medical simulator

The source department of this surgical authority can only be orthopedics.

This is also part of the orthopedic benefits.

"I'll trouble you to open one too." Luo Yun thought for a while before saying.

Treatment requires a doctor's order, and the patient has to pay. This is a matter of course. What he thought before was that Zhou Cheng had made a mistake in this process.

But when the patient heard this, his eyes rolled and he immediately said, "Reexamination? I don't think I need to reexamine."

"Dr. Luo, Dr. Liang, and this Dr. Zhou, thank you."

"You guys are really good doctors, I feel great now."

After speaking, he stretched his left shoulder again and shrugged, feeling that the pain had almost disappeared.

Then happily walked outside the emergency department.

He didn't mention anything about the reexamination, the joint dislocation manipulation and the doctor's order fee, and he didn't even take the medical records, so he left happily.

Seeing this scene, Zhou Cheng was stunned.

Is this gone?

No forearm sling yet, bro!

Zhou Cheng wanted to catch up, but Luo Yun pulled Zhou Cheng and shook his head at him.

Liang Xueya asked, "Mr. Luo, what should we do in this situation? Do we want to call him back?"

Luo Yun shook his head and said with emotion: "What else can I do? People are gone, can you still restrict other people's personal freedom?"

Then he said: "Patients have the freedom to choose whether to undergo further treatment and which hospital to go to for treatment."

Liang Xueya nodded, and knew that Luo Yun was actually quite embarrassed now, because the Orthopedics Department had already treated the patient, but it hadn't had time to issue a doctor's order, so the Orthopedics Department couldn't charge the fee, and even if the doctor's order was given to the patient in advance, The patient left without paying.

You can't say anything. The patient can say that you didn't treat him and he didn't pay the fee. Why would you treat him?

Of course, Liang Xueya saw the truth and bid farewell to Luo Yun.

Luo Yun only secretly took Zhou Cheng away, and also took away the medical records left by the patient. It wasn't that Liang Xueya forgot to take it away, but Liang Xueya left it for him on purpose...

On the way back, Zhou Cheng realized that he had made a small mistake.

Although the gratitude he could get had already been obtained, Luo Yun's trip was a waste of time.

"Mr. Luo, me." Zhou Cheng was about to explain as he walked.

On the other hand, Luo Yun said casually: "It's nothing, if you suffer, you will gain wisdom."

"Your clinical experience is still too little."

"Clinical experience is not the same as clinical experience."

"Your current clinical experience is limited to bed management and surgery experience in the ward, and experience in dealing with patients is still lacking, but this is not your fault, it is because you do not have similar experience."

"Do you think that the medical procedures deliberately emphasized in the hospital are a joke?"

Zhou Cheng really didn't think about these things. The dungeon allowed Zhou Cheng to acquire such skills. This knowledge and knowledge only reached a perfect level in terms of this skill and theoretical understanding, but the specifics of the dungeon simulation The process, and the corresponding memory, are nonexistent.

To be a doctor, in addition to your own strength, communication and communication with patients and their families is also very necessary.

Of course, Zhou Cheng's understanding in this area was not bad, and he quickly understood what Luo Yun meant.

When a patient comes to the hospital, he must first register, which constitutes a medical relationship with the department he wants to go to and the doctor who wants to see him.If there is no such medical relationship, you cannot diagnose and treat patients.

Except for emergencies and emergency escapes in special situations.

Then it is to write the emergency medical records and prescribe the doctor's orders, which is the next step of the diagnosis and treatment plan for the patient.

Patients have the right to informed consent.

Informed means that you reflect the doctor's order you want to prescribe in the outpatient medical record, and tell the patient what kind of examination or treatment you are going to do to them next, and then the patient pays.

Before the patient completes the payment, he can assume that he does not agree with the suggestion you gave him based on your interpretation of his condition.

Paying the fee means that he agrees with your proposal.

Only when the patient is informed and consented can you treat or examine the patient, otherwise, this is an unclear account...

Zhou Cheng had rarely experienced this kind of outpatient and emergency treatment before, and Luo Yun was running most of the time, so Zhou Cheng didn't quite understand.Now that Luo Yun pointed it out for him, he truly understood the deep meaning of these seemingly trivial steps that seemed incomprehensible to outsiders.

"Okay, Teacher Luo, I've made a note." Zhou Cheng nodded and said seriously.

Luo Yun also nodded, then turned his head and asked: "The manual reset you did just now is the external rotation reset method?"

"En!" Zhou Cheng nodded.

Luo Yun said with a half-smile, "Zhou Cheng, the manual reduction for anterior shoulder dislocation is written in the textbook as the Hippocratic reduction method. External rotation manual reduction is only practiced by doctors specializing in joint surgery."

"In the recent years in the department, I will take over some similar patients. How did you know this method?"

Zhou Cheng's expression was a little wary, but he replied immediately: "I often collect the methods and teaching videos of these manual reduction methods. This external rotation reduction method is also one of the eight common shoulder joint reduction methods."

"It's all over the Internet."

In order to convince Luo Yun, Zhou Cheng returned it to Luo Yun on Baidu, and immediately found out the corresponding method to reset the introduction video.

Luo Yun: "..."

Are you a fucking Baidu learning operation?

Now some knowledgeable patients don't dare to use Baidu to see a doctor. Are you demonstrating Baidu's treatment here?

fine.

It's not that I can't, I know more things than you.

But at any rate, you can still get a little bit in touch with joint surgery now, and you can be regarded as a small half of our joint surgery disciples. I will take care of you in the future and let you see the real charm of joint surgery.

Chapter 39 Don't, don't!

Luo Yun didn't bother to get to the bottom of it. Zhou Cheng had done a reset on such a difficult tibial plateau fracture that surprised even Director Cai.

Cai Dongfan didn't say much, why should Luo Yun worry about those things?

What's more, Luo Yun didn't pay attention to Zhou Cheng at all, and the group didn't think about Zhou Cheng when he had the opportunity, and Zhou Cheng didn't need to report to them in detail what he knew and how he knew these things.

"Just tell me, this common joint reset, which ones are you sure you can take off?" Luo Yun just watched Zhou Cheng's manual reset.

The timing was very good, and his understanding of joint dislocation and repositioning was quite thorough, so he simply picked up Zhou Cheng's mistakes from behind his ass.There is no need to do it, every patient does everything by himself.

Anyway, for these patients, on weekdays, the bed doctors in other groups don’t do it. In the department, he just wants to not forget his old job, so he didn’t lose this skill. People will take care of Zhou Cheng.

This problem is really a bit embarrassing until Zhou Cheng.

There are many types of joint dislocations. According to the size, there are large joint dislocations, such as shoulder joints, hip joints, knee joints, and elbow joints.

There are also small joint dislocations, such as interphalangeal joints, radioulnar joints...

If we really want to separate out the categories in detail, there are at least dozens, or even hundreds, of fragments.

As for the dislocation of these joints, Zhou Cheng is almost familiar with it. The only thing he dared not do is the dislocation of the joints of the spine. That thing really cannot be done by manual reset.

So Zhou Cheng asked: "Mr. Luo, what aspect are you referring to?"

"It's common, it should be fine."

Luo Yun and Zhou Cheng had already walked into the elevator at this time. Luo Yun was in front, ready to press the floor where the second orthopedic ward was located, but at this moment, half of the outstretched hand gradually froze.

Looking back, looking at Zhou Cheng with a sincere face, I felt amused in my heart.

Common, should be no problem?

I dare not say this sentence, you know?

Newborn calves are not afraid of tigers?

"What about the dislocation of the heel joint?" Luo Yun asked casually while pressing the elevator.

With the dice joint, the name is quite a mouthful.

Is the joint made up of the calcaneus and cuboid, both of which belong to the tarsal bones of the foot.

And this joint is not even involved in joint surgery. Only a professional foot and ankle surgeon can handle this dislocation.

Foot and ankle surgery is an extremely professional subject. Moti is in the No. [-] Hospital of Shashi. Even the three top hospitals in Hunan Province, the Department of Orthopedics of the First, Second and Third Affiliated Hospitals of Hunan University, have not yet divided this area in detail. Three professional departments come.

As for the dislocation of the calcaneus joint, currently only a few professors use surgery for reduction.If you really want to perform manual reset, you probably have to go to a department with extremely professional foot and ankle surgery like Shanghai or Kyoto.

Orthopedic graduate students can understand the anatomy of several tarsal bones, cuneiform bones, and phalanges of the foot. At most, they know the term calcaneus-cuboid joint. As for how to reset it?

To be honest, Luo Yun himself is not very clear about it.

The reason why he asked this question was to let Zhou Cheng know the dangers of the human heart, and that the sky is high and the earth is thick.

Zhou Cheng raised his head slightly and thought for a while.

Well, although the manipulation of the calcanoid joint is quite troublesome, in fact, as long as the appendages of the calcanoid joint, that is, the muscles and several ligaments between the calcaneus and the cuboid, are clearly out of shape, the manipulation of the reset is not difficult. .

Seeing Zhou Cheng's expression of careful consideration and consideration, Luo Yun shook his head slightly, then picked up his mobile phone and played casually.

He just wanted to let Zhou Cheng know how to advance and retreat, and he didn't want to get an answer from Zhou Cheng.

Zhou Cheng thought for half a minute, and after considering the types of heel joints one by one, he replied very conservatively: "As long as it is within the range of indications for manipulative reset, it should be acceptable."

Luo Yun's brain went down at that time, and the first consequence of the brain's downtime was that the flexor muscle of his right hand temporarily lost its contraction, so the mobile phone in his hand slipped out with the force of gravity.

Then Luo Yun was so scared that he showed the hand speed of his mother who had been single for 30 years, making the phone roll in the palm of his hand.

In the end, it was like holding a loach in both hands before holding the phone.

Turning his head, narrowing his eyes and wrinkling his forehead: "What did you say?"

The voice is a bit loud, and the tone is a bit weird.

Zhou Cheng understood Luo Yun's meaning, pursed his lips and said, "It's nothing, Teacher Luo, I mean! If I encounter such a patient, I will call you right away."

Very sensible.

Since Luo Yun didn't think he could reset the heel joints, then he could do as he wished.Anyway, there are not many such patients, and it is rare to encounter them. Even if we do not perform manipulation repositioning for such patients, nothing will be lost.

Even if he took the risk to do it, Zhou Cheng was sure of it, but he couldn't earn much gratitude, and Luo Yun still gave Luo Yun the label of not listening to persuasion.

Not worth the candle.

When Luo Yun saw Zhou Cheng's answer, he immediately waved his hands and said seriously: "No, such a patient, please don't call me, call Director Cai directly!"

Luo Yun can't handle the dislocation of the heel joint by himself!

If Zhou Cheng really called him to come, Zhou Cheng looked at the patient, the patient looked at himself, and he looked at Zhou Cheng and the patient.

What an embarrassing atmosphere.

If it really needs to be dealt with, Director Cai can only do the surgery.

Luo Yun didn't want to take the blame. Although this kind of dislocation is rare, who knows if it will happen.

If they meet, Zhou Cheng will call himself away, but he won't, then it will be so embarrassing.

"Okay. Teacher Luo." Zhou Cheng nodded again.

"Forget it!" Luo Yun didn't dare to talk to Zhou Cheng anymore. He felt that when he talked to Zhou Cheng, he didn't have the slightest advantage that a superior should have. He was completely led by Zhou Cheng unilaterally.

Luo Yun is not a cow, even if he is a cow, he doesn't like the feeling of being led by the nose.

So after returning to the department, he casually confessed to Zhou Cheng, and then quickly ran away...

In the doctor's office, Du Yanjun said to Zhou Cheng who was coming in with a very happy smile: "Brother Zhou Cheng, are you back?"

"A patient came here just now. It was a simple debridement with an incision of about four centimeters. I was about to call you to ask you to come and do debridement and suture for him."

Seeing that Du Yanjun took out his phone belatedly, Zhou Cheng obviously couldn't help himself, so he said, "It's okay, Yan Jun. You just need to do debridement and suture alone."

"Two people go, there is no need for such a big battle."

Zhou Cheng sighed in his heart, since Luo Yun wanted to do debridement and sutures, let him do it, there was no need to bring an assistant like Du Yanjun to do it by himself. It seems to be the most special existence.

Anyway, one more debridement and suture, to him, Zhou Cheng, is nothing more than one less thing to do.

With this time, it is better to plan the following dungeon simulation, how to start is better.

Different opening options directly affect the results and rewards...

Chapter 40 The Violent Practice of Medicine