Chapter 59 Small meeting within the group! (ps: Please collect, recommend and read!)
"Teacher Cai." After entering the director's office, Luo Yun called out to Cai Dongfan, who was sitting calmly on the chair.
It means what should we do now?
At the same time, Zhou Cheng and Du Yanjun were both there, but Zhang Zhengquan didn't come because he had to be on duty and there happened to be an emergency patient who needed to be treated.
But without Zhang Zhengquan, it doesn’t matter.
"Master, Director Yan is going a little too far," Du Yanjun muttered in a low voice.
Luo Yunheng glanced at Du Yanjun.
Cai Dongfan raised his head, looked at Du Yanjun and said, "Don't ever mention this again. No matter what Director Yan does, you are just a student in the department and it has nothing to do with you."
"There are some things that Hu Ming and I can say, but you can't."
"And this incident was already within my expectation."
"In fact, I asked Luo Yun to take a look at my relative's condition when he was admitted to the hospital. But at that time, I didn't know that his heart function was so poor. What I thought at the time was that since Director Yan wanted it, I thought...
It’s better for relatives to avoid any suspicion, so just let him go.”
"But after his preoperative examination results came out, I considered this issue."
"Director Yan will definitely find a way to bring the patient to me."
Having said this, Cai Dongfan frowned and sighed:
"In this situation, surgery is not possible, and conservative treatment is not an option!"
"It's indeed more difficult."
When Du Yanjun and Luo Yun heard this, they also touched their heads.
Cai Dongfan continued: "I have spoken to professors from the Shonan University Affiliated Hospital and the Second Hospital before."
"The patient's condition is not complicated if it can be operated on."
"The difficulty lies in the fact that the patient's own condition is so bad that if surgical intervention is not possible, there is no better way to transfer the patient's condition."
Having said this, Cai Dongfan smiled bitterly, shrugging his shoulders, and his eyes showed a deep look of helplessness:
“Conservative treatment must also be therapeutic and conservative treatment.”
"As for the fracture end with embedded soft tissue displacement, few people across the country may have encountered it."
"Those who have the guts to do it are not sure."
"In case of damage to blood vessels and nerves."
"It's difficult."
"If I were Director Yan, I would also want to bring this patient to me as soon as possible."
Transferring is not that simple. The resident must agree to the transfer, and the receiving hospital must be willing to take the patient in. Otherwise, it is against the rules.
For such a complicated patient, if there are no contraindications to surgery, the treatment will not be complicated!
However, if there are contraindications for surgery, and if surgery is not possible, it is extremely difficult to go to Shonan University Hospital or Kyoto, the magical capital. No professor is willing to cause such a big trouble for himself.
Luo Yun suddenly frowned and asked, "Director Cai, what? If a patient like this is placed in the team, wouldn't he be a patient who has been lying on the bed for a long time?"
“Hospitals are now becoming more and more strict in their management of average hospitalization days!”
"Didn't Director Yan insist on keeping the patient before?"
The hospital has a requirement for the average hospitalization days 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 team.
If there is a patient who is bedridden for a long time, it will greatly delay the average hospitalization days, bonuses, etc., which will definitely deduct a lot.
Cai Dongfan explained: "This is my cousin's father-in-law. Forty years ago, he was a cousin who came out of the gate."
"Director Yan can refuse to give it to me, but I have to accept it."
"Everyone can only work hard and I will think of a solution. I still need to come up with a countermeasure as soon as possible."
"It's better to ask for help than to ask for help yourself." Cai Dongfan scratched his head, his face full of helplessness, his head was hurting at the moment.
Yan Haihan understood this accurately and left Cai Dongfan with no choice.
When Luo Yun heard this, he didn't say any 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 professor dares to perform manual reduction on this patient?
.”
"Some old professors of traditional Chinese medicine are quite accomplished in manual reduction."
Cai Dongfan shook his head and said, "I've asked before. My cousin's family has found many old Chinese medicine doctors, but after seeing the film, they didn't dare to touch it."
"This is no joke!"
"And it is estimated that the ancients did not classify and classify fractures. Is there any special way to deal with such a special fracture?"
"What a coincidence."
"It's just like the places on the Internet where novice drivers drive to, and experienced drivers don't even dare to drive out, let alone drive in."
"What I'm thinking about is whether I can consult a professor in the Department of Cardiology to see if the patient's heart function can be improved. But this is not something that can be solved in a short time."
"Well, I'm afraid that if it takes a while, I might develop blood clots or get pneumonia..." Cai Dongfan let out a long sigh.
Du Yanjun took the initiative and said: "Master, it's okay. I will take care of this patient."
He is a student of Cai Dongfan. This patient is very complicated and his hospitalization period is long!
Du Yanjun wanted to take the initiative to take over his body. This would also make Cai Dongfan feel better and prevent Zhou Cheng and Zhang Zhengquan from being dissatisfied with Cai Dongfan.
Zhou Cheng glanced at Du Yanjun after hearing this.
Luo Yun said: "Of course you are in charge."
When he heard this, Zhou Cheng whispered: "Teacher Cai, I just said it casually, do you think this is okay?"
"The patient's current condition is that he cannot tolerate general anesthesia, and because lumbar spinal stenosis is not ruled out, there is no way to undergo lumbar anesthesia. But we can choose nerve block."
"Under nerve block anesthesia, a small incision is made to explore the specific location of the fracture tip, and then after it is confirmed to be safe, manual reduction is used."
Suggestions should be given based on the actual situation.
Cai Dongfan glanced at Zhou Cheng, obviously not expecting Zhou Cheng to speak.
He frowned, raised his head, and asked: "Nerve block? Isn't it difficult to block the nerve in the femoral area?"
If it's a fracture in the calf, that's still feasible, but the nerve distribution on the skin surface of the femur varies widely.
"The patient is so old. If the anesthesia is unstable and the painful stimulation causes cardiopulmonary failure, it will be troublesome."
When Luo Yun heard this, he also helped Zhou Cheng to speak a little, saying: "Director Cai, Zhou Cheng actually knows a bit about the manual reduction of fractures. Maybe his method can really be tried. I'm going to
I also told you about Zhou Cheng's manual repositioning in the past two days."
"Teacher Cai, do you still remember?"
"How can this be the same?" Cai Dongfan suddenly raised his tone, feeling that Luo Yun was a little unreasonable, why was he making noise here?
Zhou Chengcheng said: "Mr. Cai, if simple nerve block anesthesia is difficult to control, local anesthesia can be temporarily added during the operation. The patient's current risks are mostly concentrated on anesthesia risks. Nerve block anesthesia and local anesthesia will not
No matter how much burden it puts on the whole body, it will not put a burden on the cardiopulmonary and abdominal functions."
Speaking of this, Zhou Cheng said: "Teacher Cai, this is actually my personal idea. The specifics are still up to you, Teacher Cai."
Everything that needs to be said has been said. Whether to adopt it or not is Cai Dongfan's own consideration, which Zhou Cheng can understand.
Luo Yunze said: "Director Cai, there is no other good way anyway, so you can try it. The risk of nerve block + local anesthesia is very small anyway, and if it fails, you can stop the operation at any time and return to the ward."
"Having a good anesthesiologist monitor you during the operation is much safer than spinal anesthesia or general anesthesia."
"Otherwise, if you keep dragging on like this, blood clots and pressure sores will easily occur, and the patient's heart function will not be very good..."
"Director Cai, what do you think?"
Cai Dongfan blinked. His eyes were actually quite small and his eyeballs were not big. He seemed to be the kind of person who was quite shrewd.
But at this moment, there was only a little confusion in his eyes.
After thinking for a while, he said: "Let me think about it again. You can go about your own business first. I will give you an answer in a while. You should be more careful about this matter."
Cai Dongfan was not willing to bet this patient on Zhou Cheng, a regular student.
Zhou Cheng didn't say much and retreated with Luo Yun.
When Luo Yun walked out, he comforted Zhou Cheng: "In fact, Director Cai is under great pressure. He is the director leading 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, Teacher Luo, in fact, I don't dare to reset such a patient easily."
Although Zhou Cheng feels that without anesthesia, he is not very sure of the reduction, because although this patient's fracture edge is embedded in the muscle, there is not much shortening and displacement in the first place!
Just use enough traction and make good use of the anatomical shape of the muscles themselves.
It is quite easy to pull out the broken end of the fracture using manual traction.
It's just that he has already said what he should say. Whether Cai Dongfan wants to believe it or not, Director Cai has his own considerations.
After all, the patient was not an acquaintance of his, so Zhou Cheng was more open-minded.
Moreover, Cai Dongfan doesn’t know himself very well.
Just like now, Du Yanjun told Zhou Cheng that he could perform this technique to 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's nothing you can do about it.
Luo Yun smiled and said: "Go back and rest early. Du Yanjun will be in charge of this patient. If surgery and manual reduction are required, Director Cai should notify me as soon as possible. I will give you a call."
"Okay!" Zhou Cheng nodded, said goodbye to Zhou Cheng, and then walked directly towards the gym.