【206】Careful investigation is very important

"Relax a little, okay? Don't be nervous, Auntie." Liu Jingyun tried to calm the patient's emotions.

"I can't bend my waist. I can't bend my waist." The aunt kept complaining that her back hurt.

Liu Jingyun looked back at the clock. The surgeon might be coming soon. If he saw that the patient was not under anesthesia, he would probably be angry. This was an operation at noon, and the surgeon originally sacrificed his rest time to do it urgently for the patient.

The surgeon was angry, just like the last time in the emergency department, and finally complained to the anesthesiology department: It was just a simple spinal anesthesia, and the people in your anesthesiology department couldn't do it well?

"Don't be nervous, take a deep breath, auntie. Can I hold your hand first?" Liu Jingyun held the patient's hand, wishing she could bear the pain instead of the patient.

Xie Wanying looked at the patient's condition and looked at the patient from head to toe to see where the problem was.

Lumbar disc herniation, causing lower back pain? Are the patient's complaints exaggerated? It hurts so much that you can't bend your waist? Some patients are nervous upon entering the operating room, and their excessive nervousness amplifies their pain.

The patient's heart rate on the monitor is a little fast, but his blood pressure is strange, a little low?

"Senior Sister." Xie Wanying called her Senior Sister again.

Liu Jingyun turned around and asked her junior sister in confusion: "What's wrong?"

"It shouldn't be possible to get spinal anesthesia."

Maybe the junior sister doesn’t quite understand that spinal anesthesia can be done for lumbar disc herniation. Liu Jingyun was going to tell the junior sister.

Walking around the end of the patient's bed to the senior sister on the opposite side, Xie Wanying whispered: "Maybe we need to rule out spinal problems, such as ankylosing spondylitis?"

Spine problem? Liu Jingyun was startled.

"Emergency patient? How many examinations have been done?" Xie Wanying asked.

Liu Jingyun looked back at the medical records placed on the treatment cart. It was correct that he was an emergency patient. Maybe the emergency doctor was afraid of what would happen to the anus and rushed to perform the surgery.

What was the specific situation? Liu Jingyun walked back, picked up the medical record and checked it again. It turned out that the patient had an anal fistula and had undergone an anal surgery before. Local anesthesia was used at that time. Local anesthesia is risk-free and treats low anal fistulas. Later, it was found that the recurrence was serious and may involve high anal fistula. I came in from the emergency room and went into the operating room this time. I probably wanted to do a thorough anal surgery.

If you want to have surgery, you will basically do some preoperative tests, such as an electrocardiogram, which is generally fine, and a blood test, which shows that there is no problem with coagulation. Because of the anal fistula, there must be infection and the white blood cells are high, so surgery is needed.

Liu Jingyun thought for a while, why did the junior sister suspect that there was something wrong with her spine?

"If it hurts like this, could it be spinal deformity? The local anesthesia surgery last time may not require bending." Xie Wanying said, "And the patient is thin and has high white blood cells. It is said to be caused by anal fistula, but is there anything else? What’s the cause?”

When bending over, the pain is usually not severe enough. Even if the patient cannot bend over even a little bit, the patient will say that his head hurts as well.

If there is a problem with the spine, spinal anesthesia cannot be performed. This is a contraindication for spinal anesthesia.

It is right to be cautious, but in order to find out whether this is the cause, the patient needs to have a radiograph taken and a clinician should be contacted for consultation. If the other teachers were okay, it would be Director Zhang today, and Liu Jingyun would have a headache just thinking about it.

Putting down the medical records, Liu Jingyun walked back to the patient's bedside and reached out to touch the patient's back to check the condition of the patient's spine. This was a positioning action she had to do before anesthesia. After touching it carefully, I found that the patient's back muscles were very stiff and obviously different from ordinary people. It felt like something was really wrong.

"Didn't you take a chest X-ray?"

"Non-hospitalized patients come in from the emergency room and don't have time to take pictures." Xie Wanying said as she helped the senior sister look through the medical records.