I Can See Health

Chapter 712 Barriers between disciplines

Lu Chen had no doubts about the annual salary figure of one million.

The academic leaders of large private hospitals basically start with this annual salary, which does not include scientific research start-up funds, settlement expenses, etc.

The title of subject leader already represents many things. Ordinary directors, experts and professors cannot bear this title.

However, the current domestic environment in China is still dominated by public hospitals.

Although private hospitals have also developed significantly in recent years.

For example, the Asian Heart Hospital, a well-known private hospital in the field of cardiovascular disease, is ranked among the best in the country in terms of diagnosis and treatment. However, most of the overall medical resources are tilted towards public hospitals.

As a traditional Chinese doctor, Lu Chen certainly had the same idea.

Most medical students in China may not choose private hospitals as their first choice after graduation.

However, Lu Chen still smiled and said, "Thank you, I will consider it."

Zou Wei saw that Lu Chen didn't have this intention and was slightly disappointed.

From his illness, he has already seen that Lu Chen will definitely be a big shot in the medical field in the future.

Moreover, his uncle Zou Yi was also full of praise for Lu Chen.

If Lu Chen could come to his private hospital, he would laugh out of his dreams!

But now it seems that Lu Chen's visit to their private hospital can only be a dream...

When the two of them had just finished their meal, Lu Chen's hospital phone rang!

…

Lu Chen immediately put down his bowls and chopsticks and answered the phone.

"General surgery, right? Okay, I'll be here right away!"

Another emergency consultation!

Lu Chen looked at Zou Wei apologetically, "Sorry, I have to go to the emergency consultation here. You can eat first. Don't worry about me. I've almost eaten."

Zou Wei quickly said: "Brother Chen, go and do your work and don't worry about me."

"Okay." Lu Chen nodded and immediately walked out of the canteen.

On the phone, he learned that the patient undergoing consultation was a patient with sudden atrial fibrillation and low blood pressure.

Because some common cardioversion drugs will affect blood pressure, the first treatment for patients with hemodynamic instability is electrical cardioversion.

Lu Chen did not go to the general surgery department immediately, but called the CCU duty room.

Ask the graduate student on duty to send him a defibrillator and conductive paste.

ps: Not all departments have defibrillators.

It was the young male graduate student just now who brought a defibrillator to Lu Chen.

"Teacher Lu, when you come back, just leave the defibrillator at the CCU nurse station."

"Okay, thank you." Lu Chen patted his shoulder, and then immediately ran quickly in the direction of the general surgery department.

…

General Surgery Ward 1.

Faced with such a patient with atrial fibrillation and hypotension, the doctor in charge felt like an enemy.

He did not dare to leave the ward at all, fearing that the patient would suddenly go into shock and die.

When he saw Lu Chen coming with a defibrillator, he breathed a sigh of relief.

"Defibrillate quickly! Defibrillate quickly!" The general surgeon urged several times in succession.

Lu Chen put the defibrillator aside and did not start defibrillation immediately. Instead, he simply performed a physical examination on the patient.

The most important thing is to take your blood pressure!

The patient is generally in good condition, with a blood pressure of 85/54mmhg. He does not show any signs of shock, but is slightly flustered.

Lu Chen frowned. His blood pressure was indeed a little low, but it was not as scary as what he said on the phone.

Something like cardiogenic shock.

"Defibrillate quickly!" Seeing Lu Chen's delay in taking action, the general surgeon resisted and said, "The blood pressure is so low, the risk is too great."

"Wait a minute, my blood pressure is actually fine."

"Huh? Still waiting?"

Lu Chen nodded, "The patient is in good condition and does not have any symptoms of shock. I need to see the patient's laboratory report, such as serum potassium."

"I forgot about this. Are you in a hurry to see this?" the general surgeon frowned.

"Electrical cardioversion should be used with caution for hypokalemia." Lu Chen explained, "And this patient has no indication for the use of electrical cardioversion for the time being."

When hypokalemia occurs, the autonomic and excitability of myocardial cells increase, and their conductivity decreases. At this time, the sensitivity to electric shock increases. Electrical cardioversion may lead to more malignant arrhythmias.

Moreover, if hypokalemia is not corrected, the patient's arrhythmia is usually more difficult to recover from.

"Okay, I'm going to check the serum potassium now." The general surgeon had no choice but to listen to Lu Chen for the time being.

But when he returned to the doctor's office, he saw that the patient's serum potassium was only 2.8mmol/l.

He was also slightly shocked, it was really low.

…

When Lu Chen heard this blood potassium value, he completely gave up preparations for electrical cardioversion.

"First replenish fluids to increase blood pressure. It is best to replenish serum potassium to 4mmol/l, so as to minimize the occurrence of arrhythmia." Lu Chen suggested to the general surgeon.

"Is that it?" the general surgeon asked with some confusion, "Is there really no need for emergency electrical restoration?"

"No need." Lu Chen shook his head.

"This..." He just communicated with the patient's family and said that he was going to give an electric shock, but now there is no electric shock. It's really hard to explain.

Lu Chen continued: "Electric shock can cause serious trauma to the human body. It is best not to use electric shock if possible."

"Okay." The general surgeon could only communicate with the patient again.

However, the patient's family was more understanding and agreed to use drug treatment first.

"Doctor Lu, are you just leaving like this?"

The general surgeon looked at Lu Chen's name badge and found that Lu Chen was actually preparing to leave.

Lu Chen nodded, "This patient is very young. If his blood pressure and blood potassium rise, the atrial fibrillation should be able to recover on its own."

"What if cardioversion fails?" the general surgeon asked quickly.

"If the blood pressure goes up, you use amiodarone for cardioversion." Lu Chen said. "If the blood pressure is still low, you use vasopressors directly, and then amiodarone."

"Then please write it clearly on the consultation sheet."

"no problem."

Lu Chen had no choice but to teach him step by step.

Nowadays, specialization is becoming more and more obvious, not to mention the barriers between internal medicine and surgery.

Even between the same disciplines, such as cardiac coronary intervention and cardiac electrophysiological intervention, there are many barriers.

The consultation sheet was filled with treatment opinions, and the defibrillator was temporarily left in the general surgery department for backup, so that the general surgery department could replace it later. (CCU has many defibrillators.)

After doing these things, Lu Chen left the general surgery department.

…

Return to the CCU lounge. UU reading www. uukanshu.net

Lu Chen found a packaged meal on the table outside his home.

He took out his cell phone and saw the message Zou Wei left for him.

He was afraid that Lu Chen would not be full, so he specially ordered two more dishes in the canteen and brought them over.

"This kid is really good at causing trouble!"

Lu Chen smiled and immediately replied "thank you" to Zou Wei.

Not to mention, I came out for a consultation in the middle of the meal and was busy for more than half an hour.

Lu Chen was really hungry!

So, he carried the food, returned to the lounge, and continued to cook.

It’s impossible not to work!