I'm really an intern

Chapter 413 Esophageal rupture cannot be touched!

Three emergency gastroscopes at once?

Zhang Tianyang's eyelids twitched violently a few times.

what happened?

Three years without opening, three years after opening?

More importantly -

"How many doctors are usually on duty in the gastroenterology department? Three gastroscopes, is there enough manpower?"

But Senior Brother Qiu Ming turned his head sharply, got into the nearest gastroscopy room, turned on the computer and started typing on the keyboard.

"There must not be enough people!"

He quickly opened the doctor's workstation, typed in his account password, and Senior Brother Qiu Ming took the time to explain to Zhang Tianyang.

"There is only one front-line doctor on duty in the gastroscopy room on weekends. Normally, it can be dealt with. Today is special, with three sets. Even if he is killed, he can't do it alone!"

The interface has been opened, Qiu Ming quickly found the information of the three patients, and then smiled wryly at Zhang Tianyang.

"I'm afraid I can't go."

"I'm staying too."

The aloof Tang Zhizhi remained expressionless, and sat down in front of another computer a little further back in the room.

"The first-line doctor in the gastroscopy room should be able to handle one, plus the two of you, if not, there are also the second-line and third-line doctors on duty. I won't get in the way here."

The chubby Senior Brother Long had a slightly serious expression on his face, "I'll go to the outside area to make room for emergency patients. I'll prescribe a doctor's order."

The three attendings quickly completed their respective division of labor.

Senior brother Qiu Ming and Tang Zhizhi, who were able to perform the operation, planned to make a mirror for each patient, while Long Zhizhi, who had poor hands-on ability, chose to take care of the aftermath of the three patients.

"Junior Brother Zhang, I'm sorry, this kind of thing happened suddenly, and I was thinking of treating you to dinner later."

Senior Brother Qiu Ming apologized to Zhang Tianyang, "Junior Brother Zhang, if you have something to do later, you can go out with Lao Long, and you can watch the surgery together if you want."

Zhang Tianyang didn't think about it for long, and made a decision instantly.

"Then I'll follow along?"

"You can look at the patient information."

Brother Qiu Ming directly gave up his chair, and went to the next door to move a chair to sit next to him.

"Look, whichever patient you are interested in, let's choose that one to do. But I personally recommend doing hematemesis or blood in the stool."

Zhang Tianyang clicked on the emergency medical records of the three patients, and compared the results of the emergency blood test and various emergency examinations.

Outside the door, the nurses and nurses are already busy.

Cleaning, debugging, dispensing, and stocking, the footsteps of coming and going showed their anxious hearts.

Zhang Tianyang heard the nurse next door answering the phone, the opposite may be from the emergency department, the nurse was so irritable that she used to yell.

"What's the matter with you! Push three of them at once! Where did we get so many people to start the stage!"

"Why isn't the rupture of the esophagus sent to the thoracic surgery department? Is that a disease that we can treat under the gastroscope!"

"What? The thoracic surgery department just sent two?"

""

"Your side also exploded."

The nurse's tone gradually changed from irritable to peaceful, and Zhang Tianyang had sharp ears, so he got the general idea.

The emergency department seemed to explode suddenly.

Suddenly a lot of serious diseases came together, and the emergency internal medicine, emergency surgery, and emergency room were all overwhelmed in an instant.

The orthopedic department received three patients, and the thoracic surgery department received two patients, all of whom were critically ill and needed immediate emergency surgery.

Therefore, in addition to the two routines of vomiting blood and blood in the stool that should be given to digestive patients, patients with esophageal rupture were also pushed over by the emergency department because they were related to the digestive system.

"Junior Brother Zhang."

Qiu Ming interrupted Zhang Tianyang's trance with some worry, "You have been stuck on the information about this patient with ruptured esophagus for a long time, shouldn't you be?"

Seeing that Zhang Tianyang didn't respond, Senior Brother Qiu Ming's expression was tangled, he paused, and began to speak earnestly.

"Junior Brother Zhang, I know you always like to challenge difficult medical records, but I suggest you don't touch this one with a ruptured esophagus."

"why?"

Zhang Tianyang frowned slightly.

Brother Qiu Ming clearly expressed that he did not want to be involved in the operation of patients with ruptured esophagus, and the nurse who called at the door also showed a sense of resistance of "why would this patient be pushed to us".

"Because it's troublesome."

Qiu Ming kneaded his fingers back and forth anxiously, "Judging from the medical history, this patient has no history of trauma, and it is unlikely that the esophagus ruptured due to an external force. It is more likely that the esophagus ruptured spontaneously."

"Spontaneous esophageal rupture is a very dangerous surgical emergency. Generally speaking, such patients should be sent to the emergency department of thoracic surgery for thoracotomy. Although I don't know why they are sent to the gastroscopy room now, this patient must be very troublesome. "

Qiu Ming paused, his tone threatening.

"This is a severe disease with a mortality rate as high as 60%!"

However, his threat was mercilessly dismantled by Zhang Tianyang the next moment.

"Senior Brother Qiu, you are exaggerating."

Zhang Tianyang analyzed calmly.

"The location of esophageal rupture is divided into cervical, thoracic, and abdominal segments.

Cervical esophageal rupture has a better prognosis, with a mortality rate of about 5.00%, while thoracic esophageal rupture is more dangerous, with a mortality rate of 20%-60%, but it depends on the specific situation.

Esophageal rupture in the abdominal segment has a slightly better prognosis than that in the thoracic segment. "

"Brother Zhang"

Senior Brother Qiu Ming was a little dumb for a moment, and the frantic look was swept away on his face.

"How did you know about these data?"

And remember it!

You're just an intern, and you're not in gastroenterology at all, hey!

Zhang Tianyang blinked innocently.

"I'm going to have a gastroscopy today, so before I come here, I'll take a look at everything."

However, such an explanation made Senior Brother Qiu Ming even more frantic.

related look

From esophageal and gastric varices to esophageal rupture

It's really relevant!

I'm afraid you haven't reviewed all the digestive parts in internal medicine!

"I also recommend not participating."

The aloof Tang Zhizhi walked over from behind at some point.

"I just checked with my friend in the emergency department about the specific situation. This patient's esophageal tear is quite serious, and he was sent here because he couldn't handle it in another hospital."

"Besides, this should be the job of the thoracic surgery department. Now it's a lot of pressure for us."

"The front line on duty has already called the second line and the third line, and a deputy chief physician should come."

Tang Zhizhi paused, "Although I believe in Teacher Zhang's ability, but what is Teacher Zhang's current status?"

"I see."

Zhang Tianyang understood.

Because the patient is very troublesome, there may be disputes in the future.

Therefore, his "intern" is still an intern who does not rotate in the digestive department, so it is best not to get involved.

Otherwise, it will be difficult to deal with if someone catches the pigtail later.

In this regard, Zhang Tianyang expressed his understanding.

"Then which one shall we do the rest?"

Senior Brother Qiu Ming breathed a sigh of relief, and just about to speak, the irritable nurse next door suddenly shouted at the top of his voice.

"The patient is here! Open the door!"

Several figures responded instantly, and quickly rushed past the door.

Brother Qiu Ming who was interrupted exchanged glances with Zhang Tianyang and Tang Zhuzhi, and made a decision within a thousandth of a second.

The three figures rushed out equally quickly.

When the patient comes, pick up the patient first.

Which one to do specifically, which one to fish for and which one to do!

"Open the door, open the door!"

The little doctor in the emergency department whom I met just now hurriedly pushed open the door of the endoscopy room, and the three flat carts rattled all the way.

Patient, here we come.

(End of this chapter)