Gou is practicing medicine in the clinic

Chapter 150 Obtaining two medical skills in a row is definitely not a minor illness

This operation made Li Jingsheng feel the shortage of manpower and incomplete equipment.If the number of surgical patients received in the future increases, it will definitely be necessary to purchase some other equipment.

As for manpower, there is no need to worry about this.

As long as the business improves, new medical staff will definitely be recruited.

Boss Zhao’s Kuaikang clinic has many medical staff.

As a large amount of pus was sucked away, the patient's abscess obviously collapsed a lot.

The incision he chose was at the lower edge of the mandible, parallel to it, and the length of the incision was about 1.5 cm.

These surgical techniques require the doctor himself to read a lot of books and have a certain accumulation of surgical practice experience.Li Jingsheng has very little experience in surgery, but he likes to read books.

Cooperating with the proficient level of general surgery diagnosis and skin incision, it is natural to understand some surgical techniques and suitable knife position selection during the operation.

Just like a skilled worker, he knows how to do the job when he sees the raw materials.

General surgery diagnosis is mainly for etiological diagnosis, but it is also helpful for surgery, which makes Li Jingsheng pay more attention to this medical skill.

In the future, when the life value is sufficient, you can consider raising it to another liter.

"I didn't expect there was quite a lot of pus!"

The oral mucosa has been incised at this moment, but there is no way to place the rubber drainage strip well.

He picked up the vascular forceps and bluntly dissected the abscess cavity along the mucosal incision.

The whole operation process is very careful.

He has initially mastered sharp separation and has reached the entry level.Blunt separation has only mastered theoretical knowledge, only seen how the teacher operates, and has not reached a higher level of practical operation.

At this moment, it is hard to catch the duck.

But he had prepared and estimated before the operation.

Because this separation is not very difficult.

It is equivalent to giving him a good opportunity for practical training.

In the case of limited conditions, he must work hard to create opportunities for himself to practice this basic surgical skill.As long as the risk is well controlled, there is generally no major problem.

The ideal is to successfully reach the entry level after just one or two practice sessions.

With the help of vascular forceps, he moved gently along the parotid duct and facial nerve to separate.

Definitely still a little nervous.

After a while, the abscess cavity was successfully separated.

You can get a glimpse of most of the abscess cavity.

Severe suppuration, foul smell, all superficial tissues in the abscess cavity purulent.Similar to rotten white flesh, pale yellow, full of viscous pus.

After continuing to suck away part of the remaining pus in the abscess cavity, the next task is to establish drainage.

He began flushing the entire abscess cavity with saline.

"Ah... it hurts!"

The patient spoke indistinctly, with a slightly distressed expression on his face.

In clinical nursing, medical staff will judge the degree of pain based on the patient's expression, body movements, etc.

The pain level of this patient should be about 4 points at most.

Physiological saline flushing may bring some pain to the patient.

After all, the use of local anesthetics on the face and mouth will certainly not have a 100% blocking effect on nerves.

"Be patient a little bit! The operation will be over soon."

Li Jingsheng was not only comforting the patient, but also giving Tang Ping a reassurance.

After repeatedly flushing the abscess cavity until it was clean, he put in the rubber drainage strip.

When the drainage strip was inserted, it was not done well the first time, and it was bent, so I had to replace it with a new one.

Because it is discounted when enclosing the drainage strip, it is very easy to cause poor drainage.

At that time, the operation may fail.

The operation of the drainage strip is not as easy as imagined.

In the second time, he had figured out the direction of the inside of the abscess cavity, and the skin incision method had been upgraded to the proficient level, which made him more sensitive to the judgment of hand feeling.When inserting at this moment, operate with the touch, and carefully learn the reasons for the failure of the first insertion.

Finally placed successfully.

After the inspection, no problem was found, so the drainage strip was fixed, and it was considered a success.

The exact effect of the surgery is still unclear.

It needs to be seen whether the drainage effect and inflammation can be controlled in the next few days.

"Okay, the operation is over, take her to the infusion room for infusion! I'll prescribe the medicine right away, observe for a while and then give her the infusion."

Li Jingsheng checked and said to Tang Ping.

The patient should be in a dazed state at this moment.

After all, I just had surgery.

When prescribing, the main thing is to use antibiotics to control inflammation and prevent continued infection and suppuration.

With the efficacy and pharmacokinetics of Xiaocheng level, doing this kind of thing is simply killing chickens with a knife.

Even so, he remains extraordinarily cautious.

To treat every case, we must go all out.

When a ferocious beast catches its prey, even if it catches a prey that is many times weaker than itself, it is still cautious and goes all out.Because they have a survival rule called injury-free.

Just try to avoid injury.

In the cruel nature, injury means that there may be a risk of death.

Li Jingsheng's survival rules in opening a clinic to treat people have the same effect as hunting wild animals.

Any accidents must be avoided.

Because even a small mistake can have catastrophic consequences.

After prescribing the medicine, preparing it, and observing that the patient had no abnormal symptoms after the operation, Tang Ping was asked to infuse her.

For Li Jingsheng, this is a big job.

He summed up the entire operation process, and carefully wrote the medical records and course records.

Many doctors like to use templates to write medical records, which is definitely not good.

It saves trouble, but it loses the meaning that medical records should have, and also loses a good opportunity to summarize.

When writing medical records, he has a lot of experience in blunt dissection and drainage tube placement in surgical operations.

Subconsciously look at the properties panel.

Doctor level experience +10, general surgery diagnosis +1, drug efficacy and pharmacokinetics +1, superficial skin incision method +10, HP +61.

Compared with the two extra skills in the skill bar, the above gains are much bleak.

1/10 for blunt dissection primer.

During the operation, it can be separated with a knife handle, hemostat, stripper, or even fingers.

It can be used in conjunction with Sharp Separation or alone.

For example, when there are many small blood vessels distributed in the subcutaneous connective tissue, blunt dissection is suitable.

There are also some special tissue parts or organs that also require blunt dissection to deal with lesions.

So far, he has no worries in the field of surgical separation.

Both 'soft and hard' can be eaten.

Getting started with implantation 0/10.

This is a special medical technique. In the impression of many people, the function of implantation is to insert a urinary catheter, or to drain an abscess or chest cavity.I think this is a relatively advanced surgical skill.

In fact, it is not only closely related to puncture, but also often used in high-precision minimally invasive interventional surgery.

For example, vascular stents are placed, emergency opening of blocked cardiac arteries, pulmonary arteries, venous vessels, etc., rescue of patients with cerebral thrombosis, insertion of metal coils to solve intracranial hemangiomas for patients, etc.

This medicine is not easy.

"Small ones can lead the family well, but big ones can secure the country." '

Such a powerful medical skill is definitely qualified to be called one of the top skills in surgery.

It was really a surprise that Li Jingsheng was able to raise the implantation technique to the entry level in one fell swoop.

Although there are not many opportunities to use implantation now, he is still very satisfied.

There is a foundation here, and its proficiency can be raised in case the need arises.

If you practice the placement well, in this era when minimally invasive and interventional therapy is the trend, you are even qualified to become a sought-after item in top hospitals.

Departments of cardiology, neurology, neurosurgery, cardiology, and thoracic surgery all lack surgical talents who are good at interventional surgery.

In fact, in addition to the lack of talents in this area, doctors with strong diagnostic capabilities are also lacking in these departments.

If you can do both diagnosis and interventional surgery, then you are basically at the level of a king.

Many experts who are good at diagnosis may not necessarily perform surgery, and doctors who are good at surgery may not be suitable for consultation.

Li Jingsheng can infinitely improve the proficiency of medical skills, it is simply a 'BUG' general existence.

The Sunshine Clinic seems to usher in spring today.

Diagnosis and treatment of this area, again and again harvest.

Selling drugs over the counter is equally busy.

Xiao Gao is already too busy.

Li Jingsheng was about to go on stage in person, so he went to help, and another patient came to see him.

I had no choice but to wait for Tang Ping to finish her work and go to help Xiao Gao.

Today's Sunshine Clinic has succeeded in 'Dao Jie' and has become stronger and stronger than ever.

In fact, this is a good thing.

The clinic will inevitably experience many setbacks from being weak to becoming strong.The most serious of these is the patient making trouble.

Li Jingsheng used to be very afraid of patients causing trouble, so he tried to compromise as much as he could.

Today, his mentality has become more mature, more rational and more stable.

In the face of troublesome patients, even medical accidents, he should now be able to remain calm, and then deal with them calmly and rationally.

"Doctor, my boyfriend has a severe stomachache, please show him!"

A slender young girl helped a 21-year-old man to the clinic.

This girl is quite beautiful, with watery peach blossom eyes, long black eyelashes, beautiful moth eyebrows, thin red lips, and long hair that hangs casually.Even if she only wore a very ordinary white round neck T-shirt, a pair of black three-point shorts, and a pair of cheap light pink slippers, she still couldn't conceal her beauty.

She supported the young man with an anxious expression and worried eyes.

Li Jingsheng really wanted to find a mirror to take a look at, where did he lose?

This buddy is definitely not as handsome as he is, with a medium height, a thin body, and his hair is still very messy and in the shape of a bird's nest.

Why did you find such a beautiful girlfriend?

And he is very concerned about him.

"Come on, sit down here, and I'll check it out for you."

Li Jingsheng must be several years older than this young man, and he is still single.

Marriage is something that no one can say clearly.

"Did you suddenly have a stomachache?"

"No. He went out to drink with friends last night and came back very late. He was very drunk at the time, so I took a taxi to pick him up. As soon as he returned to the rental room, he threw up all over the floor. Wait for me to change it for him. Take off the dirty clothes, wipe off the dirt on his face, and let him lie on the bed first. Then when I was mopping the floor, he clutched his stomach and said it was a little painful."

Instead of her boyfriend who has been covering his abdomen, the girl answered the story of the onset.

The information that can be obtained now is that the young man drank a lot of alcohol last night and then developed abdominal pain.

From last night to now the duration of abdominal pain has been more than 12 hours.

After she took her boyfriend back to the rental room, she didn't let him lie on the sofa in the living room, but directly on the bed.He even vomited filth all over the room.

It shows that the economic situation of the two is average, and they only rent one room.

"I quickly poured a glass of warm water for him to drink."

It's really nice to have a caring girlfriend.

When you are sick, someone asks you about your health, and someone takes care of you.

"When I finished cleaning, he still complained of a stomachache. I hurried to the pharmacy to buy painkillers and took them home. It seemed to have some effect, and he fell asleep afterwards. When he woke up this morning, he still said Stomach pain, we originally wanted to go to the health station to see a doctor. We really didn’t want to leave when we came here, but we just saw that your clinic is full of people, and your medical skills should be good, so we came in.”

The girl has no scheming.

People with a little scheming will definitely not say the latter sentence to the doctor.

"What's the painkiller you take at the pharmacy?"

"It seems to be called...aspirin!"

The girl thought for a while before coming up with the name of the medicine.

There was a black line on Li Jingsheng's forehead. The level of pharmacists in the pharmacy is really hard to describe, there are high and low.

Commonly used pain relievers such as ibuprofen, aspirin, acetaminophen, etc.

As long as the patient has a headache, leg pain, or stomach pain, anyway, it is a universal formula.They will pay special attention to drug contraindications, and basically don't care about anything else.

In a word, it is best for the patient to take the medicine if it works, and if it doesn't work, then go to the hospital as soon as possible.

The biggest advantage of the pharmacy business model is that it takes almost no risk.

Unless the medicine the patient takes has expired, or there is a problem or something happens, there is nothing to do.You can pay whatever you want.

"Blood pressure is a little high, body temperature is 38.6 degrees, and heart rate is a little too fast."

After measuring the three basic signs of the patient, Li Jingsheng realized that the patient's problem was not a small one.

"I just vomited once when I got home last night, right?"

"No, he vomited today too. It's just that he didn't eat. He retched twice, and what he vomited was yellow-green bitter water."

After the stomach contents are almost vomited, only gastric juice can be vomited out.

If it is green, it is probably bile.

The color of bile spit out is not fixed.

It could be yellow, white, grass green, or even red.

This patient vomited gastric juice and bile, further demonstrating that Li Jingsheng's judgment was correct.

It is by no means a minor illness.

What kind of disease could it be?
He couldn't help thinking hard, and made a preliminary diagnosis based on the patient's cause, symptoms, and course of disease.

At present, his gastroenterology diagnosis has reached the level of Xiaocheng, which is still very advantageous.

The gastrointestinal diagnosis level of the senior attending doctor can basically sweep most of the diseases in this field.

Acute gastroenteritis?Gastrointestinal perforation?
"Lie down on the examination bed inside, and I'll check your stomach."

he said to the patient.

"Can it be cured?"

asked the patient, staring at him.

"Only when the cause is found out can the right medicine be prescribed. Now I can't answer you."

Li Jingsheng could understand the reason why this young man spoke a little aggressively.

Suffering from pain, it is inevitable that you will be a little impatient.

Clinically, it is very common for some patients with neuropathy to have drastic changes in temperament and not cooperate with doctor's examination and treatment.

Often need to use sedatives, even tied up people for treatment.

"After searching for so long, I can't even find out any diseases. What kind of broken clinic is this? Forget it, we will die."

The young man suddenly got angry, which made Li Jingsheng feel a little baffled.

"If you don't trust the technology of my small clinic, you can go to a big hospital. But you must not be a doctor yourself, buy some medicine and take it at home. His illness is not like a minor illness. Now he has a serious fever. Procrastinate for fear of accidents."

Li Jingsheng was not angry because of the patient's bad attitude.

Instead, they were advised to go to a big hospital for treatment as soon as possible.

The girl mentioned that she was planning to go to the health station for treatment, which shows that they are very familiar with the terrain and environment here.

Although the strength of the health station is not weak, but based on feeling, it may not be able to treat this patient.

When measuring the patient just now, Li Jingsheng listened to the patient's bowel sounds, about 8 times per minute.

It shows that the intestinal peristalsis is not bad.

Then the patient covered the position of the abdomen slightly to the left.

Li Jingsheng judged that the real source of pain might not be in the abdomen.

The most commonly used and reliable method for doctors to percusse and palpate the abdominal pain is to let the patient lie flat on the bed.

Sometimes patients are asked to lift their legs or turn sideways, raise their hands and other actions to cooperate with the inspection.

"Doctor, I'm sorry, my boyfriend may be in a bad mood. How much do you want here?"

The girl is very obedient to her boyfriend.

But she behaved reasonably politely.

"Our clinic is a free clinic, and there is no charge. Take him to the hospital as soon as possible, and don't delay his illness."

Acute cholecystitis, intestinal perforation, etc., can be fatal.

The young man is still so young, and he has such a beautiful and considerate girlfriend. It would be a pity if he lost his life.

"Thank you!"

She clasped her hands on her chest and thanked and apologized to Li Jingsheng repeatedly.

"Why tell him so much, let's go!"

The young man got up early and walked to the door.

It can only be seen that the whole person looks extremely manic.

Li Jingsheng secretly deduced that either the young man had a bad temper, or the pain increased a lot during the examination, which caused the young man to lose patience.

He didn't feel sorry to see the patient leave.

Because if this patient is not a minor illness, even if the cause is diagnosed, he may not be able to eat.

In the end, I still have to send him to a big hospital for treatment.

If you leave now, you can avoid all subsequent risks.

For small clinics, the most important thing is stability, not 'greedy'.

Outside the clinic, Boss Zhao happened to come to see Li Jingsheng for something.

Finding a new signboard hung in Li Jingsheng's clinic, Boss Zhao stared at it for a long time.

Seeing the young couple coming out, his eyes swept across the girl without any trace.

"Yo, little brother, is this sick?"

"Hello Boss Zhao!"

The young man actually knew Boss Zhao.

Li Jingsheng in the clinic just secretly observed the three of them.

Boss Zhao said that he said that he would not attack him again. Who knows if it is true or not?
Besides, it was not impossible for the station master Qiao to ask Lao Zhao to teach Li Jingsheng a lesson after refusing to be recruited by the health station yesterday.

Li Jingsheng would rather treat the belly of a gentleman with the heart of a villain.

Because he suffered too much.

"Where is this uncomfortable?"

"I drank some wine yesterday, and my stomach hurts a bit. This crappy clinic checked me for a long time, and they didn't even know what disease I was suffering from. It's much more reliable for me to go to your Kuaikang clinic for treatment."

The young man seemed to be familiar with Boss Zhao.

"Do you have a fever?"

"The doctor measured it and said it was a severe fever. He even threatened us, saying that my illness was very serious, and told me to go to a big hospital for treatment. I don't follow his set."

It seems that the young man restrained himself when he spoke inside.

I have endured Li Jingsheng for a long time.

It's just that he didn't think about it, how could a serious illness be diagnosed quickly?
Even if you go to a big hospital to register as an expert, you have to do various tests first, and then make a diagnosis based on the test data combined with symptoms and medical history.

It took about 6 or [-] minutes from Li Jingsheng's consultation to the young man getting angry and leaving.

(End of this chapter)