Chapter 450: It is better to believe in no book than to have no book
“Oh, I know, the tenth edition of the textbook, the latest edition, says that the drop is 3.9-6.1mmol/L per hour.” Luo Hao smiled slightly. .
The hospital manager of Icu was stunned for a moment.
What does Professor Luo mean? He can tell in detail the contents of the tenth edition of the textbook "Internal Medicine", which was only released in July 2024.
The disdain that the hospitalized boss of Icu had just felt in his heart turned out to be nothing.
As quickly as it comes, it goes even faster.
"Professor Luo, have you... also read the tenth edition of "Internal Medicine"?" the ICU resident manager asked in a low voice.
“After scanning it once, the overall situation is OK, but there are some minor problems.”
“!!!” The ICU resident manager felt that his ears were a little hard to use. Professor Luo just said What!
A little question, the subject is the 10th edition of "Internal Medicine"?
That's a textbook, that's a textbook! !
The hospitalized boss of ICU roared at the top of his lungs, and the silence was deafening.
No matter what you say at this time, it is inappropriate. Professor Luo can say that there is a problem with the textbook, but can he say it himself?
The hospital manager wouldn’t dare.
"It's harmful. It's better to believe in no books than to have no books at all. Textbooks are also compiled by teachers. Knowledge is always being updated and iterated, so you can't believe everything." Luo Hao said with a smile when he saw the expression of the ICU resident boss.
"Uh, for example?" Seeing Luo Hao's determination, the hospital manager of ICU asked in a low voice.
“For example, for patients with ketoacidosis, the recommended hourly glucose lowering rate should be changed from 3.9-6.1mmol/L per hour to 2.8-4.2mmol/L per hour; alkali supplementation The indication was changed to pH <6.9. "
The Icu boss was immediately reluctant, but then she thought of a possibility.
"Professor Luo, are the values you mentioned mentioned in last year's guideline?"
"Yes, there is a conflict between the guideline and the textbook. Who do the students listen to when they go to clinical practice? Patients The patient’s family complained about the disease using the textbook, and you said it was treated according to the guidelines. "
"Isn't this appropriate?"
Luo Hao's two questions made the ICU boss feel cold.
This kind of thing will either not happen, or it will be a big deal. Who can guarantee that they will have such good luck throughout their lives?
She immediately picked up her phone and started searching for the nearest guide.
Sure enough, just like Luo Hao said, the values in the guide are different from the values in the textbook.
The hospitalized boss of ICU looked solemn and walked to Luo Hao with a book and a mobile phone in his hand.
"Professor Luo, which value do you think is more reliable?" she asked in a low voice, as if this was a big secret that could not be heard.
“Guidelines.” Luo Hao gave the answer without hesitation, “Changes in the guidelines require meetings and repeated discussions with actual cases, which is more trustworthy.”
“Okay. "The ICU boss immediately changed the doctor's order and first slowed down the blood sugar lowering speed.
After revising, watching the nurse adjust the speed of the micropump, she hesitated and came to Luo Hao again.
"Professor Luo, the 10th edition of the textbook just came out not long ago. Have you really read it?"
"Don't tell me. I didn't read it carefully, so I just scanned it." Luo Hao smiled.
"Then, then, what else is wrong?" the ICU resident manager asked stammeringly.
"It's not wrong, it's debatable, and the answer may be controversial. After all, those who compile textbooks are big-name experts, and the bosses may have their own ideas." Luo Hao corrected.
“Uh~~~” The ICU hospital manager was stunned.
"After contacting some book writers, I found that no matter how good a book is, it is written by people. Everyone is responsible for a part of it. It is not easy to unify the quality between chapters. There are many small errors in authoritative books."
"... …”
Icu’s resident manager didn’t know how to respond to Professor Luo Haolo’s words.
It seems that no matter how I pick it up, it doesn’t work correctly.
Questioning the textbook? I love my teacher, but I love the truth even more?
Professor Luo can say it, but I can't.别说是说，连听一句，icu住院老总都觉得耳朵发痒，浑身难受。
“For example, the maximum repolarization potential of the sinoatrial node is -65mv, and the hemoglobin concentration is 130-175g/L for men and 115-150g/L for women. There are some problems with the values here.”
< br>Icu住院老总一脸茫然，随后想到这句话说得有些模糊，应该是罗教授自己也不记得了吧。
That’s how it should be!
她心里想事儿，脸上却藏不住，把没说的话都表现出来。
Luo Hao smiled slightly after seeing it, and did not explain much about what he had said, but continued, "Pioglitazone 15-30mg/d on page 737. But according to the instructions, the maximum dose can be 45mg/d."
"!!!"
The resident manager of ICU immediately picked up the textbook and turned to page 737. He was shocked to see that the content written on it was exactly the same as what Professor Luo said.
As for the instructions for pioglitazone, she knows it.
There is indeed a problem.
"However, the dosage still depends on clinical experience. In the past, Boss Zhou said that for mucosolvan, you can ignore the dosage in the instructions and there is no upper limit for daily use."
"!!!"
"But I don't dare to do it now. The patient's family will bring the doctor's order and instructions to sue you, and the complaint will be accurate. What's wrong with the phlegm not dissolving? Take your time." Luo Hao spat out a rare breath. Old slot.
"Professor Luo, what else is there?" The ICU resident manager was in a daze.
"There is a spelling error in the table on page 686 - deQuervian thyroiditis should be deQuervain thyroiditis."
"???"
The resident boss turned to page 686 of the textbook again.
What catches the eye is a spelling mistake.
"Professor Luo, there are so many mistakes." The ICU resident manager was dumbfounded.
The sacred textbook seemed to have become less sacred. From a milky white light to an ordinary book, it only took less than 10 minutes.
"Damn it, it's normal for bosses to make small mistakes occasionally." Luo Hao smiled, but he didn't say that the boss wouldn't read it at all. It was all written by his capable disciples and then used the boss's name.
“…”
“It is better to believe in books than to have no books at all, that’s probably the truth.”
“But this is a textbook.” The ICU hospital manager was a little anxious .
What happened before her eyes subverted her outlook.
"Boss, have you compared the difference between the first edition textbook and the tenth edition textbook?" Luo Hao asked.
The hospital manager of Icu shook his head blankly.
“The difference is quite big. There are some contents that you wouldn’t even believe would be written like this in the first edition of the textbook.” Luo Hao explained.
Later, Luo Hao gave three examples.
No more, no less, just three.
The hospitalized ICU boss felt confused. Are all textbooks so disrespectful of human life?
“There is no way around the limitations of the times. For example, when radium was first discovered, women noticed that Madame Curie’s hands had turned white and thought that radium had the function of whitening. As a result, some Whitening and skin care products containing radioactive elements ”
“ ! ! ”
“On the contrary, it is the unscrupulous fake sellers who only cheat money and put radium elements into their products, causing countless harm to users. Why? It’s not a limitation of the times.”
Luo Hao explained with a smile.
"Professor Luo, is everything you said true?"
"Yes, let me show you a photo." Luo Hao took out his mobile phone and started searching.
Each photo was numbered and named. The ICU hospital manager didn’t want to see more of Luo Hao’s privacy and turned his head away.
"Be careful when watching, don't be shocked."
"Huh?" The ICU hospital manager was startled.
Turning his head, Luo Hao saw a glowing general teacher on his phone.
“Here, this is not a gross body, it is a specimen, sealed with special materials containing lead.” Luo Hao handed the phone to the ICU resident manager, “A senior brother of mine who went to study in the United States sent it to the group. ”
The resident manager of ICU looked at the shining general teacher and his eyes went straight.
How many radioactive elements are there in this? !
"It is said that the deceased was a person from the 1950s and 1960s. At that time, there was a kind of fairy water that could live longer if you drank it. Emmm, it was just like the health care products sold now. But those around us use eggs to cheat old men. The wife’s liar sells health products made of flour.”
"What about this?" The ICU resident manager seemed to have guessed the conclusion, but she still asked Luo Hao.
"They really put a lot of radioactive elements into it. It is said that the deceased was a billionaire."
"!!!"
"So, what do others say? You have to question it and think more about it. Many new technologies need to be constantly polished, and we need to pay attention to the long-term effects. "Luo Hao, just chat, what values do you think you have?" Doesn’t it sound too daddy to talk like that?” Chen Yong’s voice came from behind.
"It's not about values, it's just a casual comment." Luo Hao didn't care, turned around and smiled, "You have nothing to do?"
"Lao Meng sent Xiaozhuang home, otherwise he would have said it It’s bamboo, it’s good at coaxing people, providing emotional value, and treating psychological trauma! Xiaozhuang has been feeling better after playing with bamboo for a while.” Chen Yong said proudly.
It’s like bamboo is still his spiritual pet.
"As long as Xiaozhuang is fine." Luo Hao thought about it, "Remind me from now on, don't let Xiaozhuang do this kind of work."
"Huh?" Chen Yong raised his eyebrows .
"Although everyone gets through this, for example, what are the ICU nurses best at?" Luo Hao asked.
The hospital manager of ICU pricked up his ears, is he turning over?
Nearly all of the more than 20 patients in the department cannot turn over on their own and have to rely on nurses to move them.
A young nurse developed a bulging disc in her waist after working for 2-3 years.
ICU is an extremely age-hungry place, and the head nurses even began to recruit male nurses in the hospital.
Boys are more resistant.
"What is it? Wipe your butt?" Chen Yong asked.
"???" The ICU resident manager was startled, and immediately remembered... She was a little embarrassed. She was the manager of the ICU, but she was not as familiar with Professor Luo and Dr. Chen.
Mainly because the job of wiping buttocks was automatically blocked by the hospital manager in the ICU.
"Of course, if you want to avoid bedsores, turning over is inevitable, but wiping your buttocks is the most important. You need to wipe it with the right amount of weight, and you must wipe it clean. There are many explanations in it." Luo Hao said.
What Luo Hao and Chen Yong said about wiping their butts was the literal meaning, not the extended meaning.
"Medical care itself is not a clean job. Xiaozhuang is so pitiful." Chen Yong was a little split.
On the one hand, he thought that he should not do medical treatment because he was afraid of getting dirty, but on the other hand, he couldn't help but start to cherish her.
"Don't think so much. New recruits pee when they hear the sound of gunfire. Just become veterans."
"Is this how you treat your doctors?" Chen Yong asked with a smile. road. "Have you finished writing the medical record?" Luo Hao asked.
"It's just that Lao Meng provides you with emotional value every day, what's there to write about." Chen Yong disdainfully said, "I'm here to see the patient."
"Oh? Then let me ask you One thing."
"Huh?"
Luo Hao stood up, took another look at the patient's vital signs, checked the time and confirmed the urine output.
Everything looks like a patient with obsessive-compulsive disorder.
"Luo Hao, your illness is getting worse and worse." Chen Yong said pretending to be concerned.
"The urine output has begun to decrease, and there will probably be no more urine tomorrow." Luo Hao sighed, "This is still the result of you inducing vomiting early in the morning. If you don't feed one spoonful of feces soup, the patient will probably die by now. We can give up the rescue."
The words should be good, but they sound a bit unpleasant.
Chen Yong carefully pondered Luo Hao's words about feeding him a spoonful of dung soup, and why he felt that he was yin and yang himself.
Luo Hao walked to the computer, randomly found a medical record, clicked on the doctor's orders and looked around.
"Here, take a look at the doctor's order and tell me what you need to do if you are the patient's family member and want to find trouble."
Luo Hao's words made the ICU resident manager feel numb. .
A simulation exercise?
Professor Luo is not joking?
Chen Yong seemed to sense the message of challenge. He pulled up a chair and sat down, and began to search carefully.
A few minutes later, Chen Yong singled out various mistakes, making the ICU hospital manager break into a cold sweat.
You are here to see patients, not even for consultation. The ICU hospital manager really wants to kick these two people out.
These two bitches are here to cause trouble!
Fortunately, Luo Hao is not the medical director. If Director Feng mentions the position of vice president and Luo Hao takes over as the medical director, it will be the end of the clinician.
"Huh? Can you see so many problems?" Luo Hao was a little surprised.
"You have to give lectures no matter what. I have been nagging you too much, and I can tell there is something wrong just by looking at it."
Luo Hao scratched his head and sighed.
"Why are you sighing? Did I say something wrong?"
"Yes, but that's not what I want to say." Luo Hao said, "Here, the patient uses penicillin to treat inflammation and symptoms. Treatment, there is a skin test, I wanted to test you on this.”
"!!!"
"!!!"
Isn't it normal to use penicillin, cephalosporins, and skin tests?
Luo Hao took a serious look at the doctor's orders, which were so sloppy that he felt helpless.
But that is all analyzed from a critical point of view, and it is not our own medical team. It doesn’t matter, as long as the patient can get well.
Luo Hao didn't say much, and lost interest in testing Chen Yong, so he started talking, "The "Guidelines for Skin Testing of Beta-Lactam Antibacterial Drugs, 2021 Edition" pointed out that cephalosporins are only needed under specific circumstances. "Skin test."
"Well, no need for skin test?" Chen Yong was surprised, " I see our patients are still doing skin tests, but I didn’t see you saying anything.”
“Yes, after so many years of skin tests, patients all know that a single guideline can resist them. Is it the fixed idea of so many patients?”
Chen Yong thought for a while and roughly understood what Luo Hao meant.
Lao Meng's work is meaningful. Even if he does it flawlessly and every step is done according to the guidelines and guiding principles, once something goes wrong, he will definitely be blasted.
As for the institutions that issue the guidelines, they will not pay attention to the trivial matters of clinical "flying and fighting dogs".
"What Lao Meng does is meaningful." Luo Hao said seriously, "The focus of medical treatment is to cure diseases, and the focus of doctors is to make money and prevent accidents."
"Good customs "
"We are all common people, doesn't your master also buy stocks?"
Chen Yong curled his lips, obviously having some disdain for the master who had money to cover his position but no money to fix his teeth.
"It would be best if nothing happens. Lao Meng spends all his energy on this. Even if it has emotional value, it is for the patient and the patient's family. Think about it, if nothing happens, who would want to trouble the doctors and nurses? Those who were looking for trouble were screened out by Director Shen from the beginning.”
"I won't be too long-winded. It's all nonsense. You should say that I instilled values..."
[As the saying goes, a man is a boy until he dies~~~]
"Hey, Professor Li."
"Okay, I'll go out now."
Luo Hao hung up the phone, turned around and took a look at the patient's vital signs on the ECG monitor and the urine in the urine bag. After making an estimate, he put on his clothes and went out.
"Professor Li, what's going on?" Luo Hao asked as he walked out.
"Little Luo, this way." Professor Li pulled Luo Hao's clothes and wanted to go to the fire escape.
Luo Hao smiled and said, "It's okay, just speak in a lower voice."
"emmmm." Professor Li hesitated a little, but saw that the fire escape was also paved by the patients' families. , it was still inconvenient to speak, so he nodded.
"Doctor in the ICU, I want to give you a red envelope. How can it be convenient for you, Ronaldinho?"
"Red envelope? No need." Luo Hao said calmly.
The sound was not loud, only he, Professor Li and Chen Yong behind him could hear it.
"I know...I know..." Professor Li said helplessly, rubbing his hands.
As for what he knew, Professor Li didn’t say anything.
"That's right, hospitals are not the kind of people who don't remember who gave something and who didn't." Luo Hao smiled.
“Really?”
“Let’s put it this way, Professor Li, do you know what red envelope is the easiest to give out?”
Professor Li shook his head.
“I have never treated a patient with paraquat poisoning. I will give you a phone number to help you contact a certain professor and expert in the hospital next door. You will be given a big red envelope after you go there, which can usually be given away. ”
"Favor?"
"Yes, this will be accepted very calmly. After all, I am still here. Receiving the red envelope is recognition of me, not your recognition of the patient's family."
What Luo Hao said was a bit convoluted, but Professor Li understood it instantly.
"Now, first of all, I'm watching from inside, and they can't get involved. Secondly, you have no chance to see me off." Luo Hao smiled, "Forget it, don't worry, I'm here "
Looking at Professor Li's expression, Luo Hao raised his eyebrows, "This way, next time I need to supercompute, you can just help me again."
"Okay!" Professor Li agreed without hesitation.
Although it is not difficult to apply for supercomputing at the University of Technology, you still have to queue up. If you want to jump in line, you need to show your face, which is not a small favor.
"If nothing goes wrong, you can rest early and go home to sleep. Don't stay at the door. Just leave someone to deal with emergencies." Luo Hao persuaded, "The acute period is 2 weeks, and there are a lot of people here every day. , I can’t bear it.”
Professor Li nodded without being too polite.
Luo Hao made a request. From now on, he can solve his request as soon as possible. There is no need to dwell here.
Returning to the ICU, Chen Yong asked, "Luo Hao, you don't accept red envelopes at Xiehe? It's impossible. I heard from my master that when he went to the Imperial Capital to further his studies, the teacher sometimes asked them to accept red envelopes, which were used as subsidies."
“It’s not that the doctor doesn’t want to accept it, nor does he have a chance.
My family, Xiehe, has a lot of experience in management flow. The process is very standardized.
First of all, after being hospitalized, the patient cannot leave the ward. The attending doctor can only see him during morning and evening rounds. A lot of people show up together. The doctor's office in the inpatient area is a big one. There are a lot of doctors working in the room, and there are too many people to send away.”
This is true, Chen Yong nodded.
"The ward is a three-person room. When talking to the doctor before the operation, the assistant usually talks to you. Just like in our family, Lao Meng does the pre-operation explanation. I basically don't do it.
The surgeon, the patient should be Invisible.
The interview room is outside the ward, a large room filled with many patients and family members, just like the waiting chairs at the train station. , there are several cameras on the roof, and the experts usually work as a team. If you sign up for the expert number, you won’t know who performed the surgery on you in the end.”
“So, I can’t send it away even if I want to. "
"And who of my Xiehe experts lives on that little red envelope money? You think so?"
"Wen Youren will accept it, did you know?" Chen Yong suddenly put on a mysterious and gossipy attitude, "This hospital charges 2,000, and ordinary patients charge 3-5,000. If you don't give a red envelope, there will be no surgery."
"I know, so I have always wanted to mess with him." Luo Hao said calmly, "There were too many people complaining about him, which made me Very annoying.”
“Have you always been so pretentious and used public tools for personal use?”
“Can you use another word, such as doing justice for heaven?”
"Hahaha, you're busy, I'm going to see Lao Liu." Chen Yong turned around, changed his clothes and left, waving his hand before leaving.
Luo Hao really didn't expect that Chen Yong would be so obsessed with a relationship that he would rather give up the entire forest for a tree.
Back in the ICU, Luo Hao continued to sit next to the patient, holding his mobile phone in his hand, browsing papers and journals, and occasionally looking up at the ECG monitor and urine bag.
Urine output is the best indicator of kidney function.
A blood test was taken at 5 a.m., and all indicators of the patient collapsed.
Although there are prerequisites such as inducing vomiting, and there are factors such as paraquat being expired and invalid, it is paraquat after all.
What is coming will always come.
Luo Hao was not in a hurry, this was all expected.
Early in the morning, Luo Hao and Qilu's Senior Brother Che "reported" the emergency test results. Senior Brother Che gave treatment advice and told Luo Hao all the corresponding responses.
Luo Hao's talent is very high. He understands what Senior Brother Che means.
Whether it is liver failure or renal failure, corresponding symptomatic treatment is carried out, and medication is targeted at pulmonary fibrosis.
Time passes day by day.
Three days later.
"Isn't Ronaldinho finished yet?" Shen Zizai asked while standing at the door of the office.
"It's almost done. The patient's acute stage of organ failure is almost over and he should be able to live." Chen Yong stood up, bent his waist slightly, took off his mask, and "reported" seriously The situation on Luo Hao's side.
Shen Zizai glanced at Chen Yong.
He clearly remembered how unruly Chen Yong was when he came here.
Unexpectedly, one year has not yet come, and he has already learned to provide himself with emotional value.
But the emotional value was too heavy, and Shen Zizai said he couldn't bear it.
(End of this chapter)