medical simulator

Zhou Cheng picked up a pen to write and draw in the notebook, all of which were illogical, mainly the names of some operations.

Don't be afraid that others will understand.

However, just as his butt was getting hot, Qin Min came to disturb him again, and said after entering the door: "Zhou Cheng, another emergency patient came, and it seems that he has a dislocated joint."

"It is said that Dr. Liang Xueya from the emergency department asked them to come to our department."

When Tan Min mentioned this, he said in a little embarrassment: "It's been a long time since we have seen such a patient in our department. You can go and have a look first, and I'll give Lao Luo a call?"

Qin Min has been employed for more than two years, which is as long as Zhou Cheng's training period. He has seen no more than twenty patients with joint dislocations, and Luo Yun is basically handling them.

And when she met Luo Yun more often, she called him Teacher Luo, and in private, she referred to Luo Yun as Lao Luo.

Zhou Chengcheng stood up and said, "Miss Tan Min, don't call yet, let's go see the patient first."

"Teacher Luo Yun just told me that for patients with dislocated joints, I can try to reset them by myself."

Tan Min took out her phone, and was about to search for cloud from the address book, when she heard Zhou Cheng's words, her hands froze.

Looking at Zhou Cheng and blinking, he asked, "Really? Zhou Cheng, don't lie to me?"

As Zhou Cheng walked out, he said, "Sister Tan Min, don't you worry about me? Teacher Luo Yun must have said this, so I dared to say this. Otherwise, I wouldn't just violate the rules."

"You have to be responsible for this."

When Tan Min thought about Zhou Cheng's usual habits, he thought it was the same.Zhou Chengsu has always been a steady person, and he has just obtained the fourth or fifth first-level surgical authority in the department, so it is not incomprehensible for Luo Yun to grant him the manual reset of joint dislocations alone.

And this kind of thing, you can know it as soon as you ask, if Luo Yun didn't say it, Zhou Cheng can take this responsibility by himself?

Certainly not.

"Of course I believe you." Tan Min said without hesitation.

"Then I'll go to work first. If you need any consumables, remember to ask me to get them."

As Tan Min said, he passed Zhou Cheng first, walked towards the nurse's station, and then explained to the patient: "The doctor on duty has arrived, and he will be able to see you soon, so you have been waiting for a long time..."

The patient and his companion quickly stood up and walked towards Zhou Cheng.

After careful questioning, Zhou Cheng confirmed the patient's basic information and medical history.

The patient, male, 46 years old, suffered right shoulder joint pain with limited mobility for 1 hour due to trauma.

The results of the current physical examination have a square shoulder deformity in the right shoulder joint!There was tenderness at the shoulder joint, the humeral head was palpable anteriorly and inferiorly, the scapular fossa was empty, the movement of the shoulder joint was limited, and the movement of the distal limbs felt normal.

Square shoulder deformity, as the name suggests, is a hallmark sign of shoulder dislocation.

However, it is not a diagnostic sign.However, based on the displacement of the humeral head and the empty socket of the shoulder joint, it can be basically diagnosed as anterior dislocation of the shoulder joint.

Anterior shoulder dislocation is the most common joint dislocation, and the number of patients is really quite a lot.

However, physical examination alone is definitely not enough to diagnose shoulder dislocation, and it is necessary to strictly check for occult fractures.

X-ray, the patient's companion had already brought it, and immediately handed it to Zhou Cheng to see.

After reading the films, the diagnosis can basically be confirmed.

This time, Zhou Cheng carefully recorded the entire medical history with the patient's emergency medical records, and then completed the physical examination and film reading in detail.

Write down the diagnosis and treatment plan in detail in the medical record and inform the patient.

"According to your current situation, it can be diagnosed as anterior dislocation of the shoulder joint, which requires reduction treatment."

The patient immediately said: "Then doctor, please treat me quickly, I am going to die of pain."

The companion also said: "Yes, doctor, my elder brother has been in pain for almost an hour. We rushed to the hospital at the first time and tossed for more than 40 minutes. The pain is really unbearable."

Zhou Cheng said: "Don't be in a hurry, because the current reduction treatment, there are two kinds of manual reduction and surgical reduction, each has its own advantages and disadvantages. Come with me to the office."

"I have to tell you in detail."

The accompanying person is the younger brother of the injured patient. He looks about 40 years old and is tall and strong. He is obviously impatient: "So what are you talking about? We definitely agree to the treatment. You should treat it quickly!"

Zhou Cheng said: "Then do you agree to surgical treatment or manual therapy? If it is surgical treatment, you have to be hospitalized first and complete the preoperative examination before surgery."

"I can give you a hospital certificate right away."

The companion immediately puffed up his eyes, and the corners of his mouth twitched: "My brother, is he going to have an operation?"

Then he took two steps back and asked his elder brother:

"Just now, that's not what the doctor said."

Zhou Cheng said: "You didn't wait for me to finish, so how do I know which treatment method you choose? You can't make a decision right away, of course I have to tell you the pros and cons first."

"Because manipulative reduction and surgical reduction are both optional treatment methods, and you can only choose by yourself. Our hospital only provides medical services and cannot make decisions for you. In your case, you can only be treated with surgery, right? ?”

Learning from the past, Zhou Cheng can only choose to be more stable now.

In the end, the patient and his companion listened to Zhou Cheng's lecture in detail for 5 minutes, and finally signed their own names, and wrote down their own names and the words requesting manipulation reset under the emergency medical records in the emergency medical record book.

Zhou Chengcai wrote another doctor's order for the two of them, and scanned the QR code to pay the fee.

Only then did he take two people into the second operating room.

There are two operating rooms in the department, which are actually two adjacent single rooms.

When Zhou Cheng and the patient went in, they happened to meet Du Yanjun who finished the debridement and suturing of the patient in front of him!

It took Zhou Cheng more than 20 minutes to go through various procedures such as consultation, conversation and signing.In addition to the previous time, Du Yanjun has already completed a debridement and suture.

Seeing Zhou Cheng bring the patient into the operating room, Du Yanjun opened the door suspiciously and took a look inside.

Then saw the following scene.

While supporting the patient's affected limb, Zhou Cheng told the patient to lie down on the bed, and then the patient's healthy limb was placed on the examination bed.

The patient immediately let out a scream.

Finished calf.

Du Yanjun quickly retracted his head!

Walking away quickly in a state of confusion...

He kept patting his chest.

Damn, Zhou Cheng is practicing medicine violently this week!

No, I have to report to Teacher Luo Yun immediately.

Otherwise this is going to be a problem...

Chapter 41 Reverse Assist!

Du Yanjun felt that the current situation was very serious.

Zhou Cheng is simply too daring this week.

Even he just dared to use the name of the teacher to do a little debridement and suture sneakily in the department, and then take advantage of no one's attention.

Mix in some emergency surgery from Luo Yun alone to do it.

But it's all violent and 'fighting' with the patient.It is not of a nature.

Du Yanjun heard the scream from the patient just now.

Is this still available?

Zhou Cheng was on duty, and Luo Yun was on the second-line shift. When the patients Zhou Cheng couldn't handle came, Luo Yun would handle them.But whether it is Luo Yun or Zhou Cheng, they all follow Cai Dongfan.

In case this patient goes to report, the first thing to deal with is the leader of the group——

Cai Dongfan.

Let's talk to Luo Yuntou first.

But Luo Yun had already slipped away, so Du Yanjun patrolled the department, but couldn't find where Luo Yun was.

Therefore, Du Yanjun could only walk into the walking stairs and secretly call Luo Yun.

In fact, for this kind of thing, I had to talk about it in private in front of Luo Yun, and it was not appropriate to make a phone call.The law does not spread to six ears.

However, the walking stairs are basically unused. This is the 11th floor. Who would take the walking stairs on the [-]th floor?

After dialing the phone, Luo Yun answered.

Then Du Yanjun immediately told what he saw.Then he said: "Mr. Luo, I think this is a bit inappropriate. The patient just now was in pain and would definitely want to hit someone. Will he report it later?"

"Brother Zhou Cheng's method may be a little violent."

Luo Yun was driving at this time, and the phone he answered was directly connected to the car's Bluetooth.After hearing what was going on, he let out a sigh of relief.

Say: "Okay, I see, you don't have to worry about this matter. Just do your own thing."

At the same time, I was shaking my head in my heart, this Du Yanjun still owes a lot in clinical practice.Although he is not a graduate student in joint surgery, and Cai Dongfan is not a professional in joint surgery, you don't even understand that Zhou Cheng is doing joint dislocation.

You even called me directly to report it to me. You said this happened?

Du Yanjun was obviously taken aback, and asked in confusion, "Do you care? Teacher Luo?"

"Our department should also pay attention to humanistic care?"

"If the patient reports it and the medical department investigates it, Teacher Cai may be implicated. If Teacher Cai gets angry, we will all suffer."

Du Yanjun was still explaining the seriousness of the matter. He felt that Luo Yun didn't understand what he was talking about, and didn't consider the seriousness of the matter for a while.

Luo Yun sighed slightly, and while turning the steering wheel, said a little tiredly: "Yan Jun."

"To tell you the truth, it was Zhou Cheng who was doing a dislocated joint reset for the patient."

"This kind of manipulation should go to the operating room for anesthesia, or even general anesthesia, but the cost of anesthesia is not low. Therefore, Zhou Chengcai chose a manipulation with the lowest cost and good effect. Timing method."

Speaking of this, Luo Yun felt that what he said might be too profound.

He said: "Although you are not a graduate student in joint surgery, joint surgery is also a big branch of our orthopedics department. If you are free, you can also read some books on this topic."

"Speaking of which, you went to the emergency department with me, and more or less came into contact with more than a dozen patients with joint dislocation and reduction. Zhou Chengquan learned it by himself."

"You don't even know what he's doing, so think about it yourself."

"Okay, that's it, don't bring this matter to Director Cai."

"It won't do you any good."

After speaking, Luo Yun hung up the phone directly.

This was the first time Luo Yun felt that Du Yanjun was a little too narrow-minded, or too scheming.

I don't know how to do my own thing well, and I don't want to study hard, so why do I engage in these speculative things?

In the past, although Du Yanjun won more learning opportunities by virtue of being Cai Dongfan's student, he also felt that Du Yanjun was a more refined person and good at using his own resources and advantages, so he easily won a lot of opportunities for him. Chance.

But thinking about it now, it seems that I am completely redundant.

I followed myself to do more than a dozen joint dislocation manipulations, but I didn't even read any books!

When I co-authored it, I felt that I, Luo Yun, called him to help, and he came here to help me with things.

If you think like this, why should I call you?

Otherwise, as long as you read a little bit of books, as for making such a big oolong today?

Looking back at Zhou Cheng, he does things without arrogance or impetuosity.

Oh, except today.

I could have done a lot of things, so I definitely didn't want to do everything, just keep my voice down, study hard, learn surgery well.Such a person is fully prepared, and if given a chance, he can ride the wind...

How to learn to accumulate knowledge is also a compulsory course for medical students. If you show off yourself with a little bit of knowledge, you are eager to express yourself, and you will suffer a loss one day.

……

Du Yanjun was in the stairwell, his face pale.

He could tell that Luo Yun was obviously angry today.

There may be two reasons.

One was that he had misunderstood Zhou Cheng, and went to inform him without even understanding what Zhou Cheng was doing.

The second must be that I secretly reported to Luo Yun, with impure motives.

After thinking about it, Du Yanjun tapped his forehead lightly with some regret, and scolded himself in a low voice: "Du Yanjun, Du Yanjun, you are so stupid."

"You only think about whether you and your teacher will be implicated. This will definitely make Teacher Luo Yun feel unhappy."