Great doctor starts with adding points

Back in the department, all the resident trainees were still fighting, and even the attending physician Wu Longshan and the attending physician of Director Qian's group returned to the ward to start working!

When Wu Xie walked into the doctor's office, Wu Longshan specifically asked, "Xiao Wu, have you checked the wards for patients in other departments in our department?"

"Patients belong to the supervisor of our department, and ward rounds must be done."

Doctors in the non-trauma surgery department cannot be required to conduct ward rounds as professionally as trauma surgeons. Everyone has their own specialties.

"I've been there, Dr. Wu." At work, and in the office, Wu Xie didn't call uncle.

Wu Longshan immediately said: "Cao Zhiyuan, those patients who are not currently living in our department will be handed over to you for the time being. You will be responsible for three of the existing beds in the department."

"Leave the rest to me and Guan Yun."

Wu Xie said after hearing the words: "Doctor Wu, I can also take care of it."

Wu Longshan shook his head: "You don't care, there are so many patients in the department now, you, the chief resident, have the heaviest responsibility!"

"Director Fu, Director Qian, Director Ning, Brother Yaolong and Brother Xu Wu don't know when they will be able to step down. The operation is difficult to end. There is a high probability that they will not be able to come to the rounds."

"Patients with open fractures must all be dealt with by emergency surgery. None of them can be delayed!"

"There is no way to call people from other places to help now."

"So you are responsible for supervising the medical orders and medical records of all patients in the department, especially Director Ning's team." Wu Longshan explained cautiously.

Zhang Qiankun, the attending doctor of Director Qian's group, has returned to work in the department, so Wu Xie can ignore the patients in Director Qian's group. However, Director Ning's group has no attending physician, only Xu Wu, who is the deputy chief physician.

Wu Xie must be responsible for all the medical orders of their group.

"Okay! Doctor Wu, I won't deal with it for now." Wu Xie nodded.

Follow instructions in all actions. Since Wu Longshan doesn't want to help himself, he should do his own thing well.

Cao Zhiyuan had already returned to his seat, typing on the keyboard.

Xiao Yunqi, the doctor on duty yesterday, has already gone to the rest room to lie down and rest. After all, he is the most tired junior doctor!

Wu Xie then took the list of patients in his hand and began to organize them one by one.

Today's ward rounds, he did not conduct slow ward rounds like senior brother Long Yuan taught him, mainly because of the limited time.

However, Wu Xie's ability to read and extract medical history and diagnosis is very strong.

After all, Wu Xie's current X-ray film reading skills and CT film reading skills have been upgraded to the expert level. And both expert-level ideas are (levels).

Therefore, Wu Xie drew a lot of ticks and crosses in the list of patients he took!

This is Wu Xie's quick judgment at the first time, whether these patients are suitable for manual reduction, and some patients with fractures who need surgery in the eyes of outsiders will be sent home to free up beds in the department!

Surgical indications and contraindications are relative to the national average. For most people, if they are suitable for manual reduction, they are classified as indications for manual reduction.

This was the reference when the guideline was developed.

However, Wu Xie also knows that the closed manual reduction of fractures is actually very difficult to operate. Many people think that surgery can be reset, so there is no need to do manual reduction so well.

Under such a mechanism, the current guideline is relatively conservative for the indications for manual reduction of fractures.

Except for a small number of professors and some with special abilities, most orthopedic surgeons operate strictly according to the guidelines.

"so?"

[Supervisor beds: 16! (Knowledge point gain: 16 points/day)]

[Responsible beds: 102! (Knowledge point gain: 25 points/day)]

[Patient in charge: 16! (Knowledge point gain: 145 points/day)]

[Responsible patient: 102! (Knowledge point gain: 152 points/day)]

[Remaining knowledge points: 42. 】

[Fracture Manipulation Reduction (Specialization) 25/321.]

If you can't upgrade, there's no way!

In the case of many patients rushing in at the same time, the necessity of rapid diagnosis is greater than the ability of treatment!

Wu Xie probably finished examining his heart, and immediately called Fu Jinjin.

The call was connected, but the other party was still communicating with the assistant about how the operation was going on, presumably the loudspeaker was turned on, and the itinerant nurse held the mobile phone without saying a word.

"Director Fu, I want to clear out some patients with fractures in the ward with manipulative reduction, and try to transfer patients who are currently living in other departments back to the department."

"Is this possible?"

Fu Jinjin paused obviously, and didn't reply for a while.

A few seconds passed.

"Who is this?" Some people even asked.

"Wu Xie, that's what the director wrote in the notes." A nurse replied.

After calming down for a few seconds, Fu Qianjin replied, "Is that you, Lin Peiyuan from Xuanxian County and Li Xiaohe, the young expert in fracture restoration?"

"When there was a car accident in your county before, you were the one who did most of the manipulation?"

This time there were a lot of patients with closed fractures. When Lin Peiyuan and Director Li Xiaohe from Xuan County led a team to support the operation, they once said in the group that it would be great if Wu Xie could be called back.

It's a pity that Wu Xie was at the scene at the time, and Fu Qianjin refused in the group!

"Yes, Director Fu. I will classify the data after reset for each case!" Wu Xie replied.

Fu Jin took a cold breath: "I wish you were in the hospital yesterday!"

"But without you at the scene, it is estimated that more people will die."

"You measure it yourself, you are currently the chief inpatient in the department!"

"Okay!" Wu Xie got the affirmation and went to do it.

At this time, you can't be reckless. In a prefecture-level city hospital, if there is a conflict between the director's choice and your own choice, you must favor the director's choice to a certain extent.

This is a more realistic question.

Everyone stands at a different angle.

After Fu Jinjin hung up the phone, Wu Xie moved his fingers first, and found that the movement of his fingers was not bad, mainly because the force of the palm was slightly limited, but it would not affect his operation.

Manipulative reduction does not require aseptic disinfection, after all, it is a non-open wound.

After this, the relatively powerful KFC delivery arrived, and Wu Xie hurriedly asked Cao Zhiyuan to come over and eat first.

Fortunately, there were quite a lot of orders, and the two attending physicians, Wu Longshan and Zhang Qiankun, didn't have enough to eat, so they ate some together, and finally they were satisfied.

I can't say how good the taste is, at least there is some meat, which can fill the stomach and provide protein.

When the meal was coming to an end, Wu Xie told Wu Longshan and Zhang Qiankun about his thoughts.

The two of them seemed to know Wu Xie as well, Wu Longshan immediately hesitated and said: "The doctor Wu that Director Li of Xuan County People's Hospital mentioned is you?"

There are many doctors with the surname Wu, and the surname Wu is barely considered a common surname in Enshi.

In the department, there are now three people surnamed Wu. Wu Xie, Wu Longshan, and Wu Qi, a resident physician in Director Qian's group.

"Well, I should be able to, so during the rounds in the morning, I didn't prescribe more examinations for patients who might be able to be reset by manipulation."

"However, in order to be cautious, I will confirm it again later."

"Dr. Wu, Dr. Zhang, can you print out the informed consent form for the operation of fracture reduction?"

"I did a rough calculation. There are a total of twenty-four patients who can be dealt with by manipulative reset."

"If you go to them to sign at the same time, we may be able to temporarily send these patients out of the hospital within two hours, and follow-up outpatient review at any time."

"In this way, we can relieve a lot of inpatients and reserve beds for emergencies." Wu Xie said.

Upon hearing this, Zhang Qiankun said: "That's just right, let's work!"

"Let's do the signing, you go to the operation room to reset!"

"If there is one less patient and one less medical record to write, everyone can go to rest first!" Zhang Qiankun is eager to try.

When Wu Xie was in Shazhen, he had treated many patients with fractures, and now it just came in handy.

Wu Longshan took the opportunity to say: "Guan Yun, you go and help Dr. Wu do the manipulation reset, responsible for maintaining order and as an assistant."

"Cao Zhiyuan, you and I will get the patient to sign first, and then arrange for the patients in other departments to return to the department as appropriate."

"Use my job number!"

The matter of transferring to another department cannot be arranged by a resident doctor like Cao Zhiyuan, but with Wu Longshan's job number, it is Wu Longshan's opinion that the attending physician in the department has such authority.

If the other department recognizes it, the nursing department in your own department will also recognize it.

Guan Yun had been eager to try for a long time, but suddenly he looked in the direction of Wu Xie as if he had discovered a treasure!

"Okay!~ Then I'll go with Brother Xie first and then conduct a house inspection." Guan Yun responded decisively.

When Guan Yun said this, residents like Cao Zhiyuan all looked enviously at him.

But there is no way, Guan Yun is a master's degree student, and master's degree students have certain privileges. This is unequal treatment at the beginning, not to mention that Guan Yun's teacher is also the director of the ward.

If there is a good learning opportunity, Guan Yun is naturally the priority.

Guan Yun and Wu Xie immediately started to go to the ward rounds again. They needed to make sure that these patients were suitable for manual repositioning before allowing Wu Longshan and others to talk and sign.

And ask the wishes of patients and family members clearly.

If they have money and insist on surgery, then you cannot force patients to perform manual reduction.

However, apparently such problems are rare.

Wu Xie and Guan Yun passed the first bed. After the patient and his family heard about it, they just asked back: "Dr. Wu, why didn't you tell me sooner? Tell me sooner, and you won't be hospitalized."

Before Wu Xie had time to return, Guan Yun hugged his notebook and said, "Dr. Wu was at the scene of the accident as soon as it happened!"

"As soon as you entered the hospital, all the chief physicians, deputy chief physicians, and even the attending physicians in our department entered the operating room and performed operations on critically ill patients!"

"You have all seen what it was like in the emergency department yesterday."

"Emergency and rescuing patients are priority!"

"It's not just our department, it's not just our hospital, it's the same in the State People's Hospital," Guan Yun said.

The patient and family members shook their heads helplessly when they heard the words.

"Doctor, we just feel unlucky. We don't blame you. I remember that a doctor in your hospital broke his leg yesterday while pushing a cart. Is he okay?" Gua asked.

"It should be fine, I didn't pay attention."

"Just heard." Guan Yun said.

Wu Xie took the opportunity and said: "If there is no problem, I will sign and agree later. Manipulation reset is a treatment option, and there is no guarantee of 100% success, but the chance of success is very high, so we came to talk to you."

"If the reset fails, surgery is still needed, but we can look forward to it. If we can recover better without surgery, we don't need to be stabbed."

"right?"

"Yes, who wants to be scratched." The patient himself said, looking at the plaster cast on his leg, he blinked.

"That's fine, a doctor will come to talk to you later, and tell you about the general risks of manipulative reduction, the countermeasures, and the expectation of recovery. Listen carefully, and then carefully consider it!"

After Wu Xie finished speaking like this, she went to the second one.

After Wu Xie finished reading the film carefully again, the patient couldn't wait to ask: "Doctor, do you think we are occupying the bed and want to drive us away and bring others into the hospital?"

In fact, what this patient said was true. Wu Xie's original intention was to drive these people out and bring in other patients.

It's just that the method and purpose of this 'catch' is not what they thought.

"Evicting people is not allowed. Eviction is not allowed in the hospital."

"It's just that our doctors will provide you with a variety of relatively reliable treatment methods, and you can choose different methods according to your own wishes."

"Right, if the results obtained are satisfactory and more reliable, I believe you can understand."

"As long as our own rights and interests are not damaged, all of us will be willing to give up resources to those who need it more, won't we?" Wu Xie asked.

Raising the moral line of the other party to a certain extent is also a way of communication and communication.

"Doctor Wu, from what you said, we are just ordinary people, and we don't understand the truth."

"But as long as we can do well, that's okay!"

"It's like riding in a car. I am old, but I have strong hands and feet. I am willing to let pregnant women and children go." This person is an old man, and he came to accompany his son!

My daughter-in-law is at work, but my wife has passed away. My granddaughter is in her 17th year of high school this year, and her grandson is in her 14th year of junior high school.

Who can I call?

The patients themselves are more concerned about the question: "Doctor, which one will heal faster when I do manipulative reduction or surgery? I want to start working sooner!"

"You also know that it's not easy for ordinary people to earn a little money and spend it."

"It's almost the same. Even if you have an operation, you will not be able to engage in physical labor for half a year. The same is true for manual resets. It may be an extra month or two."

Hearing the sound, the man asked, "What if it's writing work?"

"If you can ensure that your lower limbs don't fall to the ground, you can start after resting for a few days! It will be faster than if you are hospitalized." Wu Xie replied like this.

"You can apply to work from home."

He had a broken leg, not a broken hand, so it didn't affect the writing work. Of course, it would definitely affect the work efficiency.

"That's a good relationship, I don't need to take a long leave of absence..."

More than forty minutes passed by.

After Wu Xie went through all the twenty-four patients in the department who were eligible for manipulative repositioning, the patients with +2 beds were excluded. During the review, Wu Xie felt that the risk of his manipulative repositioning was relatively high and the prognosis was difficult to control, so he decided to It was decided to let him have surgery.

The other twenty-three can all be expected to reset.

At the same time, some patients after the previous ward rounds have signed informed consent for surgery.

And they either sit in wheelchairs or on push beds and line up at the door of the operating room.

After Wu Xie asked Guan Yun to explain the last batch of patients who could talk to the people in the office, he said, "Guan Yun, come here and help with the positioning operation!"

"You probably know the process, right?" Wu Xie asked worriedly.

"I know, I did it with Dr. Huang and Dr. Wu before." Guan Yun nodded.

He still understands the general basic skills, but he doesn't go deep into it, and he doesn't have special training.

Wu Xie nodded, and after carefully reading the film for the third time, he evaluated that the reset effect of the technique is reliable!

Then get started.

"Doctor, will it hurt?" The first young woman hesitated now.

Clenching her hands nervously, her fracture didn't hurt much except after entering the hospital, when she passed the bed, before the emergency department, it was so painful that she suspected she was alive, and she didn't let anyone touch it at all.

Fortunately, after entering the hospital, there were professionals to help lift her legs, which made her feel nothing.

"It won't be very painful, don't worry, you will feel more comfortable during the reset process, but the moment the reset is over, there will be a little dull pain."

"A little bit, as long as you are prepared in your heart." When Wu Xie explained in detail, he had already grabbed her ankle and started to reset.

The proximal end of Guan Yun was fixed at the tibial platform.

The patient's fracture was in the middle of the tibia, not a comminuted fracture, but also a wedge-shaped fracture. According to the conventional understanding, such a fracture requires surgical treatment, but Wu Xie feels that the curative effect of manual reduction can be expected!

"Okay! That's fine." The patient nodded and looked nervously at Wu Xie and Guan Yun.

Wu Xie knew that the pain after the fracture would not be caused by traction, but would make the patient feel quite comfortable. Therefore, continuous traction would not cause the patient's pain response.

When resetting, Wu Xie was still slowly comforting: "I've been operating for a while, don't you feel it? Now is the time for traction, you relax slowly, don't take the initiative to antagonize me."

"If you're nervous, close your eyes..."

As Wu Xie said, the woman really felt relieved. When Wu Xie said there was no pain, there was no pain. Then, when she said there was only a little pain, the pain must not be too outrageous, right?

Just as he was thinking this way, Wu Xie had already finished pulling, and began to unload the force back!

During this process, she really felt a little bit of pain and stimulation, it was indeed a dull pain, not the sharp pain when someone fiddled with her feet before, and the degree of stimulation was limited.

"Relax! ~Don't be nervous!~"

"right!"

Manual reduction of fractures is not as good as manual reduction of joint dislocations, and there will be a sense of bounce. Even the alignment process of muscle retraction after fracture traction is relatively slight and slow.

During this process, Wu Xie gently pushed the cuneiform bone, and it was inserted into it.

And in a rather special way, it is sandwiched between the proximal and distal ends of the fracture.

If the proximal end and the distal end of the fracture are aligned, and there is no deviation or angulation, then there will be no pain. Otherwise, even open reduction and internal fixation will cause unbearable pain.

This is the normal axis position of the human body.

Reset succeeded!

She already had a cast, and the cast was molded to her skin, so external fixation with a new cast was not necessary.

Wu Xie lifted it up with plaster, and Guan Yun quickly wrapped it up!

Two minutes later, Guan Yun tied the knot, and the patient asked, "Doctor Wu, is this all right?"

"You guys go take another photo and check it again. I'll review it again. If there is no problem, then you can go out of the hospital."

"If the alignment is really bad, then surgery is needed."

"However, if you sit up and take a look, all the deformities visible to the naked eye have disappeared, and basically there will be no misalignment. The same is true for X-ray photos!" Wu Xie was quite confident.

Her fracture is one of the easiest fractures, and Wu Xie is very confident in such a combination.

"Thank you, Dr. Wu!" Wu Xie ordered to prescribe the checklist for the reexamination, and she only needs to be pushed by her husband to the imaging department for another reexamination.

In this way, she could be discharged from the hospital, which far exceeded her expectations!

When the first patient went out, everyone who lined up outside was still dumbfounded.

"Hey, will it be ready so soon?"

"Didn't it mean that the doctors in the hospital only know how to operate, not reset?"

"Yeah, that's what it says on the Internet."

The middle-aged man in second place asked, "Sister, how do you feel?"

He is a little older, so calling me sister actually means sister, not teasing her.

"Fortunately, Dr. Wu really only had a little pain during the operation. Now I feel that my legs seem to be back, and I have some strength to hold them up." She nodded back, her face full of surprise.

It was her hope to escape an operation.

It's just that a fracture occurred, and if surgery is necessary, there is no way.

"This doctor is skilled and looks young." Someone else took the conversation in an instant.

Wu Xie ignored the flattery for now, called the second patient into the operation room, and started the second round of manipulation reset.

Then the second, the third...

Wu Xie was very cautious. Before resetting each patient's technique, he reviewed the film again to avoid mistakes.

Similarly, Wu Xie also saves time. Even if Guan Yun asked him if he could teach him, Wu Xie directly refused, saying that he would have a chance in the future.

Now what he wants to grab is time. If he can treat the patient quickly, everyone will be able to relax earlier and finish this continuous tug-of-war.

In this battle, the people in the hospital have been fighting fiercely for more than 30 hours!

In the end, how long you have to fight depends on your own ability.

And just when the first patient finished the examination and pushed back into the department, an old man stopped them at the door.

And asked: "Is this the film after the manipulation is reset? Can you show me?"

The woman heard the sound and saw that the old man was not wearing a white coat, and her eyes were somewhat cautious: "Old man, who are you?"

This man looked old enough to be her grandfather.