Chen Cang’s regulations are very clear!

First, we deduce the patient's reasons based on clues such as symptoms, signs, etc.

Then, based on the current medical history and past history, we will jointly introduce the possibility!

Then start to verify your judgment through physiological and biochemical tests.

Chen Cang's simple rescue process allowed many rules to accompany the students to form a framework of logical thinking.

Chen Cang smiled: "This is clinical thinking!"

Everyone was stunned.

In fact, as a doctor, the most important thing is the formation of clinical thinking.

At this time, Xu Dongdong's words made everyone even more curious.

"Yes! Teacher Chen, the serum electrolyte has not yet come out. How did you guess the blood potassium value? Is it judged by experience?"

"Yes! Teacher Chen, you are so handsome just now. How did you judge? Is there any secret?"

...

Looking at a group of students, Chen Cang smiled: "Of course there is a secret!"

When everyone heard this, their eyes suddenly lit up. They took out pens and papers one by one. This is "drug goods"!

Real practical information!

Seeing this, Chen Cang was also happy to share.

How did you say that sentence?

Yes! Knowledge is not your own, it is just a user and disseminator of knowledge.

More people can save more people by gaining this knowledge.

"Actually, have you noticed that I just had an electrocardiogram."

Everyone nodded: "Well, I saw it, but... the electrocardiogram is just a waveform, what does it have to do with blood potassium?"

At this time, Chen Cang said to Xiaolin: "Xiaolin, I just released an extra electrocardiogram, please help me get it."

Chen Cang just now gave an extra electrocardiogram to be on the safe side, which is now in handy.

Xiaolin took it in a hurry and handed it to Chen Cang.

Chen Cang took the electrocardiogram and said to everyone: "Don't underestimate any examination, as small as thermometers, blood pressure meters, heart auscultation or electrocardiogram, x-ray films, etc...."

"These inspections can tell us a lot of clues!"

"While the manifestations of hyperkalemia and electrocardiogram abnormalities are even a typical example, I hope everyone will follow me and remember!"

When everyone heard this, they quickly prepared the notebook and pen and listened carefully.

"When blood potassium increases, it increases the permeability of the cell membrane to potassium ions during the repolarization period, which makes the slope of the action potential steeper and the time shorter. The first electrocardiogram of high potassium is the high T wave and the qt shortened. So when I saw the electrocardiogram, I basically confirmed that the patient had hyperkalemia."

"Everyone knows that patients with hyperkalemia come and go in a hurry."

Chen Cang's words "coming and going in a hurry" made everyone laugh, but everyone knows that this is true. Hyperkalemia can cause cardiac arrest at any time and endanger life!

Chen Cang continued: "Indeed, serum electrolyte test is the gold standard for hyperkalemia, but by the time the biochemical test is out, the patient has been one or two hours and there has been no one long time ago. Why do I want this gold standard?"

"So, at this time, if you suspect hyperkalemia, you must do an electrocardiogram. This is a clinical trick!"

"And, as the blood potassium increases, different concentrations will show different symptoms. Let's start to remember!" Chen Cang reminded.

"When the blood potassium is greater than 6.5 mmol/l, q is widened evenly, and ventricular muscle conduction block may occur at this time;

When the blood potassium is greater than 7.0mmol/l, the p-wave may decrease and the time will be widened;

When the blood potassium is about 8.5 mmol/l, p waves may disappear, forming sinus chamber conduction."

These have been reported officially and can be used clinically, so Chen Cang did not hesitate when he said it.

If it was just Chen Cang’s personal experience, he would have said it was very conservative!

After everyone heard it one by one, their eyes were blazing green, and they kept recording.

A lot of knowledge will only shine when combined with clinical practice.

At this moment, Chen Cang in their eyes has a halo effect!

Each one is hungry and thirsty.

They could imagine that the difference in electrocardiograms could actually reflect abnormal signals of human blood potassium.

This is something they could not have imagined.

As Chen Cang said, if the serum electrolyte comes and the patient is gone, you don’t know why!

As a doctor, you must constantly improve your skills.

This technology includes diagnostic technology, therapeutic technology, surgical technology, and communication with patients.

There is knowledge everywhere in life.

At this time, a student couldn't help asking: "Teacher Chen, will he die directly when the blood potassium reaches 10?"

Chen Cang: "The blood potassium concentration further increases. When it reaches 10mmol/l, the q progresses and widens, and even fuses with the t wave to form a sine wave, and eventually dies from ventricular arrest or ventricular fibrillation."

Speaking of this, Chen Cang looked at everyone.

"So, the most taboo thing in clinical practice is experience, especially in emergency departments. Never use your usual experience to treat others, and don't persuade or encourage others to do whatever they do in life."

"Without you fully understand the patient, any words you say may be wrong, and any suggestions you make may be fatal!"

Chen Cang took a deep breath: "If you were tortured by the conventional electrolyte just now, vomiting and diarrhea! Isn't it just to replenish fluid to adjust the electrolyte? Replenish sodium, potassium, calcium, iron, zinc, and selenium vitamins... If this is the case, what is the patient like! You think carefully for yourself."

"Medical science cannot tolerate any sloppy. I have been in the emergency department these two months, and I don't say I hope you can learn much, but you must learn a little!"

"That's danger and caution."

In one sentence, all the students present accompanied the students to calm down.

There are many such examples in life. A method that may be applicable to oneself may become the real culprit of the death of others.

so!

The most appropriate persuasion and advice may be: go see a doctor!

Chen Cang smiled: "So, you know: What is the difference between a doctor and a butcher?"

Everyone was stunned and looked up at Chen Cang.

Chen Cang said seriously: "The doctor is becoming more timid as he does, while the butcher is becoming more bold as he does!"

The words were very humorous, and everyone couldn't help but smile after hearing this.

But... I can't laugh in my heart!

The more I smile, the heavier I feel.

Chen Cang looked at everyone, got up and left, and walked towards the office. He did not expect this group of people to remember everything, but he must remember one thing: when treating patients, he must:

careful!

careful!

careful!

At this time, a man was sweating profusely in the crowd!

He was still scared and didn't dare to raise his head.

Thinking of his ability, he felt very naive...

If this old man really dealt with it in his own hands...

What will the result look like?

This is a living life. I am only in my early 30s. If something really happens, who can be responsible?

Who is responsible for the elderly!

Only once in life?

Who can let you try it?

...

...

ps: What I want to tell you about this story is that kind-hearted suggestions to others may not be suitable for others.

Such is the disease!

Why isn't life like this?

Not having enough understanding of the disease, seemingly well-intentioned suggestions lead to misdiagnosis or mistreatment.

If you don’t have enough understanding of other people’s situation, what will seemingly kind advice lead to?
Chapter completed!