medical simulator

Chapter 22 is over, and I used too much force again (seek collection, recommendation ticket, follow-up reading)!
Although for the department, adding more chairs will certainly not constitute an economic burden.

It's just that the shift room is so big, it's impossible to fit so many chairs.

It's like, the normal operation of Shashi No. [-] Hospital requires so many people, but the proportion of formal employees is actually not much.

The reason why there are intern nurses standing in the shift room and no intern doctors is because it is October and most of the interns are already preparing for the nationally organized postgraduate entrance examination with all their heart and soul.

During the handover, Yan Haihan once again emphasized that Dr. Guipei should work hard and not give up lightly.

After the shift was over, Yan Hanhan actually wanted to lead the rounds in person after a long absence.

It's been less than three days since the last time he led someone to round the room.According to the regulations of the hospital, the chief physician and the deputy chief physician only need to make ward rounds once a week.

However, Yan Haihan, as the director of the group, whenever he wants to come to the rounds, this is his freedom, and he can't ask to come at other times.

Cai Dongfan's beds range from 25 beds to 36 beds.

Zhou Cheng managed 25-28, +9.

Du Yanjun was in charge of 29-33, +10.

Zhang Zhengquan is in charge of 34-36, +11, +12!

Such distribution is also particular.

Generally, patients will be assigned to extra beds only after the main beds are full.

Du Yanjun has five regular beds and one extra bed, a total of six beds, and the number of patients in the department is usually not so large that the extra bed needs to be filled up.Even so, Du Yanjun will still have more patients than Zhou Cheng and Zhang Zhengquan.

Zhou Cheng is much more reliable than the lazy Zhang Zhengquan, so Zhou Cheng has four regular beds and one extra bed, while Zhang Zhengquan has two extra beds.

The first thing to check is Zhou Cheng's 25-28. The three patients are all postoperative patients, so you only need to look at the wound, and then look at the X-ray results and inflammation indicators of the reexamination.

After the surgery is done, the workload of ward rounds is not too heavy.

Therefore, Zhou Cheng quickly reported the medical histories and examination results of the patients in the three beds.

Cai Dongfan said: "Well, they are all patients after conventional surgery, nothing special, let's focus on new patients."

Luo Yun relayed to the patient: "Your surgery is done pretty well, now you just need to wait for the care, and take care to protect the wound from water and avoid infection."

After speaking, the group went to Du Yanjun's bed 29 again.

Du Yanjun hurriedly reported: "This patient is a new patient with an upper femur fracture caused by trauma. He was just admitted to the hospital yesterday and has already had X-rays and CT."

"At present, the diagnosis is clear, waiting for the operation."

This is a set of reporting methods that Du Yanjun summed up by himself. The key content of the report is also the key point that the superiors care about.

The key content of a patient is the diagnosis. As for the medical history of surgical patients and other irrelevant examination results, that is what your doctor in charge of the bed should reflect in the medical record.Senior doctors don't need you to teach them how to write medical records.

Du Yanjun passed the patient's examination results to Cai Dongfan and Luo Yun. Cai Dongfan directly looked at CT, and Luo Yun looked at X-ray.

However, Cai Dongfan's reading speed was much faster than Luo Yun's. After watching the film, he calmed down a little, and handed the CT results to Zhou Cheng and Zhang Zhengquan.

Question: "Zhou Cheng, Zhang Zhengquan, although this patient is not under your care, you should come and see this patient and see if you can see something."

There were a lot of CT examination results, so Zhang Zhengquan and Zhou Chengcheng shared one of them.

Zhou Cheng just glanced at it briefly, then pointed the CT image at the incandescent lamp in the ward, read it carefully for about half a minute, and muttered, "I might need a consultation for this."

Hearing what Zhou Cheng said, Du Yanjun's eyelids twitched immediately.

no?Brother Zhou Cheng, this patient has such an obvious fracture, who do you want to ask for consultation?Are you going for an orthopedic consultation?

Ask the orthopedic department for consultation. Either the orthopedic teacher scolded me to death, or my teacher scolded me to death. Even if you think I am your competitor, you can't hurt me so much, right?
And because of Zhou Cheng's words, Zhang Zhengquan felt panicked.

As a resident physician in orthopedics, I can still see the fracture, the fracture line is obvious, and the surrounding soft tissue has edema. The diagnosis is obviously relatively clear.

What else do you need for a consultation?
But Zhou Cheng would definitely not say that for no reason, so he continued to search carefully, otherwise, if he is too good at it, no shortcuts will work...

Luo Yun had already finished reading the X-rays at this time, and after hearing Zhou Cheng's words, he was a little confused. He really wanted to correct Zhou Cheng's words, but he was afraid.Because the inspection window of X-ray is not as detailed as that of CT.If there is content on the CT that is not shown on the X-ray, then I can't talk nonsense.

Cai Dongfan glanced at Zhou Cheng quite unexpectedly. He really didn't expect that Zhou Cheng could still see this, which is still a bit level.

Then he said to Luo Yun: "Luo Yun, you also look at CT."

Luo Yun panicked, good guy, sure enough, Zhou Cheng told me he was right, he didn't see it on the X-ray, why did he ask for a consultation?

I am the attending doctor, when did Zhou Cheng have such a level?

After about 2 minutes.

Cai Dongfan looked at Du Yanjun, and Du Yanjun picked up the CT and X-ray results again tremblingly. Obviously, he had read the examination results dozens of times, but he still didn't see the key part. And Zhou Cheng, who had only read the film for a while, said the key points.

But what is that?

Which department should I ask for consultation?
Neurology?
Can neurological consultation be seen on CT?
Brother Zhou Cheng?Master?Don't think that you bullied me because I was young and didn't understand, so you lied to me.

spine?

Du Yanjun gradually became sad.

1 minutes later.

Cai Dongfan didn't find the answer in the faces of Luo Yun and Du Yanjun, so he didn't make things difficult for them.

Then he said to Zhou Cheng: "Zhou Cheng, tell me your thinking."

Zhou Cheng nodded and talked eloquently, "Teacher Cai!"

"When we look at fractures, we generally look at them from the following five aspects."

"Looking at the definition, the definition of a fracture is the continuity and integrity of the middle part of the bone. Looking at the examination results, the patient's X-ray can indeed find signs of fracture."

"Secondly, look at the location. It's also simple. The shape and position of different bones are different. This is a fracture of the middle part of the femur."

"The third is to look at the nature, that is, to see whether it is a traumatic fracture or a pathological fracture. Looking at the film, we can see that there is no normal structural shadow of the trabecular bone at both ends of the fracture."

"Bones are composed of trabecular bone structure. The trabecular bone structure of normal bones, you see, on the X-ray, it is a very smooth and continuous line shape, which is especially obvious in long bones."

"However, similar structures were not found on both sides of the fracture. Therefore, this patient cannot be simply classified as a traumatic fracture, but should be classified as a pathological fracture."

"Once the characterization is confirmed, the subsequent characterization and treatment plan can be postponed!"

After Zhou Cheng finished speaking, he found that Cai Dongfan and the others were all looking at Zhou Cheng in astonishment, all with bewildered expressions, is this what you, Zhou Cheng, should say?
Zhou Cheng immediately realized: It's over, too much force.

PS: Please collect, recommend, and follow up!
(End of this chapter)