Chapter 1216 【1216】Check Carefully

The attenuated measles vaccine is a free and compulsory vaccination program in China, and most of the citizens have been vaccinated in the childhood stage.

Universal vaccination has greatly reduced the number of measles cases in the country. Helpless, there are individual differences in some groups of people, and they will get sick even after being vaccinated, but the symptoms are milder than those who have not been vaccinated, which are basically mild to moderate symptoms.

Even so, it is certainly in the patient's best interest to catch the disease early and accurately diagnose it. A prudent doctor will check all common key diseases for the patient.

For measles patients, there will be specific signs of measles mucosal plaques, so the doctor will check the buccal mucosa in the patient's mouth.

The so-called measles mucosal spot refers to the small off-white spots that appear on the buccal mucosa of the patient's oral cavity 1 to 2 days before the rash, with a diameter of about 0.5 to 1.0mm, and there will be some blush around them. It is said to be a measles-specific sign because this symptom is only found in measles, and it can be diagnosed to a large extent different from other diseases. Once measles mucosal spots are detected, the probability of measles is almost equal.

Xie Wanying carefully looked at the buccal mucosa, but did not see measles mucosal spots. After that, the two cotton swabs continue to carefully press the child's tongue to check the throat. Cotton swabs are used instead of tongue depressors to check patients. The precautions for using spatulas are the same. The position should be placed in the anatomical position of the V-shaped groove at the junction of the front 1/3 and middle 1/3 of the tongue. superior. If it is too forward, the base of the tongue and the back of the tongue will not be pressed in place. Too high will hinder the doctor's line of sight, making it impossible to see the condition of the tonsils and pharyngeal mucosa clearly. Too far back can easily cause nausea and vomiting in patients.

"Ah."

When the doctor's sister said so, the boy obediently made an "ah" sound.

The child's throat is wide open, and with the function of the tongue depressor, the doctor can soon see two small pink lumps on both sides of the throat, which are palatine tonsils, commonly known as tonsils.

The light from the flashlight showed the congestion and edema of the child's tonsils. It seemed that there were white and thick spots on the surface, which meant that the acute tonsillitis had disappeared.

"My grandson has a cold, isn't it, doctor? You can prescribe some cold medicine for him." Grandma Zhaitong hurriedly urged the doctor to prescribe medicine, and hurried to get the medicine and go home to cook.

Xie Wanying was not in a hurry, she put down the cotton swab, and then asked about the child's diet, defecation and urination, whether there was any body pain, etc., and then looked at the child's skin for wounds or signs of rash.

"He can eat. He has stool, and his urine is a little yellow."

Based on the information provided by the patient's family members, the overall initial diagnosis tends to be acute tonsillitis in children. Xie Wanying said to the child's grandmother: "In this case, he needs to draw blood for a blood test, and needs intravenous infusion and drip."

"Aren't you going to prescribe cold medicine for him?" Grandma Zhetong asked in surprise.

"He didn't have a cold, but acute tonsillitis in a child, and there were signs of suppuration. He must get an injection, and oral medicine alone is not enough." Xie Wanying emphasized that the child's condition is relatively serious.

"Injection? Oh, I don't have that much money, I need to call his parents." Grandma Zhetong patted her thigh.

As a doctor, Xie Wanying didn't dare to say that the child might be hospitalized for treatment, mainly because the family's clothing is probably not very good financially.

Clinically, most doctors will try their best to consider patients and their families, and will consider their economic situation. If the economy really does not allow it, you can try not to hospitalize the patient and try to solve it in the outpatient and emergency department.