medical simulator

Chapter 98 Are You Serious? ! (Please subscribe!)
No wonder Zhou Cheng had such an expression.

Zhou Cheng really did not expect such a weird thing to happen.

Obviously Pang Dingkun is in the emergency department, and the emergency department called for an emergency consultation, which is really strange.

The little nurse was in a hurry because the other end of the phone she answered clearly stated that she was the director of the emergency department and asked her to find someone to answer the phone.She could only come to the doctor subconsciously.

"Hurry up and answer the phone, the phone hasn't hung up yet." The little nurse said again.

"Okay!" Zhou Cheng put the medical record under his armpit, replied with one word, and walked out at the same time.

When I got to the little nurse, I said, "Please put the case back on the case shelf for me, and I will answer the phone."

"Okay." The little nurse lowered her head first, and then nodded again, as if she was a head shorter than Zhou Cheng, she seemed a little shy.

At the nurse's station, Zhou Cheng answered the phone: "Hello, Orthopedic Ward [-]."

"Who are you? I'm Guo Haoran from the emergency department!" The other party said his identity first.

As the regular trainer of the orthopedics department, Zhou Cheng also went to the emergency department for rounds, so he naturally knew that Guo Haoran was the administrative director of the emergency department.

Immediately reply: "Mr. Guo, I am a resident doctor in the second orthopedic ward. Dr. Pang, who is on duty today, is already in the emergency department?"

"I know he's here. Hurry up and find a way to contact Yan Hanhan in your department or Dong Qiansheng. I can't get through here."

"You just say that Pang Dingkun from your department, now there is a problem with the manipulation reset, let them come to the emergency department to rescue the scene immediately! I am still calling the anesthesiology department here, so I will delay it for now."

"It won't take long."

"If Yan Hanhan, Dong Qiansheng or no one else comes after 10 minutes, I'll call Zeng Yi from the orthopedics department and ask him to come up with a solution." Guo Haoran said rather bluntly, and hung up On the phone, the tone was quite blunt.

Zhou Cheng was stunned, what kind of feathers are these?

As the administrative director of the emergency department, Guo Haoran directly contacted Yan Haihan, Dong Qiansheng and even Zeng Yi, so there was no problem.

You can also call him by his first name, but?

Pang Dingkun went to reset the technique and made a problem. What's the situation?

You can't get through the phone, where can I find a solution?These two great gods are both on the operating table now, it's no wonder you can get through the phone.

After Guo Haoran hung up the phone, Zhou Cheng pondered for a moment and decided to call Luo Yun first.

It depends on his attitude. If it is appropriate, he can ask Zhang Zhengquan and Du Yanjun to contact Yan Haihan.

Anyway, I have to take a stab in the department today, and I can't go back.

The call was connected, and it was quickly answered, but after answering, it seemed to be the voice of the itinerant nurse: "Luo Yun, the phone is behind you, turn on the loudspeaker, I'm going to the blood bank to get blood..."

When Zhou Cheng heard this, he hurriedly said, "Mr. Luo, I'm Zhou Cheng, can I take a moment to talk?"

"I know you are Zhou Cheng, and you have something to talk about. Hurry up, I'm still on stage." Luo Yun's cursing voice came, as if he was speaking to Zhou Cheng as an excuse to speak, and he was a bit uncomfortable.

Zhou Cheng continued to insist: "Mr. Luo, you may have to step down first."

clap clap!

Then there was the snapping of gloves on the other side of the phone, and the mocking voice of the handwashing nurse: "Luo Yun, is the resident trainee in your department so awesome? I just asked you to step off the stage to answer the phone."

Luo Yun didn't answer, just picked up the phone, walked out wearing a sterile surgical gown, and turned off the loudspeaker.

"Now we can talk, what's the matter with you?" Luo Yun's tone was naturally not as blunt as before, and of course he was still beating Zhou Cheng in between the words.

"Brother Pang Dingkun is on duty today. About 10 minutes ago, he went to the emergency department for an emergency consultation. Director Guo Haoran from the emergency department called the department just now, saying that Brother Kun did something by resetting the technique."

"He couldn't get in touch with Yan Haihan and Director Dong Qiansheng, so I had to find a way to get in touch with them. I was just talking about the 28-bed surgery in the department, and I was entrusted by Pang Dingkun to take care of the ward temporarily."

"I just think it's necessary to discuss with Mr. Luo, what should we do?"

"If you want to notify Director Yan, I will come to the operating room in an empty ward? Or I will contact Du Yanjun and ask him to tell Director Yan about it."

"Director Guo spoke, but he didn't reply within 10 minutes, so he called Director Zeng Yi of the Department of Orthopedics directly." Zhou Cheng replied very quickly.

Zhou Cheng was entrusted by Pang Dingkun to manage the ward, so he had to fulfill his duty of communication.

Of course, it's not easy for Zhou Cheng to publicize what happened to Pang Dingkun.

Luo Yun frowned at that time: "What kind of reset did Pang Dingkun do?"

"I don't know. Teacher Luo." Zhou Cheng breathed calmly, but he was actually a little nervous.

"You don't care about this matter, I'll tell Director Yan. Don't spread this matter to outsiders. The less people know about it, the better. If you know it, call me and insist on talking about it alone. Good job."

"You wait in the department for a while, I'll call Pang Dingkun and ask him to arrange someone to come to the ward to watch for him!"

"What tricks are you doing? Let someone from our team be on duty for him?" Luo Yun muttered rather unceremoniously...

Zhou Cheng also shook his head, regardless of this matter.

It's not to blame Luo Yun for being angry. The treatment groups where each director is located operate independently.

People from Yan Haihan's team were on duty today, and Luo Yun was called to the stage for an emergency operation.

Hu Ming's group is his own surgery day, he can't get away, and his superiors are not enough. If his name is not Luo Yun, could it be called Cai Dongfan?
However, it is reasonable to borrow someone to perform emergency surgery!

But the on-duty doctor, you are not on duty for a shift, borrowing people here, borrowing people there, your group is disbanded, okay?

Generally, unless there are extremely exceptional circumstances and a particularly serious accident occurs, the director must personally come forward to coordinate the work of everyone in the department, and then there is the organization and arrangement at the hospital level, which cannot be avoided.

About 10 minutes later, Xu Yanlin ran into the department panting, and saw Zhou Chengcheng and said, "Brother Zhou Cheng, I'm sorry to make you tired."

"It's okay, I just happen to have something to do in the department. Brother Yanlin."

"How is your surgery going?"

"It's okay, the operation is quite big, but it's going well. Brother Yifeng happened to be called to the operating room by Director Yan, so I came up." Xu Yanlin probably didn't know about Pang Dingkun yet.

Maybe he knew, but he was given a password by Yan Hanhan.

"Thank you, brother Zhou Cheng, go back and rest, as long as I'm here." Xu Yanlin said politely.

Zhou Cheng also yo-yoed.

Anyway, he only needs to obey Cai Dongfan and Luo Yun's orders, and Zhou Cheng is too lazy to meddle in other matters.

After all, if so many emergency patients today were encountered by my own medical team when they were on duty, there would be no one from the other team to replace the people in my own team on duty.

After returning home, Zhou Cheng went to the desk, opened his notebook, continued to sort out his thoughts, and began to write down the simulation scheme and plan.

……

Yan Haihan got off the operating table very annoyed at this moment, and rushed to the emergency department.

For MLGB, I have emphasized thousands of times in the department, and Wan emphasized, don’t do manipulation resets casually, don’t do manipulation resets casually, people in other groups, such as Luo Yun, don’t listen, and you, Pang Dingkun, an academic doctor, stay in the laboratory for a long time goods.

Are you deaf too?Do you really think that others flatter you as an outstanding talent in our hospital, does that depend on your clinical ability?
How much time have you spent in the clinic in 11 years from undergraduate to doctoral degree?
Although the theory is rich, is the actual operation as simple as the theory says?
On the way, I met Guo Haoran from the emergency department. Guo Haoran's face was gloomy. After seeing Yan Haohan, he went up to him and said, "Director Yan, you are here."

"Director Guo, I'm sorry. I went to a meeting in the morning and turned on the Do Not Disturb mode, but forgot to turn it off. Then I went to the emergency surgery, and the phone didn't ring." Although Yan Haihan was a little angry in his heart, he did.

The person who should be polite to Guo Haoran should be polite, after all, he is also doing it for the good of orthopedics, otherwise, he will wait for Pang Dingkun to take the initiative to call for foreign aid after Pang Dingkun can't figure it out, without thinking about it at all.

First-diagnosis responsibility system, orthopedic problems, orthopedic first-diagnosis responsibility!
"I also understand the situation, but the matter is urgent, and I can only call you, Director Yan, to step down."

"Two joints were dislocated just now, and one was a posterior dislocation of the hip joint. It didn't take long for Dr. Pang from your department to reset it."

"But there is still a patient with shoulder dislocation. Now Dr. Pang has been resetting it for almost half an hour. He has tried two or three times, but he still hasn't reset it. I suggest that Pang Dingkun stop the operation and suggest that he go to the patient's family. Talk about nerve blocks."

"I'll call you from this side again. If it continues to reset, it's very likely that the bone will be fractured." Guo Haoran explained that he didn't want to bother him too much.

Joint dislocation, after repeated failures of manual reduction, it may be necessary to switch to surgery for treatment.

It's just that I have failed several times now, and I have to communicate with family members and patients well, otherwise, if a report comes, it will be quite troublesome for the emergency department and the orthopedics department.

Yan Haihan naturally understood Guo Haoran, and said gratefully: "I'm sorry to trouble you, Director Guo, I've troubled you, let's go and see the situation together first."

"I'll treat you to a drink in two days."

"Don't mention the drinking issue, let's deal with it first." Guo Haoran hurriedly skipped this topic.

When the patient recovers in the end, drinking and eating meat are trivial matters, and you can choose cocktails, beer, and white wine at will.

If it doesn't pass, or if it's broken, do you want a cocktail?

At the door of the operating room, the anesthesiologists inside had already been called by Guo Haoran. They were preparing the patients for nerve block anesthesia, as if they were marking the points with a black marker.

Pang Dingkun was patiently explaining to the patient's family that the conversation had been going well before Pang Dingkun was reset.

The family members of the patient asked reluctantly: "Then Dr. Pang, if you don't reset it again, do you have to have an operation?"

"My wife was very happy when she heard that there was no need for surgery. Usually she is most afraid of pain."

Pang Dingkun said: "That's it. Manipulation reset is only one of the options for treatment. As an alternative, we can think of nerve block and muscle relaxation. If it still doesn't work, then surgery is inevitable. "

As a Ph.D., Pang Dingkun has solid theory and basic skills, so he explained well to patients.

Conservative treatment, manual reduction, surgical reduction.

The three steps are quite clear.

"That's hard work for you doctor, if you can try not to do surgery, don't do it. You should think of a way!" He cupped his fists and bowed to beg.

"We will find a way." Pang Dingkun squinted and saw Yan Haihan coming over.

He said: "You are here to guard your wife, I will go to watch your wife's film again, and then I will design a reset plan with our director."

"Okay, okay." He was relieved when he heard the word director. He walked into the operating room, let his wife grab his hand, and comforted her:
"It's okay, the director of the orthopedics department is here."

……

After Yan Haihan saw Pang Dingkun coming, he walked into the ward with Guo Haoran, and read the film first——

Anterior dislocation of the shoulder joint, it doesn't look like anything special.

Anterior shoulder dislocation is the second section of orthopedic joint dislocation. It is a very classic dislocation. Even if you are not an orthopedic doctor, you can know one of several treatment methods. What is going on with Pang Dingkun?

After Pang Dingkun came in, he reported the medical history: "Director, the patient is 35 years old, female. The physical examination showed obvious square shoulder deformity, tenderness, and swelling. No obvious fracture was seen on the X-rays."

"It is an anterior dislocation of the shoulder joint. It can be reset manually."

"But as if something strange happened, I tried the external rotation method, the lifting method, the hand pedaling method, and the santos method successively, but all failed." Pang Dingkun replied rather depressingly.

"I don't know what happened, we may have encountered an irreversible anterior dislocation of the shoulder joint."

Yan Haihan was slightly taken aback when he heard Pang Dingkun's words.

To be honest, the reset methods he has heard are external rotation, pulling and hand pedaling. Although Yan Haihan is the director, he has never heard of the santos reset method.

The main reason is that he does not engage in this aspect. The other three names are all knowledge reserves.

However, what Pang Dingkun said made it difficult for Yan Haihan to immediately blame Pang Dingkun.

Pang Dingkun did not act recklessly. First, he judged that there was no fracture in the diagnosis and made an assessment, which was an indication for manual reduction.

Second, he also has his own knowledge reserve and skill reserve.

Four different methods of shoulder dislocation reduction are enough, Yan Hanhan knows only three.

Then it really cannot be said that Pang Dingkun was reckless.

Moreover, Pang Dingkun's explanation caused Yan Haihan to frown, while Guo Haoran felt a little relieved, and then said: "Then what should we do with this intractable shoulder dislocation?"

To be honest, at the beginning, I heard from people in the department that the doctor of orthopedics made a problem with the manual reset, and the reset was unsuccessful several times.

The patient was crying in the operating room, and his husband was about to beat him up.

He thought he had encountered that kind of high-learned and low-energy, and thought that Pang Dingkun was a pure idiot.But now that I think about it, that doesn't seem to be the case.

Others have prepared much more than themselves.

"Director Yan, why don't you give Luo Yun a call? Let him come and take a look? I used to be a specialist in orthopedics, and I have a lot of contact with orthopedics. Luo Yun is a graduate student specializing in joint surgery." Pang Dingkun explained rather depressedly.

He also had his own ideas, and encountered this problem when he was doing the technique reset for the first time, and he felt that he had already made sufficient preparations.

But unexpectedly, who knows, just invite Luo Yun to help, even though it's not good looking.But I'm still a late learner, even though I'm about the same age as Luo Yun, I don't have much clinical experience.

"Okay!" Yan Hanhan nodded.

Since Pang Dingkun wasn't doing stupid things and did it recklessly, then he wouldn't blame Pang Dingkun or beat him at this time, he should settle the matter first!

Later, I must remind Pang Dingkun.

Yan Haihan then called Cai Dongfan first, asking him to take over Luo Yun's current operation, and explained the current situation.

Cai Dongfan agreed without much hesitation.

When facing patients, the Department of Orthopedics is integrated. If there is any trouble during the reset in the Emergency Department, it will lose the face of the entire second ward of the Department of Orthopedics.

Speaking of it, it must be that Yan Haihan's embarrassment is greater, but in the hearts of others, it is the lack of strength in the second department of orthopedics.

Breaking the bones and connecting the tendons, fighting in private, that is a private matter, it is impossible for him to trip Yan Haihan at this time.

Then Cai Dongfan immediately said: "Director Yan, I understand, I will call Luo Yun immediately and ask him to come over."

Yan Haihan was taken aback, he didn't expect Cai Dongfan to be so sensible.

Cai Dongfan called Luo Yun and he called Luo Yun, although the matter is the same, the meaning is completely different.

"Thank you, Director Cai." Yan Haihan's heart moved slightly.

"Small matters, Director Yan, please communicate with the patient first." Cai Dongfan added one more sentence, paving the way for Luo Yun.

What did he ask Yan Haihan to communicate, he must communicate about the operation.

And he took the initiative to tell Luo Yun, just to remind Luo Yun, don't do it rashly...

Luo Yun quickly came to the emergency department, wearing the hand washing clothes in the operating room. (Note: Hand washing gowns are the clothes to be worn in the operating room, usually short-sleeved trousers and green slippers; sterile surgical gowns are long-sleeved sterile gowns to be worn during surgery.)
However, when Luo Yun saw the plain film of the patient's preoperative examination, his face changed suddenly, and he looked at Pang Dingkun first.

"How is it? Luo Yun?" Yan Haihan asked.

"It is obvious that the humeral head is stuck on the humeral glenoid, which is quite a special type of irreversible anterior shoulder dislocation. I have only seen similar case reports."

"But the dislocation used the Kocher reset method, which is also the external rotation reset method used by Dingkun just now. There are no other methods mentioned in it. If we want to try again, we may still have to use the success rate to compare Gao’s Kocher external rotation reduction method.” Luo Yun deserves to be a professional in joint surgery.

I still know more than Pang Dingkun.

Even for Pang Dingkun, it is impossible to review all the literature and books of orthopedics. What he knows most is bone tumors.

But the eighth hospital is still blank in this area for the time being. After he entered the department, he suggested to Yan Haihan to perform a few small bone disease operations, but none of them were bone tumor operations.

He knows about joint dislocation, but he is not that professional.

If he hadn't heard that director Zheng in the emergency department was being eccentric, he wouldn't have bothered to do it. It wasn't that he wanted to be brave, but he felt that what he said, and the people who said those words, was something wrong and gossips.

You have the ability to talk to Yan Haihan face to face, what is the doctor on duty doing?

But now he heard about the entrapment of the glenoid, and he understood why he couldn't go up.

This is like, if you put a wooden stick in the crack of the door and insist on closing it, can it be closed?It's strange if it is closed, the method is wrong, either the stick is broken, or the door is broken...

That's scary.

"Ms. Luo, can you do it later?" Pang Dingkun asked.

"Let me try it first, it's hard to say, I'm not sure." Luo Yun said, not daring to finish his sentence.

Pang Dingkun took the initiative to inform the current situation: "I have reset three times, and I still have two chances at most."

Although the method of reset is good, you can't be greedy for too much. If you really can't do it, you have to give up if you have to give up.

Luo Yun frowned: You tried three times?

……

Zhou Chengcai opened the book, read the basic knowledge of fractures, and was about to extract the key parts of it, as the material for simulating ideas and polish it.

The phone that was flat on the desk vibrated.

In fact, Zhou Cheng usually doesn't put his mobile phone at hand when he studies, because he is afraid that he will not be able to help looking at it.But the reason why it was released today is that Luo Yun or Cai Dongfan might call him.

After all, there are a lot of emergency surgeries today, if there is another surgical patient who is going to be on stage suddenly, it must be Cai Dongfan who will take the lead.

If there is any more, there is no way to do it. It depends on whether the patient can wait or not, or go to the orthopedic department to shake people.

Cai Dongfan came to the stage and asked himself to be an assistant, so he definitely couldn't escape.

Seeing that it was Luo Yun's, Zhou Cheng sighed, stopped writing, and closed the book.

Immediately connected: "Teacher Luo, I'm Zhou Cheng."

"Zhou Cheng, why don't you come to the emergency department now. Come and take a look." Luo Yun said rather tiredly.

"Ah~?" Zhou Cheng was very surprised.

what is it today?And the emergency department, right?

Luo Yun continued: "Is it inconvenient? That's fine."

"No, Mr. Luo, I'll go right away."

"Is it the patient with joint dislocation?" Zhou Cheng asked as he got up and walked out. It was necessary to inquire clearly.

Luo Yun said solemnly: "Yes."

"After the fourth attempt to reset failed, he reported Pang Dingkun. He said that we misdiagnosed, and now the people from the medical department and the general on duty have come to the emergency department to understand the situation. Anyway, it is a mess."

"The patient's family members are very sophisticated. They politely said in person that they went out to buy water, and when they left the house, they called the medical department..."

"Hey, the medical department is mediating now. Let's think of a way to try to keep the patient from undergoing surgery. Stabilize the emotions of the patient and his family."

"I called you to let you come over and chat casually. Director Cai and Director Hu are both on stage, and there is no one else to complain about."

Zhou Cheng paused, and was startled by Luo Yun's coquettish words.

are you seriousTeacher Luo?

Call me to complain with you?
(End of this chapter)