I Can See Health

  Chapter 283

  Lu Chen stood on the podium in the classroom and looked around at the trainees below.

   Everyone looked at the question on the blackboard and was silent for a long time, but still no one could answer the question.

   This question involves the difference in body position.

  Lu Chen has gone through the National Medical Skills Competition, so he is naturally comfortable with these operations, and he also understands such skills at a deeper level.

   But these students are not the same. Everyone is new to the clinic and is confused about many things.

   It is good to be able to do the hepatic jugular venous return sign.

   "There is still some time to come. You can read the book or go to the clinical practice." Lu Chen smiled, "I'll ask you this question when we get off work."

  Lu Chen sold out.

   He let all the trainees move around in the department by themselves. They could ask the patient's medical history or check the medical record in the office.

  …

   The team leader of the trainee first came to the ward and tried to perform a physical examination on the patient, and did a hepatic jugular vein reflux sign.

   And several other apprentices took out their mobile phones and started to Baidu answers to Lu Chen's questions on the Internet.

   However, after searching for a long time, no one has found the answer to this question.

   In the ward, the team leader could not answer this question even though he had done the hepatic jugular vein reflux sign.

   "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?"

   With this question, the team leader found Cheng Peng.

   Of course, they asked in a low voice, so that Lu Chen would not hear it again.

   "Ah? What's the problem?" Cheng Peng frowned on his fat face. "The patient is in a semi-recumbent position of 30-40°? Can't it be a 60° or other recumbent position? Is there any difference?"

  Cheng Peng has never heard of such a strange problem.

   The group leader is also quite surprised, even the graduate students don’t know the answer to this question?

   "Would you like to stop asking other teachers?"

   The team leader approached Yin Xinhua again with a question.

  Yin Xinhua just finished his work.

   Seeing a trainee come to ask her a question, she smiled and said she was happy to answer.

   However, when she heard this question, the smile on her face froze.

   The team leader saw Yin Xinhua's expression and knew that she might not know either.

   "Ah... this question is so difficult?"

  …

   It's finally time to get off work.

   A group of trainees stood beside Lu Chen, waiting for him to announce the final answer.

   "You haven't found the final answer yet?" Lu Chen smiled.

   The team leader stood in front of Lu Chen and shook his head quickly: "I checked all the information, but I still can't find it,"

   At this time, Cheng Peng quietly put his head over.

   He was also curious about this question.

   "As for this question, I'll draw a picture so you may understand it better." Lu Chen took out a blank A4 piece of paper, "The central venous pressure of a normal person is 5-12cm H2O."

   "When lying supine, the jugular vein is parallel to the right atrium, and the filling of the jugular vein itself occurs, but the level of filling is limited to the lower 2/3 of the distance from the upper clavicle to the mandibular angle."

"In the semi-recumbent position, the vertical distance between the jugular vein and the upper and lower chambers and the junction area of ​​the right atrium is about 15-20 water column. If the right heart is not functioning properly, there will be systemic blood congestion, resulting in increased central venous pressure. If it is greater than 20 cm water column, there will be Jugular vein distention (jugular vein filling more than 2/3 of the distance from the superior clavicle to the mandibular angle."

   "In the 60° supine position, the vertical distance between the jugular vein and the junction of the superior and inferior chambers and the right atrium may be greater than 20 cm water column. At this time, it is not easy to identify cardiac insufficiency."

So this is ah!

   Lu Chen's words, if they were just oral, everyone might not understand.

   But Lu Chen also drew the patient's body position on the paper.

   at a glance!

  Most of the trainees understood the principle.

   This feeling of sudden opening made everyone impressed by the jugular venous return sign.

   "Damn it, so that's how it is!" Fatty Cheng sighed, "It really deserves to be Lu Chen!"

   At this time, Lu Chen also received a series of system prompts.

   "Congratulations, +1 for receiving thanks from Cheng Peng!"

   "Congratulations, +1 for receiving a thank you from Ye Qian!"

   "Congratulations, +1 for receiving a thank you from Su Cai!"

  “…”

  Lu Chen's face was overjoyed, and he received more than ten points of thanks.

   This time with trainees, it can be considered that there is no leucorrhea!

  …

   During today's work hours, as long as Lu Chen has finished his work, he will try to help the younger brothers and sisters in the department to solve problems.

   While constantly reaping gratitude, Lu Chen also gained a good reputation in the eyes of the interns.

   Back to the bedroom at night, on the system panel, the total gratitude value reached 126!

   When Lu Chen saw the gratitude value clearly, he was also a little surprised.

   This speed is too fast!

   But Lu Chen also knew that a job with apprentices like today could only happen once or twice.

   In addition, when teaching juniors and juniors in the department, it should be done in moderation.

   There are too many slugs, and they may suspect Lu Chen's attempt.

   Especially those junior sisters, if Lu Chen is too enthusiastic, he is not allowed to make others misunderstand.

  …

  After eating in the cafeteria, Lu Chen thought of Wang Zihao, who was hospitalized in general surgery.

  He bought some fruit at the supermarket inside the hospital, and then went directly to the general surgery ward.

   It was around seven in the evening.

   The entire general surgery ward is still relatively quiet.

  Lu Chen carried the fruit and came to the 12th hospital bed where Wang Zihao was.

   pushed open the door of the ward, and saw that he was half leaning on the bed, holding a laptop in his hand.

   And his sister Wang Ruoxi was not in the ward.

   "Lu Chen, why are you here?" Wang Zihao felt that someone was coming in, looked up and saw that it was Lu Chen, with a happy expression on his face.

   "You are already hospitalized, of course I have to come here." Lu Chen smiled and put the fruit basket on the table, "Do you feel better now?"

   Wang Zihao smiled and nodded: "Much better, surgery tomorrow morning. Lao Gu also came just now."

  Lu Chen sat beside the bed and saw that Wang Zihao was still checking documents on the computer.

   "Reading the paper?" Lu Chen asked.

   "Yeah." Wang Zihao nodded, "It's about my own subject."

   In his opinion, Lu Chen, who was in the same bedroom, is so powerful, and he must try his best to keep up with Lu Chen's pace.

  Lu Chen just remembered that he had promised Wang Zihao to help him check the data.

   "Zihao, I'm going to prepare for the ECG contest these days, so it may be some time before I can check the data for you."

   "This is not in a hurry." Wang Zihao smiled, "Just help me when you have time."

  Lu Chen chatted with Wang Zihao for a while.

   Wang Zihao suddenly said: "By the way, Lu Chen, did you know my sister before?"

  Lu Chen was taken aback for a moment, "I didn't know each other before, I saw it for the first time yesterday, what's wrong?"

   Wang Zihao is a little strange.

   "After my sister came back from the dormitory this morning, she has been asking about you."

   "Ask me about something?" Lu Chen didn't know why.

   "Yeah, I thought she knew you before." Wang Zihao said.

  Lu Chen thought of Wang Ruoxi this morning, there was no conflict between the two.

   Maybe it’s just pure curiosity?

   After sitting in the ward for more than ten minutes, Lu Chen returned to the bedroom.

   Although he got a lot of gratitude points today, there is still a certain gap between the 300 mark!

   (end of this chapter)