Chapter 632: [632] Re-establishing the primary diagnosis
Chapter 632 [632] Re-establishing the initial diagnosis
The reason for the misdiagnosis at the grassroots level is most likely because Xie Wanying looked at the belly of the pregnant woman. Probably the general doctor is not a gynecologist, and they are also afraid that casually pressing the pregnant woman's stomach to palpate will cause harm to the fetus. Primary clinics may only have X-ray machines and no b-ultrasound machines. Under normal circumstances, doctors are afraid of using X-ray machines to cause harm to the fetus, so they fail to perform relevant examinations on patients, resulting in inability to make accurate judgments.
The doctor knows a lot, so he worries a lot. The common people don't quite understand it, and they will only ask why they didn't see it.
"Yingying, what's up?" Realizing that her expression was not right, Wu Lixuan pulled her hair's small cuff and asked in a low voice, "Do I have to be hospitalized?"
Hospitalization is a must, and it must be done right away!
Xie Wanying took out her mobile phone and called Teacher Sun first to discuss.
"Didn't you get off work?" Sun Yubo was surprised to receive her call, thinking that all the students had left.
"Mr. Sun, there is a patient who is four months pregnant. I initially suspect that she has acute appendicitis, and the treatment in the primary outpatient clinic has been delayed for almost a week. The situation is more serious. I want to discuss with the teacher, won't she be discharged from the hospital tomorrow? Can I bring her in tonight?" The situation was urgent, Xie Wanying explained the situation directly to the teacher.
Sun Yubo asked her to wait: "The matter of the bed is not something I can decide. It needs to be decided by Mr. Tan. Mr. Tan went to the meeting this afternoon and just didn't leave. I will ask him."
said, Tan Kelin received a message from the opposite side and asked the key point: "Pregnant woman, acute appendicitis?"
"Yes!" Sun Yubo was shocked that his student was about to accept a terrible case. Acute appendicitis in pregnancy is rare. You must ask the next student: "How do you know that she has appendicitis?"
"I performed the Bryan and Alder experiments on her in the right lateral decubitus position and the left lateral decubitus position. It was obvious that the abdominal pain was aggravated in the right lateral decubitus position, and the finger pressure on the appendix point was also aggravated in the left lateral decubitus position. Furthermore, she began to have symptoms of stomach pain. Pain, then transferred to stomach pain, typical transfer to right lower quadrant pain."
The words clearly described by the students came from the phone, and the teachers listening here raised their eyebrows.
This is something they didn't teach students. Because it is a rare case, Xie Wanying has just entered the clinical practice for three months, and the possibility of seeing a rare case belongs to the lottery. For cases that have not been encountered, the clinical teacher did not expect that they would not teach.
It can only be said that what this student has learned is quite solid and comprehensive, and he can recall it quickly. Even if this case textbook mentions it, it must be a knowledge point hidden in the corner.
It is a pregnancy complicated with acute appendicitis. The grassroots hospital is helpless for this kind of patient and must be transferred to the top three. Sun Yubo asked, "Where is the patient now? At home?"
"She has been to the emergency department of our hospital, but she can't get on the number." Xie Wanying said, "Maybe our hospital's emergency room is full and we can't accept her. She took antipyretics and injections in the primary clinic, but the grassroots did not diagnose her with appendicitis. The anti-inflammatory injection may not have been strong enough. Now, it is clear that her condition has deteriorated again."
Listening to this situation, Tan Kelin didn't say much: "Take it!"
Sun Yubo ran out and told the nurse to quickly prepare an extra bed.
Fortunately, Mr. Tan is here and willing to accept it. Xie Wanying breathed a sigh of relief, seeing that the patient couldn't move around and needed a lathe. It is better to borrow a lathe from the department on the ninth floor to transport patients faster than going back to the general surgery department to go up and down the lathe.
(end of this chapter)
