medical simulator

"Let me go down and check the situation. We are the doctors on duty, and the emergency department called. No matter what happens in the end, I still have to go." Zhou Cheng thought about it, and then walked towards the emergency department.

Du Yanjun may think that this trip is meaningless, after all, such patients are rare in the department!

When I went there, I would either call Luo Yunlai, or persuade the patient to go to another hospital, and then explain to the superior doctor in the emergency department what to do when he encounters such a patient in the future.

Then he said: "Brother Zhou Cheng, you go there by yourself, I will stay in the department and look at the medical records."

"Oh, good!" Zhou Cheng didn't think much about it, since Du Yanjun didn't want to go, he could go by himself.

On the way, he went to the duty room where Luo Yun was.

Luo Yun was taken aback for a moment, then stood up, and looked at Zhou Cheng suspiciously: "Xiao Zhou, you're not deliberately planning on me, are you? In fact, this patient has already come, so you just came to look for me on purpose." ?”

When Zhou Chengcai went out, he was asked to go to the emergency department to see a patient with joint dislocation, such a coincidence.

Luo Yun doubted that he was arranged by Zhou Cheng.

Zhou Cheng quickly shook his head and said, "No, it's Du Yanjun who told me the news. The emergency department just called. If you don't believe me, Mr. Luo, you can go to the nurse's station for verification."

The corners of Luo Yun's mouth twitched for a while, and he said, "That's not necessary. If there is a patient coming, let's see the patient first."

The two came all the way to the emergency department.

Then Luo Yun and the new doctor in the emergency department introduced themselves to each other. The other was a graduate student in the emergency department of the Affiliated Hospital of Shonan University. After graduation, he worked in the emergency department of Shashi No. [-] Hospital.

They belonged to the third batch of employees recruited by the No. [-] Hospital this year. They just completed the entry procedures recently. Today is the fifth day in the department.

He is tall and thin, with dark circles under his eyes and bags under his eyes.

Either stay up late on duty, or stay up late reading.

"Mr. Luo, the patient is here. Because there is no traumatic bleeding, I asked him to wait in the treatment room next to him. Sorry, Mr. Luo, I didn't know that we can call the patient directly to the ward. "Liang Xueya explained to Luo Yun very apologetically.

Liang Xueya is from the emergency department of the Affiliated Hospital of Shonan University. Over there, the emergency treatment process for emergency patients is very organized. There is no such thing as calling the patient to the ward for the on-duty doctor to see. Each department has eight hospitals that do not exist. The chief resident physician is responsible for running emergency consultations.

Although Luo Yun's heart hurts, he could only say: "It's okay, the emergency department meets an emergency patient, and the procedure of calling a specialist doctor to the emergency department for consultation is the most formal."

There is no way, the health system stipulates the consultation system for emergency patients, you can't say that Liang Xueya is wrong.

I saw this patient soon, and the results of the plain X-ray film were at hand. After careful reading, no fracture was found, and it was just a relatively common patient with anterior shoulder dislocation.Zhou Chengcheng read the film with Luo Yun.

Ask about the medical history, consistent with the history of anterior dislocation features.

Then Zhou Cheng was asked to perform a physical examination on the patient, while Luo Yun was reading the films while making a careful diagnosis to completely rule out occult fractures.

Diagnosis of joint dislocation requires medical history, physical examination, and auxiliary examinations.

After basically being diagnosed.

Luo Yun then said to the patient: "Your condition is anterior dislocation of the shoulder joint. Manipulative reduction is required, but you have to go to our orthopedic ward with us and sign a signature by the way, so that we can perform manual reduction on you and beat you. Plaster, and then..."

"Okay." Although the patient felt that it was quite troublesome to go to the orthopedic ward, at least a professional doctor took care of him now, as if he had met a savior.

He had been left here before, and he was so panicked that he almost thought about whether he was hopeless, and he didn't find the right doctor when he came to the hospital...

"Come with me." Zhou Cheng kept supporting the patient's affected limb with both hands, and then pointed the way to the patient with his head.

"Okay, thank you!" The patient expressed his gratitude to Zhou Cheng for his enthusiastic help.

Sudden.

"Ah!~"

"Click!"

The two voices sounded at the same time, and everyone in the room was stunned!

Chapter 37 What unit did I come to? !

The patient suddenly felt a sharp pain in his left shoulder, and immediately let out a painful exclamation.

It was the left shoulder, and there was a sudden sense of emptiness, as if his hand had been separated from his physical body in a short period of time.In medical specialist examination, this is called fear sign, which will be accompanied by pain.

The sudden pain made him subconsciously tilt the left side of his body, and the brief pain immediately made his forehead covered with fine sweat!The veins are all erected.

The right hand covered his arm with great grievance and resentment, and looked angrily at Zhou Cheng who was standing on his left.

Zhou Cheng is tall and strong, and he is not small in strength, he only has one hand.

Can't beat it.

Cursed in my heart: You don't talk about martial arts, didn't you agree to go this way...

At the same time, Luo Yun and Liang Xueya were both stunned.

Didn't figure out what the situation was.

Liang Xueya turned her head slowly and stiffly to Luo Yun, with question marks all over her face.

What are the people you brought here doing?

Luo Yun looked at Zhou Cheng.

Zhou Cheng immediately let go of his hands, and said to the patient: "Try to move this hand?"

"It hurts me!"

"I can't move, I couldn't move before." The patient's tone was not very good.

I'm scolding my mother in my heart, you just messed with me like this, I won't have my surname Huang if I don't report you later, and you still let me move, do you have any conscience?

If it wasn't for the fact that my hand is injured now, do you think I will have a fight with you, where is there a doctor like you?

"It's okay, you move. It was dislocated before, and it should be reset now. The pain you just had is a sign of fear during the reset process. The short-lived existence will disappear immediately, and the original pain will also be relieved immediately."

"Am I right?" Zhou Cheng said while showing him a demonstration.

"Come on, learn from me and lift your hands up slowly."

Zhou Cheng seemed to have entered the role at this moment, and he didn't even bother to care about the expressions of Luo Yun and Liang Xueya.

Because this simple anterior dislocation of the shoulder joint is too simple.

Shoulder dislocation is a very common joint dislocation in clinical practice!

Anterior shoulder dislocation is the most common type of shoulder dislocation!

Zhou Cheng, who has a perfect proficiency level of joint dislocation manual reset, has at least four or five ways to deal with it, lifting weights like light.

If I had to use one word to describe Zhou Cheng's attitude towards the anterior dislocation of the shoulder joint, it would be to be sure.

Clinically, the most commonly used and most common method for the reduction of shoulder dislocation is the pedal hand pull method.

The scientific name is the Hippocratic reset method, but it is often called the pedal and hand pull method in clinical practice.

The method of this surgical reduction is: the surgeon puts the foot against the armpit of the affected side, and while longitudinally tracting the patient, rotates the humeral head alternately internally and externally.

This technique is classic and simple, and its success rate of reduction is not bad, but there is a relatively high degree of brachial plexus traction injury, and it is quite laborious, so it is no longer commonly used.

There has long been a relatively labor-saving and simple and applicable other reduction method in clinical practice, that is, the external rotation reduction method.

The patient, who happened to be standing on the patient, was perfectly positioned.

And the timing is just right.

The difficulty in repositioning a dislocated patient is that the joint is not in place, causing the patient to be painful and alert, so the muscles contract very severely.

For routine reduction, it is necessary to resist the patient's stress muscle contraction due to pain and the patient's defensive muscle contraction. It needs to rely on strong force or brute force traction with the addition of anesthesia or muscle relaxants. Then reset.

According to clinical research, it can be found that the protective contraction force produced by the patient's self-defense is greater than the stress contraction force produced by pain.

Therefore, it is the best time to reset the patient inadvertently and completely unprepared.

And just now the patient happened to be talking to Luo Yun, and Zhou Cheng even showed him where to go in a 'fake form' to let the patient know that he had to go to the ward before treatment.

Unexpected effects can be achieved completely.

This is the perfect level of proficiency, this is the sense and degree of control over a disease.

Of course, only Zhou Cheng knew these things, not the patient. He still looked at Zhou Cheng resentfully, and then glanced at Luo Yun who looked older.

Do you care?

Otherwise, I'll file a complaint with you later.

However, when he scratched Luo Yun with his eyes, he also clearly felt the pain in his shoulder, which became more and more mild. If the pain is compared to a tangible object.

The pain during the dislocation before may have been the size of an egg, but the pain just now suddenly turned into a basketball, and now it is only the size of a grain of rice.

Zhou Cheng was right.

And my own feelings will definitely not lie to myself.

So the patient dubiously started to move his left hand!

Lift slowly.

Well, it's okay.

Outreach, too.

Lift it up, and lift it up.

Immediately, the patient's eyes lit up, and he looked at Luo Yun and Zhou Cheng, and his tone became much better immediately: "Doctor Zhou, Doctor Luo, who am I?"

"All right?"

Zhou Cheng replied after hearing the words: "You were dislocated before, and the main symptoms of dislocation are pain and limited movement."

"Now you can also see that the activity has resumed. If you have felt the pain and the great relief, then the dislocation of the joint has been reset. You can take an X-ray review after the reset later. One click and you will get the result.”

"The reason why I took advantage of your unpreparedness just now is to reduce your defenses and reduce the force of defensive muscle contraction, just like..."

Zhou Chengcheng began to explain in detail, this is actually a sequela after the simulated copy.With perfect skills, I naturally want to fully inform patients about my treatment process and treatment ideas.

Let the patients themselves participate in the whole diagnosis and treatment process, so that they can understand, this is called the accurate measurement of the size and temperature.

Otherwise, if it is only the doctor himself who has a precise grasp of the disease, but the patient himself is not clear, it means that the communication process is not done well.

Listening to Zhou Cheng's words, Luo Yun was a little silly in a daze.

Damn, I haven't explained the follow-up treatment process to the patient yet.

Did you just finish the treatment?

Then after the treatment, you still have a live version of the teaching in front of me?

Bababababababababababa makes sense.

You, a resident doctor, want to stage a teaching session for me, am I crazy or are you crazy?

Listening helplessly to Zhou Cheng's explanation, Luo Yun closed his mouth helplessly.

Then I recalled what Zhou Cheng said, how could there be an illusion.

He knows better than me what a dislocated joint looks like?

What Luo Yun could feel intuitively, Liang Xueya could also feel naturally, and his heart was a little messed up at that time.

Damn, what unit did I come from?

I thought I was a graduate student at the Affiliated Hospital of Shonan University, and I had seen it anyway, and had a lot of clinical experience.I thought that coming here, I would be able to put my fists to good use.

But a training doctor in the Eighth Hospital is so good now?

Not only can you complete the manual reset alone, but you also need to teach on the spot in front of your superiors?

Chapter 38 Baidu cures diseases? !

"Doctor Liang, please prescribe an X-ray review for the patient after surgery." Luo Yun said helplessly after seeing Zhou Chengcheng explain to the patient.

Although he was a little shocked that Zhou Cheng was able to reset the patient's dislocated joint so neatly, and the timing he chose, the explanation for the timing selection, and the theoretical preparations were all very sufficient.

But in fact, Zhou Cheng still made a mistake in the process!

But that's not too unimportant.

Liang Xueya nodded and said, "Okay, Mr. Luo. What about the manual reduction for joint dislocation?"

"Should I drive it to your department for implementation? Or should your department charge for it yourself!" Liang Xueya has already joined the emergency department, so she is already very familiar with the patient's treatment process.

The emergency department can invite relevant specialized departments to come to the emergency department for consultation, and can also provide specialized treatment, but every kind of treatment must be issued with a doctor's order, and each doctor's order must be executed by the department.

For example, in the department of orthopedics for manual reduction of joint dislocations, the executive department can be sent to the emergency department, but this is against the rules, because in principle, doctors in the emergency department have no right to perform manual reduction of joint dislocations.