In fact, the fact that things have developed to this point is beyond Chen Qi's expectation.

He just reminded a patient and pointed out an occult open fracture. In fact, it was a very simple matter. How come it has caused a sensation in the entire department? I'm afraid it has spread throughout the hospital?

And he was a little aggrieved, thinking that a group of doctors like you, big and small, are all blind?

With such an obvious history of head trauma, subcutaneous bruises, and even the characteristics of panda eyes, and cerebrospinal fluid flowing out through the nasal cavity, how come you still don’t know that this is a skull base fracture?

Okay, even if you didn’t expect it, now that things have reached this point and he has reminded you, why haven’t you reacted yet?

This made Chen Qi a little puzzled. Faced with Li Jun's aggressive accusations, he became a little uneasy. He even said he wanted to return to school, so he had to make his words clear.

Director Jin Laifa also frowned, very dissatisfied with this new intern.

"Classmate, since you are so sure, then tell me your reasons. We who are engaged in clinical work must seek truth from facts in everything. We must not make random comments without any factual basis."

This is such an obvious accusation.

Zhu Huoyan still watched with cold eyes, ready to watch the show.

As for Lan Lijuan and several other classmates, when they looked at Chen Qi, they could not hide their worries.

Chen Qi coughed slightly, and although he was dissatisfied inside, he still said seriously on the surface:

"Teachers, in fact, the best basis for judging whether there is a skull base fracture is whether the fluid flowing out of the patient's nasal cavity is nasal mucus or cerebrospinal fluid, right?"

Zhu Huoyan nodded: "That's the truth, but how do you judge? An experiment of dropping a few drops of snot on gauze is not enough."

Chen Qi continued to explain:

"As we all know, nasal mucus is mostly caused by a type of goblet cells in the nasal mucosal glands, which secrete a lot of mucin. When the mucin is released to the outside of the cells, it absorbs a large amount of water, thus forming nasal mucus. So it is definitely sugar-free.

.

Cerebrospinal fluid is mainly produced from the choroid plexus in the lateral ventricles and needs to deliver nutrients to the brain and spinal cord, so its ingredients include sugar, adenosine deaminase, protein, etc. The normal value of glucose is 2.5-4.4mmol.

/L.

Then we just need to do a very simple experiment, get a urine glucose test paper and measure the glucose content."

What Chen Qi said was reasonable and well-founded, and he blurted out all kinds of medical terms, which immediately stunned many big shots in the ward.

Everyone, look at me and I look at you. I think this seems reasonable. Could it be that this guy really discovered a hidden fracture?

Of course Li Jun was not convinced, but he wanted an explanation, and of course he wanted to give others a chance to prove their innocence, so he huffed and remained silent.

A young doctor hurriedly brought a urine glucose test paper, personally took the patient's "snot sample", and then tested it with the test paper.

Everyone’s heads were stretched out.

In less than 5 minutes, the results came out. This "snot" did indeed contain glucose. Now many doctors in the ward started talking about it.

Obviously, it is impossible to test positive for glucose in nasal mucus.

Li Jun couldn't help it and objected loudly: "This is too arbitrary. Just rely on such a test strip? What if the patient's blood sugar is high?"

Jin Laifa's eyes moved:

"It is indeed difficult to draw a conclusion through this urine glucose test. Even if this is not nasal mucus, what if it is inflammatory secretion caused by otitis media? Then it may not show a positive result for glucose."

Zhu Huoyan remained silent, feeling that both sides sounded reasonable.

Li Jun shouted again at this time: "This patient had a skull X-ray taken when he was admitted to the hospital. I will get it now and ask several directors to consult to see if there is any fracture. The imaging film is the gold standard."

Chen Qi quickly interjected: "The possibility of skull fractures in X-rays is only 50%, and the shooting location is very important, so it is better to take the CT scans, which one can see the clearest."

Doctors now cough a few times.

Jin Laifa said speechlessly: "CT machine? How can our hospital afford a CT? Now in Haidong Province, only the First Affiliated Hospital of Hainan Medical University has a CT, and it was just imported this year."

Chen Qi slapped his forehead and instantly figured out everything.

No wonder these surgeons at the Viet Nam People's Hospital don't even know the most basic clinical manifestations of skull base fractures. It turns out that it is because of the lack of CT that domestic surgery has not yet reached this level of research, and no relevant literature has been published.
p>

There is no way to diagnose without CT, so it is impossible to identify a large number of clinical skull fractures, let alone such hidden fractures.

No wonder everyone doesn’t know that panda eyes are a characteristic manifestation of anterior cranial fossa fracture.

Li Jun came and went very quickly, and he would not necessarily come in with an X-ray film in a moment: "Director Zhu, Director Jin, look, this is the X-ray film taken when the patient was admitted."

A group of doctors, centered on Zhu Huoyan, immediately began to study the films in front of the bright light from the window.

The female patient and her husband also watched eagerly, not to mention how nervous they were.

As for the patients outside the window, looking at a group of white coats commenting on an X-ray film, their eyes are full of sacred awe, look, what do intellectuals mean?

Others saw it as lively, but Chen Qi felt numb.

For skull fractures, the most advanced X-rays in previous generations could only capture less than 30% of the results, let alone the oldest CR machine from 1981?

Several senior experts from the department consulted and looked for a long time, but could not see the fracture line. Zhu Huoyan handed the film to Chen Qi:

"This is the X-ray of the patient's admission. Take a look for yourself."

As soon as Chen Qi got the X-ray, he knew it was serious after taking a closer look. As he expected, there was no trace of any fracture line on the X-ray. No matter how many times he looked at it, it was a normal skull image.

Li Jun snorted coldly:

"Classmate, what else do you have to say now? No matter how many small experiments you do, it's just a show of force. The most important thing in our surgery is imaging diagnosis. You have also seen this film, what else do you have to say now?"

He was really relieved. Now it was over. He was innocent, his skills were reliable, and the diagnosis was correct. Then all the pressure was on Chen Qi.

Facing the distrustful looks of doctors, patients, and onlookers, Chen Qi sighed and raised his hands:

"Director Zhu, Director Jin, Teacher Li, I just said that the probability of normal X-rays to capture the skull fracture line is less than 30%, and there are certain posture requirements when taking X-rays, so I applied for another X-ray.
Chapter completed!