medical simulator

"Not in a hurry."

"Come on, move your toes and curl them up."

Although Zhou Cheng has passed the film reading and clearly distinguished the patient's fracture type, he can manually reset such a fracture type, but he must first rule out nerve and blood vessel damage.

The best way to rule out nerve damage is to check the patient's movements.

Although most of the activities are limited due to the fracture, the normal plantarflexion and dorsiflexion functions on the injured side still exist. As long as you see such a range, you can know that the nerve function is healthy, otherwise if the nerve is broken, It is impossible to move.

Manipulative reduction is not a simple reset, and the absolute contraindications of manual reduction must be ruled out first.

The patient tried to move a little, but then gave up and said, "It hurts, I can't move."

He thought that what Zhou Cheng wanted to see was his usual activities.

"It's okay, it's okay." Zhou Cheng said, handing the film bag to the patient's worker, and then said: "You push him into the operating room first, in your situation."

"It is certain that the bone is fractured, but the current fracture situation is not particularly complicated. We can try manual reduction."

"If the manipulation is restored, there is no need for hospitalization and surgery, but if it is not restored, then hospitalization and surgery are necessary."

"If you don't want to try or can't accept the result that the manipulation can't be done, then go to hospital and wait for surgery."

Zhou Cheng is also quite good at blocking the patient's words, so before the patient even selectively asks whether he should not have the operation, he blocks the back road.

"No, no, I'll do manual reset." The patient said quickly.

This does not belong to the category of work-related injuries, so he has to pay for the surgery himself, and even if he cannot work later, no one will subsidize him.

He repaired the house for his elder brother's house, and his elder brother is not a professional, so he reminded them to pay attention to safety.They do this themselves, and they don't take protective measures themselves. Under such circumstances, they can ask their elder brothers for compensation, so the money doesn't come from the wind.

Zhou Cheng smiled: "Whether the manual reset can be reset is not certain. I will prepare the materials and tools for manual reset first, and you may have to wait for me for a while."

When hearing these words, Tan Min at the nurse station frowned slightly.

When the patient entered the operation room and Zhou Cheng went to the equipment room to prepare plaster, local anesthetics and other supplies, Qin Min sneaked into the equipment room and asked:

"Zhou Cheng, are you really going to reset his hand?"

"Is this too risky?" She was a little worried about Zhou Cheng's recklessness.

Zhou Cheng explained, "No, Miss Tan Min."

"Fracture manipulative reduction and plaster external fixation is a first-level operation. Yesterday, Director Cai authorized me a first-level operation. Moreover, anyone who performs manual reduction may fail, so just make it clear." Zhou Cheng is also impossible. Bao Dalan just smiled.

After hearing this, Qin Min was surprised and said, "Oh? Have you also been authorized for surgery?"

"Other rules and training?"

"Miss Qin Min, keep your voice down." Zhou Cheng interrupted quickly. There are still many people working in the department and they haven't gone back. Zhou Cheng doesn't think that he needs to be exposed about getting authorization for surgery, and then there is a commotion.

……

Chapter 30 Fracture line?

"Oh, good." Tan Min just realized it, and obediently closed her mouth.

Then he asked with bright eyes: "Then do you still want to compete for that place in the hospital?"

"Let's see." Zhou Cheng didn't give a definite answer, that is, an affirmative answer.

The last reply to Tan Min was that Zhou Cheng felt that he had no advantage in competition, but that was before.

"Don't give up. Come on." Tan Min was overjoyed immediately, and then encouraged Zhou Cheng.

Zhou Cheng smiled and said, "Thank you, Miss Tan Min. I'll treat you to dinner next time."

Tan Min didn't reply, and didn't know whether she took it to heart or not.However, Tan Min has at least fulfilled his duty as a friend, that is, he has been persuading Zhou Cheng not to give up.

……

Manipulation reduction surgery is not something that can be done recklessly. Although it is a first-level surgery, it still has to follow the procedure.

Explain to the patient the risks and benefits of the current diagnosis and manual reduction treatment, and at the same time explain the risks and benefits of the operation.

The general difference is that manual reset has the risk of failed reset, which will be very painful, and even if the reset is not done, Zhou Cheng does not need to charge the fee for manual reset, but the fee for anesthesia is also charged.

Then it also explained that if surgery is performed, the recovery speed may be slightly faster than manual reset, and there are advantages such as being able to get out of bed earlier.

To sum it up, just one.

Manipulative reduction saves money, but there is a risk of failure, and fractures may relocate after reduction.

Surgical reduction is expensive, but the risk of failure is almost negligible, and early mobilization is possible.

Allow patients to choose their own treatment.

Both treatments are certainly feasible.

"I'll listen to you, Doctor Zhou. I will treat you as you tell me." The patient may have understood, but he is still unwilling to take the risk, so he hopes that Zhou Cheng can choose one for him.

Zhou Cheng had heard this kind of words countless times.

I also know that before patients and doctors, there are actually cognitive errors.However, doctors really have no right to advise on options.

Zhou Cheng said, "This is not a question of how I tell you to treat it, but a question of how you want to treat it yourself."

"Going to the hospital to see a doctor is not going to eat in a restaurant. You can eat whatever you want and don't want to eat. If you choose something that doesn't taste good, you can choose another one."

"It's up to you to choose. If you haven't understood the risks of manual reduction and surgical reduction, I can tell you again. Or you can call your family members."

"If you want to be safe, go for surgery. Go for hospitalization first."

Zhou Cheng pretended to accept the informed consent form.

It is impossible for him to give a tempting choice.

Even if Zhou Cheng really wanted to reset the technique for this patient, it is impossible to say that the technique is better and highlight its economic advantages.

Otherwise, if something goes wrong, the patient's first sentence must be, am I short of that little money?

"Then? Don't."

"Doctor Zhou, I'd better reset the method. Try it first." The patient hurriedly said when he heard that Zhou Cheng was going to hospitalize him.

As I just asked, the operation will cost at least 1 to [-], and it may not be reimbursed. (For this kind of work-related injury, there is usually a third party, just like there is a third party in a car accident. Conventional medical insurance does not provide reimbursement, and the regulations are not stipulated by the author.)

"Okay, then you sign here..."

……

At about [-]:[-], Luo Yun had already completed the key operations of the operation, and then left all the finishing work to Du Yanjun.

Du Yanjun will gradually start the first-level surgery as the lead surgeon, and the finishing work is also part of the surgery, so of course practice should be given priority.

Luo Yun didn't go back directly, although he lived not far from the hospital.

Zhou Cheng in his group is on duty today, so he belongs to the second-tier class.If there is an urgent emergency, he needs to arrive at the emergency consultation site within 15 minutes, and he may not be able to make it at home, so during normal working hours, Luo Yun will not go back.

Moreover, Zhou Cheng was the only one who issued a doctor's order this morning, so he had to check it out.

Although Zhou Cheng was trained in the old fashion, it was quite reliable.

But medical work, the more meticulous the better.

It was just that Luo Yun had just arrived at the department when someone from the nurse's station stopped him and secretly said, "Luo Yun, that Zhou Cheng in your group is doing a fracture reset for a patient. You have to be careful."

The nurse who spoke was Zeng Linhui, and she actually wanted to warn Luo Yun.

Zhou Cheng, as a junior doctor, should take responsibility for anything that happened during his shift, and Luo Yun, as the superior of the second-tier class.

"Ah?" Luo Yun was slightly taken aback by Zeng Linhui's words.

"Really, it's in the operating room. We are nurses, so it's not easy to talk about your doctors."

"And it seems that they have already finished. The patients and their family members just brought up the re-examination films, and they are probably still looking at them in the operating room. You'd better take a look." Zeng Linhui frowned slightly.

Manual reset, this is a rather taboo topic in the department.

Because just a few years ago, Director Hu once performed a manual reset on his relatives, and relatives who were not close to each other. As a result, he was sued by the relatives, and the department paid for the follow-up surgery expenses and nutrition expenses.

Moreover, Director Hu almost had his title revoked from senior high to deputy high because of these incidents.

But this matter happened before Zhou Cheng came to the department, so Zhou Cheng may not have heard of it.

Sometimes, if you are willing to do good deeds, you may not be able to get good rewards.

Luo Yun quickly trotted into the operating room, but when he reached the door, he pushed the door slowly and walked in, pretending that he was not in a hurry at all.

When Luo Yun pushed the door, the patients and family members inside were a little startled.

And after seeing Luo Yun, he voluntarily stepped aside.

"Zhou Cheng, I heard from the nurse in the nurse's station that you were in the operating room, so I wanted to come over and take a look." Luo Yun said without blushing and panting.

There was no sign of worry or fear of Zhou Cheng's rebellion.

When Zhou Cheng saw Luo Yun, he sighed slightly in his heart. The patient struggled for a long time, so Luo Yun stepped down from the stage.

However, sooner or later, I will not be able to hide the fact that I have to do manipulation reset in the department.

Then he said: "Mr. Luo, it's just right, come and have a look. This is the X-ray of this patient after the manipulation was reset. I think it's okay. Please give me the details."

Luo Yun looked at the plaster cast on the patient's leg, feeling very bitter.

I'm a crutch, Zhou Cheng really reset the technique.

How can this be good?

But since it has already been done, this is the only way to do it, let's cover up Zhou Cheng's matter first.

Luo Yun took a look at the reset X-ray, then shook the film in his hand, and rubbed his eyes again.

What the fuck?

Have you ever broken a bone?

What about the fracture line?

"It's okay, Mr. Luo." Zhou Cheng inserted a knife into Luo Yun very 'timely'.

Luo Yun felt bitter in his heart at that time, and glanced at Zhou Cheng, wanting to see if Zhou Cheng did it on purpose.

I cursed in my heart.

urge urge!

Urge what?I'm your superior, you know?

I haven't found the location of the fracture yet.

Then I continued to look carefully, and finally found a blur in the middle and lower part of the tibia, but I couldn't confirm whether it was the fracture location.

Luo Yun didn't dare to say that he didn't find the fracture, so he pursed his throat and said seriously: "Show me the film before reset."

Chapter 31 You are too Menglang!

Xia?

Luo Yun's words frightened Zhou Cheng into a guilty conscience.

Originally, Luo Yun's arrival was beyond Zhou Cheng's expectations. If it wasn't for the patient's entanglement, he would have finished the reset and the patient would have gone out.

At that time, I just need to show Luo Yun the film after the reset, and prove that my reset is no problem.

Luo Yun wants to watch the movie before reset?

Wouldn't it be that you will find that you have gone beyond the relative contraindication of manipulation reset to do manipulation reset?

Zhou Cheng was still thinking about how to explain it.

The patient was enthusiastic and active at this moment. When Zhou Cheng called Teacher Luo Yunluo, he knew that Luo Yun was Zhou Cheng's superior. He was older and looked more mature.

Then he quickly dug out his video data bag, handed the film inside to Luo Yun, and said, "Doctor, here, this is the film from before."

"You're holding the one you just took."

After speaking, he continued to look at Luo Yun eagerly, hoping to get definite news from Luo Yun again.He actually didn't want to have surgery, but he was afraid of his own condition, so if he didn't do surgery, the treatment would be unsuccessful.

The manipulative reduction was done, even with local anesthesia, but the fracture still existed, the pain still existed, and with the plaster cast, he couldn't use the pain to measure whether his treatment was effective.

Zhou Cheng's right hand, which was placed in front of his abdomen, stretched forward a little bit, but it retracted within five centimeters.

Although he didn't want Luo Yun to see the pre-reset film, because it might cause disputes and differences, but Zhou Cheng didn't know how to stop it, and the patient had already given it out.