medical simulator

"But if you really don't want to accept it, then I'll go and refuse to the patient and family members, that's okay." Yan Haihan said in a tone that was very considerate of Cai Dongfan.

Cai Dongfan was silent for a moment, and cursed shamelessly in his heart.

But he could only nod his head helplessly and said, "Director, let us be on the team first."

"But the process of applying for a transfer has to be run down as soon as possible."

If it breaks out, everyone will lose face!

And what if Yan Haihan went to the patient to make irresponsible remarks, saying that he was unwilling to accept him.

Then my uncle probably would really come to the department to talk to me.The inpatient is his cousin's father-in-law. The relationship is not far away, but very close, but it is just that.

But after all, it was a family in my father's generation.

Anyway, if you have to transfer to another hospital, just throw yourself here.

Hearing that Cai Dongfan agreed, the stone in Yan Haihan's heart finally fell to the ground, and said: "Since everyone has no other opinions on this patient, then write an application for transfer, and then go through the transfer process. Everyone has no other opinions." opinion?"

"Min Chaoshuo, tell the head nurse later and bring the patient to Director Cai's team."

"This is the end of our group's discussion of difficult cases."

"Director Hu, Director Cai, have you prepared a case yet?"

Yan Haihan asked cordially as if nothing had happened.

Cai Dongfan didn't speak, but Hu Ming said indifferently: "Director Yan, I haven't encountered any cases that can be shared yet. If there is one next time, I will definitely share it with everyone to study."

Hu Ming put a lot of emphasis on the word learning.

Yan Haihan deliberately pretended not to understand.

In this way, the seminar on difficult cases came to an end in this way.

After the discussion, Yan Hanhan also kindly called Yang Yifeng who was about to go out: "Yifeng, how do you feel?"

Yang Yifeng definitely heard this sentence, but Yang Yifeng walked out the door as if he didn't hear anything.

Min Chaoshuo saw Yang Yifeng walk out the door.

Min Chaoshuo deliberately ran out and called out, "Brother Yifeng, my teacher called you."

But Yang Yifeng still walked outside the department, and he didn't know if it was true that his ears were bad, or if it was on purpose.

Now, even Min Chaoshuo's complexion looked a little uneasy, and after touching his head, he couldn't do anything about Yang Yifeng.

Yang Yifeng is not a student of the No. [-] Hospital. He can even think of not wanting a doctorate degree from Shonan University. What can you talk to him about?

Min Chaoshuo had no choice but to walk back to the shift room and said, "Brother Yifeng is gone, maybe I didn't hear you."

Yan Haihan nodded with his face unchanged: "It's okay. I'll just talk to him tomorrow, and you can go to work."

"You have to implement the transfer of patients."

After the discussion of difficult cases was over, Cai Dongfan called Luo Yun, Du Yanjun and others to the director's office, intending to hold a small meeting within the group...

Chapter 58 Small group meeting!

"Teacher Cai." After entering the director's office, Luo Yun called Cai Dongfan who was sitting calmly on the chair.

Meaning what to do now?

At the same time, both Zhou Cheng and Du Yanjun were there. Zhang Zhengquan didn't come because he was on duty and an emergency patient came to him to be treated.

But without Zhang Zhengquan, it doesn't matter.

"Master, Director Yan is a bit too much." Du Yanjun muttered in a low voice.

Luo Yun cast a horizontal glance at Du Yanjun.

Cai Dongfan raised his head, looked at Du Yanjun and said, "Don't mention this again. No matter what Director Yan does, you are just a student in the department and have nothing to do with you."

"Hu Ming and I can say some things, but you can't."

"And this incident was already in my expectation."

"In fact, I asked Luo Yun to look at the situation of my relative when he was admitted to the hospital. It's just that I didn't know that his mental function was so bad at that time. At that time, I thought that since Director Yan wanted it, I thought it was It’s good for the relatives to avoid suspicion a little bit, so let him go.”

"However, after his preoperative examination came out, I have considered this issue."

"Director Yan will definitely find a way to push the patient to me."

Having said that, Cai Dongfan frowned and sighed:

"In this situation, surgery is not an option, and conservative treatment is not an option either!"

"It is indeed more difficult."

When Du Yanjun and Luo Yun heard this, they also touched their heads.

Cai Dongfan continued: "I have consulted with the professors of the Affiliated Hospital of Shonan University and the Second Hospital before."

"The patient's condition is not complicated if it can be operated on."

"The difficulty is that the patient's own condition is bad. If surgical intervention is not possible, there is no better way for them to turn around."

Having said that, Cai Dongfan smiled wryly, shrugging his shoulders, and his eyes revealed a deep look of helplessness:

"To be treated conservatively, it must also be a treatment-oriented conservative treatment."

"As for the displacement of the embedded soft tissue at the fracture end, looking around the country, not many people may have encountered it."

"Those who have the courage to do it are not sure."

"In case of damage to blood vessels and nerves."

"Difficult."

"If I were Director Yan, I would also like to throw this patient to me as soon as possible."

It is not that simple to transfer a hospital. The inpatient must agree to the transfer, and the receiving hospital must be willing to accept the patient. Otherwise, it is against the rules.

Such complicated patients, if there are no surgical contraindications, the treatment is not complicated!

However, if there are surgical contraindications and the operation is impossible, it is extremely difficult to go to the Affiliated Hospital of Shonan University or to the magic capital of Kyoto. No professor is willing to cause such a big trouble for himself.

Luo Yun frowned immediately, and asked: "Director Cai, but? Such a patient, placed in the group, isn't it just a patient who has been pressed for a long time?"

"Now the hospital's management of the average length of stay is getting stricter!"

"Didn't Director Yan insist on keeping the patient?"

The hospital has a requirement for the average length of stay of each treatment group, which is to shorten it as much as possible, speed up the turnover of patients, and improve the efficiency of diagnosis and treatment.

It is even linked to the performance of the medical staff in the treatment group.

If there is a long-term bed-pressing patient, it will greatly delay the average length of hospitalization, bonuses, etc., and it will definitely deduct a lot.

Cai Dongfan explained: "This is my cousin's father-in-law, a cousin who came out of a threshold 40 years ago."

"Director Yan can refuse to give it to me, but I can't refuse to accept it."

"I can only work hard for everyone. I will think about a solution. I still have to come up with a countermeasure as soon as possible."

"Begging for others is worse than asking for oneself." Cai Dongfan scratched his head, his face was full of helplessness, and his head was hurting right now.

Yan Haihan was sure of this, so Cai Dongfan had no choice.

As soon as Luo Yun heard this, he didn't talk about other messy things, but said: "Director Cai, why don't you ask the professors at the Provincial Hospital of Traditional Chinese Medicine to see if any professors dare to perform manual reset on this patient?" .”

"Some old professors of traditional Chinese medicine are quite accomplished in manual reset."

Cai Dongfan shook his head and said, "I asked earlier. My cousin and his family have found many old Chinese doctors, but after seeing the film, they dare not touch it."

"This is not a joke!"

"And it is estimated that the ancients did not classify and classify fractures. How can there be any special coping methods for such a special fracture?"

"It's really a coincidence."

"It's like some places where novice drivers drive to on the Internet, and veteran drivers dare not even drive out, let alone drive in."

"What I'm thinking is, can I consult the professor of cardiology to see if the patient's heart function can be improved. But this is not something that can be resolved in a short time."

"Well, I'm afraid that it will take a while, and I will develop a thrombosis or pneumonia..." Cai Dongfan sighed a long time.

Du Yanjun took the initiative to say, "Master, it's fine. I'll take care of this patient."

He is a student of Cai Dongfan. This patient is very complicated and the hospitalization period is long!

Du Yanjun wanted to take the initiative to hug him and let it go.This can also make Cai Dongfan think better, and prevent Zhou Cheng and Zhang Zhengquan from being dissatisfied with Cai Dongfan.

Zhou Cheng glanced at Du Yanjun upon hearing this.

Luo Yun said: "Of course you are in charge."

When he heard this, Zhou Cheng whispered, "Mr. Cai, I'll just say it casually. Do you think this is okay?"

"The patient's current situation is that he cannot tolerate general anesthesia, and because lumbar spinal stenosis cannot be ruled out, there is no way to perform lumbar anesthesia. But we can choose nerve block."

"Under nerve block anesthesia, a small incision is made to detect the specific position of the fracture tip, and then after confirming the safety, manual reduction is used."

Suggestions are given based on the actual situation.

Cai Dongfan glanced at Zhou Cheng, obviously he didn't expect Zhou Cheng to speak.

He frowned, raised his head, and asked, "Nerve block? Nerve block at the femur isn't easy?"

If it is a fracture of the calf, it is still feasible, but the distribution of nerves on the skin surface of the femur varies greatly from source to source.

"The patient is so old, if the anesthesia is unstable, the painful stimulation will lead to cardiopulmonary failure, which will be troublesome."

Hearing this, Luo Yun helped Zhou Cheng a little bit, saying: "Director Cai, Zhou Cheng actually knows a little bit about how to restore fractures. Maybe his method can really be tried. I also told you about Zhou Cheng’s manipulation reset in two days.”

"Mr. Cai, do you still remember?"

"How can this be the same?" Cai Dongfan's tone suddenly became higher, thinking that Luo Yun was a little ignorant, why are he making noise here.

Zhou Chengcheng said: "Ms. Cai, if the simple nerve block anesthesia is not easy to control, local anesthetics can be temporarily added during the operation. The current risk of the patient is mostly concentrated in the risk of anesthesia. Nerve block anesthesia and local anesthesia will not It will not cause any burden on the whole body, nor will it cause a burden on the cardiopulmonary and abdominal functions."

Speaking of this, Zhou Cheng said: "Mr. Cai, this is actually my own idea. The specifics are still in the hands of you, Mr. Cai."

All that needs to be said has been said, whether to adopt it or not, Cai Dongfan's own considerations, Zhou Cheng can understand.

Luo Yun said: "Director Cai, there is no other good way anyway, you can try it. The risk of nerve block + local anesthesia is extremely small anyway, and if it fails, you can stop the operation and go back to the ward at any time."

"It is much safer to have a good anesthetist supervise the operation than spinal anesthesia and general anesthesia."

"Otherwise, it's always procrastinating, prone to blood clots and pressure sores, and the patient's heart function is not very good..."

"Director Cai, what do you think?"

Cai Dongfan blinked his eyes. His eyes are actually quite small, and his eyeballs are not too big. He is the kind of person who looks quite shrewd.

But at this moment, there could only be a little confusion in his eyes.

After thinking about it for a while, he said, "Let me think about it again. Go and do your own business first. I'll give you an answer in a while. It's better to be more careful about this matter."

Cai Dongfan was unwilling to bet this patient on Zhou Cheng, Gui Peisheng.

Zhou Cheng didn't say much, and retreated together with Luo Yun.

When Luo Yun walked out, he comforted Zhou Cheng: "Actually, Director Cai is under great pressure. He is the director who leads the team, and he is the first person to be held accountable for anything that happens in the team."

Zhou Cheng smiled and didn't care: "I know, Mr. Luo, in fact, I don't dare to reset such a patient easily."

Although Zhou Cheng felt that if he did not receive anesthesia, he would have a good chance of reduction, because although the fracture edge of this patient was embedded in the muscle, in fact, there was not much shortening and displacement in this way!

As long as the traction is sufficient, then make good use of the anatomy of the muscles themselves.

It is quite easy to pull out the broken end of the fracture with manual traction.

It's just that I have already said what I should say, whether Cai Dongfan is willing to believe it, Director Cai has his own considerations.

After all, the patient is not his acquaintance, so Zhou Cheng is more open-minded.

And Cai Dongfan didn't know himself very well.

Just like now Du Yanjun told Zhou Cheng that he could reset the fracture, but Zhou Cheng didn't believe it.

However, Cai Dongfan is willing to believe that, as a member of the medical team, he will try his best to cooperate.

If you don't believe it, there is no other way.

Luo Yun smiled and said, "Go back and rest early. Du Yanjun will be in charge of this patient. If surgery and manual reset are required, Director Cai should notify me as soon as possible. I'll call you."