I Spent Those Years In the Operating Room Fighting Monsters

"Jingle bell! Jingle bell!"

I don't know when, Lu Cheng was woken up again by the ringing and vibration of the phone. Lu Cheng immediately drooped his eyes wearily. In fact, he was very sleepy, so he still put the general hospital cell phone to his ear, rubbed his eyes, and said, "Hello, hello. Orthopedics."

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While looking back, Lu Cheng thought of his master Lin Hui. Before Lin Hui left Shashi, he was always hospitalized.

When he met Lin Hui, he heard the demonic voice of the general hospital, as if there was a controlled demonic shaking.

Although Lu Cheng had only received it less than forty-eight hours later, he still felt dominated.

"Well, okay, the emergency surgery clinic, right? I'll be there on time." Lu Cheng lifted the blanket on his body and started to fold it, then slowly put it away, and then pushed the door straight away.

Fang Nixin heard the phone ringing and Lu Cheng's voice, and walked out of the room without catching up with Lu Cheng's back.

After Lu Cheng went out, he sent Fang Nixin a VX message: "Senior sister, I went to the emergency consultation. I'm sorry, I fell asleep on your sofa."

At this time, it was already eleven forty-five in the evening, and Lu Cheng probably lay down and slept for about four hours.

Fang Nixin replied immediately: "Okay, I heard you called, pay attention to taking time to rest."

Several major departments of orthopedics, now special emergency department, are thrown to the trauma center, most of the other departments are regular consultation, I don't know why Director Min Hong did not adjust the structure of the orthopaedic department, and insisted on killing the total hospitalization of trauma surgery. inside the whole.

The days of the other bosses were not too good.

Fang Nixin began to feel sorry for Lu Cheng at this moment, but in fact Fang Nixin knew why Min Hong arranged it this way. Because Li Dongshan's previous department was the emergency department, the emergency department of the Second Xiangya Hospital is very strong in the country, but most people only think that it is strong in internal medicine, and Li Dongshan is just a jerk. Now that the trauma center and the emergency department are separated, Li Dongshan naturally has to take the trauma center to climb, and by the way, he will get rid of the reputation of the second emergency trauma.

Li Dongshan is not Min Hong, nor is it Zhu Lihong and other young people. Li Dongshan himself is a veteran professor. Now that he is the head of a ward, of course he is going to make something. Going to the Min Hong Club promised Lu Cheng to follow Li Dongshan, and also wanted to give Li Dongshan some connections and let him take his revenge well.

The current core member of Li Dongshan's team is Lu Cheng alone. If Lu Cheng wants to leave, he must at least leave on the basis that Li Dongshan has cultivated a lot of follow-up talent reserves. Otherwise, Lu Cheng will be considered If you don’t go to the trauma center as the chief inpatient, you will definitely not be able to get around the fact that you follow Li Dongshan…

Lu Cheng started from home. Of course, he didn't have time to go to the department to get dressed. He went directly to the dressing room of the emergency department, put on a white coat, and walked directly to the emergency surgery clinic without wearing a badge. After entering, he asked: " Which teacher here asked for the emergency orthopaedic consultation, and where is the patient?"

Hearing the voice, a white coat without a badge came up and asked, "Is that the teacher of orthopedics? The trauma patient just now has been sent to the emergency room."

"I'll take you there."

As he said, he opened the way forward, and said briefly; "The patient was injured in a car accident, and the right lower extremity knee joint was dislocated, there was a lot of blood oozing, and there was also head trauma and chest trauma."

"The relevant department has been invited for emergency consultation, and the patient is currently in a coma."

"The amount of bleeding on the leg was very large. My teacher was afraid that the patient would go into shock due to blood loss, so he invited the orthopaedic department for consultation to see if emergency surgery was needed."

When he heard the words "traffic accident", Lu Cheng's brows were wrinkled.

Car accident injury is a very broad pronoun. It can be big or small, disabled or dead. It is the most dangerous emergency emergency inducement in surgery.

none of them.

From a mild perspective, there are soft tissue contusions, avulsion fractures, ligament injuries, backbone fractures, damage, and even cardiac arrest on the way to rescue.

"Did the patient have a head CT, how was his consciousness and vital signs?"

"What about CT of the abdomen and CT of the chest?"

Lu Cheng asked three questions in a row. In fact, there was only one question. How are the patient's vital signs now?

This person does not have a badge, either he is a regular training student who has just entered the department, or he has come to study, and it is too late to make a badge. The badges for professional postgraduates are generally communicated by the postgraduate department and the hospital, and will be made directly in advance in batches.

"Deeply in a coma, I was injured for an hour and a half. In the ambulance, a simple bandage was performed by the doctor who followed the car to stop the bleeding. At present, the dressing is very wet."

"The head CT and chest and abdomen CT have been done, and the teachers from Shenwai, general surgery and chest surgery are all reading the images. I don't know what the specific situation is."

"But it's definitely not okay to bleed like this now!" The white coat without a chest badge spoke relatively clearly, and his thinking at the moment was not disturbed. Therefore, the medical history is described in great detail.

Lu Cheng soon saw the patient. The patient's right knee joint was obviously swollen and covered with a lot of gauze and cotton pads.

After the bandage, there was still a lot of exudation to the surface, the bleeding was very heavy, and it was definitely active bleeding.

If you continue to let it go, you will definitely suffer from hemorrhagic shock.

Lu Cheng immediately judged and said, "In the current situation, emergency surgery must be performed immediately, but now the patient may not even be able to get on the operating table!"

"The situation of the head and thoracic and abdominal trauma is unclear now."

"Did anyone from their department come to see it? Do you have any comments? I'm from the orthopedics department."

Lu Cheng finally introduced his identity. First of all, he talked about handling, in order to point out the need for surgery.

"We called people in the emergency outpatient department to see the outside of the gods and the chest, and they all said that the operation should be done immediately, but the general surgery department looked at the CT and said that the situation is temporarily fine, there is no active bleeding, but the right spleen is contused. A delayed rupture of the spleen is likely to occur at any time."

"People outside of God and outside the chest also recommend immediate surgery."

"But they are afraid that when they do the operation, people will bleed to death. It is best to stop the bleeding and do it at the same time as their craniotomy and closed chest drainage."

"It's just like this, the patient has been hit in three places at the same time, and people may not be able to recover!" The person in charge was his doctor in charge, a young man in his twenties, with deep dark circles under his eyes. Words are also on point, no nonsense.

This should also be an undergraduate doctor who came to the emergency department. The reason why he is on duty at night must be because he is young and lacks qualifications, so most night shifts will be arranged for them.

This situation seems to be a dead end.

"What is the opinion of the family?" Lu Chengcheng asked.

In such a situation where there is no choice, only the family can choose.

The dark circles under the eyes of the doctor in charge and the white coat formed a very sharp contrast. At this moment, he said helplessly; "The family members haven't come yet, and the driver of the accident has fled."

"Even the money for doing CT is the total duty that you ask for."

No family.

The patient will die immediately.

This is an unsolved problem faced by the emergency department at all times.

At this moment, the people from Shenwai and the thoracic surgery department rushed over almost at the same time, and said at the same time, "The patient needs emergency surgery immediately, the family member? Call a family member to pay the money, and a family member to sign!"

"Immediately bring up emergency surgery and call someone to complete the medical record."

The boss of the neurosurgery is talking, but not the one I met yesterday. There are three wards in the neurosurgery, and there are three general inpatients; the boss of the thoracic surgery is still Chu Lin. of.

According to their argument, it is one month to be dead and alive, and two months to be happy.

The boss of the neurosurgery said with a blank expression: "He now has a large subdural hematoma, and he must have an operation immediately, otherwise he may die on the spot!"

Brain death, there are only two cases, one is complete physical death, the other is a vegetative state.

"No family members, no payment! Do you want to be authorized on duty?" The doctor in charge also asked directly.

"Hit! Call the person who brought him to contact the family as soon as possible."

"It can't be delayed."

"At least in any case, the decompression of the cranial fenestration should be done."

"Contact the anesthesiology department and the ICU, and be ready for anesthesia and tracheostomy at any time." The general hospitalization in neurosurgery is just giving his own advice.

"Where are the medical records? I'll write a consultation opinion first."

…

After the phone call, he said: "The chief shift authorizes, you go back to the operating room first, and I will bring the patient up immediately. The first four items of blood transfusion and blood type patients will be drawn as soon as they arrive. Please arrange for someone to contact the blood bank. "

"I'm really too busy to win here."

Hearing this, only Shenwai, who had finished writing his opinion, hurried back, while Lu Cheng and Chu Lin from the thoracic surgery department didn't move.

Just staring at the medical record book, writing down my opinion in a hurry.

When the doctor in charge saw this, he could only helplessly say: "Forget it, classmate, you should call the blood bank. They said that the emergency department needs a lot of blood! Then contact the anesthesiology department for emergency consultation!" Contacted the kind person who brought the patient.

But when he went out, the kind person was no longer there.

The person who sent the patient to the hospital was already showing his kindness, and he couldn't ask him to pay.

He didn't scold anything, and quickly returned to the computer again, quickly opening the doctor's order and writing materials for various conversations and signatures.

After Chu Lin wrote his opinion, he immediately handed over the medical record to Lu Cheng and said, "Brother Lu, we met again. It seems that the two brothers are lucky to be together."

In medical institutions, the system of responsibility for the first diagnosis and the system of consultation are the core systems.

Among them, the first diagnosis is responsible for avoiding shirk the patient to run here and there,

The essence of the consultation system is actually to collaboratively diagnose and treat the disease, and to hand over specialist problems to specialist doctors.

This patient must have emergency surgery, which is not wrong at all. However, if Lu Cheng and Chu Lin did not write the consultation records, once there is no consultation record or opinion except for any related department problems

No matter how perfect you are on the operating table, no matter how hard and tiring you are, the first step is wrong.

According to the consultation, it will not be counted.

Basically, people who run the consultation for a long time will not make mistakes, but it is not ruled out that they encounter some newcomers and top irons, or people who are not familiar with the core system, and they are often taken over like this.

In light of a fine for talking to you, in the worst case, your license will be revoked.

This is the biggest difference between being a doctor and being a student.

If you practice alone and take responsibility alone, you need to take full responsibility for what you do, unlike when you are a follower doctor or a doctor in charge of the bed, you are generally responsible for the superior doctor.

These are all growing up on the road to a doctor.

Therefore, even if the condition is urgent now, Lu Cheng and Chu Lin can only complete the writing of the medical records first, and then call someone to arrange the operation and other matters. Lu Cheng finished writing quickly, and then started to call the doctor on duty in his department, telling him to prepare the consent form for emergency surgery, and he would go up and get it later.

Lu Cheng only needs to be in charge of the orthopaedic-related conversations, and he doesn't need to care about other departments at all, and he can't care about it at all. However, now that there are no family members, we can only call for the authorization of the duty-in-charge first, and sign up as soon as possible after stepping down or after the family members arrive!

Lu Cheng quickly finished writing the consultation record, and then handed it over to the elder brother in charge of the bed, saying, "Teacher, it's hard for you to send the patient to the emergency operating room, I'll prepare the materials, and if the family members come later , and please call him at the door of the operating room, we will talk to him when the time comes."

"Thanks for your hard work."

After Lu Cheng said this, he went to the operating room to prepare for emergency surgery.

At this moment, the outpatient clinic outside the emergency care unit heard a voice about him again.

"Another patient with a car accident trauma appears to have a dislocation of the hip."

"Call the orthopaedic emergency consultation." This seems to be what the doctor outside said to the subordinate or the nurse. Because he still needs to perform other operations, the emergency consultation call can only be handed over to other people.

However, someone outside said: "Doctor Liu, it seems that the general inpatient of the Orthopedics Department sees patients in the intensive care unit of our emergency department."

"It's the patient with multiple body injuries in the 3-bed prison."

"Seriously. This?"

Dr. Liu said: "Then you can transfer the film and ask him to take a look. This patient has no skin trauma for the time being. I will explain it to him first, and then listen to what needs to be done. I will take a look at his chest and abdomen and Is there any damage to the head?"

Two overarching principles in emergency departments.

Save your life first.

The bottom line is to save lives!

"Okay!" The nurse walked in quickly.

After hearing this, Chu Lin smiled and said, "Your orthopedics are quite popular, here's another one."

"Brother Lu, I'll go first and go to the operating room ahead of time."

Lu Cheng nodded, and before he could say anything more, a nurse came in from outside the door.

"Are you the chief inpatient of the Orthopedics Department? Dr. Liu from the outpatient clinic called you to watch this film. It just came out. The patient's feet are swollen and he can't move. Are you free to take a look?" The nurse in green walked up to Lu Cheng , finished speaking quickly, and pointed to the computer at the nurse's station.

But the expression is still quite polite.

There is a certain time limit for the printing of plain film, CT, MRI and other examinations, so each hospital will have an independent reading system. As long as the examination is completed, the computer can read the film.

However, this kind of reading is mostly used for emergency patients, just to allow doctors to understand the condition at the first time.

The nurse just called General Lu Cheng to be hospitalized. First, he was not familiar with the orthopaedic doctor system, and second, he wanted to avoid politeness.

There are at least a dozen emergency patients in charge of her a day, and each patient even comes to three or four doctors for consultation. If every doctor is polite, she will die of exhaustion. Over time, the general hospital, teachers and doctors were used instead.

It's not that he disrespects Lu Cheng.

"Okay, I'll go take a look first. I don't know when I'll be able to take the stage." Lu Cheng immediately followed.

When I came to the computer, I read a flat sheet.

Posterior hip dislocation, look at age again, 54 years old, male.

This medical record is very suitable for emergency manual reset, but Lu Cheng does not make empirical and operational mistakes.

One of the charms of orthopaedics is manual reduction. There are many patients who are very painful to enter the hospital. It is possible that the pain of the patient can be relieved immediately through manual manipulation. Some people even enter the hospital lying down and walk out after ten minutes.

However, empirical mistakes are absolutely unacceptable.

Lu Cheng continued to read all the layers of the CT, but found no signs of fractures. After reading it, he asked, "How is the patient's current consciousness?"

"Have you had headaches, chest pains and abdominal pains?"

"If not, I will directly print a template for hip dislocation manual reduction surgery and send it to the operating room."

The nurse shook her head and said, "I don't have any headaches and chest pains, but Dr. Liu and the others are still watching related films. I think you can prepare the consent form for the conversation first. If there is no problem with Dr. Liu, I will send it to emergency surgery first. room."

"Then I'll call you after the anesthesia is complete. This patient should be taken to the emergency operating room, right?"

"Yeah! I also have an incision and exploration to stop the bleeding. It may take a while. It will take a while to send it to the operating room and do a spinal anesthesia. Then remember to ask Mr. Liu to tell the anesthesiologist and add some muscle relaxants. Wait a moment. Call me and tell me to go to the operating room, and I will take the time to do the reset." Lu Chengcheng waited.

After a hip dislocation, muscle relaxants must be added because the pain will cause the muscles behind the buttocks to tense.

"Okay!" The nurse in charge didn't ask specifically why, but felt that Lu Cheng was also a little pitiful. The last emergency patient had not been dealt with, and a new one came. And it's very late to go to this point, unless you call your superiors to help you, no one will help you.

She is in the emergency room. If she has to ask every doctor's order, many patients may be gone.

Unless she's able to spot a particularly big mistake.

Of course this chance is very small.

After that, Lu Chengcheng was really busy, so he quickly found a computer and printed out two consent forms for surgery.

Only the name of the operation and the complications and risks are written on the consent form for the operation, and the basic information of the patient must be filled in by hand. Because the patient is not hospitalized, it cannot be included in the medical record system.

One is debridement and exploration, and the other is manual reset.

I thought that I could go to the operating room after talking to the family members of the hip joint manipulative reduction. What I didn't expect was that when Lu Chenggang finished talking and was about to enter the operating room, a middle-aged couple ran in outside and hugged him. with a crying child.

The child was at most three or four years old, one hand was drooping, and the mother held his hand. The child's face was crying, and the eyes were red and red, and he was aggrieved while crying.

The guide nurse immediately called the man to register first, and called his wife to take the child to the outpatient clinic.

The woman ran and shouted, "Doctor, doctor, show my baby quickly!"

"He suddenly can't lift his hand, what's going on?" It could be seen that she was very anxious and wanted help impatiently.

There are a total of three doctors in the outpatient clinic, and the one who received him was the same doctor Liu.

When he saw the person coming, he glanced at Lu Cheng helplessly, and said, "You need to take a photo first! How did you get hurt?"

"I took my baby to the mall, I pulled him, and suddenly burst into tears."

"How to hug, how to coax, don't listen, just say that the right hand hurts. Is this serious?" She immediately replied.

Very unprofessional reply, but it is indeed a bit embarrassing for the patient's family to tell the story in professional terms in a very strict manner.

Dr. Liu almost already made a decision in his heart, but Lu Chengcheng was here, so he had no choice but to say to Lu Cheng: "The general orthopaedic department is hospitalized, why don't you come and have a look? Do you need photos and processing?"

"I write medical records!"

It's not that he is lazy or shirks responsibility, but since Lu Chengcheng is here, naturally he has to ask Lu Cheng's opinion.

After listening to the medical history, Lu Cheng basically had his own diagnosis in mind.

Radius dislocation, photos may not be helpful, diagnosis by history and physical examination.

Lu Chengcheng immediately put the conversation list on the table, and then went up to touch the child's elbow.

The child hid while crying, and while his right hand was retracting, his fingers wanted to grab Lu Cheng, and he cried, "I don't want, don't. It hurts, don't."

In fact, Lu Cheng's hand had already touched his elbow, and his eyes had confirmed through his finger movements that there was no nerve damage for the time being, and his hand could still be retracted, proving that the fracture was unlikely.

Just confirm the tenderness at the radius.

And at the same time, as long as one hand holds the wrist and the other hand holds the elbow, the thumb presses the position of the radial head, and rotates the forearm from the extension to the flexion of the elbow joint, the dislocated radial head can be reset.

He said: "Little boy, I'll check again, just check, okay?"

The child looked at Lu Cheng without a white coat, as if he had found someone of the same kind, and nodded while crying, "I'm afraid of pain."

But just as he finished speaking, Lu Cheng heard a slight click.

Then Lu Cheng flexed the child's elbow to the position where the elbow and the upper arm were very close, and UU read www.uukanshu.com and said, "It's done, you go to pay first."

"Reduce a dislocation of the radial head, take another X-ray, and hang the forearm with a sling for a week."

After Lu Cheng finished speaking, the woman said, "You're all set? Don't you fool me? Baby, are you still in pain?"

"Do it manually?"

The child nodded: "It still hurts, but it's not as painful as it started."

Move your hands when speaking.

It doesn't seem to hurt at all.

Only then did the woman say, "I thought there was something wrong. My baby turned out to be fine. Baby, let's go!"

Then, in the stunned eyes of Dr. Liu and Lu Cheng, they turned around and walked out of the emergency surgery room with their husband and children. A minute later, there was a quarrel with the nurse at the registration desk.

Hearing this voice, Lu Cheng frowned slightly, then sighed and said nothing.

Liu Xuan said: "I rarely meet family members of such patients in the emergency department. My name is Liu Xuan, and I just entered the emergency department this year. I haven't been hospitalized yet, what's the teacher's name?"

"It's too polite to call the teacher. You can call me Dr. Lu or Lu Chengcheng." Lu Cheng replied, and then said, "Dr. Liu, I'll talk to you next time when you have time. Now I'm in the emergency operating room, and there are two more. A patient is waiting for me, and the materials for the conversation are not ready!"

"Then Brother Lu, you are busy." Liu Xuan is a doctor in the emergency observation ward, and is on duty in the observation ward today.

Before Lu Cheng went out, Liu Xuan had not come, so Lu Cheng was not familiar with him, and he did not know Lu Cheng.

Lu Cheng left the emergency department in a hurry, went directly to the trauma center, and called the doctor on duty to help. Because there is an emergency operation below, it is really very emergency...