Chapter 46: A group
In the emergency department, generally speaking, the patients who receive the patient are responsible.
Because Fang Han is under the name of Miao Dalong, if the patients treated by Fang Han are hospitalized in the observation room, the patients belong to Miao Dalong, and the doctors in the bed are Fang Han and Li Xiaofei. However, Fang Han is an intern and rarely manages patients in the observation room during this period. The nurse will report to Li Xiaofei or Miao Dalong as soon as possible if the patient has any soil conditions.
In the afternoon, Miao Dalong had just finished treating a patient and came out of the treatment room. A nurse in charge of the observation room hurried over.
"Doctor Miao, the high fever in bed 15 has not yet subsided."
"Bed 15?" Miao Dalong was stunned: "Who treated the patient?"
"It's Dr. Fang." said the nurse.
"Fang Han?" Miao Dalong asked.
"Well, I was hospitalized this morning and the high fever has not subsided." The nurse said.
"Okay, I'll go and see. You go and inform Fang Han to come here." Miao Dalong nodded. Fang Han's patient was his patient.
While walking towards the observation room, Miao Dalong muttered to himself that Fang Han had been to the emergency department for several days and had been treated many patients. This was the first patient to have an emergency.
Most of the patients treated by Fang Han left the hospital on the same day and did not arrange for hospitalization. The patients who were arranged for hospitalization were all patients with bone injuries. If the patient did not have any emergencies, the nurses rarely took the initiative to find the attending doctor. They were treated according to the prescribed prescriptions and courses. The attending doctor conducted routine rounds every day.
Miao Dalong has paid a lot of attention to the patients treated by Fang Han in the past few days. The situation is good. Today, the nurse suddenly asked him to tell him that something was wrong with Fang Han's patient, and he was really a little surprised.
Fang Han came very quickly, almost Miao Dalong arrived, but he arrived. Miao Dalong had no time to ask the patient's specific situation.
"Xiao Fang."
Seeing Fang Han coming, Miao Dalong waved: "What's the patient's condition?"
As a doctor in the patient's condition, you must be aware of the situation at any time, and you must also understand the most detailed and detailed situations, and even some past medical history and treatment process must be clearly understood.
Fang Han glanced at the patient on the bed, and then suddenly realized that it was the patient that Ye Kai snatched away before. No wonder the nurse said that he had no impression of bed 15 just now.
The patient Lin Yushan informed Fang Han, and Fang Han went to check at the first time, but Ye Kai snatched the head of the patient halfway through, but Fang Han's name was registered on the nurse's desk.
And coincidentally, Ye Kai called Qin Xige again when he arranged a ward for the patient. Qin Xige met a nurse halfway through and said, "The nurse knew Qin Xige, so the patient was registered under Fang Han's name when he was registering.
As for medical records, nurses generally do not have permission to view them, so they do not know that the patient was actually Ye Kai. Even if the prescription is named Ye Kai, it is not surprising. If the prescription does not have a practitioner’s signature on the prescription, it will not take effect.
In addition, Ye Kai just came back today, and some of the nurses who were watching were not aware of it, so by chance, the patient was still hanging under Fang Han, and the name of Miao Dalong was filled in the column of the attending doctor.
Although the patient was intercepted by Ye Kai halfway, Fang Han also knew the patient's condition and heard this: "The patient had high fever for four consecutive days, showing a sign of Yangming's fever. The prescription was Baihu Decoction. He should have taken two doses, right?"
"What does it mean?" Miao Dalong had a rare opportunity to hit Fang Han and scolded: "As a doctor, you must be very cautious. Perhaps, this kind of word must never come out of a doctor's mouth. You don't know your patient?"
Fang Han opened his mouth and was about to explain, a young doctor ran over panting and said, "Huh, Dr. Miao, bed 15 is my patient."
The person who came was Ye Kai. I heard that the heat from bed 15 did not subside. Miao Dalong had already gone to see it, so Ye Kai hurried over.
"Your patient is not Xiao Fang's?" Miao Dalong looked at the two people strangely. What's going on? Did he get angry just now and get wrong?
Miao Dalong's attitude towards Fang Han is a bit complicated.
He was very optimistic about Fang Han and liked Fang Han very much, but Fang Han's performance was too conspicuous and excellent, which made Miao Dalong feel a little lacking in presence, so he wanted to hit Fang Han for a moment.
It’s like a student is too smart and can do any questions. The teacher doesn’t have much presence in front of such students. Finally, I encountered a student who did the wrong questions. Why don’t you take the opportunity to show off the teacher’s style?
Dr. Miao has this mentality, but when he looks back, he finds that he has made a mistake, which is very embarrassing.
Li Xiaofei also rushed over after hearing the news. At this moment, he hurriedly explained to the side: "The patient was taken over by Dr. Ye. Maybe the nurse did not change it."
This kind of thing has happened before, but the chance of it is small. In fact, if the patient does not have an emergency today and the high fever has subsided, the rounds will be changed back to Ye Kai's name tomorrow.
Miao Dalong looked at Ye Kai, then looked at Fang Han. Thinking of Ye Kai's sudden arrival in the morning and saying that the intern was not in a manner, he probably guessed what was going on.
So his face darkened: "Since it's your patient, let's talk about the situation."
Ye Kai wiped the sweat from his forehead and was really puzzled. Why did the high fever in these 15 beds have not subsided? He diagnosed it very clearly during the morning examination. The image of Yangming fever and Baihu Decoction should be effective quickly. Calculate the time, and the second dose of the medicine should have been taken.
"The patient had a fever for four days, his body temperature was 95, and he was sweating profusely." Ye Kai hurriedly told the situation, which was basically the same as Fang Han said. The only difference was that Fang Han didn't know the specific prescription, but only knew that it was Baihu Decoction. Baihu Decoction also had additions and subtractions and dosages. Different doctors would have some differences when prescribed.
As he spoke, Ye Kai had already handed the medical record to Miao Dalong. The attending doctor checked, and the doctor in charge naturally had to check the most detailed things for the superior doctor.
Miao Dalong took it and took a look, then looked at Fang Han: "Xiao Fang, you have also examined the patient, what do you say?"
"I didn't check it clearly in the morning, I just took a look."
As he spoke, Fang Han walked forward and looked at the patient's condition, symptoms, and pulse patterns in detail. He was not much different from that in the morning. However, he was driven away by Ye Kai before he had time to check the tongue coating in the morning, and he did not have time to ask the patient's feelings.
I checked the tongue coating and found that the patient had white greasy moss in the center of the tongue about the size of his thumb.
"The patient should have symptoms of chest tightness, right?" asked the cold side of the patient's family next to him.
The family nodded quickly: "It's because of chest tightness."
Miao Dalong also stepped forward to check, looked back at Fang Han, and gestured for a moment.
Fang Han nodded, and several people walked away. Fang Han said as he walked: "In addition to the image of Yangming's great heat, the patient also has the heat and dampness, which blocks the middle Jiao. Baihu Decoction is effective in treating high fever, but it is not very effective in dealing with the symptoms of dampness and dampness."
Ye Kai's face changed: "You mean the patient is hot and wet?"
Fang Han nodded: "The patient's tongue coating is white and greasy, and it also complains of chest tightness. It is obviously hot and damp, and dampness blocks the middle burner."
"The patient does have white greasy tongue coating in the center, which is a complaint of chest tightness and heat and dampness." Miao Dalong affirmed Fang Han's judgment and looked at Ye Kai: "What did you do?"
Ye opened his mouth, his face had turned into a pig's liver color, especially Fang Han was present next to him.
I remembered that he was a senior in educating Fang Han, but he had a mistake after taking it. The most important thing is that this disease was originally something Fang Han wanted to treat. Judging from the current results, if he didn't interfere, the patient might have improved.
"Since it's hot and wet, how should I use medicine?" Miao Dalong looked at Fang Han and couldn't help but feel a little proud.
Miao Dalong just now, after checking it himself, he deliberately asked Fang Han, just to hit Ye Kai, so that you can come back with pride and feel proud.
Fang Han didn't have much resentment about Ye Kai robbing his head, but Miao Dalong was different. Fang Han's authority was given by him, and he was responsible for any incident. Ye Kai robbed Fang Han's patient when he came back, and came to the office to complain and point fingers. This made Miao Dalong very dissatisfied. What should I do as the attending physician and report to your hospitalist?
Taking advantage of this, he just smeared Ye Kai. Fang Han couldn't answer and it was nothing. Ye Kai made a mistake. If he answered, he would have a big face. Obviously, Fang Han did not disappoint Miao Dalong.
"The prescription does not require too much change. Just add Atractylodes and Atractylodes Baihu Decoction." Fang Han replied.
In fact, to be honest, there was no error in the general direction of Ye Kai's diagnosis before, but the diagnosis was negligent, which led to the patient's high fever not regressing as soon as possible.
Miao Dalong ignored this and looked at Ye Kai with a calm face: "When I heard it, I will re-imagine the prescription according to the prescription of Xiaofang. As a doctor, you must be very cautious in treating diseases and saving people. You cannot tolerate carelessness for half a year. Doctors use medicines like soldiers using soldiers. The soldiers are inconsistent and water is inconsistent. When treating, thinking should spread and adapt to changes. You cannot stick to the rules. You only remember that Baihu Decoction has miraculous effects on high fever, but you do not find out the cause and ignore some symptoms. This will cause a big mess."
Ye Kai nodded repeatedly. As a doctor, there is no mistake. Miao Dalong, the attending physician, also made mistakes. Ye Kai is not so frightened.
But this patient was the first patient to be treated after he came back. He made a mistake when he came back. What did other people think about this? After going to Yanjing for half a year, he was at this level when he came back?
Miao Dalong ignored his thoughts and snorted: "Okay, hurry up and draw a prescription. You will study hard with Xiao Fang these days, and you are so irritable. What does it look like? If the patient hadn't had a high fever for several days and the patient's family was mentally prepared, you can wait to explain to the patient's family now."
After saying that, Miao Dalong didn't care what Ye Kai's expression was, but he had already walked away.
"" Ye opened his mouth, what's going on? I'm learning from Fang Han now?
Li Xiaofei, who was beside him suppressed his laughter and patted Ye Kai on the shoulder: "Doctor Ye, we will be in the same group from now on."
Li Xiaofei was so happy, Dr. Miao was really so. He threw down this sentence and didn’t give Ye Kai a chance. Do you think Ye Kai listened to Dr. Miao or didn’t listen?
ps: Remember to collect it, guys!
Chapter completed!