I Can See Health

   Chapter 282 Travel History

   Just as Lu Chen was thinking about how to collect a wave of gratitude from his junior, junior and senior sisters.

  Sun Guoguo walked into the doctor's office in the eighth district of the heart with a group of trainees in white coats.

   There are about ten trainees in this group.

  Sun Guoguo walked towards Lu Chen and said with a smile, "Junior Brother, are you busy now?"

  Lu Chen shook his head: "Fortunately, the doctor's order and the course record have been processed."

Sun Guoguo smiled, "That's right. I'll go to the teaching building to hand in materials later. There are more than ten trainees here. You can take them to the ward to see patients, mainly for heart failure and coronary heart disease. patients.”

   "Let me take the trainee?" Lu Chen looked behind Sun Guoguo.

   This is a group of young apprentices with curiosity and thirst for knowledge in their eyes.

   Apprenticeship and internship are not the same.

   Medical students will come to the hospital for clinical study during their senior year. At this time, they only come a few times temporarily, so they are called apprentices.

   When medical students are in their fifth year, they will stay in the hospital and rotate in various clinical departments, which is called internship.

"Well, you can take them to the hospital bed and talk to them about the diagnosis and treatment of heart failure and coronary heart disease." Sun Guoguo smiled, "They are still apprentices, so don't make too many demands, mainly Familiarize them with how the hospital works, then teach them to ask about the medical history."

   "In that case, that's fine." Lu Chen nodded.

  It was the first time for him to lecture in front of so many trainees.

   But if you can teach the class well, you should be able to earn a lot of thanks!

  …

  Sun Guoguo saw that Lu Chen agreed, and after handing over the trainee, he rescued him and left the ward.

   "Do you have a team leader?" Lu Chen stood up and looked at the group of trainees in front of him.

   A thin boy with glasses came out.

   "Teacher, I'm the group leader."

   "My name is Lu Chen, I just started graduate school, you can just call me senior brother." Lu Chen smiled.

   "Okay, brother."

  Lu Chen selected two patients who managed their own beds.

   A patient with heart failure and coronary heart disease.

   Before taking the trainee to the ward round, Lu Chen communicated with the patient and his family.

   After obtaining consent, Lu Chen brought everyone to the ward.

   "This is a patient with heart failure..." After Lu Chen briefly introduced the patient's situation, "The first step in receiving a patient is a consultation. Who wants to try a consultation?"

   There were more than ten trainees, but none of them made a sound.

   "Then the team leader, come and try." Lu Chen said to the thin boy.

  The team leader dawdled for a while, then stood up, hesitated for a moment, and then began to question the patient.

  Lu Chen was not in a hurry.

   He also came from this time.

  Although the medical certificate says how to consult a doctor, it is the knowledge in the book after all!

   It is a huge leap forward to turn knowledge from books into clinical skills in reality.

   This is a big challenge for the first-time clinical trainee.

  The group leader began to ask: "Auntie, why are you uncomfortable?"

   "Chest tightness." The patient is very cooperative, "In addition to chest tightness, there are dizziness, headache, and loss of appetite recently."

  “…”

   The group leader's initial consultation was relatively well-organized.

   But after a few questions, he started to let himself go, asking whatever he caught.

   When Lu Chen saw this, he hurriedly interrupted the group leader's consultation.

   "The team leader has already asked a good question." Lu Chen smiled, "Is there anyone else who wants to ask?"

   looked around, but no one took the initiative to stand up.

  Lu Chen had to explain it himself.

   "Inquiring about the medical history should be based on the patient's main symptoms, concomitant symptoms, the cause, location, nature, aggravation or relief of symptoms, and these aspects... You can't ask whatever you want!"

  …

   In about half an hour, Lu Chen and more than a dozen trainees watched the two patients, and then rescued them to the showroom in the eighth district of his heart.

   Next, he will start explaining the pathophysiology of coronary heart disease and heart failure.

After talking about    for a long time, Lu Chen felt a little dry mouth.

The trainee sitting below    still had a confused look on his face.

   "If you have any questions now, you can ask me." Lu Chen had no choice but to say.

   The students present were silent for a long time.

   Finally a girl said: "Senior brother, can I ask any questions?"

  Lu Chen nodded: "As long as I know about clinical medicine, I will try my best to answer it."

  The girl paused, then said, "Senior brother, I just checked the patient's medical record. I read the history of travel in the medical record. What is the history of travel? Is it the experience of traveling abroad?"

  Lu Chen was taken aback.

   This problem has nothing to do with heart failure or coronary heart disease!

   "Cough cough." Lu Chen cleared his throat, "It's just an illicit relationship between a man and a woman."

   The girl's face turned red, "I see, thank you brother."

  Lu Chen thought that this was the end of the matter, but he didn't expect that some of the boys in the room shouted.

   "Senior brother, can you be more specific?"

  Lu Chen's face darkened: "I just slept with other women except my wife."

   The boy here replied again: "Senior brother, you are sleeping with the mistress, does that count as a travel history?"

   "It shouldn't be counted." Lu Chen paused.

   "How does that count?"

  Lu Chen thought about it and said, "Going to the heaven and earth to sleep is considered a travel history."

   As soon as he finished speaking, the trainees laughed out loud.

  Lu Chen felt that something was not right, he was almost led astray by these guys below!

   He hurriedly said, "Let's talk about the problems related to coronary heart disease and heart failure!"

  Lu Chen looked around, everyone was quiet, but no one answered.

   "If you don't ask, then I'll ask one." Lu Chen smiled.

   His smile was a little creepy in the eyes of all the trainees.

   Everyone lowered their heads slightly, not daring to look at Lu Chen.

   "Just now we saw a patient with right heart failure. What are the more characteristic signs of right heart failure compared with left heart failure?"

   As soon as Lu Chen's question came out, there were whispers from below.

   After a while, the group leader slowly stood up and said, "Senior brother, is the hepatic jugular vein reflux sign positive?"

  Lu Chen smiled: "Yes, do you know how to do it?"

   The group leader nodded.

   "Instruct the patient to stay in bed, put the head on a pillow, and breathe with the mouth open. The examiner's right palm is lightly placed on the liver area, and the pressure is gradually applied for 10 seconds. At the same time, the degree of jugular vein distention is observed."

   "What is the rationale for this inspection?"

   "Compression of the congested liver increases the blood return to the heart, the congested right atrium cannot receive the return blood flow, and the jugular venous pressure is forced to rise..."

  Lu Chen nodded slightly, and the group leader answered quite well.

   However, Lu Chen's next question made everyone look at each other in dismay.

   "Why is the patient in a semi-recumbent position of 30-40° when doing the hepatic jugular venous reflux sign? Can't it be a 60° or other angle of recumbency?"

   (end of this chapter)