Although the emergency department is a little shabby and its strength is far inferior to that of the powerful departments, it has privileges in terms of seeking help that other departments do not have.
If you encounter a doctor you can't handle, you can call a doctor from any department for consultation.
The other party cannot refuse.
There are also strict limits on emergency room hours.
This is the hospital's policy.
Moreover, when a specialist doctor is on an emergency call and encounters something he cannot handle, he cannot give up and say, "I can't handle this either." If the specialist doctor on an emergency call is of a low level and cannot handle the problem, then a higher-level doctor should be asked to come over.
In the end, the entire hospital tried its best but couldn't save the patient. There was nothing else that could be done.
Report according to procedures.
Although other departments can also ask doctors from other departments to come for consultation when they encounter patients they cannot handle, the nature of the cases is much different.
For example, the orthopedic surgery department receives a patient with a fracture and suspected internal bleeding or other serious illness.
The orthopedic department felt that they could not handle the problem on their own and was afraid of something going wrong.
So we asked a cardiologist to come for consultation.
After receiving the request, the cardiologist was somewhat reluctant, because every doctor has a hard time, with a lot of work to do, so how can he have the time to take care of other people's affairs?
But this matter cannot be postponed, the process must be completed.
We are all from the same hospital. You helped me, and next time you have difficulties, I will also help you.
Unity is a must.
The internal medicine doctor came over.
Upon closer inspection, we saw that the patient was suffering from severe internal bleeding and was in shock.
Then he carefully reviewed the examination report and thought that the patient might not be able to get off the operating table.
He told the orthopedic doctor about the diagnosis and reported it to his superior. If he was the chief physician, he would not need to report it.
Maybe you can express a more positive attitude directly.
This patient is very difficult to save and may not be able to get off the operating table. You guys can handle it.
After saying that, he just patted his butt and left.
This is the difference between an emergency visit and a regular consultation.
…
Not long after, the patient's blood test report came in, and the white blood cell count was abnormal, indicating that there was indeed pus.
Doctors from the emergency department also arrived one after another. The gastroenterology department sent an attending physician, and the hepatobiliary surgery department also sent an attending physician.
This level is not low anymore.
Whether it is diagnosis and treatment experience or personal strength and level, they will not be bad.
"What's wrong?"
"Acute cholecystitis!"
"This isn't a very difficult disease to treat! Wasn't Dr. Xu the former chief physician of our surgery department? He should be able to handle it!" The attending physician of the hepatobiliary surgery department looked relieved after hearing this.
Maybe he didn't mean to mock Dr. Xu.
But no matter how you listen to it, it seems like he is looking down on Dr. Xu.
Judging from this man’s age, he should be a newly promoted chief surgeon in recent years.
There is still some fighting spirit of youth in him.
Being young and promising, it is inevitable to be a little proud.
This must be gradually resolved after years of settling down and the beatings of reality.
"Doctor Ruan, can you take a look at the patient's condition first?" Zhou Can stood by and spoke for the teacher.
The attending gastroenterologist has finished reviewing the examination data and is examining the patient.
Internal medicine examinations are done by looking at the patient very carefully, including the pupils, tongue coating, hands, complexion, etc. The patient is also asked about diet, bowel movements, the specific location of abdominal pain, and other details.
There are many cases that are not recorded in the medical records.
This usually simply records the patient's symptoms, condition, consultation time, etc.
Chinese internists actually still have some influence of traditional Chinese medicine.
Experienced internists know a little bit about Chinese medicine's diagnosis and treatment methods.
Zhou Can watched the internist examine and diagnose the patient, and secretly learned his diagnostic methods.
The physician finished his diagnosis but was not in a hurry to give his opinion.
He just stood there with a slightly solemn expression, waiting for the diagnosis from Dr. Ruan from the hepatobiliary department.
Five minutes passed, eight minutes passed... Doctor Ruan frowned, looked at the examination data, then looked at the patient, and still did not give a diagnosis.
"Doctor Ruan, you must have treated many cases of this kind of disease. I have read the medical reports and examined the patients. I wonder how you think the disease should be treated?"
Zhou Can clearly saw that the other person was having a hard time, but he still deliberately flattered him. In fact, he was quite... bad.
"Uh... well, I need to study this further!"
Doctor Ruan looked somewhat embarrassed.
"Didn't you just say that this disease is not difficult to treat?"
Zhou Can led his army.
As soon as he came in, he made it difficult for Dr. Xu to leave the stage, so Zhou Can naturally had to give him a light punishment.
Let this person be more careful with his words next time.
"This disease is generally easy to treat, but this patient is a bit difficult to treat. By the way, what are your emergency department's treatment suggestions?" Doctor Ruan has a strong ability to respond.
The topic and target were changed in an instant.
To be able to become a chief physician requires practice gained through countless interactions with patients.
If I didn't have the ability to adapt to changing circumstances, I would have been beaten countless times by family members and patients.
Zhou Can looked at the teacher.
This question should be answered by the highest ranking physician.
He is a small-scale trainee, and he has positioned himself very well.
I will never speak nonsense when I shouldn't be in charge.
"Our suggestion is to first puncture the gallbladder to drain out some bile, and then puncture the gallbladder to drain the pus around the gallbladder under contrast positioning, and give the patient anti-inflammatory treatment. After the inflammation is eliminated, elective surgery can be performed."
Doctor Xu adopted Zhou Can's diagnosis and treatment advice.
Just at this moment, the anesthesiologist arrived.
After saying hello and asking about the situation, the anesthesiologist stood by and waited patiently for the consultation results from several surgeons.
"Doctor Chi, what do you think?" Dr. Ruan looked at the attending physician of the Department of Gastroenterology.
"I support the emergency approach. This patient has underlying diseases, is relatively old, and is quite weak. In addition, there is pus around the gallbladder, so the risk of surgery is extremely high. There is also vomit residue at the corners of the patient's mouth, which means that the patient should not have fasted for a long time before being sent to the operating room. I suggest draining the bile sweat, draining pus and reducing inflammation first, and then giving infusion and nutritional support, and fasting. It will not be too late to perform surgery when the surgical indications are met."
Dr. Chi's meticulous observation is truly admirable.
"If I can, I prefer laparoscopic surgery. It's much less invasive and has lower risks."
The reason why minimally invasive surgery has become a new major surgical trend is that it causes less trauma, greatly reduces harm to patients, and allows for faster recovery after surgery.
Some frail and sickly patients may not meet the indications for traditional surgery, but they can be treated with minimally invasive surgery.
The only downside is that minimally invasive surgery is much more expensive.
Then there are very few doctors in China who are good at minimally invasive surgery.
"The preoperative fasting time is not long enough, and the patient has a vomiting reaction. I'm afraid it's impossible to anesthetize him!"
When the anesthesiologist heard that the patient had just vomited, his face changed immediately.
The hospital is currently strictly enforcing surgical safety, and he doesn't dare to take the risk.
Everyone's eyes were on Dr. Ruan, waiting for him to express his opinion.
"Okay then. We'll transfer this patient to the hepatobiliary inpatient department. I'll report this to the director. After your emergency department has communicated with the family, you can send the patient over."
Dr. Ruan took this "hot potato" back to the hepatobiliary department.
This matter has come to a temporary end.
Before leaving, Dr. Ruan stared at Zhou Can and said with a smile, "Young man, you are really defending your Dr. Xu. You are even more defensive of me!" He said this to save his own face.
If he knew that the diagnosis and treatment opinions in the emergency department came from Zhou Can, a resident trainee, he would probably look up to Zhou Can even more.
"Haha, I dare not!"
Zhou Can was not embarrassed at all when his little trick was discovered.
Dr. Xu loved him so much, and he naturally wanted to repay his teacher's kindness and protect his own teacher.
Although Dr. Xu didn't say anything while listening nearby, an expression of relief that he couldn't hide showed on his serious face.
Obviously, he was very pleased with Zhou Can's act of defending him.
This is ten or a hundred times more effective than Dr. Lu flattering him a thousand times.
Dr. Lu's flattery can only make Dr. Xu happy at the time, but he will forget it later. However, Zhou Can's "high-level flattery" is emotional, which can make Dr. Xu treat him like his own child.
"I'm leaving now. Don't delay this patient. Something might happen to him!"
Doctor Ruan gave another reminder.
The patient's condition was quite serious and no one dared to delay .
Dr. Xu personally came forward to communicate with the family and the matter was quickly resolved.
The family members’ requirements are actually very low, as long as the hospital can cure their loved ones’ illness.
"Doctor Lu, immediately send the patient to the hepatobiliary surgery department with the nurse outside!"
Doctor Lu had a bitter look on his face.
"Can't we ask Xiao Zhou to go?" After all, he is a senior resident.
Small tasks like running errands are usually assigned to people with the lowest status.
Jin Mingxi was undergoing surgery, so it was understandable that he was not asked to go.
But Zhou Can didn't have the surgery.
"You could be more eloquent. Xiao Zhou is too dumb with his words, so he's only suitable for surgery. Go quickly!" Doctor Xu's words made Doctor Lu want to buy a piece of tofu and kill himself.
If Zhou Can's mouth is considered stupid, I'm afraid no one in the world has a smart mouth.
Doctor Xu has said so much, clearly defending Zhou Can. Doctor Lu is a very smart person. If something is impossible, he will never do something unwise to offend his superiors or leaders.
I escorted the patient there obediently.
"Call the next patient in!"
Soon, a new surgical patient was pushed in. His face was pale with pain and sweat was pouring out of his forehead.
This is a patient undergoing surgery for acute appendicitis.
Before the anesthesiologist leaves.
After reading the examination report, Dr. Xu asked about the patient's condition.
Surgery is possible.
"How long has the patient been fasting?" the anesthesiologist asked the nurse who brought the patient over.
He was frightened by the outrageous behavior of the doctor in the emergency department .
The last patient who had surgery had food in his stomach that was clearly not emptied. Aren't you afraid of something going wrong if you send a patient like that to the operating room?
"It's been more than six hours."
The nurse answered honestly.
Acute appendicitis usually occurs at night.
It is estimated that the patient was brought in at night.
"I, I had a midnight snack around 10pm last night and haven't eaten since then!"
The patient has noticeable shortness of breath when speaking.
This is for pain.
Acute appendicitis can really kill people in pain.
"What is the patient's name?"
"Huang Weiyuan!"
"You were the one who received the consultation last night, right?"
"Um!"
The anesthesiologist took out a dozen informed consent forms from his box , flipped through them, and quickly found it.
"I'll go find the family members and sign the anesthesia consent form!"
The anesthesiologist went out.
Came back soon.
After checking the patient as per the usual practice, it was found that there was no problem. He was put on vital monitoring equipment, a non-invasive ventilator, and given inhalation anesthesia.
The patient soon fell into a deep sleep.
"Huang Weiyuan, Huang Weiyuan!"
No response to calling.
The patient's vital signs are stable.
"The operation can be performed now!"
After the anesthesiologist finished speaking, he moved the small black leather stool next to the wall and sat down, staring at the life monitoring equipment.
During the entire perioperative period, the anesthesiologist is there to protect the patient's life safety.
However, this is only a minor level 2 operation and should not be treated as seriously as a major operation.
"Xiao Zhou, are you confident in performing an abdominal surgery on the patient?"
"have!"
Zhou Can was overjoyed.
This was the first time that the teacher took the initiative to let him perform an laparotomy on a patient.
Although the risk of laparotomy is much lower than thoracotomy, it still makes him extremely excited.
"Come on! You must remember the principle of being bold and careful, and putting safety first. Don't operate recklessly if you don't understand."
"clear!"
Zhou Can is not an unstable person.
When performing any operation, he gives it his all, like a lion fighting a rabbit.
"Can Qiao Yu be my instrument nurse?"
Zhou Can is very caring towards Qiao Yu.
"Are you planning to train regular nurses?" Doctor Xu scolded with a smile. "Liu Xia, you should train more newcomers."
This means you agree.
Liu Xia is an experienced nurse.
She has much more experience than Tang Ling and Tian Tian.
"no problem!"
Liu Xia readily agreed.
She was not stupid, and could see that Dr. Xu took special care of Zhou Can. At the same time, Zhou Can's surgical potential was also extremely amazing.
In less than a month, Zhou Can was able to independently complete various first-level surgeries.
Now we even have the ability to perform an open abdomen and remove the appendix.
It's really horrible.
She couldn't imagine how great Zhou Can would be in the future if he could continue to grow smoothly.
She would definitely want to have a good relationship with such a promising doctor.
A while ago, Dr. Lu spread rumors everywhere, saying that Zhou Can had offended the hospital's top leaders and was going to collapse and have bad luck, etc.
Now it's over.
We are all smart people, so we will naturally think about taking the initiative to repair the relationship with Zhou Can.
You can see that in recent days, more and more colleagues have taken the initiative to greet Zhou Can enthusiastically, and you will understand.
This is the trend.
Zhou Can takes such good care of Qiao Yu.
Love the house and love the people in it.
If Liu Xia shows goodwill towards Qiao Yu now, she can not only gain Qiao Yu's gratitude, but also win Zhou Can's favor.
Why wouldn't she?
The operation officially began.
Liu Xia also spared no effort to teach Qiao Yu about the experience of equipment preparation. Different surgeries require different preparations.
Qiao Yu had a certain foundation as an instrument nurse, and coupled with her natural intelligence, she basically understood things quickly and learned them quickly.
This also made Liu Xia like her a little more.
Teachers generally like students with good grades.
If nothing else, on the one hand, it is easier to achieve good results by teaching such students, and on the other hand, it is much easier than teaching those students with weak receptive abilities.
After Qiao Yu cleaned the skin at the surgical site, Zhou Can marked the surgical site.
Doctor Xu is next to him to check.
After confirming that there was no problem, he held the scalpel, his eyes sharp as an eagle and fierce as a wolf.
Try to find the feel and cut open the first layer of the abdominal surface little by little.
This layer of skin includes the epidermis and dermis.
Blood oozed out and Doctor Xu sucked out the blood in time.
He should be satisfied with his first blow to Zhou Can.
Next, Zhou Can cut through the thicker subcutaneous tissue, fascia layer, and rectus abdominis muscle in turn. At this point, the peritoneum was exposed.
This is also the last barrier to entry into the abdominal cavity.
There is a saying that when cutting jadeite raw stone, one cut can make you rich or poor.
If you don't cut the peritoneum properly, it will cause serious disaster.
Dr. Xu dared to entrust such a surgical task to a resident student. This showed great trust in him.
Zhou Can took a deep breath and tried to keep calm.
Then find the feel and slowly cut through the last layer of barrier.
Fortunately, no trouble occurred.
It's not perfect, but at least it's above average.
It's much better than being a resident doctor.
[Cut experience +1. ]
[The first successful abdominal opening will reward +100 incision experience points. ]
The system is so generous.
A direct reward of one hundred.
But it's just this once. There will definitely be no extra rewards if I open my abdomen again.
For Zhou Can, this is another extremely important step forward in the field of surgery.
A successful laparotomy will bring qualitative improvements in all aspects, including psychology, technique, experience and courage.
Usually, only a few senior residents with strong surgical skills can, when they are trying to become attending physicians, get one or two opportunities to perform laparotomy from their senior doctors through hard bargaining.
Zhou Can's incision is now at level four, and his main treatment is at a lower level.
To level up, you need to earn 10,000 experience points.
I earned 101 cutting experience points in one go. This speed of progress is countless times faster than dissecting a rat.
It’s more comfortable to earn surgical experience points on patients.
When he cut open the peritoneum, Dr. Xu actually looked very nervous.
Now that he saw Zhou Can had successfully completed the task, Dr. Xu breathed a sigh of relief.
"Looking for the appendix will?"
"meeting!"
Zhou Can answered decisively.
At this time, Jin Mingxi finished the operation in his hand.
It is estimated that Dr. Lu will not be back for a while.
After all, for a lazy person, this is a legitimate opportunity to be lazy.
Take a half-hour break on the way back and no one will say anything.
"Jin Mingxi, come here and help me make the pinky promise!"
Jin Mingxi walked over and saw that Zhou Can had already performed an appendectomy surgery. He was extremely envious.
He had performed this type of surgery at the County People's Hospital.
However, hospitals of different levels have completely different attitudes towards surgery.
Removing an appendectomy in the operating room of the county people's hospital was like celebrating the New Year. A large number of doctors were involved.
The surgery was performed by a deputy director-level surgeon.
Look at Tuya again. Even the most inexperienced emergency department can perform this kind of surgery as if it were a piece of cake.
An attending physician was standing by and let the resident doctor perform the operation directly.
So scary.
Of course, it is undeniable that Zhou Can's ability is far beyond that of regular doctors. Jin Mingxi is not sure how strong Zhou Can is now.
All I know is that Zhou Can’s surgical skills are like riding a rocket.
Almost every day is different.
We performed surgery and practiced together, so why is there such a big gap between them?
Jin Mingxi gave Zhou Can a thumbs up and said, "You're awesome!"
Then help to make the pinky promise.
Qiao Yu saw Zhou Can's excellent performance, and she also followed Zhou Can to rise to the top and get a lot of benefits. Her heart was like drinking honey, and when she looked at Zhou Can, her eyes were full of admiration and smiles.