medical simulator

Generally, patients will be assigned to extra beds only after the main beds are full.

Du Yanjun has five regular beds and one extra bed, a total of six beds, and the number of patients in the department is usually not so large that the extra bed needs to be filled up.Even so, Du Yanjun will still have more patients than Zhou Cheng and Zhang Zhengquan.

Zhou Cheng is much more reliable than the lazy Zhang Zhengquan, so Zhou Cheng has four regular beds and one extra bed, while Zhang Zhengquan has two extra beds.

The first thing to check is Zhou Cheng's 25-28. The three patients are postoperative patients, so it is only necessary to look at the wound, and then look at the X-ray results and inflammation indicators of the reexamination.

After the surgery is done, the workload of ward rounds is not too heavy.

Therefore, Zhou Cheng quickly reported the medical histories and examination results of the patients in the three beds.

Cai Dongfan said: "Well, they are all patients after conventional surgery, nothing special, let's focus on new patients."

Luo Yun relayed to the patient: "Your surgery is done pretty well, now you just need to wait for the care, and take care to protect the wound from water and avoid infection."

After speaking, the group went to Du Yanjun's bed 29 again.

Du Yanjun hurriedly reported: "This patient is a new patient with an upper femur fracture caused by trauma. He was just admitted to the hospital yesterday and has already had X-rays and CT."

"At present, the diagnosis is clear, waiting for the operation."

This is a set of reporting methods that Du Yanjun summed up by himself. The key content of the report is also the key point that the superiors care about.

The key content of a patient is the diagnosis. As for the medical history of surgical patients and other irrelevant examination results, that is what your doctor in charge of the bed should reflect in the medical record.Senior doctors don't need you to teach them how to write medical records.

Du Yanjun passed the patient's examination results to Cai Dongfan and Luo Yun. Cai Dongfan directly looked at CT, and Luo Yun looked at X-ray.

However, Cai Dongfan's reading speed was much faster than Luo Yun's. After watching the film, he calmed down a little, and handed the CT results to Zhou Cheng and Zhang Zhengquan.

Question: "Zhou Cheng, Zhang Zhengquan, although this patient is not under your care, you should come and see this patient and see if you can see something."

There were a lot of CT examination results, so Zhang Zhengquan and Zhou Chengcheng shared one of them.

Zhou Cheng just glanced at it briefly, then pointed the CT image at the incandescent lamp in the ward, read it carefully for about half a minute, and muttered, "I might need a consultation for this."

Hearing what Zhou Cheng said, Du Yanjun's eyelids twitched immediately.

no?Brother Zhou Cheng, this patient has such an obvious fracture, who do you want to ask for consultation?Are you going for an orthopedic consultation?

Ask the orthopedic department for consultation. Either the orthopedic teacher scolded me to death, or my teacher scolded me to death. Even if you think I am your competitor, you can't hurt me so much, right?

And because of Zhou Cheng's words, Zhang Zhengquan felt panicked.

As a resident physician in orthopedics, I can still see the fracture, the fracture line is obvious, and the surrounding soft tissue has edema. The diagnosis is obviously relatively clear.

What else do you need for a consultation?

But Zhou Cheng would definitely not say that for no reason, so he continued to search carefully, otherwise, if he is too good at it, no shortcuts will work...

Luo Yun had already finished reading the X-rays at this time, and after hearing Zhou Cheng's words, he was a little confused. He really wanted to correct Zhou Cheng's words, but he was afraid.Because the inspection window of X-ray is not as detailed as that of CT.If there is content on the CT that is not shown on the X-ray, then I can't talk nonsense.

Cai Dongfan glanced at Zhou Cheng quite unexpectedly. He really didn't expect that Zhou Cheng could still see this, which is still a bit level.

Then he said to Luo Yun: "Luo Yun, you also look at CT."

Luo Yun panicked, good guy, sure enough, Zhou Cheng told me he was right, he didn't see it on the X-ray, why did he ask for a consultation?

I am the attending doctor, when did Zhou Cheng have such a level?

After about 2 minutes.

Cai Dongfan looked at Du Yanjun, and Du Yanjun picked up the CT and X-ray results again tremblingly. Obviously, he had read the examination results dozens of times, but he still didn't see the key part. And Zhou Cheng, who had only read the film for a while, said the key points.

But what is that?

Which department should I ask for consultation?

Neurology?

Can neurological consultation be seen on CT?

Brother Zhou Cheng?Master?Don't think that you bullied me because I was young and didn't understand, so you lied to me.

spine?

Du Yanjun gradually became sad.

1 minutes later.

Cai Dongfan didn't find the answer in the faces of Luo Yun and Du Yanjun, so he didn't make things difficult for them.

Then he said to Zhou Cheng: "Zhou Cheng, tell me your thinking."

Zhou Cheng nodded and talked eloquently, "Teacher Cai!"

"When we look at fractures, we generally look at them from the following five aspects."

"Looking at the definition, the definition of a fracture is the continuity and integrity of the middle part of the bone. Looking at the examination results, the patient's X-ray can indeed find signs of fracture."

"Secondly, look at the location. It's also simple. The shape and position of different bones are different. This is a fracture of the middle part of the femur."

"The third is to look at the nature, that is, to see whether it is a traumatic fracture or a pathological fracture. Looking at the film, we can see that there is no normal structural shadow of the trabecular bone at both ends of the fracture."

"Bones are composed of trabecular bone structure. The trabecular bone structure of normal bones, you see, on the X-ray, it is a very smooth and continuous line shape, which is especially obvious in long bones."

"However, similar structures were not found on both sides of the fracture. Therefore, this patient cannot be simply classified as a traumatic fracture, but should be classified as a pathological fracture."

"Once the characterization is confirmed, the subsequent characterization and treatment plan can be postponed!"

After Zhou Cheng finished speaking, he found that Cai Dongfan and the others were all looking at Zhou Cheng in astonishment, all with bewildered expressions, is this what you, Zhou Cheng, should say?

Zhou Cheng immediately realized: It's over, too much force.

Chapter 23 Invisible pretense, the deadliest!

When Cai Dongfan and Luo Yun were listening to Zhou Cheng's analysis, the structure listed was too detailed, right?

Such a strong sense of hierarchy?In-depth and simple?

Teaching like this, let alone a medical student, even a layman should be able to understand it...

Then Luo Yun turned his head and looked at Cai Dongfan, his eyes seemed to say: Teacher Cai, if you were a teacher like this usually, I would have learned it a long time ago.

Cai Dongfan's face twitched, and after listening to Zhou Cheng's analysis, he thought to himself that he was definitely not as organized and clear-minded as Zhou Cheng in teaching.

Then he glared at Luo Yun, meaning, don't be naughty.

It was only then that Zhou Cheng came to his senses. Damn it was Cai Dongfan who was leading them to teach the ward rounds today, not him leading Cai Dongfan and others to teach the ward rounds. He was still a junior doctor, not the one leading the group in the mock copy...

So Zhou Chengcheng smiled awkwardly, and pretended not to say, "Mr. Cai, I don't know what's going to happen next. You should tell me."

At that time, the saliva in Cai Dongfan's mouth began to pour into the trachea, and he almost choked to death.

Me?

Are you broken here?

Pretend not to.

Isn't it a bit unkind.

If I'm not as clear as you said next, then the fuck is it embarrassing for you or me?

However, since Zhou Cheng transferred the right to speak to himself, Cai Dongfan still had to pick it up, and said, "Zhou Cheng's speech is very good, his thinking is clear, you all should learn more from him."

"Especially you, Luo Yun, you are now the leading teacher. You have to learn more about his lecture ideas with Zhou Cheng, which is very important for your professional title promotion."

Luo Yun suddenly felt that he had suffered an indiscriminate disaster!

Aggrieved little eyes rolled in the eye sockets: Teacher Cai, this doesn't seem to have anything to do with me, does it?

But the face of the superior has to be given, good good good...

You have to bear the blame.

Cai Dongfan's professional title has already been fully promoted. It is estimated that it will not be easy to be promoted to a teaching title like a professor.

No, I can only turn around and beat myself.

Following Zhou Cheng's explanation, Du Yanjun and Zhang Zhengquan immediately saw the difference in the fracture ends.

Oh, I see.

The structure of trabecular bone still has such a function.

I really hope that Zhou Cheng will continue to talk.

Cai Dongfan continued: "So Du Yanjun, you have to ask for a consultation from the CA department."

The patient was a young man in his teens. He smiled with him on the bed and asked, "Doctor, my condition is not very serious. I don't feel particularly painful."

This is true.

For pathological fractures, bone destruction has occurred before. Although minor traumas lead to fractures, the swelling will not be as severe as high-energy traumas, and soft tissue traumas are not serious. Except for a small amount of nerves in the periosteum of simple bones , Bones have no nerve tissue.

If pathological bone changes invade the periosteum, leading to interruption of nerve tissue, pain will be relieved a lot.

Cai Dongfan said, "This needs to be further diagnosed. First diagnose what it is, and then treat it accordingly."

In fact, Cai Dongfan already had the answer in his mind. This young man was more likely to be transferred to Xiangya Hospital or the Second Xiangya Hospital. The Provincial Cancer Hospital is a hospital that treats bone tumors well. The Eighth Hospital does not have a special department for this.

Although there is also an oncology department, the oncology department cannot perform surgery, and most of them still do postoperative chemotherapy.

……

Because Zhou Cheng accidentally enjoyed a ward round with an instructor, Cai Dongfan hurriedly ended the subsequent ward round.

There was no way, because he was not sure that he could speak better than Zhou Cheng, so it was better not to force him too much, lest Luo Yun and his students make a sharp comparison between himself and Zhou Cheng, and regard himself as a frame of reference.

However, after checking the house, Cai Dongfan also became puzzled.

How could Zhou Cheng, who looked honest, very ordinary and ordinary before, hide so deeply.Usually do not show mountains and dews, no profit can not get up early.

Now that I know that there is a place for staying in the hospital, I immediately jumped out.

A big shark really exploded out of this hospital.It seemed that his previous decision was not wrong, Zhou Guo was not as simple as it seemed on the surface.

After the ward round was over, Luo Yun struggled for a long time, then walked into Cai Dongfan's office, smoked a few cigarettes with a smile on his face, and at the same time, the two exchanged with Zhou Cheng the changes they saw in Zhou Cheng.

Then it was unanimously decided to release Zhou Cheng, the big shark, and give Director Yan Haihan and the chief orthopedic department a big surprise.

In fact, they knew that after the news about the number of hospital stays was released, these people's minds were very active, and they were going to exchange this thing for some favors.

Cai Dongfan and Luo Yunke really wanted to see their plans come to nothing. Anyway, the benefits of exchanging favors would not be their turn now.

Anyway, it's bad, it just wants to destroy...

After the ward round, Zhang Zhengquan walked to a computer very depressed, and then silently made his own plan.

I thought to myself, no, absolutely not.

Compared with Du Yanjun, I can't compare with Du Yanjun in academics and education, but my strength may be stronger than Du Yanjun, but it's useless, Du Yanjun still has something to do.

Now even Zhou Cheng, I can't compare with him, I can only take a shortcut, I must take down that little girl.

She's also really good-looking, and I really like her, so it's not considered taking advantage of her.

So the beauty who sent him ten messages but didn't reply sent another message: Beauty, where do you go for lunch?

The girl was afraid of being stalked, so Zhang Zhengquan decided to stalk her to death.

……

Du Yanjun immediately took the back of a computer stupidly and actively, and then gave it to Zhou Cheng, saying very enthusiastically: "Brother Zhou Cheng, here, here."

"Come on, you should prescribe a doctor's order first."

He even pulled out the chairs for Zhou Cheng.

Zhou Cheng touched the back of his head and said, "Yan Jun, if you have something to say, just say it."

"Brother Zhou Cheng, look at what you said." The smile on Du Yanjun's face was brighter than the chrysanthemums of this season.

"I've only been on duty by myself for a short time, has our relationship faded? Of course not, you are still my brother Zhou Cheng, I'm with you."

Du Yanjun knew very well that he couldn't beat Lin Lin's academic graduate students academically, so he had to stand at a higher position than their clinical ones, so as to have an advantage.

In terms of academic qualifications, everyone is evenly matched, which is better than regular trainees like Zhou Cheng.

If you are inferior academically, then I am better than you professionally and clinically. This is also the case. At least everyone still has the strength to fight. If you only compete with them academically, it means giving up your own advantages.

Professional postgraduate students should pay attention to professionalism.

To recruit people in the department, no matter what, the ability to do things must be considered.

Unless there is a group of people who are particularly academically strong, but this group of people will not come to the Eighth Hospital.