Chapter 249 New technology of simulator (please subscribe!)

After Zhou Cheng returned to his house, he continued chatting with An Ruo for a while, and then said that he would read a book for a while.

An Ruo replied naturally.

Zhou Cheng was reading, but he was not simply reading. Today, he was still continuing to prepare for the simulation.

However, the preparations this time are quite different from the previous preparations.

Because in the past, when Zhou Cheng simulated each skill, his requirement was to simulate a certain individual skill to a perfect level.

For example, hip replacement, arthroscopic hip preservation (perfect - world definition or super world definition).

But in fact, the two surgeries, hip replacement and arthroscopic hip preservation, also have their specific corresponding diseases. A perfect level of hip replacement can be performed on patients who need hip replacement.

Naturally, there is no disadvantage.

The cases encountered in practice often do not follow the textbooks.

For example, take the patients Zhou Cheng met today.

Bed 1: Multiple bone tuberculosis debridement was complicated by bacterial infection, wound non-healing, and bone defects. Currently, there are multiple blood clots in both lower limbs.

Bed 2: Suppurative osteomyelitis: multi-resistant bacterial infection, hypertension, mild diabetes, and preoperative blood sugar fluctuations.

Bed 3. Infection after open reduction and internal fixation of fracture, non-union of fracture and sinus tract.

To put it simply, these three beds are all debridement and suturing. But can simple debridement and suturing solve the situation of these patients? How should these patients choose the appropriate surgical method to get the best results?

The therapeutic effect?

This is a question worth pondering.

You need to check the literature to see if there is any way to seek help.

Bed 4: Multiple closed fractures, intermittent atrioventricular block, it is not yet known whether anesthesia is possible.

Bed 5, Zhou Cheng operated on one today. It was similar to bed 1 and had bone tuberculosis infection.

The condition of bed 6 is good and ready to be discharged.

7 beds, because there are problems with other departments, are currently being evaluated and are ready to be transferred to the fourth department of osteopathy.

Bed 8 is the second surgery today, a more complicated infection.

9 beds, infection after multiple amputation, current treatment situation has not been determined.

10 beds, refractory postoperative infection.

Bed 11 is a post-operative patient left over from the past few days. The batch of patients who just started working in the new year have been discharged one after another. He is still in the hospital and is still in a state of post-anesthesia delirium. Quickly call the anesthesiology department and neurology department.

Internal medicine and psychiatric consultation assist in diagnosis and treatment.

The patient's family members are very noisy.

The last patient is in bed 12. The situation of 12 beds is a little more special than the previous 11 beds...

The diagnosis is unclear at the moment, but there are fractures and no trauma. A tumor test was done at a lower-level hospital, and the biopsy showed no bone tumors.

While Zhou Cheng was taking notes like this, he suddenly discovered a more detailed problem, which was also a very real problem.

The Orthopedics Department of Modou Ninth Hospital cannot add extra beds like Shashi Eighth Hospital, and the bed settings in each ward are also different.

There are a total of fifty-five beds in the three orthopedic wards, four groups, Professor Xue Xiude, and a total of only twelve beds.

The staffing of Professor Xue Xiude's group includes: Professor Xue Xiude, Associate Professor Gu Zhongliang, attending physician Shen De and chief resident physician Mao Yuxuan.

At present, all hospitals in the country and all departments in the hospital are self-financing. The twelve beds are all for trauma and postoperative infection patients. The average length of stay for such patients in the hospital ranges from a week to more.

Just over twenty days.

Equivalently, every month, the highest turnover rate is four rounds.

If based on the highest calculation, there are 48 patients in each group every month, and each patient mostly undergoes debridement and suture surgery, then even if the hospitalization cost is relatively high, it will be around 1 to 2 weeks.

The profit margin of clinical departments is after excluding the rent paid to drug suppliers, pharmacies, hospitals, departments, and operating rooms.

(Note: I won’t write about this in depth. Dear book friends, you should know that it is actually very realistic now. The operation of a department is actually to find a venue to rent in the hospital, and the same is true for surgery in the operating room. For the specific reason, don’t pay for the knife,

Xiao Dao doesn’t know.)

(If you are interested, you can find the channels on your own to find out.)

That is to say, the bonus coefficient, the maximum that can be distributed is 20%, which is considered to be as high as the sky. It breaks the ceiling.

The bonus is fully calculated, that is to say, in a month, the bonus that can be paid to a group is 13-14 thousand, and part of it must be distributed to the nurses in the department.

Then, there is a professor, an associate professor, an attending physician, and a chief resident.

Four PhDs.

Still in Magic City.

Isn't the pyramid echelon just coming out? If a young doctor's family is not well off, then...

If you want to buy a house, you just want to eat shit...

This income is not necessarily comparable to that of doctors in teaching hospitals in provincial capital cities, because there are more high-quality patients there, the surgeries are simple, and high-consumables can be used.

Of course, these questions were relatively far away from Zhou Cheng, so Zhou Cheng quickly just made an extra calculation casually.

Of course, it is possible that the reality is not as dire as one imagines. After all, in many other industries, a PhD degree is quite popular.

Read professional books.

Zhou Cheng looked through surgical textbooks and professional books, and found that basically all of the information provided only a few words to define the treatment of infection.

Thorough debridement, use of sensitive antibiotics, adequate dosage, and full course of antibiotics.

Then, it's basically gone.

Because no one can give you textbook-style guidance on the infections you encounter in real life. The infections that everyone encounters may be caused by different germs, and the strength and consultation capabilities of the pharmacy department are also different in each place.

There is also a gap in the strength of the laboratory departments.

This is the horror of infection once it occurs in surgery.

Putting aside everything else, as far as beds 5 and 8 are being operated on today, are the surgeries performed today necessarily the most correct ones?

This is difficult to determine because there is no standard answer to the diagnosis of such a disease.

However, for beds 2 and 3 that will be operated on tomorrow, the surgery that can be performed is debridement and suturing + sensitive antibiotic copper sulfate carrier built-in + continuous irrigation and drainage.

Then the second stage is curettage and bone grafting. The purpose of the first stage surgery is to control the infection.

Then Zhou Cheng looked at his skill list and discovered that the best one that could handle such a diagnosis was debridement and suturing. But in theory, debridement and suturing were only part of the treatment.

What is more important is the selection of key antibiotics and the experience of treating infections.

Not all diseases in reality are caused by textbooks.

Zhou Cheng looked at his skill list again, and finally found it among the proficiency-level skills.

Proficient skills: experience in treating shoulder joint injuries, experience in treating knee joint injuries, experience in treating tendon injuries, and experience in treating post-fracture infection.

Zhou Cheng vaguely remembered whether these proficiency-level skills came from Luo Yun's academic package, or were obtained by Zhou Cheng after he licked Luo Yun to death in the simulated world.

At that time, Zhou Cheng thought that Luo Yun was quite powerful. But later, as Zhou Cheng's perfect level skills gradually increased, he felt that Luo Yun was actually quite good.

Looking back now, compared with himself, Luo Yun was certainly very good, but he was actually not good at it.

Not everyone is the same as myself. The growth curve is a skill from 0→perfect.

More people still progress slowly from entry, proficiency, proficiency, and perfection.

Moreover, when others are learning, it is definitely not like simulating surgical skills themselves, where they only learn one thing and can only choose one, but improve comprehensively.

For example, the treatment of infected patients is a comprehensive module and a relatively large section. It is no less a subject than complex joint revision.

Infection is what all surgeons fear the most, and it is also the nightmare that all surgeons fear.

Zhou Cheng's current strength is definitely able to treat such patients. He just needs to slowly dissect it in clinical practice and provide targeted treatment step by step.

This is called adapting to circumstances. Zhou Chengcheng felt that it was still necessary for him to simulate the infection after fracture surgery in terms of basic medication. It would be best if he could simulate a skill package.

After setting the initial goal, Zhou Cheng selected several related perfect-level skills and then started the simulation.

The simulation target this time is not too difficult.

【Simulation begins!】

[You have an extremely solid theoretical foundation and clinical skills! You became interested in infected patients, so you started studying. But you still have other clinical tasks, so you don’t think much about infections. 】

[One year later, your clinical project was successfully completed, and your research group entered a new field!]

[You gradually faded away from your original research group and returned to clinical practice. Because your research project has a great impact, you were quickly awarded an exceptional master’s degree and academic qualifications, and the educational institution in your country promised that as long as you can complete enough academic studies

accumulation.】

[You can still be granted a doctorate degree and a doctorate degree as an exception, but the reason why they are not awarded at the same time is to allow the public to have an acceptance process and avoid shocking the world. ]

[Another year later, you launched a new clinical topic. You were awarded a doctorate and doctoral degree in advance, you were awarded an intermediate professional title in advance, and you were awarded an associate senior research title in advance. 】

[Three years later, your country opened a new chapter in the clinical department of orthopedics, and minimally invasive surgery was officially established. In the same year, you published your first personal monograph, which was included in one of the 100 basic books that orthopedic surgeons must read.
To be continued...