This doctor has a system

Chapter 379

"You are not allowed to pass through this door. You have to go through the south door." The security guard said, "Just make a half circle from the front."

"We are an ambulance," the driver shouted. "This door is closest to the patient."

"I don't care what kind of car you have, you are not allowed to enter through this door anyway." The security guard's attitude was very firm, "This is what the leader has told me, you can just go through the front door and that's it."

The driver was about to go around when Fan Yulong ran over.

"I'm going to make a fool of myself!" he shouted, "Hurry up and drive in. It's Wang Tianci from your department."

"Huh?" The emergency personnel in the car were shocked.

"Quick, get through!" the doctor accompanying the car yelled.

The driver stepped on the accelerator, and the thin barrier was broken directly. The ambulance turned a little too sharply, scratching the security booth, and almost made the security guard inside cry.

"Idiots! Are you crazy?" he cursed.

"If I were the patient's family member, I wouldn't be able to beat you to death!"

"I've never seen anyone use it." The person in charge really didn't understand. He had just been transferred here for half a year, and his previous unit didn't have such a thing.

"Mr. Gou!" At this time, the security guard guarding the gate ran over with tears running down his face. "A car just drove into the guard post. The blocking pole was broken and the guard box was almost knocked over!"

"Except for two tremors, it is most likely myocardial infarction." Gao Fengyan said concisely, "Do you know what diseases he had before?"

"No matter what you say, you can't damage our equipment." Mr. Gou argued in a low voice, "We have to make them pay."

"We still need to verify the situation." He turned to the person in charge and said, "President Gou, right?"

"Yes, I am." Mr. Gou said.

"They directly used violent means to destroy it, and then took away our things in broad daylight!"

"It's said that he got sick after playing basketball." The nurse said.

"Comrade police, it's a robbery!" the person in charge pointed at the surveillance camera and said, "We have tens of thousands of instruments!"

"It would be better for you to first lock up the life-saving automatic defibrillator, and then the security guard will not let the ambulance in."

Soon we arrived at the emergency department of Xiehe Union Medical College. Everyone quickly transferred Wang Tianci down. The CCU had already prepared the bed, and everyone pushed the cart so hard that it almost flew up.

"Uncle policeman, arrest them quickly!" Mr. Gou was anxious.

"Lao Wang has a single kidney, which is congenital." The doctor accompanying the car said, "There are no other problems."

The resolution of Hikvision's camera is very high. In the surveillance video, we could clearly see an ambulance roaring past, the traffic barrier breaking and the guard box swaying.

"What is a defibrillator called?" the person in charge said. "I don't know the details, but it is very expensive. This is the only one we have here."

After the police left, the security guard guarding the door came up again.

"I advise you to stop thinking nonsense. If the person is fine, just burn some incense." The older policeman said, "If the person is not rescued, hey, just wait for the family members to come and talk to you properly."

"This thing is for rescue, why did you lock it up?"

"My breathing and heartbeat stopped on the spot. Professor Gao held me down."

"Little Gouzi, I'm applying for a transfer to another position. It's too dangerous!"

"What is this?" a policeman asked.

The gymnasium was very busy now, and the person in charge who arrived belatedly called the police.

"What!" Mr. Gou, the person in charge, was furious, "Who is so arrogant! This is too much! Call the police! Call the police quickly!"

Because it was expensive, he was afraid that someone would take it away, so he ordered the people below to lock it up.

"What you did today was really a bit of a bullshit!"

"After playing, he might have lost and felt unhappy." Fan Yulong said in the ambulance, "I was comforting him, but he rolled his eyes and lay there."

"Xiao Hu, pay attention to civilized language." The older policeman reminded.

You can even hear a very clear voice from it: "I'm going to make a fool of myself!"

"What's going on?" asked the doctor on duty at the CCU. "It's like this."

"Why don't you play basketball when you have nothing to do!" A director of the emergency department also ran over, "The emergency department itself is tired from work, and you still exercise vigorously after get off work. Don't you think you have a long life?"

And he was snatched away by these two damned ones!
What a world! It's not safe even if locked!
"It should be an AED, an automatic defibrillator." said a young policeman who had received training in this area before.

"Call me Comrade Police." The older policeman's mouth twitched. "Don't be impatient. Let's take a look at the surveillance camera."

The year before last, there was a doctor in their emergency department who suddenly had a heart accident while running at night. He was not as lucky as Wang Tianci. He was completely cold when he was found.

"Fuck! What do you want to do?!"

"I was just staying in there, wuwuwu."

Mr. Gou's face suddenly turned green, and he didn't dare to say anything anymore. He could only silently pray that the other party would be okay.

"This is an ambulance, how can you stop the ambulance!" The young policeman said speechlessly, "This is obviously an accident that happened to you."

"If you block the ambulance from entering, you will be informed immediately." The policeman named Xiao Hu also said.

"We are here." An older policeman said.

Gao Feng and Li Youliang slowly returned to where they lived. They didn't talk much along the way. Gao Feng was fine, and his physique was far superior to that of ordinary people, but Li Youliang's physical fitness was only average. He lay down for a long time after returning and did not recover.

"What's the danger?" Mr. Gou was worried, "You don't have a piece of skin missing."

"We promised that there would be no risk." The security guard said angrily, "You almost told me about it today. You don't know how vicious those people are."

"I'll give you an extra 200 yuan this month." Mr. Gou said perfunctorily, "Hurry up and find someone to repair the pole."

The security guard left with satisfaction.

Mr. Gou was very helpless, these people were all his relatives.

The salary for the guard post is 6000 yuan per month. There are three gates in total, and each gate is assigned two people. The total monthly expenditure is 3 yuan.

Mr. Gou pays each security guard 2500 per month, which results in a monthly balance of 21000, which of course goes into his pocket.

So in his eyes, these uncles are really "uncle" and must be coaxed.

Thanks to Mr. Gou's prayers, Wang Tianci regained consciousness the next day, and emergency PCI showed that he had suffered a myocardial infarction.

"Where am I?" he asked weakly.

"Don't you know where this is?" The nurse touched his head, "Didn't you kid like to send us patients late at night?"

"Nonsense, I am a doctor in the anorectal department and I have never had any dealings with you." Wang Tianci said.

"Fart, you came here last week," the nurse said.

"That's helping others."

"Do you want to remove the urinary catheter?" the nurse asked.

"I'm so sorry." Wang Tianci.

"Then do you do it yourself?"

"Sorry to trouble you." Wang Tianci. "You're a little young," the nurse said with a smile.

Wang Tianci remained silent, and then the monitor beside him started beeping. The alarm indicated that his heart rate was too fast.

"Not too small, not too small, bigger than my husband's." The nurse said quickly, "Don't get excited!"

"Hmph!" Wang Tianci snorted disdainfully, looking at me and trying to kill you.

Knowing that he woke up, everyone from the emergency department ran over to see him.

"It was Fan Yulong from the respiratory department who made me angry." Wang Tianci said, "I had just finished playing and I was fine. He came over to stimulate me. Once I got excited, I didn't know anything else."

"You, an emergency department doctor, have never seen anything like this." A director scolded, "I'm convinced that you can get so angry just after playing football."

This time Wang Tianci remained silent.

Fan Yulong admitted a patient today, the father of a cardiologist in our hospital.

The patient is a 69-year-old male. His condition is relatively simple, which is cough. He went to the hospital for coughing in March.

I had a cough without obvious triggers 3 months ago. I felt mild chest tightness when the cough was severe. I fainted once when I coughed.

The patient had a history of atrial fibrillation. Due to recurring attacks, he underwent radiofrequency catheter ablation at Union Hospital 1 year ago.

"Experts, is my cough a sequelae of the surgery?" the old man asked. He was quite puzzled. He had never smoked in his life, and his working environment was nothing special, so he started coughing out of nowhere.

"How could it have anything to do with surgery?" The son was unhappy, "I have done so many radiofrequency ablation surgeries and my level is very high. Don't keep talking about this."

The emotional old man's surgery was performed by his son.

This is pretty good, at least there are no doctor-patient disputes.

Thanks to his son, the patient has done a lot of examinations, including a chest CT examination, and no major problems were found.

I also took a lot of antitussive medicines, and the coughing symptoms were milder while taking them, but as soon as I stopped taking the medicine, they immediately relapsed.

“It feels like an old lady is celebrating the New Year—every day is getting worse,” the patient complained.

"Look what you said, wasn't this meant for you to watch?" The son was a little embarrassed.

"Don't worry, old man. Let's check for other reasons." Fan Yulong comforted, "I will definitely solve this cough problem for you."

Despite his confident appearance, Fan Yulong actually had no clue inside.

There are many reasons for coughing, but this patient was obviously not caused by common factors. The chest CT showed that his lungs were clean and there was no infection.

The heart was also checked in detail, after all, his son was engaged in this field.

Gao Feng took a closer look at the patient's chest CT.

"Are D-2mers high?" he asked.

"Not high, within the normal range." Fan Yulong said, "Why do you ask that?"

"It feels like there's something wrong with this area." Gao Feng pointed and said, "This place should be the left lower pulmonary vein. It seems to be a little narrowed. I don't know if there is an embolus."

“It’s best to make a CTA and take a look.”

Chest scan has limitations and it is not easy to detect blood vessel problems.

"How about we take a look?" Fan Yulong communicated with the patient's son, "This is our Professor Gao Feng, who is very accomplished in imaging."

"Hello, hello." The patient's son shook Gao Feng's hand enthusiastically.

Soon, the patient's CTA results came out, showing that the left lower pulmonary vein was significantly stenotic.

Pulmonary vein stenosis is a rare pulmonary vascular disease in clinical practice. It has various causes and is generally divided into congenital and acquired. The symptoms are atypical, early diagnosis is difficult, and the misdiagnosis rate is relatively high.

Congenital factors include congenital dysplasia of pulmonary veins and ectopic pulmonary vein connections. Acquired factors include fibromediastinitis, malignant tumors, and sarcoidosis.

But there are also some iatrogenic factors, such as: atrial fibrillation after radiofrequency catheter ablation.

Regardless of the cause of venous stenosis, symptoms such as cough, progressive dyspnea, hemoptysis, syncope, recurrent lung infections, and pleural effusion may occur.

"You mean this is really a sequelae of surgery?" the old man asked.

"Yes, that's the reason we are considering at the moment." Gao Feng explained to him.

"Okay, it turns out it's really you!" the patient shouted to his son beside him, "I said it was the reason a long time ago, but you still refuse to admit it!"

"Dirty little thing!"

"This operation is unexpected." The son defended, "I signed it before the operation."

Hearing his words, the old man was almost angry to death.

Gao Feng found it quite funny. He performed an operation on his father and signed the informed consent form for the operation. Now that something went wrong, he couldn't cause trouble for himself.

"There's nothing we can do about it, you're out of luck." The son consoled him, "Anyway, the cause of the disease has been found. Let's take a look. If it doesn't work, I'll put a stent on you."

"Pull me down!" the old man complained, "I won't let you manipulate me anymore."

Gao Feng had some thoughts at this time. As far as he knew, it seems that pulmonary vein stenosis after radiofrequency ablation is not uncommon. About 5% of patients will suffer from this serious and progressive complication.

Some people have mild symptoms, but some may have fatal consequences.

He contacted Xin Guoyu from the provincial doctor, who told him that this was an uncontrollable factor and there was currently no good way to avoid it.

"How come there is no way to avoid it?" Gao Feng didn't believe it, "Can't we just keep the ablation energy away from the pulmonary veins?"

"This is not easy to control." Xin Guoyu said.

“Can we use ultrasound guidance?”

"This." Xin Guoyu didn't know how to answer, "Aren't you at Xiehe? Director Qin over there specializes in this. He is the most authoritative."

Director Qin, whose full name is Qin Zizhen, is an expert in cardiac electrophysiology at Union Medical College. His main focus is radiofrequency ablation of atrial fibrillation.

"Gao Feng? Which Gao Feng?" He was confused, "What do you want from me?"

Director Qin showed little interest when he learned Gao Feng's intention. He was almost too busy to have time to accompany a respiratory doctor on any research.

"As for this, I think it's just a fool's errand." He said to Gao Feng, "Gringos do this too. If there was really advanced technology, they would have used it long ago."

Gao Feng frowned. He didn't like Director Qin's words very much.

"Actually, it doesn't take much, that's what I think." Gao Feng was interrupted by Director Qin before he could finish his words.

"Go find Lao Dai, he likes to do these useless research."

The acting director is also engaged in electrophysiology, but he is not so busy.

"That guy surnamed Qin has been squeezing me out. I only have 6 beds under my name, so I can't afford to be busy even if I want to." He said cheerfully.

The acting director's teacher was the original department director. Later, because he made a mistake that men would make, there was a fire in the backyard, and he finally left the job in embarrassment.

Director Qin, who was suppressed by him, saw the opportunity and finally ascended to the position of director.

As a student of the old director, the acting director was the first to be hit. The number of beds under his name became the fewest in the whole department. He fought against this, but his arms could not resist his thighs.

However, there are advantages to having fewer patients. The acting director has not been so busy in recent years and looks much younger than the doctors of the same age in the department.

(End of this chapter)