medical simulator

"Brother Zhou Cheng went to the emergency surgery department for consultation. He said that it was multiple combined trauma, which was related to our orthopedics department. I was still talking to new patients at the time, so I sent Brother Zhou Cheng to the emergency department."

Du Ruiqi was a little nervous, for fear that Luo Yun would think him lazy, instead of going to the consultation or calling the superior doctor in his team, he would send Zhou Cheng over instead.

According to the arrangement in the department, Zhou Cheng was only responsible for the manual reset of the dislocated joint, and ignored everything else.

Luo Yun smiled and said: "You are not nervous. It is normal for you to help each other! You have worked hard, you should eat first, and I will sit in the lounge. When Zhou Cheng comes back later, you let him rest Find me in the room."

Naturally, it was impossible for Luo Yun to find trouble with Du Ruiqi or something. It was quite difficult for a junior doctor.

"Okay, Teacher Luo." Du Ruiqi nodded repeatedly, and was relieved when he saw Luo Yun go out.

……

At this moment, Li Changhong rushed towards the emergency room with a particularly headache. He just felt that today was a bad luck for eight lifetimes. The patients in the department here have not been treated well, and a patient with multiple joint injuries came to the emergency department with problems in both upper and lower extremities. , I had to call the doctor on duty in the Second Department of Orthopedics to go to the emergency consultation.

The junior doctor in my group was on duty today, Wang Yaoxiang was supposed to go, but as the first doctor of the troublesome patient in the department, if Wang Yaoxiang ran away, he would easily irritate the patient if he was not in front of the patient.

It's also impossible to ask Zeng Yi, the chief director, to come, so he can only go to the emergency consultation.

Li Changhong didn't know how long he hadn't had an emergency consultation.

But before setting off, Li Changhong finally had time to slip away and smoke a cigarette.

Then he rushed to the emergency department slowly.

When I went to the first aid ward of the emergency department, there were many old acquaintances from various departments, but they were all deputy chief physicians. After reading the situation of their own departments, they rushed to write the consultation records and at the same time greeted Li Changhong.

"Director Li!"

"Director Li."

"..."

There was a sudden surprise in his tone.

They are all employees of the No. [-] Hospital, so they naturally know who the directors of each department are, and who are the deputy directors or attending doctors who go to the emergency consultation.It is quite rare that Li Changhong, the chief physician, would come for an emergency consultation in person today.

Li Changhong nodded casually, and then walked towards Zheng Guowei. Zheng Guowei was still indifferent in front of the computer, but when he saw Li Changhong, he immediately stood up.

Come over and take the initiative to accompany him and say: "Director Li, this patient suffered multiple combined injuries in a car accident and is currently in a coma. I have already invited relevant departments of neurosurgery, thoracic surgery, gastrointestinal surgery, hepatobiliary and pancreatic surgery, and internal medicine for consultation."

"Orthopedics-related conditions include deformities in the pelvis and ankles, and open injuries in the upper limbs. After taking plain films and CT scans, there were fractures in the upper limbs."

"The lower limbs are posterior dislocation of the hip joint and dislocation of the calcaneal joint."

"Someone from the second orthopedic department said that the lower limbs can be solved by manual reset. He went to get a plaster cast. On the upper limbs, he said that the teacher from the first orthopedic department should come for consultation."

Although Li Changhong is the director of the orthopedics department, and Zheng Guowei is not an orthodox subordinate, but he is Zhenggao after all, and Li Changhong may take over as the next director of the orthopedics department. in front of the computer.

"Well! Our department's affairs should be handled by our department, and he is not to blame." Zeng Yi nodded, and understood that what Zheng Guowei meant was that people in the second orthopedic department did not want to look at the upper limbs.

But they are all from the orthopedics department, and he also explained to Zheng Guowei that this is not because the little doctor in the second orthopedics department is ignorant or trying to avoid trouble.

"Then it's hard work for Director Li to see the patient and evaluate whether he should be sent to the operating room immediately to deal with the upper limb problem. After all, there is a coma, and it is an open fracture." Zheng Guowei didn't continue to worry about other things, so he asked Li Changhong to watch the film .

When Li Changhong was watching the film, he looked up and saw it, as if it was the Zhou Cheng he had only seen in the department!

In front of many deputy directors of the emergency room, he unceremoniously opened the plaster polymer material and exposed it to the air. After measuring the length of the lower limbs, he edited and adjusted the curvature of the two ends of the plaster.

After resting, I saw him close his eyes a little more, and then dragged the comatose patient's thigh, making two clicks.

He actually directly reset the posterior dislocation of the hip joint.

Moreover, the clicking sound after the successful reset attracted the attention of many doctors in the emergency room. When they looked up, they frowned.

Even Zheng Guowei scratched his head.

Whispered: "Director Li, the second orthopedic department did not come, only this resident doctor came. He said that he needs to reset, and we are not good."

Zheng Guowei was watching, but Li Changhong stretched out his hand suddenly.

Although Li Changhong hated it very much, he even felt that Zeng Yi's manipulation of joint dislocation in the department was meddling in his own business.

However, it does not prevent him from being the chief physician of the Department of Orthopedics, and he has a certain understanding of the manual reduction of joint dislocations in the Department of Orthopedics.

He is not from joint surgery, and he may not have much contact with manual reduction, but he still knows how to evaluate whether manual reduction is done well.

At this moment, the clicking sound produced by Zhou Cheng's reset is definitely the sound made by the femur hitting the acetabulum after successful reset. It may sound a little scary, but to the ears of orthopedic surgeons, this sound is quite pleasant.

This proves that the reset was successful.

The ear hears so.

Then, the deformity visible to the naked eye, the posterior dislocation of the hip joint, also disappeared.

The patient was in a coma and could not do pain tests, but the deformity could disappear, which was almost a sure success of the reduction.

Li Changhong interrupted Zheng Guowei's words with his hand, and then he didn't want to watch the film again, but continued to pay attention to Dr. Xiaozhupei from the Second Department of Orthopedics.

I saw that after he successfully reset, he touched his hands near the hip joint.

Li Changhong knew that Zhou Cheng was feeling the hip joint to see if there was still a sense of emptiness. He was touching the position of the greater trochanter of the femur. This was one of the palpation contents of the physical examination after successful reset, which could support his own diagnosis of successful reset.

Targeted.

This resident doctor doesn't seem to be as reckless as he seems.

Immediately afterwards, Li Changhong saw that after the physical examination, Zhou Cheng came to the left calf of his left leg. After the traction of the road.

chug!

Although there was no sound this time, Li Changhong saw the muscles in his ankle bounce twice, which seems to be one of the signs that can be evaluated by the naked eye when he resets.

However, Zhou Cheng did not put plaster on the patient directly, but let go of his right hand, and did a physical examination on the ankle again.

Immediately afterwards, he exerted force with his right hand and reversed the direction of the force arm. Immediately afterwards, Zhou Cheng plantarflexed the patient's foot to the extreme.

moment--

The protruding piece on the instep disappeared without a trace.

After doing this, Zhou Cheng palpated again and felt satisfied, so he put the plaster of polymer material under the affected limb and began to wrap the plaster.

At that time, Li Changhong's pupils shrank slightly, and he stood up.

Then he looked at the time, Zhou Cheng reset the two parts, it took less than 3 minutes before and after, and now it's over?

This is no joke.

Seeing it with your own eyes is worse than hearing it.

Hearing is believing, but seeing is believing!

This Zhou Cheng, does he really know how to reset?

Cai Dongfan and Luo Yun sent him to the Department of Orthopedics before, not for any other purpose, but simply to help?

The time for plaster winding was about the same as the reset time, and then Zhou Cheng said to Liang Xueya: "Brother Liang, you must remember to re-examine the patient's pelvic plain film and the film of the left foot oblique position later, not the right side of the left ankle joint." Come on, don't make a mistake."

"I'll write it in the consultation treatment opinion later."

After putting on the cast, Zhou Cheng explained to Liang Xueya in this way.

"Okay!" Liang Xueya knew Zhou Cheng well, so he naturally believed in Zhou Cheng's professionalism, so he began to issue medical orders immediately. The exact time to implement them depends on whether the patient's other symptoms are serious. If emergency surgery is needed, you can wait for the emergency surgery Check back when finished.

But the doctor's order must be kept on hand for fear of forgetting.

Zhou Cheng waited for the general surgery and other teachers to write the consultation records.

He had only written the record of the first visit before, and he hadn't written the record of the follow-up visit. Now that he has undergone treatment, he naturally has to write it down, including the results of the physical examination after the reset and the treatment suggestions for the follow-up visit, etc.

After Zheng Guowei finished reading, he smiled and said, "Director Li, the young doctor in your department looks like a bit of a tiger."

The lower limbs belong to the scope of the second department of orthopedics, and the effect of the treatment is not something that Zheng Guowei should consider.But I still feel the need to tell Li Changhong.

Li Changhong did not answer Zheng Guowei's words, but saw the deputy directors of other departments seeing Zhou Cheng, a little tiger in the orthopedics department, waiting to write the consultation records, and immediately gave him the emergency medical records first.

His expression was full of fear.

After all, this is a comatose patient, Zhou Cheng dared to perform a reset operation on him in this emergency operating room, it is really a shame.

Moreover, the front and back operations took only two or three minutes, and it was directly declared over.

Nima's massage also takes half an hour to be effective?

Manipulative reduction of joint dislocation should be one of the surgical operations, right?

Where is Xiao Zhupei from the Second Department of Orthopedics?

This is simply the god of the second orthopedic department, they don't know how the second orthopedic department dared to release him.

See the patient for 3 minutes, reset for 3 minutes, and cast for 3 minutes, for a total of 10 minutes.

I don't even dare to do assembly line work...

Can't be provoked, can't hide.

You are a fairy, let you come first.

Li Changhong did not return to Zheng Guowei at all, but stood up and said, "Director Zheng, this patient must be sent to the operating room. After you arrange the operation here, we can go to the operating room for emergency surgery at any time."

"According to the current situation, the main cause of blood loss in the patient's coma or shock is unlikely to be an open fracture in our orthopedics department. The patient's gauze has little bleeding around the gauze, which must be due to internal organ damage."

"We only need to do debridement and external fixation during the operation according to the situation."

"Consultation records, I will write them later."

After speaking, Li Changhong walked towards Zhou Cheng who was writing the consultation records.

Zheng Guowei saw Li Changhong confessing casually, and walked towards Zhou Cheng, his heart twitched, he stretched out his hand, and said, "Hey, Director Li."

"I've already finished watching." Li Changhong didn't want to listen to Zheng Guowei's nonsense, so he had to find time to talk to Zhou Cheng quickly.

There are still a lot of difficult things waiting for him in his ward now, maybe calling Zhou Cheng over, treating a dead horse as a living horse doctor will have a solution?

When Li Changhong arrived, the other deputy chief physicians backed down one after another. Even Zhou Cheng quickly stopped writing, handed the emergency medical record to Li Changhong, and said, "Here, Director Li, you write first."

This is the status of the chief physician.

Li Changhong accepted it unceremoniously, and while writing the consultation opinion, he said casually: "Xiao Zhou, don't go back to the ward later, and follow me to the orthopedics department."

"Ah~?" Zhou Cheng was startled, looked up and looked at Li Changhong's expression, it didn't look like he was joking.

Li Changhong also looked up at Zhou Cheng, and asked, "Aren't you free? Then go get busy."

Zhou Cheng quickly waved his hands: "Yes, yes, Director Li."

Li Changhong didn't say much.

Chapter 1 goes around and around, and the magic stick comes out!

"Director Zheng, my consultation opinion is written here, and our orthopedics department is going to be on stage!"

"If there is emergency surgery in other departments, please call our orthopedics department halfway."

"If other departments feel that there is no need for emergency surgery, they can also call our orthopedics department. I will immediately arrange for someone to come down and talk to the patient and family members." Li Changhong confessed to Zheng Guowei.

Zhou Cheng was on the side, listening to the inner movement.

Li Changhong is worthy of being the chief physician, and his prevarication skills are really top-notch.

Even if you want to sneak away in a hurry, let's make it clear that our orthopedics department needs emergency surgery.

This rhetoric is still worth learning.

Of course, if I want to say this, I definitely can't be as straightforward as Li Changhong.

Zheng Guowei nodded and replied, "Okay, Director Li. I'll call you later."

Li Changhong took Zhou Cheng away from the emergency department, and explained to Zhou Cheng along the way: "Xiao Zhou, don't take what happened in the morning to your heart."

Zhou Cheng quickly replied: "Director Li, no."

Although Li Changhong was quite conflicted in his heart at the moment, he still spoke first.

"Our department received a patient with wrist dislocation in the morning, which was a bit complicated, and the patient's family members were also quite entangled."

"When Director Wang came, there was no better solution. He suggested surgery, but the patient and family members disagreed. I dare not let you see it rashly."

"Luo Yun also came to see it, and found it very difficult."

"I'm going to take you to the Department of Orthopedics now. You just watch it first and try to talk as little as possible. If you think there is anything that can help, please report it to me or Luo Yun first."

Zhou Cheng knew that Li Changhong was looking for an excuse for what happened in the morning.

He nodded and replied: "I know, Director Li, I will definitely not talk nonsense."