
"That's right." Seeing that Luo Hao stopped talking, Chen Yong repeated his theory.
"Oh? Is this okay? I remember in the Plum Blossom Book of Changes it is said that nothing can happen without a hexagram."
"Yes, isn't this something? An old scalper pulling a bullock cart brings patients for treatment. If this is not worth mentioning, it is simply too much, isn't it?" Chen Yong shouted.
"Oh, that's right." Luo Hao pondered, "You can teach me when you go back."
"What about you? I think there is very little information, so I need you to at least take a look. "Chen Yong asked his doubts, "But you gave the answer directly, is it the clinical experience of your family?"
"Yes"
"Tell me about it." >
"Macrolides antibiotics can cause QT interval prolongation by affecting the function of potassium ion passage, thereby causing arrhythmia, especially for patients with arrhythmia and tachycardia."
“The U.S. FDA has also issued a warning notice: Azithromycin may cause abnormal changes in cardiac electrical activity, leading to potentially fatal arrhythmias.”
“Glycyrrhizic acid is the glycoside compound with the highest content in licorice. It can be hydrolyzed into glycyrrhetinic acid and produce a wide range of pharmacological effects.
For example, it can enhance the level of hydrocortisone in the blood, and hydrocortisone has a similar effect to aldosterone and has the effect of water and sodium retention. Affects electrolyte balance, leading to hypokalemia. ”
“These two drugs should not be used together. Compound licorice tablets will increase the effect of azithromycin on electrolytes and cause hypokalemia.”
< br>
"The situation you mentioned, my first thought was ion disorder. Later, after hearing about these two drugs, I judged that it was most likely caused by hypokalemia."
The two people's judgments were perfectly consistent.
The whole process seems irregular, but it is this irregular way of seeing a doctor that creates a hidden danger.
Meng Liangren took out his notebook and wrote on it that azithromycin + compound licorice tablets caused hypokalemia.
"Old Meng, are you going to go back and do some research?" Luo Hao asked with a smile after seeing Meng Liangren's movements.
"Well, although compound licorice tablets are not common now, there are still small clinics in villages and towns." Meng Liangren nodded and explained, "I have a bad memory. If I don't write it down now, I will forget it."
"Brother, why are there no more compound licorice tablets?" Zhuang Yan asked, "I remember that I often took them when I was a child, and they were very useful."
"This is a good question." Luo Hao praised.
"???" Zhuang Yan looked at Luo Hao stupidly, not knowing what the problem was.
"Old Meng, please explain." Luo Hao smiled and looked at Meng Liangren who had no physical performance.
"Ahem~" Meng Liangren coughed twice, "Compound licorice tablets should be called licorice-flavored compound opiates, which are fruit-flavored psychoactive drugs. A few years ago, someone bought a large amount of compound licorice tablets and refined them using local methods. He was arrested. ."
"Oh? Isn't it a prescription medicine? Can I continue to refine it?" Zhuang Yan's eyes flashed with clear stupidity.
"You kid, Lao Mengdu said, licorice flavored compound opium. Opioids, what are you talking about?" Luo Hao explained softly.
Some words could not be said clearly, so Luo Hao could only give Zhuang Yan a gentle nod.
"Oh oh oh." Zhuang Yan nodded repeatedly. She was just being naive. Luo Hao reminded her and he immediately figured it out.
"Later it was stipulated that you must have a doctor's prescription before you can buy it. I didn't take it seriously at the time, but the infectious disease hospital soon ran out of this medicine."
Before Zhuang Yan asked, Meng Liangren started explain.
After all, there is such a novice here, and it is very troublesome for her to ask questions even if she doesn’t understand clearly.
“Because it involves something that cannot be touched, and something happened with this medicine, the hospital leaders just cut off the compound licorice tablets. If they cut it off and don’t sell it, then there will be no problem.”< br>
“Isn’t this laziness?” Zhuang Yan was stunned, “This is simply too much!”
"Harmful." Luo Hao smiled.
Zhuang Yan's clarity and stupidity are simply a breath of fresh air in the medical team.
Not to mention it himself, Meng Liangren is an old doctor and a seasoned doctor, and nothing can tempt him. As for Chen Yong, he was holding his mobile phone and wondering if he was chatting with Lao Liu. He was beaming and didn't care about it at all.
Only Zhuang Yan was angry and stupid.
This is not good, it is easy to have high blood pressure.
"There are a lot of things involved here. Xiaozhuang, you can go home and ask Dean Zhuang." Meng Liangren was vague.
"Lao Meng, tell me, my dad won't talk about this." Zhuang Yan started to act coquettishly.
Lao Meng's scream was so heart-wrenching.
"emmmm, tell me." Luo Hao made the final decision.
“I didn’t do any research on purpose, I just opened a pharmacy with someone at that time...”
"Oh? Lao Meng, do you still have this experience? It was quite profitable to open a pharmacy a few years ago." Luo Hao asked.
"Would you like to make some money? It's not shabby. I went out of my way to get a pharmacist certificate." Meng Liangren smiled and said, "The infectious disease hospital didn't make any money. I still had a family at that time and had to support my family. It's not like being alone now. The whole family is not hungry when they are full, so they don’t think about those things at all.”
“Lao Meng, you’ve talked too much.” Chen Yong was beaming when he interrupted, “You mean Luo Hao won’t give. Do you make money? You secretly poking Luo Hao, be careful he holds a grudge."
"How can you..."
"Go on, ignore him, pick on others. "Yes." Luo Hao smiled, "What happened next?"
"First, to prescribe compound licorice tablets, you need to register your ID card and enter it manually, which is troublesome. The salesperson is unwilling to sell it."
"Second, it requires a doctor's prescription. Although I am qualified, but it involves this type of I’m still more cautious about medicines. I just want to make some money, and I don’t want to break the law.”
“Thirdly, 100 tablets cost 10 yuan. , the salesperson simply hid the compound licorice tablets and said no. "Huh?" Zhuang Yan was stunned.
In her world, cheap, effective medicine is king, and salespeople should be willing to sell it.
Unexpectedly, not only large public hospitals do not sell compound licorice tablets, but also small pharmacies do not sell this medicine.
"The pharmacy has a series of assessment systems, which were developed by my partner. They are quite practical." Meng Liangren said honestly.
It sounds like it has nothing to do with compound licorice tablets, but in fact it has a much bigger connection.
"Is there anything else?"
"If you sell other medicines, you get a higher commission, and the salesperson is willing to sell them. It's not easy for me to manage. After all, there are performance regulations, and the partners also want to make more money. So. Well, I stopped doing it later.”
Meng Liangren sighed.
“Aren’t hospitals and pharmacies places where people can save lives and heal the wounded?” Zhuang Yan asked.
"Don't be stupid. It costs money to save lives and heal the wounded. Who will pay?" Chen Yong said disdainfully, "The old man here is sitting in a bullock cart by himself, leaving an old scalper who can die at any time. Come here, does he have money for medical treatment?”
“I can pay in advance.” Zhuang Yanhu blinked.
"Don't make trouble." Luo Hao nodded on the table, "There are too many similar things in the hospital, and your solution can't help." "Then what should I do?!" Zhuang Yan was a little anxious.
It can be seen that Zhuang Yan is indeed a newly graduated graduate student, who has not yet been polished by society and has not shed her youthfulness.
Even Dean Zhuang’s words and deeds are not enough.
"Luo Hao, show her the solution." Chen Yong continued to chat on his mobile phone with great joy.
Luo Hao glared at Chen Yong fiercely.
"Well, it's not that difficult actually. You have to find the right way."
"The way?"
"We are a public hospital. We must never forget this at any time." Luo Hao Said seriously.
“…”
“…”
Not only Zhuang Yan, but also Meng Liangren was startled.
How come Professor Luo is still singing a high note when his family is sitting together.
Luo Hao picked up his phone and sent a message.
“To whom?”
“Director Feng.”
"Is our hospital paying in advance? The emergency department may not be happy." Meng Liangren suggested in a low voice.
"There are many ways. The hospital has targets every year, but the disease is too small to cost a few dollars. The hospital's targets are reserved for patients with serious and serious illnesses." Luo Hao smiled, "Targeted poverty alleviation, Treatment is also one of them.”
Meng Liangren didn’t quite understand what was going on here.
Similar things vary greatly from region to region, so he simply kept his mouth shut.
“Eat.” Luo Hao said, “Don’t go hungry. If it’s not enough, add more food. I’ll treat you.”
"You're paying for it, this meal is too cheap." Chen Yong said again.
After a few minutes, Luo Hao was a little surprised that Feng Zixuan didn't reply to his message.
He glanced at his phone. It was still early and he couldn't rest.
Strange.
"What? Director Feng didn't reply to your letter?" Chen Yong asked.
"Well, they usually reply in seconds. I don't know what big things are going on at the medical office today. I guess they are busy." Luo Hao had something to say.
Meng Liangren sighed inwardly.
Medical Director, reply to a doctor or a professor in an instant. No matter who comes from these words, it feels unreal.
That’s what Professor Ke Luo said, and it’s quite logical.
"I'll give Uncle Feng a call." Zhuang Yan took out her mobile phone.
"Forget it, Director Feng should be busy. I'll go find him tomorrow." Luo Hao smiled, "Where's the old scalper?"
"Let Xiaoshuai take it with him." Chen Yong replied.
“I’ll go see the old scalper later.” Luo Hao said with emotion, “I heard Boss Xia say that the old scalper understands human nature.”
“You still say Boss Xia? I don’t think so. I know." Chen Yong said.
"Especially those with names, they cannot eat meat, and they will be buried after natural death." Luo Hao ignored Chen Yong and spoke seriously.
"???"
"???"
"With a name, there is a bond and aura. Don't you know?" Luo Hao asked.
"I seem to have heard of some people giving names, but they are all given by the powerful." Chen Yong was a little vague.
"There are also ordinary ones, do they have feelings? So don't give people names easily, right."
Luo Hao's ridiculous statement sounds like nonsense at first glance, but if you think about it carefully, it makes some sense.
“That old scalper knelt down for me.” Chen Yong said seriously, “I was kneeled down by it, and I will pay for it.”
“No, I will teach you this time. Xiaozhuang. You have to learn to adapt to many things in clinical practice, just like Lao Meng."
Meng Liangren was not sure whether Professor Luo was praising himself or hurting himself, so he just lowered his head and smiled.
"Lao Meng is a slick and careless doctor who has been in charge for thousands of years. This is not what I said, it was how my master described himself."
"It's better to be smooth and greasy. How can you mix in society if you are so passionate about melon and eggs?"
Chen Yong curled his lips, and Zhuang Yan disagreed with Senior Brother Luo's statement.
"Brother Luo, a mixed society... I didn't expect you to say that. We want to build a beautiful China, not a mixed society, not a mixed society!"
Luo Hao glanced at Zhuang Yan, Smile slightly.
“I will teach you skin cutting and suturing, ligation and hemostasis, deep knot tying, and fine anastomosis. Preoperative planning, anatomical levels, intraoperative decision-making, and perioperative management. I guarantee that you will be the surgeon for 5 years. You will be unique and have superb skills. How about being all-powerful? ”
"Ah? Okay!!!" Zhuang Yan was excited.
“I will teach you to establish pneumoperitoneum, stably wear trocar, walk in the gap, and stop bleeding. I am proficient in all of the eighteen instruments; the new auxiliary plan is just right. I will ensure that you keep pace with the times and eat well. Bonus, a rising star, how about it?”
“!”
Senior Brother Luo actually wanted to teach so much!
"Bioinformatics analysis, meta-research, prospective review, holding everything in hand. Reagent preparation, electrophoresis column running, flow sorting, transgenic mice. Guarantee you fruitful scientific research, All the Way Fund High School, young and promising , how about overtaking in a corner? ”
Gan!
Zhuang Yan cursed in her heart.
She finally knew that Senior Brother Luo was joking.
"Old Meng, which one do you want to learn?" Seeing Zhuang Yan stunned, Luo Hao turned to ask Meng Liangren.
"Hehe." Meng Liangren just smiled but said nothing.
"Lao Meng, say whatever you want." Luo Hao raised his eyebrows.
"Professor Luo, everyone thinks about what you taught, but in the end it may become something that cannot be said." Meng Liangren clicked on Luo Hao's puzzle.
"What can't be said?" Zhuang Yan asked.
“Guess.”
Zhuang Yan shook her head.
"Teach you how to speak eloquently and seize the source of disease; exploit cattle and horses to plunder the results; fabricate data to defraud funds; collude with businessmen and cling to the powerful. How about it?"
Luo Hao asked softly.
“!!!”
“It’s basically like this. How did academic circles come into being in academia? In the beginning, they all wanted to be serious, but in the end they became colluding with businessmen and clinging to the powerful. , Squeeze the cows and horses.”
Zhuang Yan was stunned.
She thought for a while, then took the pen and notebook from Meng Liangren's hand, "Senior brother, please say it again."
Luo Hao just smiled and made a joke. There is no need to be so serious.
Meng Liangren's cell phone rang. He glanced at Luo Hao and saw that Luo Hao was "training" Zhuang Yan, so he picked up the cell phone and started operating it.
Chen Yong was curious and came over to take a look.
“Lao Meng, you do all this kind of thing!”
"Huh? What is Lao Meng doing?" Luo Hao asked.
“I’m writing a good review for Pin Xixi!” Chen Yong almost jumped up, “Luo Hao, let me just say that the medical team makes less money! Look at Lao Meng, a good review worth 2 yuan is too much. Write with your conscience.”
“My conscience is worth 1 yuan, and 2 yuan is a profit. It doesn’t take much trouble to write a single amount.” Meng Liangren explained with a smile.
Luo Hao turned a deaf ear to Chen Yong's words.
The money earned from one trip to India was enough for Lao Meng to last for a long time, and the income from the first hospital of the medical university was actually not low.
Although in the medical system they are all tertiary hospitals, they are actually much different.
Working in a top hospital in the province like the First Hospital of Medical University, Meng Liangren can earn more than 20,000 yuan a month. Although he is not rich, he is definitely not poor.
It can even be said that it is quite moisturizing.
Especially after Meng Liangren "wanted to understand", the brother is alone and does not have to support the family. The little money is enough for him to live freely.
In fact, it is very easy for Meng Liang to get married and have a family. The doctors at the First Hospital of the Medical University are honest and steady, and their income is not low, which are all plus points.
But Luo Hao doesn't want to care so much, why does he still think he has too little to do?
It would be enough for Luo Hao to worry if Lanke had to go alone.
[As the saying goes, a man will remain a boy until he dies~~~]
The phone rang.
"Hello, Director Feng."
"Oh oh oh, okay, I'm having a meal across from the hospital. I'll go over there."
"Okay, let's meet and chat."
Luo Hao put down his phone, "Chen Yong, what are you doing today? Will you go home late? "
"Lao Liu is on duty. I will deliver food to her later and then go back to the dormitory." Chen Yong has turned "home" into "dormitory".
"Okay, you are busy." Luo Hao stood up, "Xiaozhuang, come with me."
"Okay!"
Zhuang Yan knew that Senior Brother Luo wanted to teach her clinical experience, so she called her.
The establishment of pneumoperitoneum, interstitial walking, and lack of bleeding all require time and surgery, so don’t rush.
On the contrary, this kind of "greasy" social experience is what I lack most.
Knowing her senior brother’s purpose, Zhuang Yan followed Luo Hao happily.
"Senior Brother Luo, you really don't want to go to the demonstration of surgery."
Zhuang Yan couldn't help but asked after not speaking for a minute.
“I won’t go.”
“Why, go there for surgery and become famous. When the time comes for consultations abroad, world-renowned experts will call you bro or bro when they call you. . ”
“I have too much to do. You are still young and can’t help. If you are successful, I may leave the surgery to you.”
Zhuang Yan was startled, all the responsibility lies with her?
Tch~
The two said a few words and then fell silent. Luo Hao had no idea of looking for a topic, and Zhuang Yan did not ask for trouble. She just calmed down and prepared to imitate Luo Hao. Senior brother's "greasy".
When he arrived at the door of the medical office, Luo Hao was startled and saw a clerk sweeping the floor in Feng Zixuan's room.
The tea cup was broken, and the clerk was cleaning it carefully, being cautious and not daring to make any sound.
oh?
Angry? Will Feng Zixuan, who has always been gloomy and cruel, get angry?
No wonder Feng Zixuan hasn’t left yet so late.
Luo Hao understands Feng Zixuan's style of doing things, and there are not many things that can make him angry.
"Ronald, here we come." Feng Zixuan greeted him with a smile on his face as usual.
But Luo Hao felt a gust of cold wind around him, and if it wasn't for his strong yang energy, he might have started to shiver at this moment.
(End of this chapter)