"This one, I felt a little uncomfortable for the first two days. It's like something is falling on my arm, and I can't lift it up."
The man raised his left arm and patted,
"Sometimes it hurts a little bit, but it gets better soon."
The patient's words made Qin Feng's eyes shine.
This condition is very similar to the symptoms of a relatively rare vascular disease, and it is a location that is generally not checked.
"Okay, I see, you put it down first."
Immediately afterwards, a series of physical examinations and inquiries were conducted, and after confirmation, I stood up straight.
"Doctor, am I okay?" The man asked nervously.
"Hehe, don't worry, it's not a big problem. We may have to do some inspections for you later to confirm."
Qin Feng shook his head and comforted him with a smile. He just walked out of the ward when he looked at Director Han next to him.
"Director Han, I want to do a few more checks on him to make sure."
"Have you found the cause?"
Han Yun asked curiously.
"It's not sure yet, we have to wait for the results."
After pondering for a moment, he nodded and looked at Lin Ran,
"Doctor Lin, please ask the nurse to measure the skin temperature and blood pressure of the patient's left upper limb."
"Okay, I'll go now."
After speaking, Lin Ran turned and walked up to the nurse's desk.
The temperature of various parts of the human body is different, even very different.
The head is higher, the foot is lower, and the temperature of the different skin is determined by the thermal balance of the body's core and skin surface heat and environmental influences.
In a normal and comfortable environment, the average human body temperature is about 33 degrees Celsius, and the error is relatively small.
The measurement of skin temperature is generally recorded habitually, so it is very simple to measure.
In the duty room, Qin Feng and Han Yun are discussing.
Patients experience dizziness, fainting, vision loss, and diplopia.
Left upper extremity weakness, slight pain, feeling of falling objects.
These situations are very important basis for judgment and exclusion.
"Come here, the skin temperature of the patient's left upper limb is 33 degrees, and the systolic blood pressure of both upper limbs is 33mmHG."
At this time, Lin Ran ran in and handed over the record sheet in his hand.
"The systolic pressure differential exceeds 20mm?"
Hearing this, Han Yun was also a little surprised, "Are you sure you didn't measure wrong?"
"No, the head nurse and I personally measured it."
Lin Ran shook his head.
"It wasn't that high when I checked this morning, but suddenly it's so different."
Han Yun frowned, lost in thought.
"The systolic blood pressure of both upper limbs is too high, and this range is already very small."
Qin Feng nodded, basically consistent with his guess,
"Well, Dr. Lin, please make an appointment with the imaging department now to do an angiography and arterial ultrasound of the patient's left upper limb to the collarbone."
"OK."
Lin Ran was taken aback when he heard this, and nodded.
Angiography of the left upper extremity, this situation is basically rare. Especially in emergency room.
"Xiao Qin, do you suspect that the patient is Subclavian Steal Syndrome?"
Director Han Yun also reacted when he heard this, and asked immediately.
Subclavian Steal Syndrome!
The main reason is that when the subclavian artery is severely stenotic or occluded, the cervical vertebral artery leading to the intracranial is driven by the siphon effect to supply blood to the subclavian artery in reverse.
This causes a relative decrease in blood supply to the brain, showing transient dizziness, amaurosis, syncope, etc. After a short rest, the symptoms will improve.
At the same time, the patient will experience upper extremity arterial ischemia symptoms, manifested as increased blood pressure difference between the upper extremities and weakened radial artery pulse on the affected side.
"Yes, Director Han, this situation should be Subclavian Steal Syndrome."
Qin Feng nodded, according to his judgment, all the conditions of the patient fit the symptoms of the disease.
Especially after seeing the pressure difference between the two upper limbs just now, his judgment was even more affirmed.
Soon,
The inspection result came out.
The moment Han Yun saw the report, she nodded in surprise and handed the report to him.
"Xiao Qin, you are right, it is indeed Subclavian Steal Syndrome."
Having said that, she couldn't help being a little surprised and envious,
"Meng's eyes are really vicious, with you in intensive care medicine, maybe he can also consider himself.
I also heard a little bit about you. I heard that you have been in the emergency department for three years, and during that time, you have been the director of two departments in a tertiary hospital for nearly two years? "
"Hehehe~ It's all in the past, and it can't be compared with the capital."
Qin Feng nodded slightly, and smiled modestly.
"There is no luck in clinical medicine, only strength."
Han Yun shook his head, his eyes lit up strangely, and his tone was a bit complicated,
"You have surpassed all your peers with just a bachelor's degree, and I am afraid that you are the only one who can stand with us old guys.
You are welcome to come to our emergency department when you have time, young doctors like Lin Ran still need people like you to get in touch with, hehehe~"
"Okay, thank you Director Han, I will come here often in the future."
Qin Feng smiled and nodded in response.
In fact, he also has a natural sense of closeness when he goes to the emergency department, which may be the same as the emergency department of Jiangcheng First Hospital, he is very familiar and nostalgic.
Although the days in the emergency room are tiring, they are more fulfilling, and they face all kinds of life all the time.
Aren't doctors supposed to face life and death?
…
In the ward, Qin Feng brought Lin Ran in with the report.
"Doctor, you are here, how is my health?"
The man saw the two coming and asked quickly.
"Don't worry, it's been found out, it's Subclavian Steal Syndrome."
Qin Feng nodded, looked at the patient and his family and said.
"We don't understand the doctor, is this disease serious?"
The man and his wife looked at each other and asked nervously.
"Don't worry, this disease is not a serious one, and it won't harm your body for the time being."
Qin Feng smiled and began to explain to his family members, while Lin Ran stood aside and stared at his skillful and relaxed communication,
"Let me describe it to you, that is, half of an artery under your collarbone is occluded.
The arteries themselves are under a lot of pressure, and you should know that, so once it becomes narrow, a phenomenon called siphoning will appear.
The blood is drawn away through some small blood vessels around the arteries, which is what we call blood stealing.
This leads to a lack of blood supply, so you pass out, and your arms are uncomfortable. …"
Seeing Qin Feng's extremely simple and easy-to-understand narration and actions, the patient's family members listened carefully, without any ambiguity.
Such a rich and harmonious doctor-patient communication made Lin Ran envious~~~~
"That's good, thank you doctor."
After hearing what he said, the man and his wife finally breathed a sigh of relief, and thanked him with a smile.
"It's okay, this is a relatively common blood stealing under the clavicle, which will affect the large blood vessels of the brain, upper limbs, chest and back, so you still have to pay attention at ordinary times, and you must not sit for long periods of time, eat and drink too much, and damage your body. Balanced."
Qin Feng warned,
"At present, we are giving you conservative treatment, mainly relying on drugs and exercise.
I will prescribe some medicines to promote blood flow and blood supply for you later, you must insist on taking them, and exercise more at ordinary times, and you will recover slowly after a long time. "
"But I'm telling you something ugly, if this continues, once the blood vessels are completely blocked, it may cause other problems for you, and you must have surgery."
"I know I know."
The man smiled awkwardly, scratched his head, nodded repeatedly,
"Don't worry doctor, I will take medicine and exercise when I get back!"
"Well, okay, let Dr. Lin give you a bill later, and you can leave the hospital after packing up."
Qin Feng nodded and handed her the report in his hand.
After leaving the ward, Lin Ran followed behind with a look of admiration.
"Okay, my task is complete, and the rest is up to you."
Qin Feng stopped, put his hands in the pockets of his white coat and smiled.
"Senior Qin, how on earth did you become so powerful?"
Lin Ran blinked and asked curiously.
"Practice makes perfect, hahaha~"
Looking at the pretty face in front of him, he couldn't help laughing,
"Learn from Director Han well, and you can do it in the future. I'm leaving."
After speaking, Qin Feng left the emergency room without looking back.
"Hmph! Don't say it, anyway, my goal is intensive care medicine, just wait!"
Lin Ran looked at the handsome back who was striding away, and arched his lovely Qiong nose angrily.
Ring ring ring!
Just out of the emergency room,
His cell phone rang.
"Hello, I'm Qin Feng."
"Qin Feng, are you still in the emergency room?"
Lin Hai's familiar voice came from the phone.
"I just arrived at the door, what's wrong?"
"Just sent a serious case, the situation is urgent, I can't leave here, Director Meng asked you to take a look!"
"OK!"
Qin Feng was shocked when he heard this, and he didn't have time to think about it.
Hang up the phone, turn around and rush to the emergency room!
…
15 hours ago, late at night, at a construction site in a residential area.
A group of migrant workers were staying up all night to transport all the window glass to the floors, each of them was exhausted, gasping for breath and sweating profusely.
There are black and white gray marks all over his body, but no one cares.
"Finally finished, I'm almost exhausted."
"If you do it this way, I will die of exhaustion before I can go home to see my baby during the Chinese New Year."
"Zhang, isn't this just to make more money, it's worth the effort!"
"Hahaha! If you are really exhausted, you will be relieved. Your wife and children can also get a lot of money. How easy is it?"
"Old Lu! You have such a bad mouth! You are so exhausted! I have to go back to make out with my wife, and I haven't been back for more than half a year."
"Old Lu, today you are the one who moves the most and earns the most money. It's your turn to treat!"
"Okay, okay, let's go, I'll treat you tonight, enough wine under 30!"
…
After finishing speaking, the men wiped the sweat off their bodies, dusted off their clothes, chatted and laughed and went downstairs in the elevator.
Several people went straight to the small restaurant next to the construction site, and they had already gotten acquainted with the owner of the restaurant for more than half a year.
"Boss, stir fry a few side dishes, 3 bottles of white wine, and a dozen beers. Let's take it ourselves!"
"Okay, you guys drink first, the food will be ready soon!"
The back kitchen was busy, and several men skillfully carried and poured the wine by themselves, and drank it down.
I don't know how long it took, and finally returned to the construction site dormitory in the middle of the night.
The next morning,
"Why isn't Lao Lu getting up? I'm going to work right away."
"Hey, he's resting today. He drank a lot last night and moved more than us, so don't call him, let him sleep more."
After speaking, several people washed up and left the dormitory seeing that they couldn't wake up.
Rest at noon, when a few people returned to the dormitory after eating, they saw the man still lying on the bed snoring soundly, but there was no snoring.
"How much did Lao Lu drink last night?"
"A bottle of white, maybe five or six bottles of beer. He drank a lot."
"I've slept for more than ten hours, will you be okay?"
One of the men frowned slightly, worried.
"I don't know, why don't you call me out."
"Old Lu, Old Lu! Get up!"
A young man walked to the bed, slapped his face, and said loudly.
Nothing!
Seeing this, several people looked at each other, and suddenly a tense atmosphere appeared in the dormitory.
"Old Lu! Old Lu!"
An older man stepped forward, yelled twice and tested his breath, his expression suddenly sank a lot,
"I can't wake him up, don't let anything happen, Xiao Zhu, go find the foreman!"
"Okay, I'll go right away!"
After speaking, the young man rushed out of the dormitory.
…