Chapter 248: It’s easier to get things done with acquaintances. This matter is really hard to explain
Normally, the safe dosage for adults is about 40-100 ml of 50% glucose solution injected intravenously.
Zhou Can had already given him the maximum dose.
If the patient eats normally, there is no need for intravenous injection. He or she can directly take sugar water, candy, biscuits, etc. orally.
After treatment, the patient slowly woke up and his body returned to normal.
But he still looks very weak.
If we don't cure his vomiting disease, he will get into trouble sooner or later.
Patients are unable to eat, which will result in the calorie intake being lower than the energy consumed by exercise and metabolism, and the stored energy substances will be continuously converted into glucose through gluconeogenesis for energy supply.
However, the patient's body has limited energy reserves, and without energy supplementation entering the body for a long time, the reserved energy is consumed and converted into glucose. Finally, when there is not too much glucose consumed, hypoglycemia will occur in the body.
This type of hypoglycemia caused by hunger is extremely common.
Some people are reluctant to spend money on food because they are short of money, have not found a job yet, or are under great financial pressure.
Eventually he fainted from hunger on the street.
If you encounter this situation, if there is sugar, give the patient a pill to hold in his mouth, and he will slowly recover.
Then let the patient eat in time to replenish energy.
"Give him a nutritional infusion first!"
Zhou Can wrote another medical order.
I don't know how Director Shang is coordinating things?
The patient's lesions have been identified, and the craniotomy surgery to remove the worms is not complicated, so the patient can be cured in time.
He decided to take the initiative to go to Director Shang's office to ask about it.
This is also a responsibility to the patients.
When I arrived outside Director Shang's office, I heard a muffled "bang" sound coming from inside. It sounded like someone was slapping the table or smashing something.
It seems that Director Shang has been upset again.
Boom boom boom!
Zhou Can hesitated outside the door for a few seconds and finally decided to knock.
"Come in!"
Director Shang’s calm voice sounded.
When I pushed the door open, I saw a thick book dropped on the ground.
Zhou Can naturally bent down to pick it up, put it on the table and said, "Director Shang, the patient with brain parasites just now fainted due to hypoglycemia."
"How is he now? He is vomiting violently and cannot eat normally. You should quickly give him an intravenous glucose solution. Use 60 ml first. Use a 50% dilution of glucose solution."
Although Director Shang was still breathing heavily due to anger, he immediately became nervous when he heard that something was wrong with the patient.
And quickly and calmly gave a treatment plan.
"The patient has already been given medicine, and has basically recovered. I'm just worried that the worm will keep crawling around in his brain. It would be a shame if something unexpected happened. Has the neurosurgery department agreed to send someone to perform the surgery?"
Zhou Can secretly guessed that this matter might not go smoothly.
Director Shang was so angry that he threw things just now, probably because the coordination of this matter was not going smoothly.
"Don't mention it! Those bastards in the neurosurgery department are all masters of official rhetoric. I said I wanted to see Director Wu, but he told me that he was performing surgery on a patient and asked me to tell him first if I had anything to say and they would pass it on later."
Director Shang got angry when he talked about this.
And the more he spoke, the angrier he became.
I was so angry yesterday because of the official language of a young nurse. Today I found someone who should be of a higher level, but he was still perfunctory and procrastinating.
"It's really annoying. I also know your difficulties, so just wait a little longer. I just prescribed a nutritional infusion for the patient, and I have to go to the ward to take care of it. Please be busy."
After Zhou Can came out of Director Shang's office, he thought to himself that he still needed to act as a matchmaker and build bridges in this matter.
Delaying it any further will not be good for the patient or the gastroenterology department.
He was quite familiar with the chief physicians in neurosurgery, and Chief Wen was the closest to him. He could also have a say in Wu Baihe, but he was still a little behind.
Zhou Can thought about it and decided to try Director Wen first.
As for helping Director Shang vent his anger and dealing with the nurse who answered the phone, forget it.
Isn’t there an old saying that goes, a prime minister’s stomach can hold a boat, and a general’s forehead can hold a horse!
It’s inevitable to feel angry in this world.
Zhou Can walked to the end of the corridor and then called Director Wen's cell phone.
"Director Wen, hello, I'm Xiao Zhou!"
"I know, I've been saving your number! I was still talking about you a few days ago, and today I finally got your call. It was not easy. How is your training going recently? Is it going well?"
Director Wen's attitude towards him was as cordial as ever.
Full of concern.
"Thanks to you, my training went smoothly. But yesterday I saw a patient with parasites in his brain who needed a craniotomy to remove the parasites. My gastroenterology department doesn't have the ability to perform this operation. So I came here to ask for your help."
Zhou Can never beats around the bush when talking to these close people.
So as to avoid being scolded.
They prefer direct talk.
"Open the skull to remove parasites? You are fully capable of performing this minor operation. Do you still need me to help?" Director Wen knew Zhou Can's abilities very well.
When Zhou Can was undergoing training in neurosurgery, his surgical skills were already quite impressive.
With Zhou Can's speed of improvement, and after such a long period of time and rotation training in multiple departments, his surgical skills will only become stronger.
Not to mention opening the skull to remove parasites, Zhou Can is also capable of performing more difficult operations.
"My rank is not high enough! Craniotomy is a major surgery at the third or fourth level, and requires at least the rank of associate chief physician or above. If you have time to come and guide me in the operation, that would be perfect."
Zhou Can said with a smile.
He is growing too fast and may have some troubles.
For example, due to low professional title, one is not qualified to perform major surgery.
Due to insufficient years of work experience and qualifications, it is impossible to apply for a personal outpatient number, etc.
"What kind of parasite is it? How long do you estimate the surgery will take?"
Director Wen asked this, obviously ready to help him.
"Sparganum. We have only seen one through the brain CT scan so far. If everything goes well, the operation will probably take at least 20 minutes. If we need to open the skull, it should be done within three hours."
Zhou Can estimated the operation time.
The body of the sparganum should be very long, part of it is in the cranial cavity, and part of it even drills out from the gap in the skull, just under the scalp.
During the operation, if it does not run away, Zhou Can can directly clamp its body part under the scalp layer and pull it out completely. However, this has certain risks and needs to be operated according to the specific situation.
If its body is torn apart, it will definitely be necessary to open the skull and remove the worm.
Many parasites have strong regenerative abilities like earthworms and leeches. Even if their bodies are broken into many pieces, they can still regenerate multiple new lives through the remaining limbs.
Therefore, when removing parasites, doctors will try to remove their entire bodies.
Prevent the situation where the torn body parts remain in the patient's body.
“When can the patient undergo surgery?”
Director Wen asked again.
"If you can agree to come and help, I can discuss it with the senior doctor right away. It depends on when it's convenient for you."
Zhou Can sighed in his heart that connections are really important.
If it weren't for his close relationship with Director Wen of the Department of Neurosurgery, this matter would have been delayed for at least another day or two.
It requires coordination with chief physicians from other departments to perform the surgery together, which is quite difficult.
It can definitely be done.
However, waiting for two or three days, or even longer, will undoubtedly increase risks in various aspects, and the patient's treatment costs will also increase significantly.
"After 6 o'clock this afternoon, if you can arrange everything, then send the patient to the neurosurgery operating room. I will work overtime and help perform the operation."
Director Wen didn't even ask about the patient's condition. He agreed to the matter out of complete trust and care for Zhou Can.
The time was also very short, just on the same day.
The price is that Director Wen needs to work overtime.
I have to say that Zhou Can is really prestigious.
As for the arrangement of the operating room, this also requires Director Wen to coordinate personally.
In a society where personal connections are important, with the care of acquaintances, many things that were originally difficult can become simple and easy.
"Thank you for helping me so hard! I'm really sorry to bother you all the time."
This is not the first time Zhou Can has troubled Director Wen.
Every time, the other party readily agreed to help.
"Don't be polite with me. Practice your medical skills in all aspects and try to master them as soon as possible. We old guys are really looking forward to the day when you officially take up your post!"
Director Wen helped him without expecting anything in return.
Instead, he hoped that Zhou Can would have a bright future and become a great doctor.
After ending the call, Zhou Can still felt warm in his heart.
He is very lucky. Since he started his residency training at Tuya Hospital, he has met many excellent senior doctors who have helped and trained him with all their efforts.
The matter has been settled. All we have to do now is talk to Director Shang and he can arrange surgery for the patient in the afternoon.
I believe that both Director Shang and his family will be very happy.
He went back to Director Shang's office, only to find that Director Shang had left.
Just then Duan Zifu walked over from the direction of the ward.
Zhou Can quickly asked, "Doctor Duan, have you seen Director Shang?"
"He just left not long ago. He seems to be rushing to school. He told us to talk to Deputy Director Shi first if we have anything to ask."
In Director Shang's group, Deputy Director Shi is the only deputy chief physician with a long career. In the absence of the group leader, Director Shi handles all matters, big or small.
"Okay, then I'll go find Director Shi."
Zhou Can is much more experienced than Duan Zifu, and he won't call Deputy Director Shi left and right.
It would be so disgusting if someone heard it!
He found Deputy Director Shi who was about to go to the outpatient clinic for a consultation.
"Director Shi, the neurosurgery department just agreed to perform surgery on the patient with brain parasites, and asked us to send the patient to the neurosurgery operating room at 6 pm."
Craniotomy requires some specialized equipment.
The interventional operating room of the Department of Gastroenterology is only suitable for interventional surgeries.
When doctors perform interventional surgery, wearing a lead suit weighing 20 kilograms is enough to make people uncomfortable, not to mention anything else.
Some lead suits weigh as much as 40 kilograms, which are simply too heavy for ordinary female doctors to wear.
For older male doctors, wearing them is like wearing a heavy suit of armor. In this case, operating on patients is much more taxing on the body.
Therefore, if the internal medicine department cannot perform a surgery, just seek help from other departments.
Generally, the patient will be asked to be pulled over.
No surgeon is willing to go to the interventional operating room of the internal medicine department and be exposed to radiation.
"Oh! Has the neurosurgery department finally agreed? When Director Shang left just now, he was still complaining that the doctors and nurses in the neurosurgery department were too difficult to deal with. It seems that it is more effective to ask the hospital leaders for help."
Deputy Director Shi was very happy to hear that the Department of Neurosurgery finally agreed.
Zhou Can was slightly surprised when he heard this.
"Did Director Shang find the hospital leaders and complain about the neurosurgery department?"
The chief physician has a really bad temper.
After being very angry with the nurses and doctors in the neurosurgery department, he went directly to the hospital leaders to complain.
Director Shang is not the only one who has done this kind of thing. Director Xie has also done it.
It’s just like when a child feels wronged, he likes to go to his teacher or parents to complain.
Sometimes, these chief physicians who hold extremely high status and have achieved considerable academic and medical skills also have a childish side.
"I went to see Vice Dean Ye. I guess he got scolded by the hospital, so he quickly agreed to this matter."
Deputy Director Shi said with great relief.
Zhou Can's lips moved, but he finally swallowed back .
It seems that I am still too young.
If I had known earlier, I wouldn’t have made that call to ask Director Wen for help.
Now that Director Shang has made such a fuss, how can he explain it to Director Wen?
…
In the afternoon, Zhou Can was assigned three new patients.
This means a total of seven beds are managed.
Director Shang went to school and never came back. Deputy Director Shi was in the outpatient clinic, and he and Duan Zifu and others were busy in the inpatient department, which was equivalent to logistics.
By about five forty, Zhou Can had handed over all the patients in his care to the chief resident, Luo Shengsheng.
The fashion director also rushed back to the department after class.
Zhou Can and three graduate students under Director Shang pushed the patient with brain parasites to the neurosurgery department. Director Shang led the team himself, and the family members accompanied him.
The group arrived at the Department of Neurosurgery, and Zhou Can was thinking on the way about how to explain to Director Wen later.
"Hello, we are doctors from the Department of Gastroenterology. We have brought here the patient with a parasitic brain infection. Which operating room will be used to perform the surgery on the patient?"
Director Shang asked the nurse at the nurses station with an expressionless face.
"Director Wen has already arranged it. It's in Operating Room 2. Doctor Zhou, do you want me to take you there?"
When the head nurse Hu Shuiling saw Zhou Can was there, she quickly greeted him with a smile.
In her heart, Zhou Can's status is much higher than Director Shang of the Department of Gastroenterology.
Zhou Can is highly regarded by many chief physicians in neurosurgery, and just one word from them could affect her future.
However, no matter how high Director Shang's position is, he is ultimately only the director of the Department of Gastroenterology.
For her, the head nurse of neurosurgery, it was beyond her reach.
So, she didn't care much about Director Shang.
Zhou Can even suspected that when Director Shang called yesterday, it was Hu Shuiling who answered the phone?
"No, no, we can go there by ourselves. You are busy."
Zhou Can is very familiar with the neurosurgery operating room.
The patient was pushed towards the operating room.
"Hmph, these people from the Department of Neurosurgery were difficult to deal with before. Now they have learned to behave themselves. Look at their enthusiastic attitude, it really makes me feel relieved." Director Shang snorted.
Director Shang felt particularly relieved when he saw that the Department of Neurosurgery had already arranged everything and their attitude towards receiving them was quite warm.
After getting rid of the anger in my heart, I felt much better.
He thought that the change in the attitude of the neurosurgery department was due to the effect of the complaint, but he didn't know that it was the result of Zhou Can secretly asking Director Wen for help.
The patient was quickly pushed into the operating room and the anesthesiologist was ready.
It was Doctor Guan, whom Zhou Can hadn’t seen for some time.
For this level of surgery, an official doctor is enough.
Dr. Feng will only personally perform major operations with extremely high risks.
"Long time no see, Doctor Guan!"
Zhou Can greeted him with a smile, and took the initiative to step forward to help perform the anesthesia operation on the patient.
"It's been a while. I heard that you joined the Department of Internal Medicine. Sometimes I missed you." Doctor Guan could indeed feel much more relaxed with his help.
Zhou Can is almost fully capable of completing most anesthesia surgeries on his own.
Whether it is general anesthesia or spinal anesthesia.
"After I finish my internal medicine training, I will definitely have plenty of opportunities to meet in person. I'm just afraid that by then you'll find me annoying when you see me every day."
As long as Zhou Can returns to the emergency department, he will definitely form a surgical team.
By then, it might be possible to meet Dr. Guan every day.
