My Medical Skills Give Me Experiences

【My medical skills can add experience points】【】

Director Shang was already alert to the diagnosis and treatment of this case, thinking that Dr. Huang Liang was only cooling down the fever, and it was inappropriate to add fluid and expand the volume.

After all, the patient's pain has become like this, which shows that the intra-abdominal symptoms have not been relieved, but are gradually aggravating.

Some diseases progress very rapidly.

Once it develops to a certain stage, it will be like a rock cracking and a landslide, unstoppable.

The number of patients who die in Tuya Hospital every year is unknown, and many of them died after the onset of the disease and the rescue failed.

The real death of extubation is very small.

Director Shang heard Zhou Can speak so seriously, and his expression became serious.

Others don't know Zhou Can's strength, but he has experienced it deeply.

Zhou Can saved a medical accident on his first day in the Department of Gastroenterology. Subsequently, he made great contributions to the diagnosis and treatment of many cases.

With such strength, the only difference is his qualifications.

Otherwise, they are fully capable of standing alone and directly becoming the backbone of the department.

"Director Zheng, this patient is in your group, what's your opinion?" Director Shang looked at Zheng Hongtao.

In terms of age, Zheng Hongtao is two years older than him.

But in any unit, status has never been determined by age. Instead, it depends on ability, talent, contacts, education, performance, etc.

Both Director Shang and Zhou Can chose to ignore Dr. Huang Liang, which made Huang Liang's face turn red for a while, and then slowly turn blue.

In front of so many doctors, nurses, family members, and patients, he must feel uncomfortable being treated as a transparent existence.

If you want to blame, you can only blame him for being unclear.

The patient is already so serious, and he still has a sense of personal presence. It is considered polite for Director Shang not to scold him in public.

"Could Director Shang also support Zhou Can's point of view?"

Zheng Hongtao was a little hesitant.

The patient's condition was somewhat out of his control, and he had to admit that he lacked experience in diagnosing such patients.

Not to mention him, even Director Shang felt the same difficulty in diagnosing this patient.

Surgery and internal medicine, in fact, there is still a boundary.

They are proficient in gastroenterology, and they are really not sure when encountering such symptoms that are biased towards surgery.

"Zhou Can, tell everyone about the basis of your diagnosis."

Director Shang turned to look at Zhou Can.

"There are two bases for my diagnosis. First, the patient has persistent abdominal pain, and the symptoms have not been relieved after symptomatic treatment, but have worsened. This morning, the body temperature has risen and fever has begun, which shows that the symptoms are already inclined to sepsis. .When the patient did not have a cold, I think the rise in body temperature may be due to intestinal perforation, infection in the abdominal cavity, and an inflammatory response in the body."

Zhou Can introduced the basis of his diagnosis very calmly.

A lot of surgeries are done in surgery, and some symptoms of patients are easily ignored by other doctors, but Zhou Can can keenly judge the possible dangers.

When everyone heard that the patient had symptoms of intestinal perforation, their nerves tensed up.

Especially Director Zheng Hongtao, who didn't care too much at first, has become more serious than Director Shang.

He was responsible for this patient, if something happened, he would definitely be out of luck.

Intestinal perforation is extremely dangerous and can easily lead to death.

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【My medical skills can add experience points】【】

"Secondly, the blood leukocytes are 32.08×109/L, which can also help prove that my diagnosis of intestinal perforation is probably correct. In addition, the patient has compensatory metabolic acidosis and less urine output, which further shows that These diagnostic results will only appear if the patient has not only experienced intestinal perforation, but also has had perforation for a long time. The intestinal contents contaminate the abdominal cavity and begin to cause systemic acute sepsis symptoms."

Zhou Can's diagnosis logic is rigorous and his thinking is clear.

The physicians at the venue were just blindfolded before, because they were paralyzed and not familiar with the diagnosis of surgical symptoms, so they failed to discover the danger.

After listening to Zhou Can's analysis at this moment, they all had solemn or serious expressions.

"Director Zheng, I think it's better to be cautious. Immediately ask a doctor from the gastrointestinal surgery department for consultation, or send the patient directly for a second abdominal CT."

A deputy chief physician under Zheng Hongtao persuaded.

"I also think it should be taken seriously and rescued as soon as possible. If it is really intestinal perforation, the disease will progress very rapidly. Once shock occurs, it will be too late to rescue."

Another chief physician agreed with Zhou Can's diagnosis.

"But... the patient had undergone abdominal ultrasound and abdominal CT examinations when he was admitted to the hospital, and no problems were found!"

Huang Liang was still a little unwilling to admit defeat, and was still defending for the so-called face.

"Stupid! The patient was hospitalized a day ago, so much time has passed, it is very possible that the patient's intestines were perforated. You are really stupid to argue here with the examination made a day ago."

Zheng Hongtao was the first one who couldn't listen anymore, he didn't need Director Shang to start scolding, he just stiffened his neck and jumped to scold Huang Liang angrily.

Any virtuous doctor would hate to take the patient's life seriously for the sake of so-called face.

In front of the patient's life, all personal vanity and interests should give way.

The hospital allows competition and even advocates competition, but infighting is never allowed.

From the first day of medical study, the first lesson a doctor learns is to respect life.

Huang Liang was severely scolded by Zheng Hongtao in public, which woke him up a bit.

After being stunned for a moment, he immediately lowered his head and said with shame on his face, "I'm the one who has painted the lake."

No one sympathized with him, but everyone felt that Director Zheng scolded him well.

"Doctor Zhou, what do you think the patient should do next?" Zheng Hongtao asked shamelessly, seeking Zhou Can's opinion in public.

This is also a little reward for Zhou Can's success in helping him resolve a medical accident.

In other words, it is more appropriate to highly recognize Zhou Can's diagnostic ability.

"According to my opinion, it is best to send for general surgery immediately. However, according to the hospital's diagnosis and treatment procedures, it may be necessary to perform an abdominal CT to clarify the location of the intestinal perforation and the current situation in the abdominal cavity before performing surgery. "

Zhou Can gave his opinion.

The hospital has relevant standard procedures for diagnosis and treatment.

It is uncertain whether this patient has intestinal perforation. If the patient's abdominal cavity is opened and intestinal perforation is not found, it will be difficult to explain to the family members.

Also, the human large and small intestines almost cover the entire abdominal cavity.

Only when you know exactly where the perforation is, can you accurately select the surgical knife position for laparotomy.

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【My medical skills can add experience points】【】

"Okay, send the patient for an abdominal CT right away! Huang Liang, you take two interns to send the patient there. You must be quick and explain the situation to the doctor who checked the situation directly. This patient can't wait."

Zheng Hongtao directly arranged for Huang Liang to accompany the patient for examination.

In addition to the fact that this patient is under Huang Liang's management, there is also a small intention to punish Huang Liang.

Otherwise, the senior resident physicians who are about to be promoted to attending care would rarely do this kind of errand chores.

Zheng Hongtao quickly issued an examination application for the patient. The family members heard that the patient's life was in danger, and they were already anxious.

Do what the doctor tells them to do.

All we have to do now is save the lives of our loved ones.

"Director Zheng, I have another immature suggestion!"

Zhou Can was not arrogant because of his meritorious service.

Instead, he was not surprised by favor or humiliation, and remained humble and polite.

"Please say!"

Zheng Hongtao's attitude towards Zhou Can now is completely different.

It's not as lukewarm as it was two days ago.

Instead, Zhou Can was directly treated as a person of the same level to talk to.

"I estimate that the patient's condition will progress very quickly. After the CT scan, the operation should be performed immediately. I suggest that you greet the general surgery department now, and make preparations there. As soon as the diagnosis is confirmed here, the patient will be sent there immediately for emergency treatment." .”

Zhou Can suggested.

Forewarned is forearmed, without prejudging the waste.

Only by taking precautions can we no longer waste every minute of precious rescue time.

"Okay, I'll call and communicate with Director Xiao immediately."

Zheng Hongtao agreed so easily, which shows that he has a good friendship with Director Xiao of the Department of Digestive Surgery.

Many times, the chief physicians meet each other, try to expand their network, say hello to each other, and have various friendships. The purpose is to be able to get things done through the acquaintance relationship when something happens.

Zheng Hongtao called and communicated with Director Xiao on the spot, and it was done in just a few words.

The surrounding doctors looked enviously.

It's easy to do things with acquaintances.

Director Zheng has a deep friendship with the newly established director of gastrointestinal surgery, which is really enviable.

"Director Zheng is worthy of being the boss of our gastroenterology department. He has a wide network of contacts, which is really enviable."

Director Shang stayed at the scene to watch Zheng Hongtao deal with the matter.

If there is something wrong with Director Zheng, he will definitely help. It is absolutely impossible to watch the patient have an accident.

"Hey, what are my connections? Director Shang knows a lot more people than me. Today, this patient is really thanks to the help of Director Shang, Dr. Zhou and others, and almost caused a catastrophe."

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Zheng Hongtao was already in a cold sweat from the fright.

He also changed his hostility towards Director Shang and Zhou Can because of this incident.

Sometimes, people, it's just the tone of the fight.

An opportunity can make the two sides shake hands and make peace.

"We are all doctors in the same department, and we should help each other. Director Zheng, please don't be polite. In the future, some patients in my group will have problems and I can't find them in time. Don't I have to ask you for help?"

Director Shang smiled.

"You are right, we are doctors in the same department, we are a family."

Director Zheng said that, the two sides basically settled their suspicions and shook hands to make peace.

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【My medical skills can add experience points】【】

The two strongest chief physicians in the department shook hands and made peace, which is good news for all the doctors and nurses in the department.

Sometimes, it's really not easy to stand in line.

"It's getting late, let's continue our ward rounds."

Director Shang led the crowd to continue rounds.

When they found out the female lawyer with liver cirrhosis in bed 79, Zhou Can reminded Director Shang to do splenic venography for the patient.

Without further ado, Director Shang ordered the patient to be examined on the spot.

From this little incident, it can be seen that Zhou Can's status in Director Shang's heart has risen to a very high level.

Before the ward round was over, Huang Liang, who was taking the patient for an examination, had already called.

The results of CT examination showed that there were free gas shadows in the abdominal cavity, the intestinal tube was dilated, and the effusion between intestinal loops was serious.

This shows that the patient really has intestinal perforation, and the perforation has been going on for some time.

No wonder the patient is in such pain.

For intestinal perforation, CT is generally preferred because its sensitivity is higher than traditional X-ray examination.

There are many old doctors who especially like to use X-ray examination.

This is not only a complex, but also a habit developed due to previous medical conditions.

At that time, nuclear magnetic resonance had not yet come out, and CT examination equipment was also in the 1970s, and it was gradually introduced to China in the 1980s.

Doppler ultrasonography and X-rays were the most commonly used examination methods in large hospitals in the past.

Many older doctors grew up from that era. This also makes them have a soft spot for traditional inspection methods.

When Director Zheng heard that the patient was really diagnosed with intestinal perforation, and the condition was extremely serious, he really felt like he would survive the catastrophe.

Thanks to Zhou Can for discovering the danger in time.

So many chief physicians and deputy chief physicians didn't see the patient's intestinal perforation, but Zhou Can, a regular trainee, did. This is because Zhou Can happens to have experience in general surgery and relatively rich clinical accumulation.

This is why the current large hospitals, when cultivating core cutting-edge doctors, will choose from the general practitioners.

Because doctors with clinical experience in all departments, whether they are assigned to surgery or internal medicine, their diagnostic ability is obviously stronger than that of regular recruits.

Gui Peisheng, who was recruited to the hospital, was only familiar with diseases in that field.

They lack awareness of diseases in other fields. After formal work, they dare not touch patients in other fields in clinical work.

"Director Shang, I have to rush over there immediately to send the patient to the gastrointestinal surgery department for emergency surgery, so I will withdraw first."

After Zheng Hongtao answered the phone, he hurried to the general surgery department.

The diagnosis of the 7-bed patient also brought Zhou Can into the vision of many doctors, and everyone began to know this young and promising doctor.

During the ward rounds, many doctors took the initiative to chat with Zhou Can and chat for a few words.

It is enough to show that his status and popularity in gastroenterology have risen to a big level.

…

After the house inspection, Zhou Can's really busy day began.

He sent 77 beds of gastric cancer patients to the interventional operating room for endoscopic surgery.

Director Shang will be the chief surgeon.

This female patient is currently in the advanced stage of gastric cancer.

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【My medical skills can add experience points】【】

Medical practice is to say that the disease is serious.

In fact, her stomach cancer is still in the early stage, not really stage II stomach cancer.

That's why Director Shang agreed to perform endoscopic surgery on her.

Usually, if stomach cancer develops to the severe stage of stage II, the cancer cells have metastasized severely. At this time, the opportunity for surgery was lost. More interventional therapy and chemotherapy.

This treatment can only prolong the patient's life.

It has been difficult to heal.

In the early stage of gastric cancer, surgery is performed in time. As long as the cut is clean, radiotherapy is used to consolidate the curative effect. Satisfactory results can generally be obtained.

In the operating room, the patient has already prepared for the operation and is lying quietly on the operating table waiting for the operation.

Director Shang brought Huang Xinggui and three graduate students to ~www.wuxiax.com~ but Zhou Can was thinking in his heart that if he could get this surgery, he would be more likely to have endoscopic surgery in Director Shang's group in the future. Easy to get your hands on.

Gastroenterology is the department with the most endoscopic surgeries.

Several of his surgical skills are only at the fourth level. If he can take advantage of the two or three months of regular training in the department of gastroenterology, he can upgrade them to the fifth level. This will be very beneficial to Zhou Can's future development.

One step first, one step at a time.

Especially incision, separation, and anastomosis are particularly difficult to upgrade.

Endoscopic surgery often rewards 100 experience points at every turn, which is definitely the best choice for quickly upgrading these three medical skills.

"Director Shang, you have checked my experience in endoscopic surgery last time, can I do this surgery?"

Zhou Can gritted his teeth, and before Director Shang took the chief surgeon position, he directly opened his mouth to grab the chance of surgery.

Different from the position of the main surgeon in traditional surgery, in endoscopic surgery, the doctor who is the chief surgeon generally chooses a position that is easier to operate, and at the same time can easily look up to view the endoscopic screen in front.

"Are you sure you're serious?"

Director Shang stared at Zhou Can, the invisible pressure still made Zhou Can quite guilty.

However, he also understood that at this time, he had to show strong self-confidence in order for Director Shang to trust him with the operation.

"I'm serious. If I'm not sure, I will stop in time, and I will never force the operation. I have carefully studied the patient's film many times, and I dare to ask you for the operation only after I am sure that I have the confidence to complete the operation."

Zhou Can's tone was sincere and his eyes were clear.

Dan Dan's self-confidence was revealed.

(/novel/)