My medical skills can add experience points Chapter 117: First entry to the orthopedics department, external fixation of fractures
Zhou Can looked at the training schedule, and the second training department was orthopedic surgery, which lasted for three months.
Orthopedic surgery plays an extremely important role in the field of surgery, ranging from thoracotomy and craniotomy to replantation of a finger, all of which cannot be separated from orthopedic surgery.
It is a must for surgery.
Zhou Can is full of expectations for this new department.
During the three months of regular training in the emergency department, he mainly stayed in the operating room.
What I have learned is also the knowledge related to surgery.
The three-month surgical operation in the emergency department is even more than the five-year work of others.
He currently has several basic surgical skills that have reached the intermediate level of attending.
With this strength, if you enter the training of orthopedic surgery, you will be able to succeed soon.
The next day, he and Jin Mingxi rushed to report to the orthopedic surgery department early.
The second stop of the regular training of the two is orthopedic surgery.
When I walked into the orthopedic surgery department, I saw a long queue at the clinic. There are those in wheelchairs, on crutches, with bandages hanging on their arms, and some patients are even lying on carts.
Most of the patients who come here for treatment are accidental injuries.
"Good guy, the number of patients here is no less than that of the emergency department!"
Jin Mingxi couldn't help sighing.
"Orthopedic surgery and general surgery should be the two busiest departments in surgery. Let's go to the doctor's office first."
Looking at these patients, Zhou Can's eyes sparkled. These are all experience points!
"Hello, may I ask who is Dr. Gui Pei reporting to?"
Zhou Can didn't ask the nurse this time.
I happened to see a middle-aged male doctor in his forties passing by, so he hurried forward to ask.
"Which department are you from?"
"Emergency Department!"
"Come with me!"
"thank you!"
In Zhou Can's impression, orthopedic surgeons are generally aloof. This middle-aged male doctor is also very easy to talk to, right?
Ask for directions and take them to report in person.
From time to time along the way, doctors or nurses took the initiative to greet the man.
Call this person Dr. Yang.
"Come in! Everyone take a form and register."
Doctor Yang led the two into a fairly spacious office.
At this moment, several young doctors are already filling out the same form as them.
"Xiao He, how many people have the hospital arranged for orthopedic training this time?"
Dr. Yang asked the young doctor who was sending and receiving forms in the office.
"There are thirteen people in all departments, plus the five we recruited, a total of 18 regular training doctors."
The regular training department is generally coordinated and arranged by the hospital.
For example, Zhou Can and his colleagues transferred from the emergency department to the orthopedic surgery department, and Gui Peisheng from other departments would be transferred to the emergency department.
Only in this way can the stable operation of the entire hospital be guaranteed.
"There are too many people! But this is also a good thing. One more person works, and everyone can relax."
Dr. Yang sat at the main seat in the office.
It seems that this batch of regular trainees belongs to him.
Zhou Can also said how did the orthopedic surgeon become so enthusiastic? It turned out to be the right person to ask.
While they were filling out the form, people came to report one after another.
"Hurry up and fill out the form. You only need to write one or two specialties that you think you are best at. If you really don't know how to write them, just write which department you are from."
Dr. Yang raised his wrist to look at the time, maybe he felt that these rules were too dark.
So he urged.
Zhou Can has already filled it out.
In the special column, he wrote about suturing and ligating.
Because the experience value of these two basic medical skills is the highest, and they are about to reach the excellent level of attending.
Soon, all the 18 Gui Peisheng completed the forms.
"Let me introduce myself. My surname is Yang. I am in charge of your preliminary arrangements and the management of the entire orthopedic surgery training period. First of all, on behalf of the orthopedic surgery department, I would like to extend my welcome to you."
Doctor Yang's eyes swept over the eighteen people.
"Since the restructuring of Tuya, the system has been implemented in which the capable go up, the mediocre go down, and the survival of the fittest. I don't care which department you are from or what background you have, the competition for training opportunities will be treated equally."
This is an early vaccination.
Let those who come from important departments put away their arrogance, and let those who have connections with backgrounds stop thinking about it.
Don't think about going through the back door, giving gifts, etc.
Clinical departments have always been a place of failure for related households.
If he didn't have real skills, no doctor would dare to let him do it to patients, even if it was the dean's son.
What should I do if I cut down the patient with one knife?
If something happened, the dean would not only not appreciate it, but would also wish to slap the superior doctor to death. Are you **** trying to kill my son? Knowing that his surgical ability is weak, let him do the cutting.
"Let's talk about the department's needs for Gui Peisheng first. There are only two 100,000-level operating rooms in the operating room and six Gui Peisheng are needed to assist. The outpatient manipulation recovery room needs one. The more the inpatient department, the better."
Every fool knows that regular training in the operating room is definitely the best.
Outpatient manipulative reduction is not bad.
The worst thing is to be a regular trainee in the inpatient department. The work is heavy and tiring, and it is easy to be scolded by family members and patients. All kinds of managing beds, being on duty, writing medical records, and doing odd jobs are enough to make people tired.
"Of course, you don't have to worry too much. The hospital's standardized training for you is all-round. It doesn't mean that you won't have the opportunity to study in the operating room when you are assigned to the inpatient department. It's just that the focus of learning is different."
After seeing everyone's slightly nervous expressions, Dr. Yang comforted everyone with a gentle smile.
The Orthopedic Surgery Department asked him to manage Gui Peisheng, so he naturally has strong management and coordination skills.
"For the sake of fairness, you will enter the operating room in batches in the first three days. Those who perform well will be retained by the chief surgeon in the operating room. Don't be discouraged if you are eliminated. Surgery is not the only way out. And even if divided When I manage patients in the inpatient department, as long as I perform well, I can still win opportunities for surgical training.”
Surgeons cannot perform operations, and the only way out is to choose more difficult academic research.
It's just that there are very few people who have made a name for themselves on this road.
A careful observation of the famous doctors in each surgical room shows that all of them performed exquisite operations. Most of their academic achievements are also closely related to their surgical ability.
After all, science comes from practice.
"Anyway, everyone has the same opportunity, so I will randomly assign you the jobs for the first three days."
Dr. Yang directly divided the eighteen data sheets in his hand into three parts.
"Xiao He, read the names of the six people working in the operating room today."
He handed the first information sheet to the young doctor.
"Fan Wen, Wang Bin, Jin Mingxi..."
A total of six names were read.
Zhou Can may not be in the first batch because he submitted the form late.
This is also good, you can spend one or two more days to familiarize yourself with the environment of orthopedic surgery.
He knew very well that if he couldn't be selected into the operating room, his development would definitely be much worse.
Although his surgical ability is very strong, enough to crush everyone, but the lion fights the rabbit, he must do his best to be more secure.
"The six people whose names were read just now went to work in the operating room. The remaining twelve people stayed in the inpatient department. Your main task for the first three days is to be familiar with the entire process of patients from admission to discharge. Manage the bed, write I don’t need to say more about cases, operations, and ward rounds, you have already learned them during the internship stage.”
What is done in the internship and regular training stages is actually different.
Just like going to kindergarten, the main thing is to learn to abide by the campus rules, as well as the recognition and reading of the pinyin alphabet, and the meaning of the numbers 1 to 10. In the first grade of elementary school, children are required not only to recognize and read pinyin letters, but also to be able to write and spell, and to start learning to write simple Chinese characters. In terms of mathematics, children will also be required to learn addition and subtraction within 10, as well as larger numbers.
The same goes for doctors.
Step by step, step by step to improve business capabilities.
Regulatory training doctors need to gradually complete certain risky affairs independently.
Such as tube bed.
What should the intern do if he finds that the patient is coughing violently or complaining of stomach pain? Then I must call the superior doctor to come and deal with it!
If Dr. Guipei encounters this kind of thing, he must learn to diagnose it by himself.
Call the superior doctor for something serious, and you will definitely be scolded to death.
"Xiao He, go ask Mr. Xiang to come over!"
Doctor Yang ordered.
Mr. Xiang is not the boss of any company, but the president of the hospital.
That's what hospitals are usually called.
Many newcomers think that the overall status of hospitalization is very high, but it is not.
Don't look at the hospital who always treats many regular trainees and interns as grandchildren, directing this work and arranging that work.
In fact, the overall status of hospitalization is much lower than that of attending.
This position is usually rotated, and the time is one year, which can be regarded as a hard job.
To live in the hospital on duty.
Being able to become the chief resident has some things in common, and the working experience of the resident physician is more than three years. I have advanced training.
In fact, this is also a necessary process for promotion.
Usually, they go to study for half a year to a year, and after returning, they will be hospitalized for a year, and then they will take the examination for promotion to attending physician. After passing, you will get the attending physician certificate. If the hospital has a quota, it will hire you as the attending physician.
However, the number of appointments is limited, so there is no need to worry if you are not hired within a year.
At this point, as long as no catastrophe occurs, basically the indications are stable.
Mostly just waiting in line.
It is worth mentioning that the difficulty of the examination is not high, and many people can pass it at one time.
What is really difficult is to take the medical license exam one year after graduation. The pass rate is quite low, basically only one of the five people passed.
If you fail the exam in the first year, you can retake the exam in the second year.
I failed the test the first time, the second time, the third time... There is a high probability that I still fail the test.
The smart way is to switch to administration in time, or change careers.
After all, age can't stand it.
He graduated from a bachelor's degree at the age of 24 and obtained a certificate at the age of 26. People with dull qualifications have been failing the exam, and they will be close to 30 years old after just two or three years. It will be very stressful at that time.
It's not that piece of material, it's the smartest way to stop loss decisively.
Soon, a male doctor in his early thirties hurried in.
The man was of medium height, with thick and bushy eyebrows, as if he had two black brooms above his eyes.
From the perspective of physiognomy, such a person is generally very irritable and rough.
"Mr. Xiang, I will let you arrange the twelve people first. After three days, when the people in the operating room are selected, you will make long-term training arrangements for them."
Doctor Yang said to the man.
"no problem!"
Doctor Xiang glanced at Zhou Can and the others, and waved his hand.
"Come with me!"
This style of acting is really vigorous and resolute, never procrastinating.
Zhou Can and others followed him to the ward area.
There are nine inpatient wards for orthopedic surgery, and the rest are open bed areas. The total number of beds is conservatively estimated to be at least three hundred.
The scale is quite terrifying.
Many smaller tertiary hospitals have a total of only about 500 beds. In order to be rated as the top three, some even need to inflate a part of the hospital beds to reach this number.
Tuya is just an orthopedic surgeon with more than 300 beds. It has so many departments, and the total number of beds must be an astonishing number.
With this size, it is difficult to find three companies in one province.
What's more, the number of beds in its affiliated first and second affiliated hospitals has not been added yet.
"I don't know your names. In order to save time, I'll just divide the beds for you according to the list. For the three days, you are only assisting for the time being, and you don't need to be in charge of these beds."
Dr. Xiang read according to the list, and each assigned a batch of beds.
The number of beds per person is about 8 to 12, and the number varies.
The number of tube beds is mainly determined according to the ability of the tube bed doctor.
Zhou Can was allocated beds 115-124.
There are ten beds in total.
As Dr. Xiang said, he was just assisting in the management. These ten beds are under the care of a doctor named He Zhang.
This person will definitely have regular training and interns to assist him.
"Who, don't be dazed, hurry up and help put the plaster on."
A busy doctor waved to Zhou Can.
"It means you, come here quickly."
Zhou Can hurried over.
He has taken a scalpel, but never put a plasterboard on a patient.
"The patient was injured by a fall from a high height, and his right leg was seriously fractured. He has already undergone surgery. The navicular bone in the arch of the left leg has a slight fracture and fracture. The attending doctor asked us to fix him with a plaster cast."
It can be seen that the patient's right leg has been wrapped into a mummy.
It's not clear what surgery was performed.
In the case of a fracture, even after the operation, it needs to be fixed from the outside to allow the bone to heal.
This cycle will be relatively long.
There is a principle of priority for doctors to deal with patients' conditions. Fatal injuries are dealt with first, serious injuries second, and minor injuries last.
There are many kinds of high falls, such as falling from upstairs, falling from a cliff, or a branch breaking when climbing a tree, and unlucky falling to the ground.
High falls are often accompanied by serious internal injuries.
The patient in front of him only broke his leg, which is very lucky.
"Look at you stupid, haven't you put plaster on the patient yet?"
"It's true that I haven't done it!"
Zhou Can squatted down, not knowing how to help.
"I'll teach you once! First measure the length from the sole of the patient's foot to the ankle. Then measure the width of the sole of the foot."
The doctor is not tall, estimated to be only about 1.65 meters.
Age twenty-eight or nine years old.
Zhou Can didn't know him, but the general hospital doctor assigned Gui Peisheng just now, and he must have been watching.
"Okay, I remember. Are you Dr. He Zhang?"
The other party spoke politely, at least not as fierce as imagined.
Only then did Zhou Can dare to ask the other party's name.
"Well! I'm a resident doctor here, and I manage beds 115-124. Besides you, there are three interns. There was originally a regular trainee, but it has been transferred today."
It really was Dr. He Zhang.
Even in a large hospital like Tuya Hospital, the workload of a regular training doctor is already very heavy. It is almost used as most of the residents.
The training doctor who was handed over was transferred away before the arrangement was in place.
This shows that the staffing of doctors in the whole hospital is quite tight.
"After measuring, you memorize the length, and then make the plaster ring into a plaster strip of appropriate length. Generally, you don't need to worry about the width. The limbs that are too wide can be splinted directly. For this kind of case, a plaster cast is enough. "
Dr. He Zhang's hands and feet are quite nimble.
The patient, like most patients, remained silent.
Quietly watching the doctor busy for him.
"These things are necessary for plasterboard. Plaster, plaster wool, bandages."
He identified Zhou Can one by one.
The three things are easy to distinguish, Zhou Can nodded to show that he remembered it.
"After finishing the gypsum strips of appropriate length, the next step is to make gypsum wool. Remember, the length, width and narrowness must be grasped."
"Sword Comes"
In fact, it is customized according to the patient's left foot.
"Go and fetch half a bucket of hot water. The temperature is about 50 degrees. The hot water is available in the boiling water room over there."
He Zhang deliberately let Zhou Can quickly familiarize himself with the environment.
Soon, Zhou Can called the hot water.
There is no way to measure the water temperature specifically, and it is tested with a beater.
The temperature of the human body is about 36-37 degrees, and it feels a little hot to the touch, which is the water temperature of about 40 or 50 degrees.
Dr. He Zhang was very satisfied when he saw that he had fetched the water so quickly.
He tried the temperature of the water with his hand, and a smile appeared on his face.
"It's okay to do things! What's your name?"
"My name is Zhou Can! You can call me Xiao Zhou."
Zhou Can was so narrow when he first came, and kept his posture very low.
"Doctor Zhou, the next step is to soak the plaster strips in water."
I saw that after the gypsum strip was soaked in, a lot of air bubbles began to emerge immediately.
"Remember, you must wait for the bubbles to stop before taking it out."
After a while, it stopped bubbling.
Dr. He Zhang took out the softened plaster strip. Quickly pinch it with your hands.
"Squeeze out as much water as you can, then spread it out on top of the plaster wool. Be quick, not too long, or it will harden very quickly."
After finishing it, Dr. He Zhang instructed Zhou Can to lift up the patient's left leg.
"If the patient has the conditions, you can directly ask him to step on it."
After speaking, Dr. He Zhang looked at the patient.
"Uncle, it will hurt a little, just bear with it."
Beside them, two family members of the patients were watching.
The explanation must be explained in place, so as not to cause unnecessary misunderstanding.
I saw Dr. He Zhang pressing the patient's instep with one hand, and holding the plaster on the patient's sole with the other hand. Then quickly wrap it according to the shape of the patient's foot.
"Doctor Zhou, hold on, don't let the plaster come loose."
Dr. He waited until Zhou Can supported him, then removed the bandage and began to wrap the patient. When one roll of bandages is used up, another roll is taken apart.
After a few minutes, the plaster cast was firmly secured to the patient's foot with bandages, all the way down to the heel.
"Remember~www.mtlnovel.com~ the bandage should not be too tight or too loose. Especially for these parts, if it is tightly wrapped, it will lead to ischemia and necrosis of the limbs. After wrapping it up, you can adjust the plaster by hand shape so that it fits more closely on the patient's foot."
Zhou Can was just laying hands on the whole process.
When the patient's plaster cast is finished.
【Congratulations, you have obtained external fixation of fractures, which can perform external fixation for fracture patients and help the fracture site heal quickly. 】
[External fixation of fractures, current experience value: Level 1 1/10, unqualified level for interns. 】
Zhou Can was overjoyed to gain another orthopedic skill.
Although it is just the most basic medical technique in orthopedics, it has a very high probability of being used in surgery.
Especially in the department of orthopedics, many minor fractures only need to be cast with a plaster cast.
"There is another cast over there. This time, you will operate it, and I will guide it by the side."
"OK!"
Zhou Can readily agreed.
Dr. He Zhang definitely hopes that he can get started quickly, and next time there is a plaster cast, he can directly call Zhou Can to complete it.
This is a patient with a broken hand, who needs to be put in a plaster cast and hung on his neck.
"His severe fracture is mainly the hip joint. The operation plan has not yet been formulated. First, fix his fractured arm." This is a very thin middle-aged woman, lying on the hospital bed and humming.
He kept yelling, he was going to die, he was going to die.
Zhou Can is usually very careful when encountering such patients.
The family member who accompanied her to see a doctor was a young man in his twenties, who should be her son. This unfilial son was holding a mobile phone and playing games beside him. +Bookmark+