Nineteenth Century Medical Guide

Chapter 230 227. Olmitz Fortress General Hospital Surgery Symposium [3] - City General Hospital No Weak Chickens
Delvaux's relegation made the atmosphere in the conference room very depressed.

In the medical field, only the chief surgeon has ever surrendered his identity and acted as an assistant temporarily, because only in this way can students have the opportunity to practice and stand out.I have never seen any medical institution that downgrades a chief surgeon to an assistant. Not only is this practice not beneficial, but it will seriously damage the confidence and morale of doctors.

Carvey also had this concern at the beginning, but considering that the reform will inevitably affect the interests of some people, he was relieved.

In order to ease the conflict, he specially gave enough space to the scoring system, only 1 point will be deducted for mistakes, and 3 points will be awarded for one compliment.As long as Anan works according to the instructions in his military doctor's manual, even if he has no talent and cannot be praised, the deduction of points will not be enough to deduct less than 15 points.

If someone among the assistants can get two praises and rise to 16 points without making mistakes, that is enough to show his value, and it is okay to give him a chance.

In theory, only when these two situations occur at the same time can the substitution mechanism be activated.But at that time, according to Carvey's previous prediction, it would have to be considered in the middle stage of the war. The assistants had already accumulated quite a lot of experience in wards and operating tables, and it was not impossible to replace them.

Who knows, the surgeon who was called up from Innsbruck gave him a big surprise.

It's only been a few days since the battle started, and the score has dropped to 12 points, which is the point deducted only after Kawei closed his hand.According to the top three foreign emergency standards of the original job, such performance is enough to expel him three times.

But in the eyes of everyone, the standard for judging surgeons is still in place, and Delvaux's performance is not bad.

From the afternoon of the 26th to last night, he performed a total of 9 major abdominal operations, debridement and amputation are countless, and there is no credit but hard work.At this time, directly deducting his points to this point, and even replacing him as the chief surgeon, is really unreasonable.

The audience looked at the podium, which had become a foregone conclusion, and everyone began to discuss in low voices.

We are all surgeons in their 40s and [-]s. Although they come from all over Austria and don’t know each other, they all have the same goal at the beginning: to serve the empire, then get the rewards they deserve, accumulate a wave of qualifications, and return to the In the original hospital, the body can also be tougher.

It was only after seeing Kavey's surgery repeatedly in Vienna that their goal changed: to learn some more advanced surgical techniques on the basis of the original.

"Do you use the number of operations to describe a surgeon as good or bad?" Carvey didn't understand this kind of thinking. "If the chief surgeon has done a lot of operations, he is qualified to stay in this position? Then I may only have enough to go to the hospital." Serve as an army doctor on the front line, because the number of surgeries I perform cannot compare with yours."

"Should he directly downgrade his position as chief surgeon, should he consult the military medical office or the chief surgeon?"

"Mr. Ignatz's requirements are stricter than mine. Fortunately, he doesn't care about this kind of thing." Carvey directly denied one of his options, and then said, "As for the military doctor's office, I have the king's authorization, so I don't need to ask Mr. Edinson reported, besides, I am the director of this hospital."

Surgeon and assistant are not promoted or promoted in ordinary companies. It is not as simple and easy as outsiders think, because it will be very difficult to climb from assistant to chief surgeon again.

Even if this happens, it depends on Kavey's face whether he can pick up the scalpel again.At this time, watching Sarsen get up from the seat at the back of the seminar and walk quickly to the front of the stage, everyone was in danger for a while.

Since the withdrawal from the chief surgeon to the assistant was unavoidable, the doctors in the audience hoped to prevent another decision.

After all, a junior assistant who has just graduated from medical school and has only been working in the clinic for less than a year, is suddenly promoted to a chief surgeon, which is not good for anyone.They couldn't help but put a big question mark, is this really okay?
"of course can."

This time, Carvey did not argue with them about rules or work attitudes, but directly presented examples:
"Watman, the dean of the Austrian Academy of Surgery, picked up the scalpel and performed the first amputation three months after graduating from the University of Vienna Medical School. His son, who is now the chief surgeon, Mr. Ignatz, is even more ruthless. He already showed his amazing surgical talent while he was studying for a Ph.D., and won the first amputation operation in his life."

The audience shook their heads at this kind of example. After all, this father and son is a once-in-a-century talent in Austria, and there is really no universality.

"If this is not enough, then I can say something even crazier." Seeing that they were still unconvinced, Carvey could only continue, "Karvey Hines, a first-year undergraduate student at the University of Vienna School of Medicine, has completed nearly 70 Surgery. Now he is leading the top surgeons in Austria to try his best to rescue the wounded soldiers in the war.”

The audience was stunned.

It's okay to pull yourself out, it's a foul
"Look at Sarson, he is not an ordinary medical school graduate you have seen." Carvey explained, "He is an excellent student carefully selected by Mr. Ignatz, who is stricter than me. ...If you still feel that these reasons are not sufficient, then go and see what the doctors from the Municipal General Hospital are doing now."

Municipal General Hospital?
Only then did they realize that Sarsen came from the Municipal General Hospital in Vienna, a very large welfare hospital with the most beds and the most surgeons in Austria.

The doctors who come out of here can be a little stubborn, a little arrogant, and these and other character problems, but there have never been mediocre doctors here.

Watman is from here. Ignatz is now the chief of surgery. Needless to say, Carvey. Although Hills has left the Municipal General Hospital, he has been there for seven or eight years and is now the head of the fortress hospital. The Acting Chief, Herman, is a first aid member of the First Aid team.

Among the younger generation, Bergett was the third assistant of the first team, and Melen was already the doctor of the third infantry regiment of the first army, and only Sarson was still working as an assistant.

Gold always shines, and Carvey's surprise is fairly balanced. When Delvaux made frequent mistakes, Sarson proved himself.

His grades in the medical school were already good, he was No.2 in his class, but he had been overshadowed by Beckett's light before, so he seemed inconspicuous.

Carvey cleared his throat: "Think about your grades in medical school. If you only talk about the grades in these subjects, he is better than everyone here. I know this cannot be used as a basis, but it can prove that his learning ability is enough to digest Get rid of everything in that medic's handbook."

The performance ability is good enough, and the hardware level behind him is guaranteed. Sarson is now a veritable chief surgeon of the Fortress General Hospital.

In the face of such facts, some different voices finally appeared in the audience: "I agree with Dr. Carvey's point of view. Although Sarson is not qualified enough, his talent and hard work are beyond his peers. I agree."

"Okay, okay, I agree too, the operation went really smoothly with him as an assistant."

"Then I also agree. His assistant level is indeed a level higher than others."

"When you say that, I also feel the same way. He can always expose the parts you want in front of your eyes in advance, and it's not tiring at all."

"I also."

Until this time, the doctors in the seminar discovered an interesting fact.Sarson is not like other assistants who only talk to specific surgeons. During these three days, he has been an assistant to almost all surgeons.

The operations on these beds were what he saw in the operating room.

Delvaux's assistant was not on the scene at the time, and there were only two people on the operating table, so he was dragged to the stage because he was too busy.

In fact, Delvaux's surgical skills are not bad, otherwise he would not have passed the examination.However, his understanding of surgery still remained at the previous level. He did a very poor job of preventing possible postoperative complications regarding some supportive treatments before and after surgery, and observation of patients after surgery.

In other words, after studying the requirements in the military doctor's manual, he still didn't think about what happened after the operation.

In this regard, Sarsen has been following Ignatz and has taken Kavey's operation seriously, so he has developed a good habit over time.

After seeing Delvaux's surgical work, he saw that the reminder didn't work and the other party still went his own way, so he could only choose to record all possible situations in text form.

This is also the medical record writing work that Carvey has always hoped that doctors can complete, and it has also become an important evidence that Dr. Delvaux can become a negative teaching material.

Of course, his original intention of writing the medical records was just to record the changes of the patients, and he also hoped that there would be traces to follow when discussing the final death cases.Even Sarson himself didn't expect that the habit of writing medical records that Kavey forced to develop in the Municipal General Hospital would win him the position of chief surgeon here.

The chief surgeons were really uncomfortable, but it was very good news for the assistants outside the conference room who were still busy with other chores.

Because relying on points to grab the position of the chief surgeon is not empty talk, but a fact that has already happened.The jump in status not only provides them with more income, but also writes a strong stroke in their resumes in the army.

For the 20 surgeons in the conference room, this time it sounded the alarm for them.

Delvaux has been reduced from being a surgeon to an assistant, breaking their previous position thinking mode.If the treatment of the wounded is not serious enough, it will not only be a superficial punishment such as deducting points, but it will really lose the current job.

After graduating from medical school, it took ten years of hard work to get the position of chief surgeon, and no one would let it go easily.

Delvaux's case has been fully analyzed, and Carvey also explained the reason for Sarsen's appointment, and the discussion returned to normal: "Okay, now let's get down to business, and return to Ronagne."

"Everyone, please pay attention."

Carvey took out a long stick and tapped a head on the white cloth behind him: "As I said before, if the wounded has a history of craniocerebral trauma, if the wounded suffers severe headache and vomiting that is difficult to relieve, and appears to be confused Waiting for a series of symptoms, which means that the intracranial pressure has increased, and the brain tissue is under pressure that they cannot bear. At this time, the skull must be opened to release the pressure."

This is the surgical treatment of craniocerebral trauma clearly stipulated in the military medical manual.

It seems that the text is straightforward and easy to understand, but from the perspective of those surgeons, it is too risky to open the skull so easily, and it is contrary to other methods of treatment.

"I admit that this article is very vague, and the time was too tight when I wrote this manual." Carvey said, "I admit that the content of the manual is not complete, and now I have to make some changes to the criteria for judgment."

Symptoms are an extremely subjective judgment, and there will definitely be deviations between the patient's feelings and the doctor's understanding of symptoms.In modern medicine, symptoms can only be clues, not a necessary condition for diagnosis. Only specific numbers and images can determine what words the doctor writes in the diagnosis column.

Therefore, it is not a rigorous method to judge intracranial pressure from symptoms alone.

"Last night, Ronagne had an increase in blood pressure, which is a sign of increased intracranial pressure [1]." Carvey praised again, "The nurse is really sharp, and according to me, every day Blood pressure measurements are given at intervals."

"He himself can't tell how he feels, and I can't fully judge his intracranial pressure just by blood pressure."

As Carvey said, he asked Sarsen in the audience to take out a device【2】that he used last night: "This is the intracranial pressure measuring device I use. It is a very simple device, but it is difficult to operate. From We can judge the level of the intracranial pressure of the wounded very well on the scale, if"

Suddenly, Delvo, who stepped down just now, jumped up: "It turns out that the problem lies with you. You didn't write down the method of measuring intracranial pressure. How do you ask me to judge?"

Carvey put down the pressure gauge unhurriedly, and said: "Doctors will definitely make mistakes, and there will also be deaths of patients and wounded. This is an unavoidable thing. Your mistakes are never dead, but because of your bad behavior." Clinical work attitude! It was you who didn’t care and only focused on managing your own status, which led to their deaths. This is something I can’t tolerate!”

(End of this chapter)