Chapter 263 Physical Examination

In the morning, Ling Ran, who only had one surgery, went through the room leisurely, and got 4 treasure chests of heartfelt thanks again.

Looking at the 16 primary treasure chests accumulated on the system interface, Ling Ran hesitated a little. Theoretically, 16 can be written as 2 to the 4th power, which is the result of 2*2*2*2. If it is placed in binary system, 16 is written as 10000, which is really an integer that cannot be rounded.

So, is it unboxing, or is it unboxing?

The last time I opened the box, I got two skills at once.

Although the overlap between tension reduction suture and intradermal suture is slightly greater, it can be regarded as a combined skill. If you think about it this way, it seems more useful to have two skills in succession.

With 16 primary treasure chests, the probability of obtaining two skills makes people less confident.

Ling Ran thought deeply, and then quickly made a decision, saying: "If no operation has been arranged until now, shall we have another round of physical examination?"

Lu Wenbin was invincible, but asked strangely: "Is there anything you didn't see just now?"

"There's no one who can see everything." Ling Ran curled his lips.

Lu Wenbin had no objection.

From a doctor's point of view, no amount of examination is enough. The complexity of the human body is far beyond human cognition. Take the simplest blood pressure measurement as an example. Different methods of blood pressure measurement will vary. There will be differences in blood pressure. There will be differences in blood pressure measurements in different postures. There will also be differences in blood pressure measurements in the morning, middle and evening. That is to say, the blood pressure indicators do not need to be accurate.

Even MRI films, the reference materials for judging whether it is normal or not, only use the films of more than 100 healthy people, or more than 400 healthy people as the standard.

If it weren't for all kinds of video films that always make people worry about radiation, and methods such as blood draws that always make people worry about losses, the requirements for human daily physical examinations would be much more complicated.

Physical examination is a very environmentally friendly inspection program, but the frequency of execution is gradually decreasing.

Patients always want to get affirmative answers, and so do medical lawsuits, but it is difficult to do so in physical examinations.

However, as a primary judgment, the role of physical examination cannot be ignored.

So Ling Ran went around again, giving the patients in the ward another physical examination one by one.

Lu Wenbin followed behind, feeling dizzy from busy work, and couldn't help sighing: "I heard that doctors in the 1960s and 1970s would make rounds twice, but I didn't expect such a thing to happen now."

"The first rough screening meets the patient's basic needs, and the second careful inspection aims to solve the patient's problems in a targeted manner. There is nothing wrong with that." Ling Ran paused for a moment, then continued: "It's a pity that I'm not a physician. .”

Surgeons and physicians have very different indications and different coping abilities.

Problems like diarrhea may be minor problems that patients can handle at home, but in the hospital, when a surgeon hears a patient talking about diarrhea, he is far less fluent than a physician.

There are so many things to consider that doctors can often only address the symptoms, not necessarily the problem.

Surgeons prefer to hear words like colic.

Ling Ran also couldn't prescribe medicines for patients at will, and if something went wrong occasionally, he would arrange for the patient to have further examinations.

Lu Wenbin didn't even master the skills of a surgeon, and was still climbing the roots of the skill tree. He only felt that his record book was getting heavier and heavier, and worried that his medical records would become more and more difficult to write.

However, I dare not say these words to the superior doctors, and I can only think about it in my heart. As long as I say it, any superior doctor I meet will definitely be scolded.

Lu Wenbin looked at the notebook, and could only pick out good things to say: "Your level of physical examination is higher than that of many physicians, and you can find several problems in just a short while."

Ling Ran nodded "graciously" and said, "Since there are no more hospital beds, we should do more checkups, those who recover quickly, and those who have no other problems can be sent home."

Lu Wenbin chuckled,

He had already guessed this trick.

After checking all the way, Ling Ran got another "sincerely grateful" primary treasure box, and arranged the discharge time of two patients, which is considered an achievement. When they arrived at the last ward, Lu Wenbin was already panting with relief, but Ling Ran stood still and did not intend to leave, and then made a detailed examination of the 52nd bed, went out to the corridor, and said, "Please come to the hepatobiliary surgery department for consultation." .”

"The situation is not good?" Lu Wenbin's face changed slightly.

As Ling Ran's assistant, although Lu Wenbin has participated in hundreds of surgeries, his status is still that of a resident doctor. When he is in the ward, he is the bed doctor. Therefore, he has the closest relationship with the patients. Yes, not only understand the patient's condition, but also worry about their condition.

After all, he is a patient with daily contact. After two weeks, he not only knows the name of the other’s dog, but also has met the other’s parents, relatives, distant cousins ​​and work colleagues...

Ling Ran is actually a superior doctor, and a superior doctor of the surgical system. Therefore, his main job is surgery, and his direct understanding of patients is far inferior to that of bed doctors.

This kind of setting is actually a natural development of the hospital system.

Whether it is China, Japan, South Korea, India and other Asian countries, or European and American countries, the surgeon who performs the surgery will consciously draw out the specific patient management system.

This kind of behavior cannot be explained only by the heavy workload, and the workload of physicians is also very heavy, but the doctors of the Department of Internal Medicine often have the image of meticulous and hands-on.

After all, it is the work of surgeons that makes them unwilling to get too close to patients and their families.

However, although Ling Ran was not good at dealing with people, he understood Lu Wenbin's current state.

So, Ling Ran deliberately thought about it for a moment, and said: "It may be cholecystitis, which tends to be acute. There are tenderness and rebound tenderness. The tenderness of the gallbladder is not too obvious, but it may be developing."

Acute cholecystitis may require surgery, but only a physical examination is not enough to confirm.

Lu Wenbin breathed a sigh of relief. To the doctor, such an illness is really nothing, as long as it is arranged quickly.

After a while, someone from the Department of Hepatobiliary Surgery ran down.

The level of hepatobiliary surgery in Yunyi is average. Of course, this is based on the standards of top tertiary hospitals. In the face of acute cholecystitis, a professional hepatobiliary surgeon can just bring in any attending doctor to solve it.

"Doctor Shan. Doctor Ling." Lu Wenbin met the other party and introduced him casually.

Doctor Shan nodded slightly: "Show me the medical records."

Lu Wenbin handed the prepared medical records to the other party. The latter started reading in the corridor.

"Heart rhythm, blood pressure and other indicators are a bit high, so it's not easy to perform surgery." Dr. Shan frowned when he saw Lu Wenbin's record.

Lu Wenbin coughed twice, and said, "This is a physical examination done by Dr. Ling himself, and it's normal data."

"Blood pressure is more than 130 for such a young man, you tell me it's normal? A heartbeat of more than 90 is also a bit high." Dr. Shan was not satisfied with Lu Wenbin's answer.

Lu Wenbin looked around, and said: "Generally speaking, when Dr. Ling conducts physical examinations, some female patients, especially unmarried young women, tend to have higher blood pressure and heart rhythm indicators. You can subtract 15 from this value. At 20, it's almost there."

Doctor Shan's glasses almost fell off, he turned his head to look at Ling Ran who had a calm expression, and then looked at Lu Wenbin, and said, "You're kidding me."

Lu Wenbin looked sad: "What's the point of me teasing you? Guess how I know the value will drop?"