medical simulator

Everyone in the shift room gasped for an instant!

It can be seen from the CT and X-ray levels that the broken end of the fracture is quite sharp!

The angle of lateral displacement is super large.

What appeared to be the sharp end of the fracture had, by accident, penetrated directly into a muscle or other soft tissue.

Many people looked in the direction of Hu Ming, as if they were asking, would you go for bone traction for such a patient?

The muscles on Hu Ming's face twitched, and he secretly cursed Yan Haihan!

Scheming villain!

Min Chaoshuo then added: "Although the patient's current fracture classification is C3.1, it is classified according to the fracture line and fracture part."

"But the patient's current situation is very special. We can see from the CT scan that the acute angles of the proximal end and the distal end of the fracture have been completely deformed under the pulling of the muscles."

"So our group considered that the patient's fracture end may have pierced the soft tissue and caused compression."

"Therefore, even with bone traction, the chance of traction reduction is very small. And during the traction process, if the strength of the traction cannot fully return the broken end of the fracture."

"Incomplete distraction would have resulted in severe soft tissue cuts by the sharp edges of the fracture, and the possibility of severing the femoral artery has not even been ruled out."

"Moreover, if this patient does not receive surgical treatment and chooses conservative treatment, it is absolutely impossible for the fracture to recover."

"That's right, I ask all the teachers to give you more guidance." Min Chaoshuo was very calm during the whole process.

Hu Ming was watching his nose, nose, nose and mouth, and his mouth was watching his heart, so he had no time to talk.

This TM is definitely a hole that Yan Haihan instructed Min Chaoshuo to leave for everyone, and it was reserved for himself and Cai Dongfan.

Cai Dongfan is more shrewd, he has been cultivating his temperament without saying a word.

Otherwise, according to the normal case discussion process, the X-ray results should be put on the first ppt.

Hu Ming has heard something about this patient!

Someone in the family works in the health system, and his position is not low. He was originally an acquaintance of Cai Dongfan, but Yan Haihan took him into his group.

Hu Ming didn't bother to pay more attention to the bullshit...

Now the situation is quite complicated, the side shifted at least five or six centimeters, and the broken end of the fracture pierced into the muscle.

After conservative treatment until death, the fractures on both sides cannot heal, and the bone cells can't find a way to crawl.

Bone traction does not have to fight.

The strength of bone traction is limited, if the strength of traction is not properly controlled.

It is really possible to turn the sharp edge of the fracture into a knife and swing it in the body to cut off muscles or nerve vessels.

No more surgery.

In such a situation, it has already been said.

Only then did Yan Haihan look at the crowd unhurriedly, and said sincerely: "Everyone has seen the situation of this patient, and it is quite special. No matter who has any opinions, they can speak freely."

"I'm here today to ask you for advice."

However, no one answered Yan Haihan's words.

"Director Cai?" Yan Haihan specifically named Cai Dongfan.

Cai Dongfan laughed: "Director Yan, it's better for you to grasp the patient's situation yourself, I can't control it."

Hu Ming's lesson from the past is right next to him, so of course Cai Dongfan doesn't speak!Afraid of getting into another pit that Yan Haihan left or detouring himself into a dead end.

I'm not Hu Ming, I have to prove that I'm strong.

Not worth the candle!

This is a dead end. Surgery is impossible, and there is no recovery without surgery.

Lying down all the time is almost synonymous with blood clots and heart and lung failure, and we can only wait for death.

And didn't you insist on pulling this patient into your own group before? I told you that I was an acquaintance, and you used the principle of admitting and treating patients in the department to talk about things.

Seeing that no one spoke, even Hu Ming and Cai Dongfan, who were qualified to talk to Yan Haihan on an equal footing, played with their fingers.

Yan Haihan could only take the initiative to ask: "Xiao Yang, if your teacher encounters such a case, how would you deal with it?"

Following these words, everyone turned their heads to look at Yang Yifeng.

Bright eyes.

Yes, a high-achieving student from the Affiliated Hospital of Shonan University happened to come to the department today, so you can ask him if he has ever seen such a 'wonderful' case and how to deal with it.

Yang Yifeng took a small half step forward and said: "Director Yan, this patient has a disease between relative contraindications and absolute contraindications to surgery. If the heart function cannot be improved, it will be difficult to perform surgery anywhere in the short term." It's unrealistic."

"And the case characteristics of this patient require additional intervention."

"If the conservative treatment of traction + plaster external fixation is not an option, then the only remaining option is manual reduction + plaster external fixation."

"However, my teacher has never encountered such a special patient before, so this is just my personal opinion."

Yang Yifeng admitted generously and calmly that his knowledge was limited, and he had never heard of such a strange patient.

But these words made many people turn their heads to look at Yan Haihan...

Chapter 57 Misfortune is brought to the east!

Some time ago, someone in the department was doing the manual reset of the fracture, and that was Director Hu Ming.

However, once Hu Ming was tricked by his relatives, and the department lost money!

Therefore, Yan Haihan personally issued a ban, and no more manual reset operations in the department.

Yan Haihan himself said this, is he going to be the first to break this prohibition?

Hu Ming was naturally looking at Yan Haihan.

Hu Ming had an innocent face at the moment, as if he was saying, I didn't say this, it was Yang Yifeng who said it, you brought this person here too, I didn't instigate him.

Yan Haihan remained expressionless, continued to look at Yang Yifeng, and asked, "Yifeng, is it difficult to reset the fractured femur? Did you all do it routinely before?"

Yang Yifeng shook his head and said: "Routine development is definitely impossible. As the saying goes, an arm cannot twist a thigh."

"Manual reduction of the femur requires a lot of skills, and it is only carried out in special cases!"

"The more conventional treatment is intramedullary nailing."

"We have never encountered such a situation with this patient before."

It is not an exaggeration to say that such a special case is one in a million.

Yang Yifeng didn't want to drag a patient to his master on the first day he came to No. [-] Hospital, and it was such a difficult patient.

Although Yang Yifeng had other plans, he didn't intend to piss off his teacher to death.

Yan Haihan sighed with emotion, this Yang Yifeng is really very shrewd, so knowing the advances and retreats, it is hard for him to say that he should ask Yang Yifeng to contact his teacher to see if he can transfer the patient.

People have said that they have never encountered it before, but if you insist on asking him to contact his teacher, isn't this asking him to scold him?

But this patient still has to be transferred out.

Yan Haihan then asked: "Director Hu, you have done manual reset before. What do you think about this patient? Can manual reset solve it?"

When Hu Ming heard this, his eyelids twitched, and he hurriedly said: "Director Yan, now that the hand is raw, I can't even do the normal fracture reduction."

"Director Yan, as you know, I'm a bit psychologically overwhelmed by the hand reset."

"Don't do it now, it can't be done."

What Hu Ming said was half true and half false, even his own relatives sued him, he was bitten by a snake for ten years and was afraid of well ropes.

And such a patient, who dares to do reset rashly?

Anyway, he is not a patient in his own group, so why bother Hu Ming?

Anyway, don't ask, if you ask, you can't do it!

And I was afraid, and my hands were born.

If you have to ask why the hands are raw, then you have asked.

Hu Ming didn't mind repeating what Yan Hanhan emphasized before.

"Don't other people have any other opinions?" Yan Haihan then looked around the crowd and asked.

No one dared to return, even Yang Yifeng retreated into the queue.

The reason why the Affiliated Hospital of Shonan University is strong is that it is strong in grasping the details of treatment, and it is not reckless.

For such patients with surgical contraindications, no one dares to administer anesthesia or undergo surgery when they go there.

The reason why surgery contraindications are contraindications is because it is very dangerous and even endangers the patient's life.

The premise of a good operation is that the person must be alive.

Otherwise everything is empty talk.

Yan Haihan said: "Since everyone has no other opinions, then I will apply to the medical department for transfer."

"During the transfer period, Director Cai, let the patient go to your group first."

"Recently, patients keep whispering in my ear, saying that they want to go to your group and get to know you better." Yan Haihan said without blushing, as if he was asking Cai Dongfan if he had eaten well. Simple.

Cai Dongfan was taken aback at the time, how could he have anything to do with him?

Immediately said: "Director Yan, why did the patients leave me here? They are all going to be transferred out."

Yan Haihan said: "Patients and family members have been nagging at my place, saying that they want to go to your place, Director Cai. Moreover, Luo Yun has also visited twice, and patients are always asking Director Cai if he has any opinions?"

"Luo Yun?"

"Right?"

Luo Yun looked up blankly: "Huh?"

The expression became extremely complicated at that time.

No, why does this have something to do with me again?

Director Cai asked me to see the patient, which is correct.

Otherwise, how could Luo Yun take care of any complicated patients in Yan Haihan's group? It's none of his business?

Then Director Cai asked me to transfer the patient to our group?

But on the day the patient was admitted to the hospital, you did not agree to transfer the patient to our group.

I have been talking about things based on the principle of admission and treatment of patients in the department, isn't it just to get in touch with the family members of the patients?

Oh, it can't be cured now, so it's sent here again?

Even if you are the director, you can't be so shameless, right?

"I went to see a patient." No matter what I thought in my heart, I still had to admit the fact.

Cai Dongfan's face suddenly turned dark, with an undetectable haze on it.

Although Yan Haihan is the director of the ward, this is a bit too much.

But Cai Dongfan really couldn't help it. In fact, he didn't want this patient in his heart. After he was admitted to the hospital, his acquaintances also looked for him many times. At that time, Cai Dongfan agreed to let the patient into his group, and talked to Yan Haihan.

But Yan Haihan disagreed at that time!

Later, the patient's family also thought that Yan Haihan was the director of the ward, and Cai Dongfan was just the chief physician.

I didn't get too entangled in which director's treatment I would be under.

But now?

I'm a garbage dump here, right?

Cai Dongfan said: "Director Yan, the rules for admission and treatment of patients in the department are not accepted by any group, but are they under the control of that group?"

"And now we're almost at the stage of transfer. It's a bit inappropriate to transfer the patient and then transfer again, isn't it? Director."

On the bright side, Cai Dongfan is still willing to give Yan Haihan a little face, and he didn't hate him too much.

At this time, the atmosphere in the shift room became quite delicate.

"This is a special matter. Director Cai, since the patient wants to go to your place for treatment, we still have to respect the patient's own wishes. Right?"

"Our department is relatively open-minded, and we don't set the rules so rigidly."