How ignorant can people be in the hospital?

Daily Q&A

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Some people ask: How ignorant can people be in hospitals?

I don't know if you have this experience or feeling: after people arrive at the hospital, they always feel that they don't know the southeast, south, and northwest, nothing will happen, and even their IQ has declined.

The doctor obviously said it several times, but he turned around and went out and forgot everything.

Obviously, it was a sign with his head up, but he couldn't see anything with his eyes open.

This happens a lot, and many people experience it.

In fact, this can not be regarded as ignorance, but because after arriving in an unfamiliar environment, it is impossible to adapt, coupled with illness or family members, anxiety and nervousness, and some care is lost.

This is a normal and understandable state.

But sometimes true ignorance leaves people speechless.

For example, on the first day of the Chinese New Year, I met a middle-aged female patient on my night shift.

The patient came to the emergency room because of repeated coughing and sputum coughing for five days, which affected sleep, and the examination found that there was acute bronchitis, and the white blood cell count exceeded 20X10^9. In the most popular words, the patient's infection index is relatively high, and it should be actively controlled, otherwise the follow-up may aggravate the cough and fever.

Based on experience and local epidemiology, I recommend infusion therapy for patients.

However, the patient is not willing to be treated with infusions, because she feels that the infusions take several hours, and she still has to go home to visit the New Year and entertain relatives and friends.

Since you don't want to infuse, take medicine. But I'm going to tell her about the fact that oral medications may not have a noticeable effect for a short time, after all, patients come to the hospital because of coughs that affect sleep.

The patient thought about it for a while, or asked for an infusion. I didn't sleep well for several days, and I wanted to get better as soon as possible.

But can infusions get better right away?

Obviously not, after all, there will be a process from infusion to symptom relief.

The patient made a request that made me cry and laugh: the infusion could be done, it had to be effective, and there were no side effects.

This request, which seems ordinary, actually reveals some ignorance.

First of all, the doctor only recommends infusions based on experience, and there is no need to ask you for infusions. The doctor's advice is only from the perspective of the patient's recovery to help the patient. But patients believe that the infusion is a request that the doctor force himself.

Secondly, there must be an effect, which is a difficult requirement for a strong person, everyone's specific condition is different, that is, the use of the same drug, there may be some people with obvious effects, and some people with non-obvious effects. What's more, the patient did not do a pathogenic examination, and there were no drug susceptibility test results. Everything is just empirical treatment based on the patient's symptoms and the epidemiological treatment of the local bacterial virus. The possibility of poor or no effect also exists, and even if it is effective, there is a problem of the length of action. Therefore, this "must have an effect" requirement cannot be satisfied.

Secondly, there can be no side effects. This is completely difficult for strongmen. Side effects are a matter of probability, probably only one in tens of thousands, but who can guarantee that you are not the unlucky egg? What's more, for some people, he will blame all the symptoms that appear during the infusion on the toxic side effects of the drug. For example, patients with gastroenteritis vomit during infusion, and patients with lung infections have fever during infusion, whether these symptoms are the problem of the disease itself, they will only blame them on the toxic side effects of the drug. In the face of this situation, doctors can only say a hundred words most of the time.

Therefore, I simply cannot meet the patient's requirement of having an effect and not having side effects.

In fact, the doctor just tries his best to help the patient, to provide the best treatment plan for the patient, which must have some unknown and uncontrollable factors, but the patient treats this as a business, and the doctor is regarded as a merchant who deliberately sells goods to himself.

I didn't end up giving this patient infusion treatment because it was fraught with the risk of a dispute. After being prescribed two boxes of oral medication, the patient left.

In fact, the story of this patient is not very impressive, after all, bronchitis, respiratory infections are only common diseases, if it really reaches the point of aggravation, I believe that patients will also come to the hospital for further treatment.

The real fear of ignorance is the situation that is obviously life-threatening, but the patient and family members do not care.

About last year, in July and August, I received a middle-aged couple in the emergency room.

The patient, a husband in his forties, came to the hospital six hours after chest tightness and back pain.

Such patients naturally want to do the electrocardiogram at the first time, but the patient and his wife are unwilling, their reason is: "The heart cannot have a problem, and the electrocardiogram that was done in the physical examination half a year ago did not say that there was any problem." ”

I told him that heart disease is something that comes and goes, there are dynamic changes, even if you have done an electrocardiogram yesterday, you still need to be checked.

The key is, did you have chest tightness and back pain when you did the ELECTROCardiogram half a year ago? Aren't these symptoms only present today? What do you come to the hospital for without a check-up?

The reason is so simple that most people understand. But instead, the couple in front of me didn't understand, like a doctor hurting himself.

After communicating for a long time, I finally did an inspection.

The ECG does have a problem, suggesting an anxious inferior myocardial infarction.

I told the patients and their families the actual situation, and improved the myocardial enzyme test, and all the troponin and myoglobin were elevated.

The diagnosis of the disease is clear, and the following is how to treat it.

In the vernacular, acute myocardial infarction is known to everyone, and the first choice is intervention, and stents are placed. If not, thrombolysis.

After being informed of the risks, the couple declined all treatment. The reason they refuse is not because they don't have money, nor because they don't trust it.

Instead, I felt that I was only slightly in pain, and I could hold on for a while, but I really couldn't do the operation again.

Finally, he said that he would go home and rest and eat nodding spores.

That night, the patient's condition worsened, 120 was sent to the emergency department, and the operation went.

This is ignorance, almost giving yourself a life.

END

I was the last dopamine, recording real sounds.