Practicing Medical Skills in a Small Clinic novel Chapter 750

Chapter 750: Chapter 348: The Illness That Stumps the Directors—Masters at Passing the Buck (Part 2)

The diameter of the right pupil is smaller than the left, with the right pupil diameter being only 1.6mm, while the left is 2.7mm. Light reflex is present.

Additionally, it was found that the child patient has a slight tilt to the left side.

After being admitted, necessary examinations were conducted on the patient, but no signs of vascular occlusion were found.

In a case like this, Li Jingsheng’s first reaction is issues like stroke, cerebral hemorrhage, or cerebral infarction.

It seems that the condition is far more complex than imagined.

No wonder Director Hua called him over.

Li Jingsheng is known for tackling difficult cases successfully.

This child patient’s identity is not simple. If the orthopedics department can make significant contributions during the consultation, it would be more than just a matter of prestige. The benefits would be substantial.

The attending physician has already conducted a detailed physical examination and tests on the child.

The muscle tone in the right upper and lower limbs is high, while it is low in the left lower limb.

During muscle strength testing, the right side is evidently worse than the left side.

Seeing this, Li Jingsheng is very suspicious of whether this boy has already developed hemiparesis.

At the very least, it’s worth investigating.

He even suspects whether the child’s fall was due to a sudden hemiparesis happening on one side of the body at that time.

Based on the current examinations, he strongly suspects this possibility.

Otherwise, how could an eight-year-old boy fall inexplicably while going to the toilet at home?

Even if he did fall, no obvious lacerations or hematoma were found on the head, indicating that the likelihood of the head hitting hard objects like table corners or walls is low. This loss of consciousness seems very strange.

Additionally, the unequal pupils of the child seem to support this hypothesis.

However, the emergency doctor’s tests show that the boy’s limb tendon reflex is quite active.

The boy’s abdominal wall reflex and cremasteric reflex are absent.

The Kernig sign test is negative.

The Brudzinski sign test is also negative.

The Babinski sign test is positive on the right side and negative on the left.

This so-called Babinski sign test is generally conducted simultaneously with the pinprick test.

The method involves using a blunt pointed object to stimulate along the lateral edge of the sole from the heel forward to the small toe, then turning inward.

At this point, a normal person will exhibit toe plantar flexion.

A positive reaction will show dorsiflexion of the toes, and sometimes other toes will simultaneously splay out.

The purpose of conducting this test is to check if the upper motor neuron is functioning normally.

Director Luo immediately felt immense pressure.

"Uh... Secretary Bei Yan, please don’t worry, because the condition is rather complex, we don’t dare to make rash conclusions."

After speaking, Director Luo turned his attention to the head of the emergency department.

"Director Yan, you have the richest experience in emergencies. Everyone wants to hear your opinion first!"

This old fellow is quite cunning, with excellent skills in passing the buck.

The emergency department director, who somewhat resembles Dad Big Head, looked like he was just over fifty years old, with hair slightly disheveled.

He was sitting comfortably here, and suddenly, he found himself taking a hit.

Director Luo had passed the burden onto him.

The child was admitted to the emergency department, and now he couldn’t shirk the responsibility even if he wanted to. Internally, he might be cursing, but his face was stern as he adjusted his gold-framed glasses.

"Currently, based on the chest X-ray, the heart shadow is widened bilaterally, and there are obvious consolidation symptoms at the hilum. Then, the ECG results show atrial premature complex and sometimes bigeminy, along with a pulse of only 47 beats per minute. I suggest immediately inviting cardiovascular experts for a consultation. Our emergency department, although experienced in handling various emergencies, is not specialized in heart and neurological problems."

Director Yan exerted great effort yet managed to pass the burden again.

He handed it over to the cardiovascular expert who was still sleeping at home.

"Can this be treated at the Second Hospital? I gave birth to this son after much effort at thirty-three, now I am forty-one, and he’s my only child. You need to tell me which expert you’re calling for consultation, give me the name. Or if you think the chances are low and suggest I transfer my son to another hospital, you can openly tell me. It has been more than an hour since admission, but my son’s condition continues to deteriorate, and as a mother, I am indeed feeling extremely anxious, hoping you can understand."