Chapter 46 Steady and Seeking Progress (Please collect, recommend and read!)
When I was on duty in the afternoon, I routinely admitted two emergency fracture patients. Since Zhou Cheng was on duty, they were admitted to Cai Dongfan's group and became Cai Dongfan's patients.
The rules in the department are as follows: whichever group of doctors is on duty will manage the patients admitted that day.
So the number of patients in the group depends entirely on luck.
Fractures can be divided into open fractures and closed fractures based on whether they are connected to the outside world.
To put it simply, if the skin is broken and bleeding, it is an open fracture; if there is no skin, it is a closed fracture.
Therefore, when many doctors are on duty, the first thing they ask when treating patients with fractures is: Is there any blood?
In fact, he was asking if he wanted to go on stage.
They were all closed fractures, so there was no need to go to the emergency room for treatment. Luo Yun felt lonely in the department in the afternoon, so he slipped back home during the normal off-duty time.
Although he is in the second-tier class, he does not have to stay in the department 24 hours a day.
Zhou Cheng originally planned to ask Du Yanjun to go back, but Du Yanjun refused to go back and stayed with Zhou Cheng until eight o'clock in the morning the next day, when the shift ended!
Today is Saturday, which is a weekend holiday, and the hospital does not arrange elective surgeries.
Luo Yun also knew that Zhou Cheng and Du Yanjun were on duty today, so he rushed to the department at eight o'clock on time and took two people to check the ward. The most important thing was to check the preoperative medical records of the three patients who were admitted yesterday. Check and improve it.
In the evening, a patient with a fracture came and was admitted to the hospital.
Don't think that there are very few car accidents nowadays. In the emergency department of the hospital, you can encounter them almost every day, and they get together...
In addition, adjustments were made to postoperative patients.
At 8:30, Zhang Zhengquan didn't even show up in the department, and the ward rounds were over.
After checking the ward, Luo Yuncai asked Du Yanjun to send a message to Zhang Zhengquan, asking him not to come to the department. For his patients, Zhou Cheng and Du Yanjun would be responsible for adjusting the medical orders, and changing the dressings. Go back and rest.
There were three patients, each of whom was assigned to one. Zhou Cheng and Du Yanjun completed all the admission medical records last night.
So at ten o'clock in the morning, I handed over the shift with the next doctor on duty, said goodbye to Du Yanjun and went home.
Zhou Cheng chose to walk back.
On the way, Zhou Cheng was actually a little tangled in his heart.
Because several patients admitted to the hospital yesterday, although according to the current guidelines, must undergo surgery, they can actually achieve good fixation and reduction through manual reduction, which can completely eliminate the need for surgical open reduction and internal fixation.
But there is no way. The guidelines were formulated by an expert group invited by the Chinese Health Commission.
It was Zhou Cheng who thought things too well before. Although the fracture reduction method was a downgrade operation.
However, performing manual reduction on patients beyond the scope of surgical indications specified in the current guidelines suddenly raises the level of surgery, which is a new research and new surgical technique.
You must have a chief physician level to take the lead.
The words Luo Yun reminded him before actually hid this meaning.
There are not many trauma patients admitted from outpatient clinics, and the ones that can be admitted from outpatient clinics are extremely complex, and most directors don't want to admit them. Most of the patients with infections and various complications are sent to Shonan. Three affiliated hospitals of the university.
As a result, it was difficult for Zhou Cheng to raise the topic of exploring the adaptability of the 'new' fracture reduction technique with Director Cai Dongfan and Yan Haihan in the department.
This is actually a very influential topic, but it is not suitable for the current Eighth Hospital, nor is it suitable for the current Zhou Cheng.
If we want to do this project, we have to re-evaluate the indications for surgery for the current patients in the hospital and the patients admitted to the hospital. Then the department with a small number of patients will shrink even more.
The fracture patients he finally encountered accounted for 70% of the surgery volume in the department. Zhou Cheng looked at the fracture patients in the department. If measured according to his own standards, at least 40% of the patients were
, they can all be manually reset and discharged on the spot.
This is destroying the jobs of the chief physicians. Can they agree?
Yes, not one or two.
Therefore, it is obviously quite unrealistic to perform a sit-up method to reduce fractures in the department. Unless Zhou Cheng can obtain authorization, or Cai Dongfan and Yan Haihan are more open-minded and open-minded enough to grant him permission!
But Zhou Cheng is just a resident doctor, extremely ordinary.
"Alas!" Zhou Cheng sighed, feeling that he still thought too much.
You have to eat one bite at a time, and the road has to be walked step by step. Although I have mastered the redefined level of fracture reduction, others have not yet. To truly promote it, even if I set the standard, it will be a long-term thing.
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What's more, the existing indications for fracture surgery have been accumulated through many years of clinical experience, and are naturally not excessive medical treatments.
It is a fracture treatment guideline formulated under the current situation and based on the existing medical level and comprehensive consideration.
After all, not every doctor or practitioner is a director from the beginning. Every hospital is a top hospital like the Magic City or Kyoto. Naturally, one size fits all...
However, Zhou Cheng also considered an alternative plan that could speed him up to start the project in advance.
That is to expand the business volume of the department. For example, if I can perform open reduction and internal fixation of fractures with small incisions, there will definitely be many patients coming here, and there will be more surgeries.
There are no more patients in the department.
It is only right to follow the trend and perform manual reduction of some simple fractures. Moreover, although open reduction and internal fixation of fractures with small incisions is a new field and new surgical method, it is still effective.
If the Eighth Hospital masters this technique, it will suddenly be ahead of several affiliated hospitals of Shonan University in this field, and the number of patients it can attract will be quite a lot.
Minimally invasive and small incisions are now the general trend, but the progress in this field is not deep at present.
After thinking about this, Zhou Cheng understood that he still had to develop the existing fracture simulation copy.
You have to write a plan in detail.
Tomorrow and the day after tomorrow are both weekends, and there is not much going on in the department. We need to carefully plan and study how to start, so that we can achieve certain breakthroughs in open reduction and internal fixation of small-incision fractures.
After returning home, Zhou Cheng checked the relevant literature. With proficient medical English skills, reading the literature was no longer a problem. Except for a few medical terms that needed translation, the rest were quite comfortable to read.
After searching around, I didn't find much. At present, there are corresponding applications in the tibial plateau, but there are very few case reports.
For fractures in other parts of the body, the traditional and safe open reduction and internal fixation is still used.
Surgery is all about visual field. The wider the visual field, the smoother the surgical process and the better the surgical effect.
Making progress while maintaining stability is a necessary step in medicine.