Although the emergency department is a bit shabby, and its strength is far inferior to the weighty departments, it has privileges that other departments do not have in terms of asking for help.
If you encounter a doctor who is uncertain, you can call a doctor from any department to come for consultation.
The other party cannot refuse.
There are also strict limits on the time you can go to the emergency room.
This is prescribed by the hospital.
Moreover, when a specialist doctor comes to the emergency department, he can't pick things up when he encounters something he can't handle, saying that I can't handle it. The specialist doctor who came out of the emergency room is of a low level, so if he can't handle it, please ask a higher-level doctor to come over.
In the end, all the efforts of the hospital could not save the patient, so there was no other way.
Report according to the procedure.
Although other departments encounter patients who are uncertain, they can also invite doctors from other departments to come for consultation. But the nature is much different.
For example, the orthopedic surgery department received a patient with a fracture, suspected internal bleeding or other serious diseases.
The orthopedic department felt that it could not be done with its own ability, and was afraid of accidents.
So I invited the doctor in my heart to come for a consultation.
After receiving the request, the doctor in my heart was somewhat reluctant. Because it is not easy for any doctor, and there is a lot of work to do in his hands, how can he have time to take care of other family's affairs!
But there is no way to push this matter away, the cutscene must go.
We all belong to the same hospital. If you help me, next time you have difficulties, I will help you too.
Solidarity is a must.
The internal medicine doctor passed by.
At first glance, alas, this patient is bleeding so badly that he is already in shock.
Then, after carefully checking the examination report, he thought that the patient might not be able to get off the operating table.
While telling the diagnosis opinion to the orthopedic doctor, he reported to his superior. If you are the chief physician yourself, then you don't need to report.
It may be possible to express a more positive attitude directly.
This patient is very difficult to save, and it is very likely that he will not be able to get off the operating table. You can figure it out.
After finishing speaking, you can leave with a pat on the butt.
This is the difference between an emergency call and a general consultation.
…
Not long after, the patient's blood test report was brought, and the white blood cells were abnormal, and indeed there was abscess.
The doctors who came out of the emergency department also rushed to the hospital one after another. The Department of Gastroenterology sent an attending, and the Department of Hepatobiliary Surgery also sent an attending.
This level is no longer low.
No matter the diagnosis and treatment experience or their own strength and level, they will not be bad.
"What's wrong?"
"Acute cholecystitis!"
"This is not a difficult disease! Wasn't Dr. Xu the chief physician of our surgery department before? He should be able to handle it!" The attending doctor of the hepatobiliary surgery looked relaxed after hearing this.
Maybe he didn't mean to laugh at Dr. Xu himself.
It's just that no matter how you listen to it, there is a sense of contempt for Dr. Xu.
Judging from this person's age, he should be a newly promoted attending surgeon in recent years.
There is still a little fighting spirit of young people in him.
Young and promising, it is inevitable to be a little proud.
This must go through the precipitation of years and the beating of reality before it can be slowly restrained.
"Doctor Ruan can take a look at the patient's condition first." Zhou Can stood beside him and spoke for the teacher.
The attending doctor of the Department of Gastrointestinal Medicine has finished reading the examination materials and is examining the patient.
Internal medicine examines patients very carefully, checking eyes, tongue coating, hands, complexion, etc. carefully one by one. And ask the patient some details about diet, defecation, specific parts of abdominal pain, etc.
There are many situations that are not written in the medical records.
This is generally a simple record of the patient's symptoms, condition, consultation time and the like.
Huaxia's physicians, in fact, still have the shadow of Chinese medicine in them.
Experienced physicians know a little bit about Chinese medicine.
Zhou Can watched physicians examine and diagnose patients, and secretly learned their diagnostic methods.
After the physician's diagnosis was completed, he was not in a hurry to express his opinion.
He just stood beside him with a slightly dignified expression, waiting quietly for Dr. Ruan, who was out of his liver and gallbladder, to come out with the diagnosis result.
Five minutes passed, eight minutes passed... Dr. Ruan frowned, looked at the examination data, and then at the patient. No diagnostic opinion has been given for a long time.
"Dr. Ruan, you must have treated this disease a lot. You have also read the examination report and the patient. I don't know how you think it should be treated?"
Zhou Canming obviously had a hard time seeing the other party, and deliberately put a high hat on him, but it was actually quite...'bad'.
"Uh... Well, I still need to do more research!"
Dr. Ruan's expression was somewhat embarrassed.
"Didn't you just say that this disease is not difficult to deal with?"
Zhou Can sent his army.
As soon as he came in, it made it difficult for Dr. Xu to step down, so Zhou Can naturally wanted to punish him slightly.
Let this person save some morals next time.
"This kind of disease is generally easy to treat, but this patient is a bit difficult to treat. By the way, what is the treatment opinion of your emergency department?" Dr. Ruan is quite adaptable.
The topic and target were changed in an instant.
To be able to be an attending doctor is something that has been practiced in dealing with patients countless times.
I don't have the ability to adapt to changing circumstances, and I don't know how many times I have been beaten by family members and patients.
Zhou Can looked at the teacher.
This question should be answered by the highest ranking physician.
He is a small-scale Pearson, and he puts the position very well.
Never talk nonsense when you should not call the shots.
"Our opinion is to puncture the gallbladder first to extract part of the bile, then puncture to extract the pus around the gallbladder under contrast positioning, and give the patient anti-inflammatory treatment. After the inflammation is eliminated, elective surgery will be performed."
Dr. Xu adopted Zhou Can's diagnosis and treatment opinion.
Just at this time, the anesthetist also arrived.
After saying hello and inquiring about the situation, the anesthesiologist stood by and patiently waited for the consultation results from several surgeons.
"Doctor Chi, what's your opinion?" Dr. Ruan looked at the attending doctor of Gastroenterology.
"I support the emergency approach. This patient has underlying diseases, is older, and is quite weak. In addition, there is pus around the gallbladder. The risk of surgery is extremely high. Moreover, there are vomit residues at the corners of the patient's mouth, indicating that he was sent to the operating room. Before, the time of fasting should not be long. I suggest to drain the gallbladder and sweat, drain the pus and reduce inflammation, and then give infusion nutritional support and fasting. It is not too late to perform surgery until the indications for surgery are met.”
Dr. Chi's meticulous observation is really impressive.
"I'd prefer laparoscopic surgery if I can. It's a lot less invasive, and the risks are lower."
The reason why minimally invasive surgery has become an emerging trend in surgery is that the trauma is small, the damage to the patient is greatly reduced, and the postoperative recovery is fast.
Some frail and sickly patients may not meet the indications for traditional surgery, but minimally invasive surgery is fine.
The only downside is that minimally invasive surgery is much more expensive.
Then there are very few domestic doctors who are good at minimally invasive surgery.
"The fasting time before the operation was not long enough, and the patient himself had a vomiting reaction. I am afraid that there is no way to anesthetize it!"
When the anesthetist heard that the patient had just vomited, his expression immediately changed.
The hospital is strictly tightening the safety of surgery recently, and he dare not take this risk.
All eyes were on Dr. Ruan, waiting for him to express his opinion.
"That's fine, the patient should be transferred to the hepatobiliary inpatient department. I will report to the director here. After you communicate with the family members in the emergency department, you will send the patient there."
Dr. Ruan took this 'hot potato' back to the hepatobiliary specialist.
This matter is temporarily over.
Before leaving, Dr. Ruan stared at Zhou Can and said with a smile, "You guys are very supportive of your Dr. Xu, and you will return my army!" When he said that, he was asking for a step down.
If he knew that the diagnosis and treatment opinions in the emergency department came from Zhou Can, a regular trainee, he would probably look at Zhou Can even more highly.
"Hehe, don't dare!"
It's not embarrassing at all for Zhou Can's little thought to be seen through.
Dr. Xu loves him so much, people are not grass, how can he be ruthless. Naturally, he also wants to repay his teacher's kindness and protect his own teacher.
Dr. Xu listened beside him, although he didn't speak, but there was a hint of relief on his serious face that couldn't be concealed.
Obviously, Zhou Can's act of defending him has benefited him a lot.
This is ten times and a hundred times stronger than the effect of Dr. Lu flattering him a thousand times.
Dr. Lu's flattery can only make Dr. Xu happy at the time, but forget about it afterwards. But Zhou Can's "advanced flattery" is about feelings, which can make Dr. Xu treat him like his own child.
"I'll go first, don't delay this patient, for fear of accidents!"
Dr. Ruan gave another warning.
The patient's condition is quite serious, and no one dares to delay.
Dr. Xu personally communicated with the family members, and the talks were settled soon.
The requirements of the family members are actually very low, as long as the hospital can cure the illness of the relatives.
"Doctor Lu, you and the nurses outside immediately send the patient to the hepatobiliary surgery department!"
Doctor Lu had a bitter look on his face.
"Can't you ask Xiao Zhou to go?" After all, he is a senior resident doctor.
Small things like running errands are usually done by the lowest-ranking people.
Jin Mingxi is undergoing surgery, it is understandable not to ask him to go.
But Zhou Can did not undergo surgery.
"You can be eloquent. Xiao Zhou's mouth is too stupid, so he is only suitable for surgery. Hurry up!" Dr. Xu's words made Dr. Lu wish to buy a piece of tofu and kill him.
If Zhou Can's mouth is still stupid, there is no one in the world with a smart mouth.
Dr. Xu talked about this for the sake of it, clearly protecting Zhou Can. Dr. Lu is very smart, he can't do anything, so he will never do some unwise actions to annoy his superior doctors or leaders.
Honestly escorted the patient to go.
"Call the next patient in!"
Soon, a new surgical patient was pushed in, his face was pale from the pain, and his forehead was constantly sweating.
This is an acute appendicitis operation patient.
Before the anesthesiologist left.
After reading the examination report, Dr. Xu inquired about the patient's condition.
Surgery is possible.
"How long has the patient fasted?" the anesthetist asked the nurse who brought the patient.
He was frightened by the coquettish operations of the doctors in the emergency department.
"It's been over six hours."
The nurse answered honestly.
Acute appendicitis generally occurs at night.
It is estimated that the patient was brought in at night.
"I, I didn't...have anything to eat after I had supper around 22 o'clock last night!"
The patient has obvious shortness of breath when speaking.
This is for pain.
Acute appendicitis can really kill people.
"What's the patient's name?"
"Huang Weiyuan!"
"Did you receive the doctor last night?"
"Um!"
The anesthesiologist took out more than a dozen copies of the informed letter from his box, flipped through it, and found it quickly.
"I'm going to find the family members to sign the anesthesia consent form!"
The anesthetist is out.
It didn't take long to be back.
According to the usual practice, the patient was checked and there was no problem. He was put on a life monitoring instrument, a non-invasive ventilator, and given inhalational anesthesia.
The patient soon fell asleep.
"Huang Weiyuan, Huang Weiyuan!"
No response to calls.
The patient's vital signs are stable.
"Surgery is ready!"
After the anesthetist finished speaking, he moved over the small black leather stool by the wall and sat down. Eyes fixed on vital monitoring instruments.
Throughout the perioperative period, anesthesiologists are there to **** and **** the patient's life safety.
However, this is only a second-level minor operation, and it is not treated like a big enemy like when it is a major operation.
"Xiao Zhou, are you sure you can open the patient's laparotomy?"
"have!"
Zhou Can was overjoyed.
This is the first time the teacher asked him to open the patient's laparotomy.
Although the risk of laparotomy is much lower than that of thoracotomy, it still makes him very excited.
"Come on! You must remember the principle of being bold and cautious, and safety first. If you don't understand, you must not operate indiscriminately."
"clear!"
Zhou Can is not the kind of unstable person.
For any operation, he is like a lion fighting a rabbit, going all out.
"Can you let Qiao Yu be an equipment nurse for me?"
Zhou Can took good care of Qiao Yu.
"Are you planning to train permanent nurses, kid?" Dr. Xu scolded with a smile. "Liu Xia, bring more newcomers."
This is agreed.
Liu Xia is an old nurse with rich experience.
His qualifications are much older than Tang Ling and Tian Tian.
"no problem!"
Liu Xia readily agreed.
She is not stupid, she can see that Dr. Xu takes extra care of Zhou Can. At the same time, Zhou Can's surgical potential is also extremely amazing.
In less than a month, Zhou Can not only was able to complete various first-level surgeries independently.
Now they even have the ability to open the abdomen and cut the appendix.
It's just too scary.
She couldn't imagine how great Zhou Can would be in the future if he could grow up smoothly.
With such a potential doctor, she must have a good relationship.
A while ago, Dr. Lu spread rumors everywhere, saying that Zhou Can had offended the big leaders of the hospital, that he was going to collapse, that he was going to be unlucky, and so on.
Beep Pavilion
Now it's over.
We are all smart people, so we will naturally think of taking the initiative to repair the relationship with Zhou Can.
Looking at the recent days, more and more colleagues actively greeted Zhou Can enthusiastically, and you will understand.
This is the general trend.
Zhou Can took such good care of Qiao Yu.
Love the house and the house.
Now that Liu Xia shows kindness to Qiao Yu, she can not only gain Qiao Yu's gratitude, but also Zhou Can's favor.
Why would she not do it?
The operation has officially begun.
Liu Xia also spared no effort to teach Qiao Yu related equipment preparation experience. Different surgeries require different preparations.
Qiao Yu has a certain basic knowledge of equipment and nurses, plus she is talented and intelligent, basically she can understand everything, and she can master it as soon as she learns it.
This also made Liu Xia love her a little more.
Teachers generally like students with good grades.
Not for anything else, on the one hand, teaching such students is easy to achieve results, on the other hand, it is much easier than teaching those students who are weak in acceptance.
After Qiao Yu cleaned the surgical site, Zhou Can drew out the scalpel.
Dr. Xu next to him checks.
After no problem, he held the scalpel, his eyes were as sharp as an eagle, and as fierce as a wolf.
Try to find the feeling, and cut the first layer of abdominal surface little by little.
This skin layer includes epidermis and dermis.
Blood gushed out, and Dr. Xu sucked up the blood in time.
He should be satisfied with Zhou Can's first cut.
Next, Zhou Can incised the thicker subcutaneous tissue, the fascia layer, and the rectus abdominis in sequence. At this point, the peritoneum was exposed.
This is also the last barrier to entry into the abdominal cavity.
When cutting rough jadeite, there is a saying that one is poor and one is rich.
If the peritoneal layer is not cut properly, it will lead to disaster.
Dr. Xu dared to entrust such a surgical task to him, a regular trainee, what a trust this is.
Zhou Can took a deep breath, trying to keep his mind calm.
Then find the feeling, and slowly cut through the last layer of barrier.
Fortunately, there was no accident.
It's not particularly perfect, at least it's above the standard.
It's much better than a resident doctor.
[Cutting experience value +1. 】
[Successful first laparotomy, reward +100 experience points for incision. 】
The system is so generous.
One hundred was awarded directly.
But only this time. If you open your stomach again in the future, there will definitely be no extra rewards.
For Zhou Can, it is another extremely important step in the field of surgery.
A successful laparotomy will result in qualitative improvement in all aspects, regardless of psychology, technique, experience, and courage.
Usually, only a few senior resident doctors with strong surgical ability, when they challenge the attending physician, are soft and hard, and they are likely to get one or two laparotomy opportunities from the superior doctor.
Zhou Can's incision technique is now at the fourth level, which is the lower level of attending.
To upgrade, you need to earn 10,000 experience points.
He earned 101 cutting experience points at once, which is countless times faster than dissecting a white mouse.
It is still comfortable to earn surgical experience from the patient~www.mtlnovel.com~ When he cut the peritoneal layer, Dr. Xu's expression was actually very nervous.
Seeing that Zhou Can had successfully completed it, Dr. Xu also breathed a sigh of relief.
"Will looking for the appendix do it?"
"meeting!"
Zhou Can answered firmly.
At this time, Jin Mingxi finished the operation in hand.
Dr. Lu guessed whether he would be back in a while.
After all, for a lazy person, this is a legitimate opportunity to be lazy.
Rest for half an hour on the way back, no one will say anything.
"Jin Mingxi, come and help pull the hook together!"
Jin Mingxi came over and saw that Zhou Can had already performed an appendectomy, he was really envious.
He also had this kind of operation in the County People's Hospital.
However, the level of the hospital is different, and the attitude towards surgery is also completely different.
Cutting out the appendix, in the operating room of the County People's Hospital, it was like celebrating the Chinese New Year. A whole bunch of doctors are involved.
The surgeon at the deputy director level performs the surgery himself.
Look at Tuya again, the best emergency department performs this kind of operation, just like playing.
An attending doctor rushed to the side, and directly asked Dr. Guipei to perform the operation.
It's scary.
Of course, it is undeniable that Zhou Can's strength far exceeds that of Dr. Guipei. Jin Mingxi doesn't know how strong Zhou Can is now.
All I know is that Zhou Can's surgical ability is like riding a rocket.
Almost every day.
They also operated together and practiced together, so why is there such a big gap?
Jin Mingxi gave Zhou Can a thumbs up, "You are awesome!"
Then help pull the hook together.
Qiao Yu watched Zhou Can perform so well, and she also followed Zhou Can to ascend to heaven, reaping great benefits. It was like drinking honey in my heart, when I looked at Zhou Can, apart from admiration, there was a smile in my eyes.