The road to the rise of great doctors

Chapter 72 Dangerous
Liu Dong is working the night shift today.

Unlike gynecology, obstetrics and emergency departments are somewhat similar. People get acute illnesses regardless of morning or evening, and pregnant women give birth to babies day or night.Taking advantage of the crowds during the day, he left the department early and went to the hospital canteen for a quick dinner.

By the time Liu Dong returned to the ward, the evening shift had not yet begun.

He stared at the corridor and saw pregnant women with big bellies walking around. Their bodies were so light that they could walk quickly, but their bodies were so heavy that they moved slowly while holding on to the handhold on their side.There are also those who are pregnant with twins or triplets, whose bellies are bigger, their bodies are bulkier, and their movements are more inconvenient. After they are admitted to the hospital, they usually just walk around the room or hold on to the bed.

The obstetrics department is generally divided into two parts. One is the external maternity ward, which is basically the same as other departments, with single rooms, double rooms, and triple rooms, but rarely extra beds.

The other part is the delivery room, which is similar to the operating room. Just like the place where surgeries or invasive operations are performed in the reproductive medicine department/reproductive andrology department mentioned before, it is slightly smaller and has all the internal organs. In addition to doctors and nurses, there are usually Professional anesthesiologist.

The maternity ward is where Liu Dong and other interns stay with other doctors and nurses.As for the delivery room, except for doctors and nurses who are scheduled to be there, or who need to enter for surgery, and aunties who do cleaning, basically no one else is allowed to enter.Just like the entrance of the operating room, there is also a "guard checkpoint".

After turning in his shift and checking the time, Liu Dong picked up the A-ultrasound machine and began to detect the fetal heart rate in sequence according to the bed number.

Usually the ultrasound examination that people do is B-ultrasound, which is Doppler modulated ultrasound, also called color photography. It uses the Doppler principle to convert the blood flow signal into an easily identifiable color signal. Two-dimensional ultrasound combines the blood flow map to generate a Color Doppler Ultrasound.In obstetrics, ultrasound is also widely used and can provide a lot of clinical information. For example, the attached software can evaluate the fetal weight and corresponding parameters based on the fetal head circumference, abdominal circumference, biparietal diameter, and femoral length. The number of gestational weeks; it can also assess the amount of amniotic fluid, the position and thickness of the placenta, and monitor the fetal position and orientation, so that abnormalities can be detected and dealt with in a timely manner.

Thanks to previous mission rewards, Liu Dong has rich experience in ultrasound of the abdomen and urinary system.Liu Dong also learned about obstetric ultrasound, but he just didn't have the opportunity and hasn't come to confirm it further.

A-ultrasound, which is amplitude modulated ultrasound diagnosis, is the earliest ultrasound diagnosis method and has been gradually eliminated in clinical practice.However, because the machine is relatively small, it still retains some applications in monitoring fetal heart rate in obstetrics and viewing blood vessels during vascular surgery.For remote areas, where the application of B-ultrasound has not been fully promoted, there are also reservations.

"Boom. Boom." Liu Dong followed the bed number, hung a stethoscope, and held an ultrasound machine, doing it one by one. He was monitoring the fetal heart rate through intermittent auscultation, which was also part of the monitoring during childbirth.

The baby is not fixed in the pregnant woman's body, and often moves around. When the fetal heartbeat cannot be heard in the normal position, it is necessary to roughly determine the position of the lower fetal back through stethoscope and abdominal palpation, and then continue Measure fetal heart rate.

Liu Dong thinks that what is more difficult to measure is the case of twins or multiple births. The baby's back is a little far away from the mother's belly, and the sound will appear "distant and weak" when measuring. For the safety of the baby, it is necessary to confirm Don't be careless about the frequency and intensity of fetal heart rate. It will be a headache at this time. You need to be patient and repeatedly find the best measurement position.

When it's fast, it takes a few minutes, one after a few minutes, and the measurement is completed in less than half an hour.When busy, it may take one person five to 10 minutes, and the total measurement will take more than an hour.

Stand up - bend down - stand up - bend down. Even if you do it for a long time, you will not be able to bear it. No wonder, this job will be done by newcomers. Liu Dong thought a little darkly, "Let them experience the book." What are the examinations described in the article to increase the degree of integration of theory and practice? It is also to save the waists of obstetric doctors and nurses and other "old people", hahaha."

It was finally over. After filling in the measurements one by one in the shift record, Liu Dong could finally stop, straighten up, and stretch his muscles.

His work in the maternity ward has temporarily come to an end, the next time will be around 10 o'clock in the evening (before the mothers go to bed), and the next time will be in the morning of the next day (experienced hands can be later, novices, when there are many hospitalized people, or there will be more When you have other things, you have to do it earlier, 05:30?) In the adjacent delivery room, doctors, nurses and mothers who are about to give birth are still waiting for the signs of a new life to start.

In the operating room of this building, the resident doctor on duty, followed by the deputy chief physician or chief physician on duty, were performing cesarean sections one after another.
Being on duty in the obstetrics department is also a sleepless night for most people.

Returning to the duty room, Liu Dong did not lie down. After doing a few sets of stretching movements, he took out "Obstetrics and Gynecology" from his bag, spread it out, and turned to the chapter on obstetric emergency. He took it seriously. Look, think, mark any questions you have with a red pen and leave them blank for answers.

At about 11 o'clock in the evening, Liu Dong put away his books and slept in his clothes.

"Dong dong dong, get up and help, go directly to the ultrasound room!" There was a knock on the door of the duty room, and an anxious voice came out.Then the person who knocked on the door heard her footsteps fade away without waiting.

Liu Dong did not sleep deeply. He had already woken up when he heard the first knock on the door, but his head was still a little groggy.By the time the knocking on the door ended, I was basically fully awake.

Hearing such an urgent voice, he immediately realized, "It's an emergency!"

He got up, put on his Crocs and a white coat. Within a few seconds, Liu Dong opened the door and left.

The obstetrical ultrasound room is located on this floor near the door. There is a bed and a B-ultrasound machine.

When he arrived here, the ultrasound doctor and chief resident of the obstetrics department were already there, and the second-line attendants in the ward were also called over. Everyone looked serious.

The pregnant woman is lying on the ultrasound examination bed, the dressing pad under her body is wet. There is a male family member, probably her husband, standing aside, with his hands tightly clutching the corners of his clothes, his brows frowning. Stare at the screen seriously.

"Xiao Liu, go and ask the man's family about the basic information first, and get to know the current medical history, past history, surgical history, allergy history, etc. The mother has a lot of vaginal discharge, and she may need emergency surgery. Hurry up and write down the medical record before the surgery. It's gone." The chief resident doctor ordered after seeing Liu Dong.

"it is good."

Liu Dong glanced at the ultrasound image on the monitor and said, "Well, placental abruption." He made a rough judgment in his mind.

(End of this chapter)