medical simulator

Chapter 46 Be Steady and Make Progress

When I was on duty in the afternoon, I routinely admitted two emergency fracture patients. Since Zhou Cheng was on duty, I accepted them into Cai Dongfan's group and became Cai Dongfan's patients.

The regulations in the department are like this: Whichever group of doctors is on duty, the patients admitted that day will be under the control of that group.

So the number of patients in the group depends entirely on luck.

Fractures can be divided into open fractures and closed fractures according to whether they are connected to the outside world.

To put it simply, if the skin is broken and bleeding, it is an open fracture, and if it is not, it is a closed fracture.

Therefore, when many doctors are on duty, the first thing they ask a patient who has a fracture is to ask: Is there blood.

In fact, he was asking if he wanted to go on stage.

They are all closed fractures, so there is no need to go to the emergency department for treatment.Luo Yun was lonely in the department in the afternoon, and he slipped back home at the normal off-duty time.

Although he is in the second-tier class, he doesn't have to guard the department 24 hours a day.

Zhou Cheng originally planned to ask Du Yanjun to go back too, but Du Yanjun just refused to go back, and stayed with Zhou Cheng until eight o'clock in the morning of the next day, when the shift ended!

Today is Saturday, which is a weekend holiday, and there are no elective surgeries in the hospital.

Luo Yun also knew that Zhou Cheng and Du Yanjun were on duty today, so he rushed to the department at eight o'clock early, and took the two of them to check the room. Check to perfect it.

In the evening, a patient with a fracture came and was admitted to the hospital.

Don't think that there are very few car accidents now. In the emergency department of the hospital, they can be encountered almost every day, and they get together...

In addition, the postoperative patients were adjusted.

At 08:30, the ward rounds were over before Zhang Zhengquan even showed up in the department.

After checking the ward, Luo Yun asked Du Yanjun to send a message to Zhang Zhengquan, asking him not to come to the department. For his patients, Zhou Cheng and Du Yanjun were responsible for adjusting the doctor's orders and changing the medicines, and then they all went to bed early. Go back and rest.

Of the three patients, one of them happened to be assigned to each of them. Zhou Cheng and Du Yanjun finished writing the admission medical records last night.

So at ten o'clock in the morning, I finished handing over the shift with the next doctor on duty, said goodbye to Du Yanjun and went home.

Zhou Cheng chose to go back on foot.

On the way, Zhou Cheng was actually a little tangled in his heart.

Because several patients admitted to the hospital yesterday, although according to the current guidelines, surgery is necessary, but in fact, he can achieve good fixation and reset for the patients through manual reduction, which can completely avoid open reduction and internal fixation of surgery.

But there is no way. The formulation of the guidelines was formulated by an expert group invited by the Huaguo Health Committee.

It was Zhou Cheng himself who thought things too well before.Although manual reduction of fractures is a degraded operation.

However, to go beyond the scope of surgical indications specified in the current guidelines to perform manipulative reduction on patients will suddenly raise the level of surgery, which belongs to new research and new surgical methods.

You must have the rank of chief physician to take the lead.

In the words that Luo Yun reminded him before, this layer of meaning was actually hidden.

There are not many trauma patients admitted from the outpatient clinic, and those who can be admitted from the outpatient clinic are extremely complicated, and the general director does not want to admit them.Most of those infected and patients with various complications were sent to the three affiliated hospitals of Shonan University.

As a result, it was difficult for Zhou Cheng to open his mouth to discuss with Cai Dongfan and Director Yan Haihan the topic of exploring the indications of the 'new' fracture reduction technique in the department.

This is actually a very influential topic, but it is not suitable for the current No. [-] Hospital, nor is it suitable for the current Zhou Cheng.

If you want to do this project, you have to re-evaluate the surgical indications of the current inpatients and hospitalized patients, and the department with a small number of patients will shrink even more.

The fractured patients who were finally encountered accounted for 70.00% of the surgery volume in the department. Zhou Cheng took a look at the fractured patients in the department. If measured according to his own standards, at least 40.00% of the patients could be manually reset on the spot discharge.

This is smashing the jobs of the chief physicians, can they agree?

Yes, not one or two.

Therefore, it is obviously quite unrealistic to reset the fracture by sitting up in the department.Unless Zhou Cheng can get the authorization, or Cai Dongfan and Yan Haihan are more open and open to him very openly!
But Zhou Cheng is just a resident doctor, so ordinary that he couldn't be more ordinary.

"Oh!" Zhou Cheng sighed, feeling that he was thinking too much.

Meals have to be eaten one bite at a time, and the road has to be walked step by step.Although I have mastered the redefinition level of fracture manipulation, others have not. To really realize the promotion, even if I make the standard myself, it will be a long-term thing.

What's more, the existing indications for fracture surgery are accumulated after years of clinical experience, so it is naturally not excessive medical treatment.

It is a fracture treatment guideline formulated under the current situation and based on the existing medical level and comprehensive consideration.

After all, not every doctor, every practitioner is the director from the beginning, and every hospital is the top hospital in Shanghai or Kyoto. Naturally, it is impossible to make a one-size-fits-all...

However, Zhou Cheng also considered an alternative plan, which could speed him up to start the project ahead of time.

That is to expand the volume of business in the department. For example, if you can carry out open reduction and internal fixation of fractures with small incisions, there must be a lot of patients coming here, and there will be more operations.

There are no more patients in the department.

It is the right way to follow the trend and do the manual reset of some simple fractures.Moreover, although open reduction and internal fixation of fractures with small incisions is also a new field and a new surgical method, it is enough.

If the No. [-] Hospital has mastered this kind of operation, it will be ahead of several affiliated hospitals of Shonan University in this field, and the number of patients it can attract is quite a lot.

Minimally invasive and small incisions are now the general trend, but the current progress in this field is not deep.

After thinking about this, Zhou Cheng understood that he still needs to develop the existing fracture simulation copy.

A plan must be written in detail.

Tomorrow and the day after tomorrow are both weekends, and there are not many things in the department. It is necessary to plan and study carefully how to start, so as to achieve a certain breakthrough in open reduction and internal fixation of small incision fractures.

Back home, Zhou Cheng checked the relevant literature. With a proficient level of medical English skills, reading the literature is no longer a problem. Except for a few medical terms that need to be translated, the rest are quite comfortable to read.

After searching around, there is not much to gain. At present, there are corresponding applications in the tibial plateau, but there are very few case reports.

For fractures in other parts, the traditional and safe open reduction and internal fixation is still used at present.

Surgery pays attention to the field of view, the wider the field of view, the smoother the operation process and the better the effect of the operation.

Seeking progress while maintaining stability is a necessary step in medicine.

……

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(End of this chapter)