Come on, Dr. Wu

Chapter 14 Gallbladder Perforation
  In fact, the cases in the emergency observation room are not many complicated.

Most complex patients have already been sent to specialists the moment they enter the emergency department. Those who can stay here are either patients that the emergency department wants to retain, or they are too complex and have multiple specialties integrated into them. For systemic diseases, various specialties are pushing the envelope and cannot send them out, so they need to be dealt with after multi-disciplinary consultation.

Then there are those who are making trouble, such as patients injured in car accidents. Because the claim settlement is not clear yet, in order to protect their own interests, they can only stay in the hospital until the claim settlement is clear before leaving. This kind of thing, the specialist beds are tight, so usually They will not be accepted, they can only be observed in the emergency room first, and these are also included in the cases at this time.

But this is not Wu Xiaofu’s focus. He just goes through the cases and remembers them.

The focus is on the first two.

Especially those patients who want to be detained in the emergency department. The First Affiliated Hospital of Donghai Medical University has its own emergency operating room, and there are three surgical teams to perform operations. Some operations that can be performed in the emergency department will not go to the specialist if they encounter them. Once the patient is transported, it is performed directly in the emergency operating room. The surgery represents income. Only when the department's income increases can doctors achieve greater performance.

There are also many surgeries that can be performed in the emergency department. The most typical ones are appendix and gallbladder surgeries in the general surgery department. As long as the patient has experienced acute appendicitis or acute cholecystitis and gallstones from the emergency department, don’t even think about it in the general surgery department. I did it, because there is an observation room, I stayed there for a day or two after the operation, and then I was discharged directly.

Because of this, almost every hospital is in trouble with the emergency department. After all, these two are also the main surgical income of the general surgery department. If the emergency department robs them, the income of the general surgery department will drop.

There are also some acute surgeries in the Department of Cardiology and emergency interventional surgeries in the First Affiliated Hospital, which are performed well.

There are also some acute surgeries in the gastroenterology department, such as acute abdomen and gastrointestinal bleeding, which can also be performed in the emergency department.

There are others, but the surgeries in these three departments mainly account for the majority. The cases in the observation room before and after these surgeries account for the majority.

Wu Xiaofu naturally wanted to have surgery. He would definitely do surgery in the future. Surgeons, the ones who were fed during the surgery, were all in the emergency department. How could Wu Xiaofu not seize the opportunity? Opportunities don't come waiting for him. He should first familiarize himself with the cases. When the opportunity comes, jump right in.

The doctor system in the observation room is also the inpatient system. The page is still different from the outpatient clinic yesterday, but it is not difficult to get familiar with it.

"Dr. Liu, there is a patient who needs emergency surgery. Director Zhang took it in and asked him to prepare for the operation quickly."

A nurse rushed into the medical office in a hurry, arriving before anyone else arrived. This is also a major feature of the emergency department. Almost all the doctors and nurses who leave the emergency department are in a hurry because they are used to racing against time. .

After entering the medical office, the nurse saw that Liu Wenyin was not here, and looked at Wu Xiaofu and Qu Ying, "Where is Doctor Liu?"

Qu Ying was still a little at a loss, but Wu Xiaofu had already stood up, "Doctor Liu is out. Let's contact her and tell me first what kind of patient it is."

The nurse looked at Wu Xiaofu's name badge. She had never seen Wu Xiaofu before. There was not much information on the name badge. Doctor Wu Xiaofu. If they didn't introduce them carefully, who would know that they were interns.

Seeing Wu Xiaofu's imposing appearance, the nurse stopped delaying and said, "The gallbladder is perforated and requires emergency surgery."

Wu Xiaofu immediately understood that this was an opportunity. He asked the nurse's name, quickly typed out the patient's outpatient medical record, and turned to look at Qu Ying, "Qu Ying, let's go see the patient."

Ah!
  Is it so exciting? Qu Ying hurriedly followed.

Following the nurse, Wu Xiaofu quickly browsed the emergency medical records. Although it was an emergency medical record, Director Zhang had already written it in great detail.

Sun xx, male, 10 years old, mainly complained of pain and discomfort in the right upper abdomen for days, which worsened one day.

Emergency abdominal color ultrasound showed gallbladder stones; gallbladder perforation?

Liu Wenyin's call was quickly answered.

"Teacher Liu, there is a patient with gallbladder perforation. Director Zhang is here to treat the patient. He requires preoperative preparation as soon as possible."

"You guys ask about the patient's medical history first. I'll be right back."

Wu Xiaofu agreed, passed by the nurse's desk, and said to the head teacher, "Sister, I want an operating room for patients with gallbladder perforation."

The head teacher glanced at Wu Xiaofu's badge and nodded, guessing that it was Liu Wenyin who told him.

Bed Six, the patient on the bed at this time was huddled together in pain, his face was pale, and he was sweating profusely.

There were many family members, five or six in total, and they were all very anxious at this time. "Hang on, the doctor is here."

The nurse shouted, and the family members surrounding the patient moved out of the way. When they saw Wu Xiaofu approaching, they hurriedly gathered around him.

"Doctor, how is our grandson doing?"

"Director Zhang said I need surgery, when can I do it?"

"Doctor, is it dangerous? Can you not do surgery? Old Sun is usually fine and there is no problem."

"doctor……"

……

Five or six family members, who spoke to each other, had already begun to convey their opinions to Wu Xiaofu. Wu Xiaofu quickly screened their appeals, picked out the useful ones, and finally set his sights on a middle-aged woman, "Who can sign? "

Five or six family members immediately focused on the middle-aged woman.

"Doctor, I, I am the patient's daughter-in-law."

Wu Xiaofu nodded, came to the patient's side, and began to check the patient's physical signs. There were tenderness in the right upper quadrant, rebound tenderness, and muscle tension. Murphy's sign was positive. The physical signs were very typical. The patient was in so much pain that it was difficult to speak. Wu Xiaofu directly Looking at the patient's wife, "When did it start hurting?"

"Are there any other symptoms? Are there any nausea or vomiting?"

"Nurse, take your temperature."

"Have you had any tests before?"

"Have you ever had any other illnesses? Have you had any surgery?"

……

Quickly sort out the medical history. When asking about the medical history, if the patient cannot cooperate, the patient's wife can be said to be the doctor's favorite person to see. After all, this is the relative the patient gets along with day and night, and is much more reliable than his son or daughter.

"Doctor, do we have to do surgery?"

The patient's wife is obviously still hesitant about the surgery, but since Director Zhang has already admitted her, she must have communicated about this matter. The inquiry at this time is just for a positive answer.

"The patient's gallbladder has been perforated. Without surgery, it will be very dangerous. We recommend surgery."

"Director Zhang said the same thing, well, let's do it."

"When can we do it? Look at how much pain my brother is in. You should take care of it. Don't just ask questions."

"Yes, brother, it's so painful. Let's stop the pain first and use the medicine first."

……

Wu Xiaofu was besieged again, but he didn't care. He looked at the patient's wife and said, "Let them take care of the patient first. You and I will sign the pre-operative procedures and we will operate as soon as possible."

After saying that, Wu Xiaofu went straight to the medical office.

The patient's wife hurriedly followed. The other patient's family members saw that Wu Xiaofu ignored them and said they needed to operate as soon as possible. In addition, the patient had already left, so they could only continue to worry around the patient.

(End of this chapter)