Gou is practicing medicine in the clinic

Chapter 101

To be honest, it's a bit unruly for him to do so.

Because Li Jingsheng is a doctor outside the hospital, he has not been registered in the Second Hospital.It is definitely not allowed to wear work clothes for clinical operations in the Second Hospital.

"It's a good thing we have more helpers in the orthopedic clinic! At least when we have to hug the injured in the future, there will be an extra man to help!"

The nurse said with a smile.

"Hello handsome guy, my name is Li Li, an outpatient nurse, and I am very happy to be your colleague."

The female nurse seemed quite enthusiastic.

"Hello, please take care of me!"

Li Jingsheng's answer is a universal formula.

This petite female nurse with thin willow-leaf eyebrows and exquisite makeup has hidden sharpness in her eyes, and she doesn't know if she will be easy to get along with?As a newcomer, the interpersonal strategy he chooses is not to be close friends, not to offend, not to alienate, and to maintain a peaceful face.

The doctor surnamed Chen was a little cold. When he met Li Jingsheng's eyes, he just nodded and did not talk to Li Jingsheng.

"Li Li, call the first patient in!"

Dr. Xu is sitting on the 'handsome seat', ready to fight.

"Xiao Li, when you feel the bones, you must carefully feel the bones, muscles, and tendons, and then pay attention to distinguishing the patient's bone condition. The patients treated here are mainly trauma, but occasionally they will also be accompanied by other bone diseases. .If these bone diseases cannot be found, the bone setting is likely to fail and even cause trouble.”

Before going into battle, this was the last reminder to Li Jingsheng.

In fact, it can also be regarded as a kind of special care.

Dr. Chen next to him couldn't help but look at Li Jingsheng with a little jealousy.

Apparently, he had never received such special care.

The No. 1 injured person was sent in, and he was directly injured at the level of Wang Bo.

Hip dislocated,
The person could no longer stand or sit, and lay on the stretcher humming non-stop. The injured looked pale and dying.

Seeing this situation, ordinary doctors have long been trembling in their hearts.

Who dares to reset his bones?What if the injured person is stimulated during the operation and the breath is broken?
Moreover, the treatment after hip dislocation is often open and surgical reduction.

"How did this happen?"

Dr. Xu was not in a hurry to examine the patient, but asked the patient first.

"I was hit by a car while riding my motorcycle."

The family members seemed a little annoyed when they responded.

The middle-aged man who was helping to carry the stretcher next to him had an apologetic expression on his face.

Li Jingsheng knew at a glance that the middle-aged man carrying the stretcher was probably the driver who caused the accident.

Under normal circumstances, when a car collides with a motorcycle, regardless of whether it is wrong or not, the big car is in a weak position.Unless it is clearly stipulated in the current traffic law that the person hit by running a red light, it is possible to sentence the other party to full responsibility.

"We also heard that the second hospital's orthopedic restoration skills are very good, so we came here specially to seek treatment. Please be more considerate."

The driver who caused the accident took out a pack of good cigarettes from his pocket and secretly handed it to Dr. Xu.

Li Jingsheng secretly laughed, that kind of society is often brought into the hospital, in fact it is because they do not understand doctors.

Serious hospitals pay great attention to the construction of medical ethics and medical ethics, and they will not accept gifts at all.

Some people swear that red envelopes must be given to the surgeon, anesthesiologist, and nurse before the operation. They also said that they did not give red envelopes to the anesthesiologist, and they woke up halfway through the operation.

I dare not say that there must be no such thing, at least it is difficult for such a thing to happen in a regular hospital.

The medical department and the discipline inspection and supervision office are not decorations.

As long as the root of the hospital is not rotten, a complaint call can immediately make the doctor concerned go away.

"I will definitely treat you with all my heart, don't worry. Our hospital stipulates that we cannot accept gifts, so please don't do this. Otherwise, you will be harming me." Dr. Xu said in a serious tone.

The driver who caused the accident put the cigarette back in his pocket resentfully.

Doctor Xu looked at the patient on the stretcher.

"What's your situation now? Can you still move?"

Before setting the bone, you must ask a doctor and understand all the necessary information before starting the treatment.

"I can move my hands, but I can't move my legs. My butt hurts... I feel like I'm dying."

The patient was a thin man in his 50s, and his speech was weak.

When the driver who caused the accident heard this, he almost didn't cry in fright, and stood beside him with a worried expression on his face.

"Can you feel me touching your leg?"

"can!"

"Did you have a full body check?"

Dr. Xu asked family members this time.

"It was done, it was done, and it was said that there was nothing serious about other places. It was just a skin abrasion on the arm and so on. The right hip joint was dislocated."

The driver who caused the accident rushed to answer.

Dr. Xu received the film from the family and examined it carefully.

Li Jingsheng stood by and watched along with him.

He was pleasantly surprised to find that after his proficiency in general surgery diagnosis reached the proficiency level, his ability to read films seems to have improved.

When looking at the chest X-ray, there is a more accurate insight into whether there are bleeding points, fractures, etc.

Some bleeding points are very hidden, and doctors in the medical laboratory may not be able to find them.

However, experienced chief physicians can sometimes discover doubts from some clues, so as to avoid medical accidents.

The chest, abdomen, and head were checked, and there was really nothing serious.

Only the right hip was dislocated.

The wounded looked like he was dying, and he was still screaming that he was going to die. No matter how you looked at it, it seemed a bit like 'blackmail'!

At least it has the meaning of scaring the driver who caused the accident.

Everyone has their own little Jiujiu, and they just want to get a little more compensation.

"Xiao Li, look at the X-ray of the hip joint."

The patient took a lot of films, not only X-ray examination, but also CT.

The lack of an MRI examination should be due to the conscience of the doctor, who did not issue this application.

After all, MRI examination is a very precious medical resource.

If it is in a larger hospital, MRI examinations are often given priority to those patients who really need them.

For example, a tumor that cannot be diagnosed, or a disease for which the cause cannot be found.

Dr. Chen next to him looked at Dr. Xu with resentful eyes and gave Li Jingsheng the hip X-ray.It feels like the difference between biological and non-biological.

Li Jingsheng took the film and examined it carefully.

"Remember the bone position of the hip joint dislocation in the film, and then you check the hip joint for the patient."

Dr. Xu calmly gave Li Jingsheng an incomparably precious opportunity to touch the bones.

Dr. Chen next to him was completely fortified.

What the hell, what is the origin of this new Dr. Li?Could it be Dr. Xu's relative?

I've never seen Dr. Xu take such care of any subordinate doctor.

After watching the film, Li Jingsheng squatted down and began to recall the key points of the bone touching technique.

First light and then heavy, first far and then near...

He began to carefully feel the bones of the patients.

Because of the special position of the hip joint, where the fat layer is extremely thick and the muscles are rich, it is not easy to touch the bones.

"Ah yo ah yo...it hurts, it hurts..."

The patient screamed.

This time, it no longer sounded weak, but more full of energy.

Actor!
The family members stood by and watched, with worried faces and anger in their eyes.

"If you don't want to have surgery, you have to bear with it. It is not only cheap, but also quick to recover, and there is no sequelae. Surgery is much more painful than this."

Dr. Xu helped Li Jingsheng speak calmly beside him.

After the family members heard this, their expressions became more natural.

The patient also gritted his teeth and endured, no longer so 'delicate'.

He's dislocated his hip, and it hurts when you touch the bone, that's for sure.After all, Li Jingsheng is a novice, he has just learned the theory of bone touch technique, and now he has not even reached the entry level.

It was bad luck that the wounded fell into his hands.

It is no wonder that many patients go to the hospital for treatment, and the most fearful thing is to encounter intern doctors and nurses who use them as guinea pigs for practice.

Of course, whether it is an intern doctor or an intern nurse, they will not tell the patients and their families that I have just been an intern and I want to test my clinical practice skills with you.

If you really say that, no family member will agree.

After touching his bones, Li Jingsheng gradually gained some experience.

The X-ray images memorized in the mind correspond to the actual bone position after bone palpation, and then slowly summarize and correct the deviation.

After touching it for seven or eight minutes, several layers of cold sweat appeared on the patient's forehead, which was painful.

The patience of the family members is gradually approaching the limit.

Li Jingsheng also quit as soon as he saw it, and he stopped his hands and stood up after he had almost practiced the bone touch technique.

"No fracture was found, and the patient's muscles were tight. Before reduction, he should find a way to relax the muscles around his hip joint."

Doctor Xu nodded slightly after listening.

"Oh, are the muscles tense? Let me see."

After speaking, he started it himself.

Compared with Li Jingsheng's unfamiliar operations, he is obviously much more sophisticated.

After touching it for less than ten seconds, I stood up and said to the family members, "I'm afraid I need anesthesia before the bone setting and reset. It may be because of pain and tension, the muscles are very tense, and this cannot be done at all."

"It's ok, as long as I can help my brother reset his hand, it's no problem to get some anesthetic."

The family members nodded in agreement.

"The anesthesia is very good, and there will be no pain when the manipulation is reset."

"The technology here is really good, and the two hospitals have said that they need surgery to reset."

Several family members talked with each other and discussed one after another.

The driver who caused the accident stood beside him honestly and did not speak, fully cooperating with the patient's treatment.

In addition to blocking nerve conduction so that patients do not feel pain, anesthetics also have another effect, which is to relax muscles.

The hip joint is very special, located at the junction of the trunk and lower limbs.

There's no way to use local anesthesia in this place.

Unlike the arm, the brachial plexus can be anesthetized directly.

Hip joint reduction is usually performed under general anesthesia or epidural anesthesia.

Dr. Xu has asked the nurse to bring the anesthesiologist over.

It must be mentioned that an epidural is not a spinal anesthesia.The former is commonly used, while the latter is rarely used.

Because spinal anesthesia may damage the spinal nerves.

It may even cause local infection.

Because of the relatively strong side effects, doctors seldom use spinal anesthesia in line with the principle of seeking good luck and avoiding evil.

After the anesthesiologist arrived at the scene, anesthesia was quickly arranged.

"Come on, lift the patient onto the treatment bed."

Dr. Xu instructed Li Jingsheng and Dr. Chen to carry the patient to the treatment bed.

This treatment couch is reinforced and extra strong.

It is slightly higher than normal hospital beds.

It should be for the convenience of bone setting operation.

Relatively speaking, epidural anesthesia is much safer than general anesthesia.The operation is also more convenient.

Anesthesiologists are very cautious when cooperating with nurses.

After the puncture is successful, give a small test dose first.

Then wait patiently and observe the patient closely.

After more than ten minutes, the patient was asked if there was no waist numbness, and then a large amount of anesthesia was injected.

Li Jingsheng watched them operate from the side, envious in his heart.

The seemingly easy puncture is actually full of risks and extremely technical.

Although the anesthesiologists are taciturn and extremely low-key, they are called the patron saints of patients' lives during operations.

Since ancient times, there has been a saying that the main knife cures the disease and anesthesia saves life.

Anesthesiologists have veto power in preoperative risk assessment.

The chief surgeon thought the operation could be done, but the anesthesiologist thought the risk was too high, so he had to give up.For this reason, there are often quarrels between the chief surgeon and the anesthesiologist in the consultation room.

In fact, they are a pair of close comrades-in-arms.

"Old Yu, is it almost there?"

Dr. Xu asked the anesthesiologist.

"Well, it's alright."

The anesthetist named Lao Yu is about 40 years old, with beards all over his face, about 1.8 meters tall, quite tall, but not strong.

From coming in to now, there are only four words spoken in total.

"Is he the one getting the epidural?"

Then check and evaluate the patient, and the nurse asks the patient whether he has a history of drug allergy and underlying diseases.

"No problem, please sign the family."

"You must not move during the anesthesia."

These are the four sentences that the anesthesiologist said when he came in.

Li Jingsheng always feels that many anesthesiologists who don't like to talk often have long-term high tension during their work, and then develop mental and psychological diseases, so they have a cold face and don't like to talk much.

Of course, I would never dare to say this in front of other anesthesiologists.

Dr. Xu walked to the left side of the hospital bed and said to Li Jingsheng and Dr. Chen, "For the reduction of this type I hip joint injury, the muscles need to be relaxed first, followed by anesthesia, and then manual reduction can be performed."

"When resetting, let the patient lie on his back on the hospital bed or on the ground. Doctor Chen, hold the patient with both hands to stabilize his body."

"okay!"

Dr. Chen finally had a sense of presence, and a happy smile appeared on his face.

Not to mention him, even the attending physicians in the department are rarely able to perform hip joint reduction proficiently.

Probably the method is basically understood, but the actual operation is completely different.

If you haven't learned the bone palpation technique, it will be difficult to succeed in a slightly more complicated bone setting reduction.

"Xiao Li, look carefully."

Dr. Xu's next words froze the smile on Dr. Chen's face instantly.

Personal or biological.

Wild is still wild.

Apart from envy, he also wants to know what is the relationship between Li Jingsheng and Dr. Xu?
Dr. Xu didn't even give face to the dean, but he gave Li Jingsheng careful guidance everywhere, which was too enviable.

"During bone setting reduction, stand facing the patient, let the patient's joints bend, and then hold the back of the patient's knee with both hands and do continuous stretching. At this time, you have to feel the degree of muscle relaxation of the patient, and rotate outwards slightly after reaching the condition... ..."

click!
A bone sound sounded, and the patient's right leg looked much more natural.

Doctor Xu looked at Li Jingsheng, "Do you understand?"

"Well, I probably understand."

Li Jingsheng nodded.

"You check the patient to see if the hip joint has been successfully reset."

This is another chance to give Li Jingsheng a bone-touching opportunity!
With the approval of the teacher, the treatment is different.

Li Jingsheng recalled that when he was working in another big hospital, the superior doctor didn't even use him as a pull hook, and now he is given ample opportunities everywhere, which is completely double treatment.

He bent down to touch the patient's bone.

It is obvious that the patient's leg muscles are in a state of relaxation, and the position of the bones has also changed.

It feels more natural to the touch.

From far to near, when touching the hip joint, carefully feel the bone position and joint shape at the joint.Not satisfied with this, he touched the patient's left hip joint for comparison.

The family members didn't say anything this time, but watched nervously, expecting a good result.

The driver who caused the accident was even more discordant.

If you really want to have hip surgery, he heard that the treatment cost more than 20 yuan if it is more expensive, and more than 3 yuan if it is cheaper.

Even if it is an infant under 18 months, the treatment fee will cost more than [-].

The key is also the patient's lost wages, nutrition expenses, and nursing expenses. The sum of seven or seventy-eight eighty-eight will definitely make the driver brother faint in the toilet.

If the manual reset is successful, many costs will be greatly reduced.

Everyone looked at Li Jingsheng expectantly, waiting for him to give the result.

Dr. Chen stood by and was extremely envious.

"The bone positions of the hip joints on both sides are basically symmetrical, and the bone position on the right side is natural. There is no dislocation in the joints, indicating that the manual reset has been successful. But if you want to be more accurate, it would be better to take an X-ray."

Li Jingsheng added one more sentence at the end.

Taking an X-ray is not expensive and can reduce disputes.

If the reset is not successful, but it is not touched out, and the femoral head necrosis is caused after a long time, the responsibility will be great.

There were smiles on the faces of the driver and family members, including the patient himself, who also showed the joyful expression of being reborn after the catastrophe.

"Dr. Chen, please take the patient and his family to take a film to see. If the reset is successful, the patient will be admitted to the hospital. He needs to stay in bed for leather traction and wear anti-rotation shoes."

Dr. Xu's words made Dr. Chen tortured again.

Why can't the newcomer Li Jingsheng be called?
He glanced at Li Jingsheng with resentful little eyes, and then honestly took the patient to take a film.

Anesthesiologist Lao Yu packed up his toolbox and prepared to leave with the anesthetist nurse.

Staring at Li Jingsheng, he asked Dr. Xu, "A new apprentice?"

"No."

Doctor Xu flatly denied it.

"Hmph, this kind of treatment is probably only available to apprentices. Let's go."

Lao Yu looked at Li Jingsheng meaningfully again, and left with the treasure chest.

The most mysterious person in the hospital should be the anesthesiologist.

They can often be seen in operating rooms, wards, and emergency rooms.When he appeared, he always carried a treasure chest with green skin and yellow lid, and came and went in a hurry.

Dr. Xu pretended not to hear, and instead of calling new patients in, he asked Li Jingsheng, "What did you gain from touching the bones just now?"

"I can feel the position and shape of the bones, as well as the surrounding muscles and fat layers."

"It's not enough. What you feel is superficial. You have to go deeper and discover some details."

After Dr. Xu heard his words, a trace of satisfaction clearly flashed in the depths of his eyes.

There was no expression on his face.

There is no praise for what is said, only encouragement.

"When you go back, you must understand the whole process and details of the hip joint reset just now. This kind of reset is relatively rare." After speaking to Li Jingsheng, he turned to look at nurse Li Li. "Call the next patient in!"

(End of this chapter)