White armor

Chapter 46 Grow up, but not grow up

"Where's Dr. Luo?" Lin Yuming asked the intern.

"I was seeing patients in the emergency room, and even the elderly patients had no blood pressure..." The intern was chattering, but Lin Yuming didn't want to listen and strode directly into the emergency room.

Luo Hao stood beside the rescue bed, staring at the values ​​and graphics on the ECG monitor, thinking about something.

"Doctor Luo." Lin Yuming said solemnly.

"Director Lin? Why are you here?" Luo Hao turned around and saw Lin Yuming, "It's not safe to drive on such a slippery road. What are you doing here?"

Although it is a complaint, there is concern between the lines.

Lin Yuming felt relieved.

The children have grown up and know how to care for others, and they are not as ignorant as before.

It’s best to have someone to handle the chores, and to be able to take command from the center, and to handle things that need to be done in a flattering manner. In the past, Lin Yuming did not receive such treatment.

Although the medical office does not need to be perfect, and it is okay to just dawdle, Lin Yuming knows that he is facing a living life, and he must try his best if he can.

If you are more diligent, one person may be saved. You should only do good deeds to accumulate merit for yourself and gain some blessings for your son.

Although it is not materialistic to say this, doctors and nurses rely on a breath of immortal energy, which is not materialistic in itself, but very metaphysical.

Now that Luo Hao is here, the emergency department is in good order. Even if he rushes to take charge, he cannot achieve this effect. Lin Yuming is quite satisfied with this.

Yes,

very good!

Lin Yuming smiled.

He felt a little uneasy today, his heartbeat was racing, and he always felt like something was happening. That's why I came here.

Seeing Luo Hao handle the matter clearly, Lin Yuming felt that his worries were in vain.

"Director Lin, the orthopedics department is still busy, and then there is the intensive care unit. It would be great if there were doctors on call at any time." Luo Hao comforted him and began to make requests.

Lin Yuming nodded, "I'll make arrangements. What's going on with this patient?"

The patient's family members were not in the orthopedic department where they were putting on casts, so it was easier for Luo Hao to talk.

After briefly reporting the medical history, Luo Hao continued, "I think the patient has aortic dissection and needs an emergency 64-slice CT."

Lin Yuming looked at the energetic Luo Hao with mixed emotions.

If it weren't for his own nephew, if any of his department staff or even the department director dared to say that, Lin Yuming would definitely be fooled.

Then he carried him and asked him to look at the ground outside. In this situation, how could he find someone to work overtime?
  What's more, it's still a preliminary diagnosis.

Lin Yuming frowned, "Is there any other way?"

Luo Hao also knew that it would be dangerous to bring people from home to do a 64-slice CT in this kind of weather. He scratched his head and said, "Director Lin, I can also operate the machine."

"!!!" Lin Yuming was speechless.

Luo Hao's meaning is very simple. No one can do it. As long as he gives him permission, he can do it.

As for qualifications, Luo Hao's intermediate certificate was obtained by Lin Yuming himself, and Lin Yuming felt like he was in the clear.

"Director Lin, the patient's condition is critical and difficult. Even if the diagnosis is clear, our mine manager cannot perform surgery."

"What should we do?" Lin Yuming asked.

"Shame on you." Luo Hao said naturally, "I'll ask my senior brother to fly over to do it. If the diagnosis is correct, the patient needs elephant trunk surgery, which we probably haven't done in our mine."

Hey!
  Lin Yuming cursed directly.

Treating illnesses and saving lives is all about curing illnesses and saving lives, but Luo Hao doesn't treat illnesses like this.

Elephant trunk surgery is what doctors call it. Officially, it is simpler. It is called elephant trunk surgery, also called aortic arch replacement surgery.

This name comes from the fact that the aortic arch is shaped like an elephant's trunk.

This operation is one of the largest operations in cardiothoracic surgery. The industry considers it to be more difficult than almost all cardiac operations.

Not to mention the mine director, no one in the provincial capital now dares to pat their chests and say that they can win it [-]% of the time.

Luo Hao wants to undergo elephant trunk surgery at the mine manager?
  What to do when a patient dies? Nowadays, doctor-patient disputes are so serious that it is better to have one less problem than one more problem.

Lin Yuming had a lawsuit on his head and his head was buzzing.

"Director Lin."

Luo Hao continued while Lin Yuming was stunned, "The patient's condition is a little stable now. I want to take him for a lung CT first to see how he is doing."

Lin Yuming sighed.

Just after praising Luo Hao for growing up, he got a big thunder for himself.

It's nothing.

Lin Yuming nodded, and Luo Hao began to recruit people to move the patients.

I asked four male interns to follow me. They were strong and strong, and they didn't look like the emergency department was short of staff at all. They rushed all the way to the CT room.

On the way, Luo Hao came close to Lin Yuming and whispered, "Uncle, I feel that the patient has aortic dissection. His condition is critical and there is no way to transport him. He can only ask an expert to perform surgery."

"Hmph!" Lin Yuming snorted coldly, expressing his dissatisfaction with Luo Hao's "noisy" behavior.

"Uncle, my senior brother has a high success rate for this kind of surgery."

"Very high?" Lin Yuming caught Luo Hao's "speech problem" and asked, "Is it a [-]% or [-]% success rate?"

"Hey." Luo Hao could hear Lin Yuming's dissatisfaction and did not continue.

No matter how high the success rate is, the mortality rate of this type of surgery is far higher than that of other surgeries.

In the era of doctor-patient disputes 3.0, it is better to do less than to do more. Lin Yuming prefers referral.

If you are kind-hearted, you can contact the higher-level hospital and never waste time, which means you are doing your duty. Why bother yourself?

This little guy Luo Hao, Bai Xiang himself just praised him for growing up and knowing how to care for others.

In the blink of an eye, this guy got himself into big trouble.

When he came to the CT room, Lin Yuming had a gloomy face.

Luo Hao directed the interns to lift and place the patient gently on the machine for examination.

After the scan, Lin Yuming squinted at the image.

After all, he is one of the first batch of doctors to graduate from imaging majors in China and has rich clinical experience.

Lin Yuming smiled as soon as he caught sight of him. Luo Hao, a bitch, even made misdiagnosis sometimes.

"Luo Hao, how did you diagnose aortic dissection?" Lin Yuming said easily, "Anyway, I haven't seen any images of aortic dissection. Come on, come on, teach me."

The patient's CT scan showed clear pericardial effusion, right pleural effusion, right obstructive pneumonia, and atelectasis.

Although lung CT cannot diagnose aortic dissection, experienced doctors can always find some clues in lung CT. (Note)
  The lung CT scan of the patient who Luo Hao said would die if he did not undergo elephant trunk surgery was not serious. The main thing was to treat the patient first.

Lin Yuming did not think that the patient had aortic dissection.

"Uncle, the lung CT cannot confirm the diagnosis. Why don't you discuss it with the director of the CT room? Start the machine and do 64 rows? Aortic dissection can't be delayed. Besides, if it's an operation, we have to fly someone in. How many hours earlier? Hours." Luo Hao said with a smile while licking his face.

At this time, Luo Hao was extremely humble. He was not at all like the sunny and upright young man he usually was.

He was like a veteran in society. Although he had a humble attitude and soft words, Lin Yuming was sure that if she didn't do what he said, Luo Hao might even roll on the ground and pretend to be dead.

Never give up until the goal is achieved.

Who the hell did you learn this from? Lin Yuming felt helpless.

"Uncle, I have three, upper, middle and lower..." Seeing that Lin Yuming didn't speak, Luo Hao continued to encourage.

"Get out!" Lin Yuming couldn't control the anger in his heart and yelled, "That's bullshit, up, middle, and down. Who do you think you are?"

Only one plan is given, and if it fails in the end, it is the responsibility of the person who made the plan.

But given three plans and they failed in the end, it is the responsibility of the person who selected the plans.

Lin Yuming did not expect that the slick and secretive approach in the book would appear on Luo Hao.

This child grew up so fast. Lin Yuming immediately found something to praise Luo Hao.

After all, he is his own child, so he should be praised.

"Uncle, we still need to do a 64-slice aortic CT scan." Luo Hao said respectfully.

Although his expression was respectful, his tone was extremely firm and soft-spoken, even though the general CT scan had been finalized without any problems.

"Luo Hao, that's too much!" Lin Yuming said sternly.

"It's a trivial matter to do more examinations. I'll talk to the patient's family." Luo Hao said shamelessly, "But if you are negligent, the patient who could have been treated suddenly dies suddenly. Aren't I worried that you will be in trouble?"

"It's your fault, I knew it was nothing good as soon as you mentioned it." Lin Yuming scolded, "The image is here, tell me where there is aortic dissection?!"

Luo Hao remained silent in the face of Lin Yuming's questioning.

But he didn't give up, praying with his eyes.

I really can't stand it... Lin Yuming couldn't bear it when he looked at Luo Hao's resentful and pleading eyes.

For a moment, Lin Yuming thought of Luo Hao's father, his late friend.

The two men have the same temper, what a shame! Lin Yuming cursed in his heart.

"Uncle, just this once, if there is no aortic dissection, what will you say in the future?" Luo Hao begged softly.

"If there was, I would have eaten the film."

"Don't worry, that stuff is hard to digest." Luo Hao heard a glimmer of hope and said quickly, "Then I'd like to thank you on behalf of the patient."

"patient?"

"No, no, no, I thank you."

Lin Yuming was really helpless.

Maybe Luo Hao is still in the rebellious stage, forget it, just do what you want.

Lin Yuming calmly called the director of the CT room.

Although the Medical Office is the superior department, it still needs to be treated with due respect.

Moreover, the person operating the machine this time is not a professional doctor in the CT room, so many troubles are no less complicated than doing an elephant trunk surgery.

When it comes to people, nothing is that simple.

After contacting him for half an hour, Lin Yuming "persuaded" the director of the CT room to open the door to the CT room in row 64.

The machine buzzed and started running. Luo Hao acted as both a doctor and a nurse, communicating with the patients' families, inserting needles for the patients, creating contrast agents, and conducting examinations.

Seeing Luo Hao shouldering all the work, Lin Yuming's emotions became even more complicated.

Luo Hao is really capable, but he is a bit too capable and always looking for trouble.

Before the film came out, Lin Yuming said earnestly, "Xiaoluohao, the county hospital in Libo County below was smashed yesterday, did you know."

"why?"

"A patient drank alcohol after taking antibiotics and developed an acute allergy. He was unable to be rescued at a small clinic and was sent to the county hospital. He had a tracheotomy and was rescued, but he died in the end."

Luo Hao concentrated on operating the machine and chatting with Lin Yuming "by the way".

"This is quite normal. The patient's family is not willing to give in? What's so fussy about this? Taking antibiotics and drinking alcohol, isn't this looking for death?" Luo Hao asked.

"The family filed a complaint with the Health Commission, saying that they had a minor illness and they were sent to the hospital. As a result, the doctor made a mistake and cut the trachea." Lin Yuming warned Luo Hao with an example.

"!!!"

"I admit that the vast majority of people are good, and they also understand the medical staff. But if you imagine a scenario - as long as you are dissatisfied and complain, you can gain something, ranging from exemption of hospital expenses to tens of thousands at most , hundreds of thousands, hundreds of thousands in compensation.”

"If it were you, what would you think? Would you be moved?" Lin Yuming asked.

"I'm not short of money." Luo Hao looked at the machine screen intently and said casually.　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　 companies

Lin Yuming slapped Luo Hao on the back of the head.

"Uncle, it's easy to beat someone stupid here." Luo Hao complained, covering the back of his head.

"Be serious, you are likely to encounter this situation in your future work."

"There's nothing we can do about it." Luo Hao said helplessly, taking a look at the luck value.

I really want to add all attributes, physical strength, mental energy, and luck.

The attribute points given by the system are completely insufficient.

If possible, Luo Hao would fill up all his attribute points.

With such a high luck bonus escort, he should not encounter unreasonable family members of patients, Luo Hao thought in his mind.

"It's better to do less than to do more. Even if you want to fulfill your responsibilities as a doctor, you have to consider the situation."

"This patient's family seems to be quite reasonable. Don't worry, uncle, I know what's going on."

Lin Yuming's persuasion was once again rejected by Luo Hao.

Damn it, let the facts educate him. Reason with him yourself and say that Luo Hao has ten sentences waiting for you.

Lin Yuming decided to speak with facts.

The first fact is that Luo Hao made a mistake in diagnosis.

After seeing the ghost of aortic dissection, Lin Yuming made up his mind and looked at the ordinary CT images again.

According to his analysis of many years of clinical experience, the patient did not have aortic dissection.

Lin Yuming thought viciously after watching the movie.

"Uncle, there's a problem!"

Luo Hao's voice interrupted Lin Yuming's thoughts.

"Is there a problem? Where?" Lin Yuming looked at the 64-row aortography screen.

"Here." Luo Hao pointed his hand on the screen, "There is an aortic dissection aneurysm just where the ascending aorta exits the heart! It cannot be seen with ordinary CT, it can only be seen with 64 rows."

Lin Yuming stared at the position of Luo Hao's fingers.

Sure enough, there was a less typical image of an aortic dissecting aneurysm.

Really are!
  Lin Yuming was not ashamed of what he said before. In front of his own nephew, everything he said was fart. Luo Hao could still laugh at him.

When he saw the aortic hemangioma, Lin Yuming felt his hands were a little numb.

Difficult patients.

There are several types of aortic dissection, and type 1 is the most difficult to deal with. Unlike other types, it is most likely to be solved with a big rack, and the vascular department can do it.

The patient in front of me belongs to the most difficult type of type 1 aortic dissection.

Dissection occurs just after the blood vessel leaves the heart. Even if an operation is required, the difficulty of the operation will soar.

Luo Hao got himself into big trouble.

Lin Yuming even felt a little gloomy in his heart. It would be better not to detect this kind of patient than not to detect him.

If it cannot be found out, the patient died suddenly, but there may be a medical dispute.

But what if we find out...?

Elephant trunk surgery?

Not to mention the current mine managers, even the mine managers in their heyday couldn't do it.

Not to mention the mine manager, what about the hospitals in the provincial capital? Elephant trunk surgery is not a routine surgery for them.

Explain the truth to family members. It's easy to do so when you meet someone who is reasonable, but if you meet someone who is pretentious, the probability of medical accidents and medical disputes will immediately increase to more than 80%.

Just when Lin Yuming was stunned, he suddenly heard Luo Hao's voice.

"It's me, your adoptive father."

"Seriously, who is the teacher with the highest success rate in performing elephant trunk surgery in your hospital?"

"Huh, I don't change my original intention. I used to call me teacher, and I still call me teacher now. It's not like you, who used to call me foster father, but now that I'm the deputy director, I want to change my name."

Lin Yuming was dewy-eyed when he heard this.

"I have a type 1 patient here. The imaging data will be sent to you as soon as possible. The patient's condition is not very good. He needs to hurry up and perform surgery. The sooner the better."

"Teacher Han, am I embarrassed to trouble him? I think it would be more generous to find you, forget it, I'll ask Teacher Han."

"Hang up."

With that said, Luo Hao hung up the phone.

"Who did you contact?" Lin Yuming asked.

"Director Choi Myung-woo of Ahn Jung."

Hey!
  Directors Luo Hao and An Zhen have such communication as foster father and foster son? Thinking back to Luo Hao's words just now, Lin Yuming's hands became even more numb.

"Uncle."

Luo Hao approached Lin Yuming and asked softly.

"What's wrong with holding it back? If you have anything to say, just say it." Lin Yuming had a bad feeling.

"The patient's condition is critical. For aortic arch replacement surgery, at least 20 units of red blood cells and 1500 ml of plasma must be prepared. As for platelets, it is best to have them."

Knowing that Luo Hao didn't hold it in well, Lin Yuming glared at Luo Hao fiercely.

"I will contact the experts and communicate with the patient's family. These are all minor problems. But some big problems can only be solved by you, uncle. You see..."

As soon as Lin Yuming heard Luo Hao call him "you", he got headaches again and again.

……

……

"Comrade, I am Wen Youren, Director of the General Surgery Department of the Mining General Hospital. I am reporting to Lin Yuming, the Director of the Medical Department, and Luo Hao, the Director of the Medical Department, with my real name."

Wen Youren arrived at his destination with a heavy package of information.

After entering the house, he couldn't wait to get warm and explained his purpose directly.

Wen Youren is familiar with this matter because he has done it before.

Many years ago, an old director who was as famous as Wang Guohua always looked down on Wen Youren, and Wen Youren held a grudge against him.

After retirement, the old director did not return to the mine. Instead, he went to a private hospital and used his technical skills and connections to attract many patients.

The anesthesiologist in the private hospital is served by his lover who does not have the scope of practice of an anesthesiologist.

This was Wen Youren's breakthrough. He patiently collected information on dozens of surgeries, and finally reported it with his real name, knocking the old director who offended him to the ground and stamping on him several times.

In Wen Youren's view, the old director was so tyrannical that he went to a private hospital and asked his wife to undergo anesthesia in order to earn more money, which violated medical principles.

I am on the side of justice.

This moment is like that moment.

For his own benefit, Luo Hao used medicine beyond the scope and gave patients iodized oil that was not mentioned in the instructions and could enter the bloodstream.

This is a pest in the medical world! Worms! Must be cleaned up.

Among the thick documents, there are instructions for iodized oil, the operation records of Luo Hao's surgery, and medication records.

Wen Youren has been collecting this information for a long time, but has never revealed anything, just for today's thunderous strike.

Report with your real name, even if someone wants Paul Hao, you can't protect him!
  Wen Youren held the materials with a smile on his face.

But his cheeks were frozen, and his imaginary smile was a little ferocious, like a hungry wolf in winter.

……

……

Luo Hao's cell phone rang.

Answered the call, it was the emergency department nurse.

The patient reported a critical value, but the reason why it was delayed was that the laboratory department felt that the value was too outrageous, so it conducted a reexamination, which delayed the time.

Hemoglobin 38g!

Before the operation, a blood transfusion was required.

This time, not only Lin Yuming, but also Luo Hao felt a splitting headache.

The hemoglobin level must be at least 70 before surgery can be performed. Luo Hao scratched his head.

"I'll talk to the patient's family." Luo Hao sighed.

If you want to make trouble for yourself, you can't blame others.

The patient's family members did have a fracture. He was hanging in front of him with a plaster cast and sitting in the emergency room waiting worriedly.

Luo Hao called him out when he came back.

"This is your mother's condition." Luo Hao first briefly talked about the patient's condition, and then said, "The hemoglobin is too low now and a blood transfusion is needed."

After hearing about the blood transfusion, the eyes of the patient's family members lit up.

"Doctor, I have 12 blood transfusion certificates!" the patient's family said, "I can have free blood transfusions! This is not a problem."

Gan!
  Luo Hao cursed in his heart.

Is it that simple? joke.

But the more this happens, the more difficult it is to explain to the patient’s family.

Luo Hao looked at the progress of system tasks moving forward little by little. Wouldn't it be better to win by lying down? Why treat such a difficult patient?
  The thought flashed in Luo Hao's heart and then dissipated.

If the patient still has a glimmer of hope, it must lie with him.

The entire mine can always hire someone who can perform such a difficult elephant trunk surgery in a short period of time, but he is the only one.

Forget it, Luo Hao sighed deeply.

"That's right." Luo Hao explained.

……

Note: At this point, I still have to wail.

On duty a few days ago, another patient vomited blood. For emergency treatment, the director was shaken from home to contact the center, and he communicated with the gastroenterology department to perform ligation to stop the bleeding at any time.

After the patient's condition stabilized, he smoked and chatted with the director. The director said that 80% of patients in the department who vomited blood rushed to my shift.

Shrugging shoulders, spreading hands, looking at the sky.

There is no way, this is metaphysics.

When I was in the Department of Thoracic Surgery, in 15 years, 8 patients with rib fractures complicated by aortic dissection were handled by my shift.

Misdiagnosis of this rare complication is almost equivalent to death. I have never seen other patients with rib fractures die suddenly, so it is basically certain.

However, I diagnosed all 8 patients with ordinary CT scans.

One of the cases was not obvious. I had my face scanned in the middle of the night, and I consulted with my most trusted CT doctor and looked at the film to get a confirmed diagnosis.

I really can't help it. Maybe after I retire, the number of emergency rooms in our hospital will be less.

Sorry.

(End of this chapter)