Chapter 22 It’s over, I used too much force again (please collect, recommend, and continue reading)!
Although for the department, adding more chairs will certainly not constitute a financial burden.
It’s just that the shift room is so big, it’s impossible to accommodate so many chairs.
Just like, the normal operation of the Eighth Hospital in Shashi requires so many people, but the proportion of formal employees is actually not very large.
The reason why there are all intern nurses and no intern doctors standing in the handover room is because it is October now and most of the intern doctors have already devoted themselves to preparing for the nationally organized postgraduate entrance examination.
During the handover, Yan Haihan once again emphasized that doctors in training must work hard and not give up easily.
After the shift was over, Yan Haihan personally led the ward rounds for the first time in a long time.
It has been less than three days since the last time he led someone to make ward rounds. According to the hospital's regulations, the chief physician and deputy chief physician only need to make ward rounds once a week.
However, as the director of the team, Yan Haihan is free to come for ward rounds whenever he wants, and he cannot ask for it at other times.
Cai Dongfan's beds start from 25 beds and go up to 36 beds.
Zhou Chengguan’s score was 25-28, +9.
Du Yanjun was responsible for 29-33, +10.
Zhang Zhengquan is in charge of 34-36, +11, +12!
This kind of allocation is also very particular.
Generally, the patient will be placed in an extra bed only when the main bed is full.
Du Yanjun has five regular beds and one extra bed, for a total of six beds, and the number of patients in the department is generally not so large that extra beds are needed. Even so, Du Yanjun's patients are still more likely to be treated than Zhou Cheng.
Much like Zhang Zhengquan.
Zhou Cheng is much more reliable than Zhang Zhengquan, who likes to be lazy, so Zhou Cheng has four full beds and one extra bed, while Zhang Zhengquan has two extra beds.
The first thing to check is Zhou Cheng’s 25-28. All three patients are postoperative patients, so we only need to look at the wound, and then look at the X-ray results and inflammation indicators of the re-examination.
Now that the surgeries are done, the workload of ward rounds is not very heavy.
Therefore, Zhou Cheng quickly reported the medical history and examination results of the patients in the three beds.
Cai Dongfan said: "Well, they are all regular postoperative patients, nothing special. Let's mainly focus on new patients."
Luo Yun relayed to the patient: "Your surgeries have been done very well. Now you just need to wait for the care slowly and pay attention to protecting the wound from getting wet to avoid infection."
After saying that, the group walked towards Du Yanjun's bed 29 again.
Du Yanjun immediately reported: "This new patient has an upper femur fracture caused by trauma. He was admitted to the hospital yesterday and has already had X-rays and CT scans."
"The diagnosis is now clear and we are waiting for surgery."
This is a set of reporting methods summarized by Du Yanjun himself. The key contents of the report are also the key points that the superiors are concerned about.
The key content of a patient is the diagnosis. As for the surgical patient's medical history and other irrelevant examination results, that is what your doctor in charge should reflect in the medical record. Superior doctors do not need you to teach them how to write medical records.
Du Yanjun handed the patient's examination results to Cai Dongfan and Luo Yun. Cai Dongfan looked at the CT directly, while Luo Yun looked at the X-ray.
However, Cai Dongfan read the film much faster than Luo Yun. After watching the film, he calmed down a little and handed the CT results to Zhou Cheng and Zhang Zhengquan.
Question: "Zhou Cheng, Zhang Zhengquan, although this patient is not under your control, you should come and see this patient to see if you can tell anything."
There were many CT examination results, so Zhang Zhengquan and Zhou Chengcheng each took one.
Zhou Cheng just glanced at it briefly, then immediately pointed the CT film at the incandescent lamp in the ward, read it carefully for about half a minute, and then muttered: "You may need to ask for a consultation on this."
Hearing what Zhou Cheng said, Du Yanjun's eyelids immediately jumped.
Isn't it? Brother Zhou Cheng, this patient has such an obvious fracture, who do you want to ask for consultation? Do you want to ask the orthopedics department for consultation?
I asked an orthopedic department for consultation. Either the teacher of the orthopedic department scolded me to death, or my teacher scolded me to death. Even if you think I am your competitor, you won't harm me like this, right?
And because of Zhou Cheng's words, Zhang Zhengquan felt panicked.
As a resident physician in the Department of Orthopedics, I can still see the fracture. The fracture line is obvious and there is edema in the surrounding soft tissue. The diagnosis is obviously relatively clear.
What kind of consultation should I ask for?
But Zhou Cheng definitely wouldn't say that for no reason, so he continued to search carefully, otherwise if he was too incompetent, no shortcuts would work...
Luo Yun had already finished reading the X-ray. After listening to Zhou Cheng's words, Luo Yun was a little confused. He wanted to correct Zhou Cheng's wording, but he was afraid. Because the examination window of the X-ray was not as detailed as that of the CT. If there were
You can't talk nonsense about things that are not shown on the X-ray.
Cai Dongfan glanced at Zhou Cheng in surprise. He really didn't expect that Zhou Cheng could still see this. He was quite capable.
Then he said to Luo Yun: "Luo Yun, you should also take a look at the CT scan."
Luo Yun panicked. Good guy, indeed, Zhou Cheng was right. He didn't even see it on the X-ray. Why did he need to ask for a consultation?
He is the attending physician. When did Zhou Cheng reach such a level?
About two minutes later.
Cai Dongfan looked at Du Yanjun. Du Yanjun picked up the CT and X-ray results again with a little trembling. It was obvious that he had read the test results dozens of times and still could not see the key part.
Zhou Cheng, who had just read the film for a while, explained the key points.
But what is that?
Which department should I call for consultation?
Neurology?
Can neurological consultation be seen on CT?
Brother Zhou Cheng? Master? Don’t think you’re bullying me because I’m young, because I don’t understand, so you’re lying to me.
spine?
Du Yanjun gradually became sad.
Another minute later.
Cai Dongfan couldn't find the answer on the faces of Luo Yun and Du Yanjun, and he didn't embarrass them anymore.
Then he said to Zhou Cheng: "Zhou Cheng, tell me your thoughts."
Zhou Cheng nodded and said eloquently: "Teacher Cai!"
"When we look at fractures, we generally look at them from the following five aspects."
"Looking at the definition, the definition of fracture is the continuity and integrity of the middle part of the bone. When we look at the examination results, we can indeed find signs of fracture on the patient's X-ray."
"Secondly, look at the positioning. This is also simple. The shapes and positions of different bones are different. This is a fracture of the middle part of the femur."
"The third step is to look at the nature, that is, whether it is a traumatic fracture or a pathological fracture. From the film, we can see that there is no trace of the normal structure of trabecular bone at either end of the fracture."
"Bone is composed of trabecular bone structure. The trabecular bone structure of normal bones. As you can see, on the X-ray, they are very smooth and organized and continuous lines. This is especially obvious in long bones."
"However, no similar structures were found on both sides of the fractured end. Therefore, this patient cannot simply be classified as a traumatic fracture, but should be classified as a pathological fracture."
"Once the characterization is determined, the subsequent finalization and treatment plan can be postponed!"
After Zhou Cheng finished speaking, he found that Cai Dongfan and others were all looking at Zhou Cheng in astonishment, with confused expressions. Is this what you, Zhou Cheng, should say?
Zhou Cheng immediately reacted: It's over, you used too much force.