Gou is practicing medicine in the clinic

Chapter 170 Mastered another class, can't do good things?
"It is most convenient for two or more people to operate. One person can fix the patient's fracture site, keep it stable, and then put on the splint. If the patient is relatively young, or the degree of cooperation is not high, then this method cannot be used, and holes must be drilled." Do invasive external fixation directly."

Dr. Xu's words frightened the patient as well-behaved as a kindergarten baby.

After all, no one wants to have a doctor drill a few holes in their legs.

After finishing the treatment of the patient, the patient was directly and carefully lifted onto the flat bed.

Transfer to inpatient ward care is sufficient.

"Remember, for patients with severe fractures, even if the manipulation is done, they must find a way to prevent the occurrence of aseptic inflammation. In severe cases, it can directly lead to bone necrosis and joint degeneration."

"Ok!"

Li Jingsheng and Dr. Chen nodded to express their understanding.

Aseptic inflammation mostly occurs in bones and joints, which is extremely harmful.

"The strong young man outside should be able to get local anesthesia. Lao Yu, since you are here, let's give that man a brachial plexus anesthesia before leaving! His muscles are stronger than that of a gorilla, and the dose and depth of injection are probably only you. This kind of senior anesthetist can grasp the precision."

Doctor Xu looked at Lao Yu who packed up his treasure chest and was about to leave.

"You are the only one who has a lot to do! Well, why do we have some friendship!"

Old Yu happily agreed.

"Also, I'm an anesthesiologist, not an anesthetist, not an anesthetist!"

This made everyone laugh.

Anesthesiologists hate being called an anesthetist because it sounds like a technician.

They are actually serious doctors, and they are well versed in emergency medicine, intensive care medicine, and anesthesiology, and they also have some knowledge of general medicine.

It's not for nothing that he treats the disease with the main knife and anesthesia to save his life.

Many of the early critical care medicine departments were intensive care medical teams formed by excellent anesthesiologists and excellent doctors and nurses drawn from various departments in the past.

Especially the doctors and nurses in the two departments of respiratory medicine and cardiothoracic medicine have made great contributions.

So far, the rescue of patients in the Department of Critical Care Medicine is still based on the two major signs of breathing and heartbeat.

The establishment of the two major circulatory systems is basically based on these two physical signs.

Lao Yu went out with the box.

"Xiao Li, you will operate it for him, and I will guide it beside you."

Dr. Xu really "takes care" of his disciples.

Just handed over a difficult case to the apprentice, and then came another more challenging one.

"Teacher, you also saw that man's fist, it's bigger than a bowl. I'm afraid I didn't catch him properly, and the fist will hit my face."

Li Jingsheng said with a bitter face.

The patient just now is of high quality and good temper.Li Jingsheng treated him for a long time, and he didn't say a single bad word.

But the strong man outside, his temper is not easy to provoke.

The risk of being beaten is multiplied.

"As long as you operate according to my instructions, you'll be fine. You should first recall the technique of folding and spinning!"

The operation techniques and skills of folding and turning have already been taught to Li Jingsheng.

It's just that practice and theory are completely different things.

Li Jingsheng tried his best to remember the key points of the top-flip maneuver.

"During operation, the thumbs of both hands rest on one end of the protruding fracture, and the other four fingers overlap and surround the other end of the sunken fracture. When it is predicted that the distal and proximal cortices of the fracture have been offset, it suddenly turns back..."

The following key steps have a small level of bone touch, and the difficulty is not great.

At least he was completely sure of finding out the changes in the patient's bone position.

The technique of turning is similar to the technique of rotation in rotational flexion and extension, but the specific operation is different.

When I came outside, Dr. Xu was already chatting with the patient.

"Young man, your muscles are very developed, and it takes a lot of strength to reset your manipulation. This can only be done by our young doctor. The young doctor has little experience, so you should be more responsible when you do it. In case the manipulation cannot be reset, Then there is no way, you can only consider surgical reduction."

After listening to the strong man, he didn't even think about it, and readily agreed, "No problem, just let me treat it. If it's really not good, I won't blame you, don't worry!"

Now that the patient has agreed, there is nothing to say.

Lao Yu gave local anesthesia to the patient himself, and then Li Jingsheng reset him.

The man's arms are too thick.

Fortunately, the local anesthetic has a good muscle relaxation effect, which provides the necessary basis for the manual reduction.

Just now Lao Yu prepared the local anesthetic, but Li Jingsheng didn't see it.

It definitely feels like there's more than one lidocaine.

He memorized all the injection points for brachial plexus anesthesia.

"Xiao Li, please check the patient again."

Doctor Xu asked Li Jingsheng to touch the patient's bone again.

"It appears that there is soft tissue embedded in the fracture site."

After the muscles were effectively relaxed, Li Jingsheng felt the bone more smoothly this time.

Not only the image and position of the bone can be clearly felt, but also the condition of the surrounding soft tissue can be felt more clearly.

"Use the maneuver first to completely free the embedded soft tissue. You first determine the path of the backward displacement of the fractured end."

After Li Jingsheng nodded to confirm that it was all right, Dr. Xu continued, "Use the operation in the opposite direction of the fracture displacement when turning, and boldly increase the force when pulling."

Li Jingsheng followed his advice.

"Yes, that's it. Turn it backwards in the direction of the original fracture displacement, so that the broken ends face each other. You can carefully listen to the bone fricative of the broken ends until you are sure that the soft tissue is completely released."

The teacher taught by hand, Li Jingsheng himself has a good foundation.

The operation process is fairly smooth.

"You must hold the two fracture ends with both hands, so that the broken bone cortex is close to each other, so as to avoid increasing soft tissue damage..."

"Yes, yes, very well done!"

Dr. Xu can judge the progress of reduction just by listening to the bone fricative.

After Li Jingsheng finished, he touched it, and then said, "It's enough to directly perform the top-folding method to reset. You know the other techniques, so I don't need to teach them."

The patient turned his head the whole time, not knowing whether he was afraid to look at it or didn't want to look at it.

Loosening the embedded soft tissue is only the first step.

He began to use the top-folding technique to reset the patient.

After two consecutive operations, he failed to reset successfully, but his seventh advanced bone setting technique reached the entry level.

This is simply sleepy came to send a pillow.

Before the patient got angry, Li Jingsheng secretly upgraded the newly mastered top-folding maneuver to the proficient level.

Confidence increased this time.

try again.

Still fail.

The patient's muscles are too developed, which also makes the reduction exponentially more difficult.

"Damn, the proficiency level can't be reset, it seems that it can only be upgraded to the Xiaocheng level."

It only takes 100 health points to upgrade to the proficient level, and 500 to upgrade to the minor level.

Fortunately, he has accumulated a lot of life points now.

It took another 400 points of life to upgrade the top-folding maneuver to the small-success level.

If it doesn't work this time, then there is no other way.

try again.

Once in place, the whole process was smoother than expected.

Small-scale bone-setting techniques can help him feel more fully the resistance from muscles and soft tissues.At the time of reset, it has even been able to act with some resistance.

"All right!"

Just when the patient was uneasy, the two words Li Jingsheng uttered were like the sounds of nature.

"Hey, don't move, don't move! It hasn't been fixed yet!"

Li Jingsheng noticed that the patient wanted to stand up, so he quickly comforted him.

Xiaocheng’s advanced bone-setting techniques are really amazing. In the future, even if you encounter oblique fractures with dorsal displacement, spiral fractures, and severe soft tissue embedding, he can treat them all.

Up to now, he was only short of learning the last advanced bone-setting technique.

Massage massage belongs to the type that is easy to learn but difficult to master.

It involves the mastery of comprehensive knowledge of bones, soft tissues, joint structures, blood vessels, etc., as well as the effect of massage in practice.

For Li Jingsheng, what he likes the most is medical skills that are easy to learn but difficult to master.

As long as he enters the door, he can open and hang all the way.

He only needs [-] health points to get the experience and experience that other people can gain by practicing for ten years.

"Old Xu, no wonder you made an exception, this kid's talent is too demonic!"

Lao Yu watched Li Jingsheng set the patient's bone the whole time.

Even if he is just a layman, he can clearly feel how terrifying Li Jingsheng's progress is.

When I first got started, the technique was still very unfamiliar.

But after only three or four attempts, the level suddenly rose to a higher level.

That's not counting, after another failure, he went up a level again.

Lao Yu has been an anesthesiologist for so many years, and he has never seen a surgeon who can improve his skills so quickly.

A surgeon who has made great progress in a year and a half can already be called a very good surgeon.

"This kid doesn't care about boasting. If you praise him, he'll go away." Doctor Xu said that, with a mixture of satisfaction and complacency on his face, even a fool could tell that he was very satisfied with this apprentice.

"To be serious, my kid is graduating from a master's degree today, and he is also studying surgery. Why don't you make an exception and accept my kid?"

With a slightly shy face, Lao Yu asked solemnly.

It is undeniable that if you learn the skills of Dr. Xu, you will have no worries about eating and drinking for the rest of your life.

And it can avoid the fierce competition of major surgery.

"I can't take it."

Dr. Xu directly refused.

Li Jingsheng and Dr. Chen silently splinted the patient beside him.

Hearing Dr. Xu's refusal to accept Lao Yu's son as an apprentice, he couldn't help secretly rejoicing that he was so lucky to be able to get an admission ticket and learn bone setting from Dr. Xu.

"Can't we make an exception because we know each other so well?"

"It can't be broken!" Dr. Xu refused again mercilessly.

"Okay, okay! I didn't say that! Go back!"

Lao Yu waved his hand depressedly, and left with the treasure chest.

Looking at his unwilling eyes, he will definitely not give up.

"Are you finished? Hurry up, there are still many patients waiting outside!"

Dr. Xu urged Li Jingsheng.

"It'll be ready soon!"

Li Jingsheng has now learned seven advanced bone-setting techniques, and the weakest ones have been upgraded to the proficient level. Basically, more than 90% of fractures and joint dislocations can be treated.

Sometimes, people still have to push.

The potential is truly endless.

He also didn't expect that on the first day when he officially came to work in the Second Hospital, he directly learned two advanced bone-setting techniques.

And they are the two most difficult ones.

Now he has truly possessed the strength to be a doctor.

The next thing to do is to work hard to earn life points, and try to improve all the bone-setting techniques to above Xiaocheng.

……

Worked until twelve o'clock at noon.

Li Jingsheng did not count how many patients he treated in total.

Thirty should have.

"Let them come back after one o'clock in the afternoon!"

Doctor Xu has no intention of working overtime.

Just ask the nurse to tell the patient to come back in the afternoon.

"From [-]:[-] noon to [-]:[-] noon is the time for eating and resting. At one o'clock in the afternoon, you will arrive at the clinic on time to work."

Doctor Xu left immediately after speaking.

Li Jingsheng saw that there were many patients queuing up outside, and felt a little bit unbearable.

But he also understands that doctors are humans, not machines.

Only by eating and drinking enough and keeping the spirit up can more patients be treated.

"Doctor, doctor, please help my son! We came here after nine o'clock in the morning, and we have been in line all morning. My son's problem is very small, just a dislocated elbow joint."

A young mother walked into the clinic with a three or four-year-old boy in her arms, begging Li Jingsheng to work overtime.

Li Jingsheng took a look at the X-ray film taken by the patient.

The problem is not big, it is subluxation of the radial head.

The development of the radial head of the child is not perfect, and the annular ligament of the elbow is loose. Sometimes a fall or the parent's pulling force is too strong, which may lead to the dislocation of the radial head of the elbow joint.

After the dislocation occurs, the child will cry because of the pain, the injured forearm cannot be supinated, the elbow joint cannot flex on its own, and the injured arm cannot be raised.

For a bone-setting master like Li Jingsheng, it was indeed just a small problem.

For children and parents, it is a big deal.

Seeing a child crying due to pain, and his arm is half-disabled, parents will feel very scared and worried in their hearts.

"Okay, I'll work overtime to treat the child. You can use your mobile phone to pay the bill."

Li Jingsheng gave the patient a list of charging items.

Thank you so much for the child's mother, and quickly paid the fee directly with the hospital APP bound to the mobile phone.

I saw that Li Jingsheng first felt the bones of the child to understand the position of the bones and the soft tissue damage around the joints.Immediately afterwards, he pressed his right thumb on the child's radial head, held the child's wrist with his left hand, and supinated the child's forearm.

Next, press firmly with the thumb on the radial head.

"Crack!"

A slight bone groan sounded.

This is the bone-cracking sound of successful joint reduction.

"All right!"

Li Jingsheng said to the child's mother with a smile.

"Thank you, thank you so much!"

The mother of the child thanked again and again.

"His injury is not serious, and he does not need to be bandaged and fixed, but he must be carefully maintained for about two weeks. Children recover quickly, and there should be no problems after two weeks."

Li Jingsheng successfully received good reviews and cured another patient, he was also very happy.

11 health points in hand.

I have learned how to easily reset the prolapsed joints of patients after orthopedic surgery, and feel full of accomplishment.

When the patients outside, as well as nurses Li Li, Dr. Chen and others looked at him, the admiration they cast on him also benefited Li Jingsheng.

In terms of growth rate, it is still faster in large hospitals.

Three days a week in a large hospital and four days in a small clinic, this model is still very good.

When he slowly earns enough life points and raises his other medical skills to a higher level one by one, then not only will his status in the Second Hospital be even higher.Even in the domestic medical field will gradually gain a place.

The most comfortable state in life is this state where hard work can be seen.

"Doctor, I broke my foot because of riding a battery car, and now it hurts badly. Your medical skills are so good, can you work overtime and help me treat it too?"

Another patient walked in on crutches.

Totally uninvited.

Age around 40 years old.

Next to him should be his wife.

"We're off work, come back in the afternoon!"

Li Jingsheng found that not only the patient asked the doctor to work overtime, but the patients and their family members waiting outside were also staring at him closely.

At this time, as long as he agrees to work overtime again, he will not even think about having lunch today.

The following patients will continue to flow.

It was the first time for him to officially work in the outpatient clinic.

Unlike the inpatient department, as long as the time is up and the patients in hand are processed, they can leave after handing over to the doctor on duty.

There is no handover system in outpatient clinics.

It is impossible for the hospital to arrange additional on-duty doctors if they go off work directly at that point.

Unless it's the emergency department.

"Didn't you also work overtime to treat this child just now? We waited longer than this child. And my injury is more serious. You can do it, can't you work overtime to help my husband?"

The man's wife pointed to the child and the child's mother who left happily.

"I'm sorry, I'm really off work now. I've been working all morning, and I need to eat first, take a break, and then come back to work in the afternoon. Otherwise, I don't have the energy to cope with the work tasks in the afternoon. Please understand."

Li Jingsheng firmly refused.

I can never promise again this time.

People are selfish. What patients and their families consider is to relieve the pain as soon as possible. What the doctor considers is to have a meal, take a rest, restore the spirit and restore physical strength, so that he can better perform the work in the afternoon.

"You can help them, but you refuse to help us, isn't it because the child's mother is beautiful?"

The mouth of the female family member is really sharp.

"In the eyes of our doctors, there are only patients and nothing else. Come back in the afternoon!"

Li Jingsheng's tone this time was much colder.

Encountering such unreasonable family members can really drive the doctor to death.

He will not be mad at his family members like Director Yang at the People's Hospital.

Li Jingsheng ignored the patient and the female family members and left directly.

I had just finished eating in the cafeteria and was about to start eating when Dr. Xu called.

"Xiao Li, what happened? More than a dozen family members and patients called the medical department to complain about our outpatient room, saying that we treat them differently. Now the medical department asks us to go over and explain."

Doctor Xu probably didn't expect his apprentice to be so good at handling things.

He had only been gone for less than 10 minutes, and Li Jingsheng made such a big mess.

"Why do so many family members and patients complain about me? I just worked overtime to treat a child, and then a patient with a broken leg asked me to work overtime, but I didn't agree. The female family member scolded me. I just I only talked back to the family of this one patient, and did not conflict with other patients!"

Li Jingsheng is also the first and the second eldest.

For such a thing to happen, he is simply more wronged than Dou E.

It was out of kindness that I worked overtime temporarily, but I didn't expect to be complained by so many people.

It's so chilling.

"I'm almost finished eating, I'll go over and ask later. You hurry up and go to the cafeteria to eat, and you may go to the medical department to explain later. You also know that the medical department specializes in me."

When Dr. Xu mentioned the medical department, he was somewhat resentful.

(End of this chapter)