Gou is practicing medicine in the clinic

Chapter 348: All directors are masters of blame-shifting for their illnesses.

Chapter 348: All directors are masters of blame-shifting for their illnesses.

Ordinary people don't understand medicine, so they are more likely to spread rumors and directly deify doctors.

Under normal circumstances, when a patient has a fracture, it takes more than ten to ten minutes to take a X-ray.This is when patients are highly cooperative and there is no need to queue.

If it was just a dislocated shoulder joint and there were no other abnormalities, it would be possible for him to cure the patient in just a few seconds.

The electric car quickly drove Li Jingsheng to the entrance of the Second Hospital.

"arrive!"

"Thank you! Remember to find me at the clinic tomorrow."

Li Jingsheng hurried to the emergency department.

The two best places to find a hospital are the emergency room and the registration hall.

The emergency room is usually connected to the registration hall, right next to it.There is usually at least one ambulance parked in front of the door.

Li Jingsheng rushed into the emergency room and glanced at the triage table, but did not see Director Hua.

Looking towards the emergency room, there was a crowd of people outside the door.

This is often the case there, so there's nothing surprising about it.

Some patients have many family members and may be quite enthusiastic. After the accident, relatives and friends rush to the hospital to visit and provide help.

Some patients may be working alone in this big city, and when they are sent to the hospital for rescue, they can’t even find anyone to sign.

It's still around [-]:[-] in the morning, and the emergency department is not very busy.

Only a few sparse patients could be seen receiving medical treatment.

Usually emergencies occur at night.

For example, stomachaches, getting drunk, causing trouble and getting injured, or some couples pursuing excitement and using some weird tricks to cause problems. Occasionally, asthma patients also have problems, and children have high fevers in the middle of the night. This is the most common.

In short, the period from midnight to eight in the morning in the emergency department is relatively leisurely.

"Dr. Li, are you here so early to attend a consultation?"

"Yes! Director Hua of our Orthopedic Surgery Department informed me to come for consultation and said that a boy fell and suffered a coma and fractures."

"The directors are all in the consultation room! You can just go in. The condition seems to be quite complicated."

The doctor on duty in the emergency room pointed in the direction of the consultation room.

"Okay, thanks!"

Li Jingsheng walked quickly to the consultation room, which was the third room diagonally opposite the emergency room.

It is said that the consultation room was initially located in the first one opposite the emergency room, but during the consultation process, family members often broke in and disrupted the doctor's discussion and consultation.Later it was changed to the innermost room.

Concern is chaos.

Family members are worried about the patient's safety and will do anything when they are anxious.

The door is hidden.

You can hear the doctors discussing inside.

Even the nurses are actively speaking out.

Li Jingsheng did not knock on the door because in this case knocking would disturb the ongoing discussion about the condition.After pushing the door and entering, he saw Director Hua at a glance.

The director and two chief physicians of the emergency department were also present.

In addition, Director Luo from the Department of Neurology also came.

It is almost impossible for these directors to work the night shift. To use Director Hua's words, the chief doctors are generally older and their energy and physical strength are not as good as before. Working the night shift can only be hard work for young men and girls.

In fact, intern doctors and trained doctors are the main force working the night shift.

Larger departments will have an attending physician to guard them.

Smaller departments often leave a resident physician with more seniority to take charge.

Emergency situations generally do not occur at night, and the attending physician is basically not required to intervene.

When Li Jingsheng saw so many hospital bosses appearing together, he immediately smelled something unusual.

The chief doctors are sitting here discussing, obviously they have been here for a while.

It takes about 10 to [-] minutes to get here from home, right?
Doesn't that mean that they rushed to the hospital at around six o'clock?For ordinary patients, even if they are seriously injured, it is difficult for so many chief doctors to appear at the same time.

Adults are useless to get up early.

There is only one possibility, the identity of this patient is not simple.

To be precise, the parents of the boy who was injured in the fall were not simple.Most likely not ordinary people.

"Jingsheng, sit over here!"

Director Hua waved to him.

The other chief doctors and nurses just looked at Li Jingsheng lightly and did not take him seriously.

"Director Hua, how is the sick boy doing now?"

"In the rescue room, the person is still in a coma. This is the patient's information. You can take a look at it first."

Director Hua showed Li Jingsheng the patient's examination information and consultation records.

The little boy was only eight years old. He got up in the middle of the night to go to the toilet and suddenly fell down.The family heard the noise and when they got up to check, the man was already semi-conscious.

I quickly called 120 emergency number.

Because there is only the Second Hospital and one third-level hospital in the south of the city, which is almost a monopoly, the boy was brought here by an ambulance.

The admission examination record showed that the body temperature was 36.6 degrees, which was normal.

The pulse is 47 beats/minute, which is a bit scary.

Breathing 29 times/min, close to normal.

Blood pressure 121/70mmhg.

When he was admitted to hospital, he was in a state of mild coma, and no bruises or subcutaneous bleeding were found on the surface of his body.The superficial lymph nodes were not swollen, and there were no obvious lacerations or hematomas on the head.But the patient's right arm fell and fractured.

Then the patient has an irregular heart rhythm, and an apical systolic murmur can be heard during cardiopulmonary sound diagnosis.The breath sounds in the lungs were clear, the abdomen was soft, and no obvious abnormalities were found in the liver and spleen.

The patient had a pain response during a pinprick test.

It is the most commonly used probe to prick some superficial parts of the patient, and an obvious stinging reaction can be seen.

Also, the patient's pupils are unequal in size on both sides.

The diameter of the right pupil is smaller than that of the left. The diameter of the right pupil is only 1.6mm, while the diameter of the left pupil is 2.7mm.Light reflection exists.

It was also found that the sick child was slightly tilted to the left.

After admission, some necessary examinations were performed on the patient, but no vascular embolism was found.

In the case of this sick child, Li Jingsheng's first reaction was problems such as stroke, cerebral hemorrhage, and cerebral infarction.

It now appears that the condition is far more complicated than imagined.

No wonder Director Hua called him over.

Li Jingsheng has repeatedly made extraordinary achievements when chewing hard bones.

The identity of this sick child is not simple. If the orthopedic surgeon can make a great contribution in the consultation, it will not just be as simple as gaining glory.The benefits will also be great.

The attending doctor has conducted detailed physical examinations and tests on the sick child.

The muscle tone of the right upper and lower limbs is high, and the muscle tone of the left lower and lower limbs is low.

During the muscle strength test, the right side was significantly worse than the left side.

Seeing this, Li Jingsheng wondered whether the boy had suffered from hemiplegia.

At least it's questionable.

He even wondered whether the cause of the patient's fall was due to a sudden hemiplegia on one side of the body?
Judging from the available examinations, he highly doubted this.

Otherwise, how could an eight-year-old boy fall down for no reason while going to the toilet at home?
Even if he fell, no obvious lacerations or hematomas were found on his head, indicating that it was unlikely that his head hit a hard object such as a table corner or wall.His coma also seemed very strange.

There is also asymmetrical pupils on both sides of the sick child, which seems to confirm this speculation.

However, the tendon reflexes in the boy's limbs performed by the emergency doctor showed that they were all active.

The boy's abdominal wall reflex and cremasteric reflex disappeared.

Kellniger's sign test was negative.

Brookin's sign test was also negative.

Babinski sign test, positive on the right side and negative on the left side.

This so-called Babinski sign test is usually performed simultaneously with the sting test.

The examination method is to use a blunt pointed irritant along the lateral edge of the patient's foot, from the heel forward to the ball of the foot at the heel of the little toe, and then turn inward.

At this time, normal people will have plantar flexion of the toes.

A positive reaction will result in dorsiflexion of the toes, and even other toes may fan out at the same time.

The purpose of this test is to check whether the upper neurons are normal.

Positive indicates damage to upper motor neurons.

The boy's right side was positive, indicating damage to the right upper motor neuron.

There is also a big problem with the sick child's pulse being so low.

An eight-year-old boy like him can usually have a pulse of 100 beats/minute.Higher ones can even reach 120 times per minute.

The sick child's pulse is now only 47 beats per minute, less than half of normal.

Means the heart is beating very badly.

After Li Jingsheng read all the patient's examination information, his heart sank to the bottom.

If the cause of this sick child cannot be found out within a short period of time, not even gods can save him.I'm afraid he will die directly in a very short period of time.

Just as everyone was talking and expressing their opinions, the door of the consultation room was pushed open again.

A woman about 40 years old came in.

She was wearing home pajamas and a simple long coat.

Wearing glasses, he looks very majestic.

"Doctors, have you got the results of your consultation? The doctors in the emergency room told me that my son's condition is still progressing and worsening. All they can do there is the simplest life support, and the main thing is to wait for your diagnosis. As a result, finding the real cause was the only way to save my son.”

The woman's narrow phoenix eyes swept over the crowd, and finally landed on the face of Neurology Director Cologne.

Director Luo suddenly felt tremendous pressure.

"Uh... Secretary Beiyan, please don't worry. Because the condition is complicated, we don't dare to jump to conclusions."

After Director Luo finished speaking, he turned his attention to the director of the emergency department.

"Director Yan, you have the most experience in the emergency department. Everyone wants to hear your opinion first!"

This old boy is also cunning and has a first-rate ability to deflect blame.

The director of the emergency department who looks a bit like the little-headed father looks like he is in his early 50s, with slightly messy hair.

He was sitting here doing well, but suddenly he got shot.

Director Luo threw the burden to him.

The sick child was admitted to the emergency department. Now he couldn't push it away even if he wanted to. He was probably scolding her in his heart, but he had a serious expression on his face.Yang pushed up his gold-rimmed glasses.

"Currently, judging from the chest X-ray taken, the heart shadow expands to both sides, and there is obvious congestion in the hilum of the lungs. Then the electrocardiogram results show atrial extrasystoles, sometimes showing bigeminy, and the pulse is only 47 beats per Minutes, I suggest calling in a cardiovascular expert for consultation immediately. Although our emergency department has rich experience in handling various emergencies, specialist issues involving the heart and nerves are not our strengths."

Director Yan spent a lot of effort to throw the pot away again.

Dumped to the cardiovascular specialist who was still sleeping at home.

"Can the Second Hospital treat it? I finally gave birth to this son when I was 33 years old. Now I am 41 years old. I have only one offspring. Which expert do you want to invite for consultation? Tell me the name. Or maybe you feel unsure. , suggested that I take my son to be transferred to another hospital, or you could tell me clearly. It has been more than an hour since admission, but my son’s condition is still deteriorating. As a mother, I am really anxious. I hope you can understand. ."

Even though she is just a woman, her aura is very powerful.

None of these chief doctors dared to stand up to her.

It was obvious to everyone that Beiyan was getting angry.

There is only one child in the family. She is 41 years old and the possibility of having another child is very slim.

"Beiyan, we all understand that you are worried. I am also a mother of two children. Every time I see my child sick, I feel as painful as a knife. But your son is unconscious now, and he is not There is obvious trauma and the condition is indeed complicated. If you transfer to another hospital, you may not be able to receive him immediately! The best way now is for the experts from our second hospital to work together to find out the cause of the child's illness and then formulate a practical plan. Treatment programs.

Even if you really want to transfer your child to another hospital, I suggest you wait until your child's condition is stable before making this consideration. "

The speaker should be the head nurse of the emergency department and director of the nursing station.

Her status is quite high.

At least she has some weight to speak in the emergency department, and the nurses at the nursing station will listen to her arrangements.

She probably saw Director Yan of the emergency department bearing Bei Yan's anger, so she stepped forward to help resolve it.

After all, she and Director Yan are both comrades in the same camp.

It’s the same in any department, and the department director and head nurse often get along like comrades-in-arms.

On the contrary, if the chief physician under him has any thoughts about the position of department director, he may sometimes stumble and use some tricks secretly.

Li Jingsheng does not know the specific identity of Bei Yan yet.

It's like going to the village committee and everyone calls you director or leader, maybe it's just a polite term.

In this case, transfer to another hospital is really not appropriate.

Unless her energy is amazing.

Even if her position is very high, the other hospital may not dare to accept her!

Accepting the past and curing the child is a great achievement.If the child is not cured and the child dies in the hospital, who can bear the responsibility?
There probably aren't many doctors who are willing to do something that could cause serious harm to one's body.

Let alone someone at the leadership level of director of department.

The first rule of survival for leaders is to take responsibility for things that can be deduced.No one is stupid enough to hold it on their head.

This sick child's condition is complicated and his status is special. If he is transferred to another hospital, even the director of the emergency department may not be able to make the decision.You have to ask the hospital's leadership for instructions.

"I'll just sit here and wait for your results! If I want to invite any expert to come for consultation, please help me. If they can't be invited, I'll call your director Fu and ask him to help."

She sat down in the back row.

With this Beiyan sitting at the scene, the atmosphere in the consultation room became tense.

Everyone is somewhat stressed.

The head nurse poured Beiyan a glass of water and said, "We are already contacting the experts in the cardiovascular department. Director Yan and several experts will also work harder."

Bei Yan's face looked a little better.

Just still in a rush.

His brows are always furrowed, and he glances at his watch from time to time.

"Considering that the child fell and fell into a coma, I think the possibility of a concussion is relatively high. We still need to check the possibility of subdural blood because the child's condition is getting worse, but there is no obvious trauma on the head. A fracture of the right arm should not be enough to cause coma and hemiplegia."

Director Luo put forward his own opinion.

Concussions can indeed cause a brief, shallow coma, which can last only a few minutes.

It may take a few days for relief over time.

"I support Director Luo's point of view. However, the child's pulse is only 47 beats per minute, and the heart systolic murmur indicates that there must be a heart problem. Director Hua, will the fracture of the patient's right arm cause severe internal bleeding?"

Director Yan also actively participated in the discussion.

After all, Beiyan was sitting there and listening.

"Judging from the films taken during the examination, the possibility of internal bleeding is very slim. Dr. Li Jingsheng in our department is very good at diagnosis in this area. It would be safer to ask him to check the child. After all, there is sometimes a possibility of missed detection in instrument examinations. .”

If there is extensive internal bleeding, the fluid will definitely be visible on the radiograph.

Therefore, the possibility of such missed detection is very slim.

Director Hua was looking for an opportunity to push Li Jingsheng out and give him a chance to stand out.

"As long as it is beneficial to my son's treatment, I will support it! Who is Dr. Li Jingsheng?"

Beiyan asked after hearing this.

"I'm Li Jingsheng."

"You are very young! Please go to the emergency room to check my son and confirm whether there is internal bleeding at the fracture site."

It's a completely commanding tone.

Many powerful leaders have this tone when they arrive at the hospital.It's just that other leaders speak more politely and tactfully, and are not so blunt.

Beiyan was worried about her son's safety, so she couldn't care less about it.

"Despite his young age, Dr. Li is the chief physician at the Orthopedic Surgery Clinic of our hospital. Many patients from other provinces come here to see him for treatment." Director Hua praised Li Jingsheng's skills.

Sometimes it's just that, you have to sell melons and boast about yourself.

Otherwise, since he is young and Beiyan does not know that his medical skills are very high, it is inevitable that he will despise him from the bottom of his heart.

This is also human nature.

It is extremely detrimental to his diagnosis and treatment work.

"You are a young and promising doctor. That's great. Thank you for your hard work, Dr. Li."

Her attitude towards Li Jingsheng was obviously much more polite.

People are so realistic.

"Should be."

Li Jingsheng came to the emergency room and briefly explained the situation to the nurse. The nurse guided him to the emergency bed of the sick child.

The child's face was unusually pale and his breathing was normal.

The elbow of the right arm is red and swollen, and the shape is obviously different.

Based on Li Jingsheng's experience, he can tell at a glance that this is a dislocation of the elbow joint.

Before coming here, I had seen a x-ray of the child's hand.

There are minor fractures and joint dislocations.

This kind of injury is nothing in Li Jingsheng's eyes and can be cured easily.

Of course, he wouldn't treat a child's arm right now.

Otherwise it would be too presumptuous.

(End of this chapter)

Tap the screen to use advanced tools Tip: You can use left and right keyboard keys to browse between chapters.

You'll Also Like