Abdominal physical examination is the most common, almost everyone has seen it, it is nothing more than touching the stomach. For routine abdominal physical examinations, you have to touch both the upper and lower abdomen.

Experienced doctors can find out the size of the patient's liver and spleen in just a few simple strokes, whether there is inflammation around the gastrointestinal cavity, whether the inflammation affects the abdominal cavity and causes the most surface abdominal muscle tension, whether there is liquid oozing out of the stomach, and even nodules on the surface of the organs can sometimes be touched by palpation of the abdomen.

After a set of abdominal physical examinations, the old man only had a little dull pain in his upper abdomen, but the degree was very mild.

"Okay, sit up and look at me." Qi Jing put his left hand on his sore waist muscles, and clenched his fist with his right hand and tapped the back of his left hand, "How are you urinating these days?"

"The urine is good, I don't have prostate hyperplasia." The old man was knocked twice by Qi Jing, and there was no reaction. "'It feels a bit comfortable to knock like this."

"It doesn't hurt if you knock it up, it means it's not a urinary tract stone." Qi Jing recorded the examination results and turned on the blood pressure monitor, "Take your blood pressure, do you have high blood pressure?"

"Yes, but the blood pressure is not too high." The old man stretched out his arm, looked at himself tied with a cuff, and continued, "I have been taking hypertension drugs for several years."

“Have you been eating it?”

The old man nodded: "I keep eating, but sometimes I will break for a few days."

Is it also called taking medicine all the time?

Qi Jing looked at the mercury column in front of him: "The blood pressure is OK, 125/70, did you take medicine this morning?"

“This morning…”

The old man's thoughts drifted back to the morning.

He felt something was wrong in the morning, so he got up and ate something and went out to take the bus. He went to Danyang Hospital, which is far away from home, for treatment: "I really forgot to take it in the morning, and my blood pressure is not high now."

Qi Jing didn't reply to his words, but began to disassemble the cause of the patient's illness at his own pace: "I guess I haven't eaten these two days."

"I didn't seem to have eaten much during this period." Although the old man admitted that he was greedy for saving money, he was still a little dissatisfied and said, "My blood pressure is well controlled. Look, my blood pressure is quite normal now, what medicine should I take if I do this?"

"You sit for a while." Qi Jing did not explain, but got up and ran to the next clinic.

Ji Qing and two interns were dealing with a female patient in her 30s. When they saw Qi Jing running over, they said, "What's wrong?"

"A patient has to do CT, maybe he has to stay in the eye."

"Seriously ill?"

"First do a CT and ECG and take a look, you can lend me alone."

After Qi Jing finished speaking, he picked an intern and took the person away, not even giving Ji Qing a time to refuse. As soon as he left the house, he sent the person to the iCu: "Get the electrocardiogram."

After saying that, he called another nurse: "Uncle Zhou, come find a hospital bed push cart."

"It's been used long ago, and you won't see how many patients have come."

"Is that wheelchair available? This patient is not very able to walk around, please help!"

Uncle Zhou gritted his teeth and said, "Okay, I'll find a car for you."

......

The old man had an electrocardiogram first, and was sent to an emergency CT. He didn't know if he didn't check it. After the examination, he was startled. He had a hemangioma in his abdominal aorta, which compressed his waist. The huge hemangioma divided a lot of blood, and it was also the elderly, which caused insufficient blood supply to the brain, so he became drowsy.

The doctor outside the blood vessel came down and took the patient away after seeing him. Qi Jing finally breathed a sigh of relief.

The general emergency department has to see hundreds of patients a day, and I don’t know where this kind of irregular time bomb will appear. It looks good, but once something happens, it will be a big deal.

Time slowly flowed forward, and with his help, the number of patients to be treated was gradually reduced. The patients and their families who were congested in the clinic were slowly cleaned up by him and the female doctor, and now some seats sitting outside the door can be vacant.

“No. 176~”

The one who walked in outside the door was a student-like big child, who looked like a high school student. He covered his cheeks and was pressed with a ball of gauze in his mouth. Qi Jing could barely see a lot of blood on the gauze.

Following the student was a mother and a female doctor with a **********.

"Are you a dentist?" Qi Jing was a little curious.

"Well, the dental defense center next to Caoting New Village." The female doctor nodded, and then briefly introduced the patient's condition. "This child came to pull the back groove at nine o'clock in the morning, but after the teeth were extracted, the alveolar was bleeding and could not stop it, and it was very much. When he was about to equate, he said he was dizzy and had a little pale complexion. Will he lose too much blood?"

Dentists are also doctors, and they also graduated from oral majors from regular medical colleges.

As for whether the oral major has enough knowledge of internal and surgical science, Qi Jing doesn't know. At least in this passage, Qi Jing found a lot of complaints at first glance, but there are still many patients outside now. It is better to ask questions instead to find out the cause of the bleeding as soon as possible. The most important thing is to find out the cause of the bleeding as soon as possible.

Qi Jing took the medical record book and looked at the high school student with a pale face and a little nervous: "I don't go to the dentist now, I'm just finished the college entrance examination in my third year."

"Yes, the inflamed and painful part of the mouth last week. We saw the dentist and said we wanted to pull the teeth." The mother put her hand on the child's shoulder worriedly and complained, "Who knew that the pulling was wrong, what should I do if the blood couldn't be stopped?"

Qi Jing sighed, comforted her a few words, and then asked the dentist: "Have you done the suture?"

Seeing that the female dentist was quite experienced, she immediately replied: "I have done some compression and stop bleeding. I can't press it with three pieces of gauze. After sewing two stitches, the sewing effect is not very good. Although the blood is not fast, it just can't stop it."

Qi Jing took out the pen lamp, signaled the child to take off the gauze and looked in. The patient's left lower teeth were empty, replaced by a blood hole. As soon as the gauze was removed, the blood began to seep out. Although the leakage was not fast, the oral area was very small, and blood soon spread into his throat.

It is not uncommon to bleed continuously after dental tooth extraction.

Some are accidents during tooth extraction, such as improper operation, causing wounds, grinding, drilling, cracking, drilling, and breaking; some are indeed complications, especially when the lower teeth are pulled out, it may damage the lower alveolar artery; more often it is because the patient has underlying diseases, and under the inducement of tooth extraction, the underlying diseases are amplified or aggravated the degree of bleeding.

Strictly speaking, tooth extraction is fully in line with the definition of surgery. Preoperative examinations should be improved before tooth extraction, and some risk factors should be eliminated just like other surgeries.

But few people are really willing to do everything, and preoperative examinations are often selectively ignored.

If you have underlying diseases, such as an elderly person who has had cerebral infarction, myocardial infarction, cerebral hemorrhage, and bleeding after tooth extraction is likely to cause serious major problems. But now he is facing a young high school student, and these serious underlying diseases can be eliminated.

"Do you have hypertension?" Qi Jing asked while putting a blood pressure monitor cuff on the patient.

"No." Both the patient and the mother shook their heads.

"120/65mmhg, heart rate 85..." Qi Jing looked at the mercury column that was moving downward, got the blood pressure value, and then pointed to his forehead. Has his head been injured? ""

"No."

"Have you taken any medicine before tooth extraction?" Qi Jing paused and said, "For example, antibiotics, or other messy drugs?"

"My son is in good health," the mother said for the son who couldn't speak. "The last time I took medicine was in junior high school, I caught a severe cold once. I ate water for two days and took medicine for three days when I went home."

Qi Jing nodded, talking about the flu, and the time was so long that it had nothing to do with bleeding from tooth extraction.

Since abnormal bleeding caused by hypertension and coagulation dysfunction caused by liver function caused by drugs, Qi Jing focused the problem on complications caused by tooth extraction. He looked at the female dentist and asked, "Have you taken the film? Have you brought it?"

"Take it." The female dentist took out two films from the plastic bag on her hand: "One was before the tooth extraction, and the other was after the tooth extraction. I've seen it, there's no problem."

“No problem…”

Qi Jing murmured, "If you don't even have a film reader, you'll put the film in front of the bright window glass: "If you don't even have a film, it's a big problem..."

If this condition is not a postoperative complication, it is very likely to be a coagulation disorder. Just now, the drug-derived coagulation dysfunction was ruled out, so the remaining factors that can cause coagulation disorders are not simple.

"Has the skin on your body been scratched and bleeding?" Qi Jing asked as he looked at the film.

"He is a big boy, and his knees are often broken."

"Did you have a lot of bleeding at that time?"

"No bleeding, just rinse it and apply some medicine."

Qi Jing nodded, then called the female dentist to her side and inserted the film into the reader: "You can see his jaw canal in these two films. Compared with the root of other teeth, is the jaw canal too close to the base? When extracting the teeth, use a little force horizontally. Just touch it gently, the lower alveolar artery in the jaw canal will rupture."

The female dentist frowned and looked at the patient's jawbone x-spliers. Only after Qi Jing's prompt could he barely see a very faint phantom: Can you see this?

"Just in case, do two blood tests." Qi Jing took the blood routine and blood coagulation function checklist from the small grid beside him, filled in the name, circled the examination items and handed over, "After the investigation, go and hang up the water."

The mother smiled and took the checklist: "Is my son okay?"

"It seems that there is no problem now. Let me see it after the report comes out." Qi Jing handed over the prescription for replenishing liquid, "Remember to hang water."

"Okay." After receiving a positive answer, my mother breathed a sigh of relief.

However, the female dentist felt a little strange: "The patient was dizzy and had a bad face. Did he lose too much blood?"

It’s not her fault that she can’t tell the jaw tube. It’s impossible for a stomatologist to strictly master such sufficient imaging knowledge. But her judgment on blood loss is a bit outrageous, and this is the second time she has raised this question.

"This is a small artery, it's okay." Qi Jing explained, "Besides, blood pressure and heart rate are good."

"Then why does he feel dizzy..." The female dentist didn't understand.

"It's almost two o'clock now." Qi Jing looked up at the wall clock. "A child who is still in the developmental stage has eaten at 7 o'clock in the morning. It's been nearly 8 hours since then, and he is likely to have low blood sugar. I added blood sugar and added sugar saline to the rehydration fluid. I'll know when I'm going to see the report."
Chapter completed!