Auto chess in the operating room

Chapter 93 Inexplicable high fever after appendectomy
Watching Tang Lou complete the operation, Ma En and Wang Daquan stood quietly, waiting for Qingping's treatment.

Looking at Tang Lou, Qingping was naturally very happy, but also had some headaches, although the final result proved that Tang Lou's choice was correct.

"Okay, Tang Lou, you go to clean it first, and we will have a small meeting in the office later."

Qingping couldn't tell whether it was joy or anger in his tone, and he looked at Ma En and Wang Daquan again, and the latter nodded obediently.

As for Tian Linsheng, he is still cleaning up the mess.

Ten minutes later, the general surgery office.

The Qingping group gathered around the desk, and Qingping looked at Ma En: "What do you think of the patient just now? If you encounter a situation that may not be able to be handled, what will you do?"

Ma En swallowed his saliva, and naturally replied obediently: "First of all, for the appendicitis perforation just now, Tang Lou's operation was smooth and correct. If I couldn't do it better. But, if I was at that time, I definitely wouldn't be like this." Taking risks, I will definitely obey Doctor Qing's arrangement and absolutely obey the orders of the superior doctor."

Qingping nodded, then looked at Wang Daquan: "What about you?"

Wang Daquan was modest and low-key, approaching Ma En, choosing political correctness: "Doctor Qing, as you know, I can suture and open the abdomen well now. As for finding the appendix, I don't even dare to think about it. Everything depends on Doctor Qing and Ma. Doctor's order."

Qingping looked at Tian Linsheng again: "What do you think of the operation just now?"

Tian Linsheng didn't know what was going on. In the operating room just now, he was just doing his job well. He was cautious and followed Tang Lou's movements all the way. He only knew that the operation was successful, including appendix gangrene or perforation, and the possible risks of the operation. , no concept.

Regarding Qingping's questioning and training, he was a little nervous, so he smiled: "I just pull the hook and stand quietly watching."

"."

Wang Daquan glared at him, thinking, if you don't pull the hook, whoever pulls the hook.

The corners of Ma En's mouth twitched, God stood there watching quietly!
Qingping was speechless, and finally looked at Tang Lou: "What about you? What do you want to say."

Tang Lou said solemnly: "Strive to become an attending doctor as soon as possible, as skilled and experienced as Doctor Qing."

"???"

Qingping was almost so angry that he couldn't speak for a few seconds. The two interns, one rotten wood and the other smart and solid, were short of going to the house to expose the tiles.

This medical team leader is too difficult!

Qingping calmed down before picking up his train of thought: "Tang Lou, this kind of disobedience to orders today is not allowed to happen again!"

"Oh." Tang Lou responded perfunctorily.

"As punishment, you will continue to perform ten appendicitis operations in the next half month."

"Oh." Tang Lou responded flatly.

Ma En watched the two of them as if they were double reeds, and he completely understood in his heart that Qingping clearly wanted to reuse Tanglou.

"Doctor Qing! I don't think it's right."

Wang Daquan was a little jealous, what kind of punishment is this?

"Wang Daquan, what's your opinion?"

Qing Ping looked at Wang Daquan, and asked slowly, his tone was calm, Wang Daquan calmed down all of a sudden, just now he justified his words and followed the arrangement of the superior doctor. After knowing it, Doctor Qing is playing a big game of chess!
Blushing, Wang Daquan really thought of a reason in his desperation, and quickly explained: "Doctor Qing, didn't you arrange for Tang Lou to do dressing changes for burn patients? Lou is exhausted, but I can actually share some of it.”

Wang Daquan praised his wit, looked at Qingping sincerely, and divided the appendicitis operation into me, divided me into it!
Qingping thought for a while, and it made sense: "What's your idea, Tang Lou?"

Tang Lou thought about it for a while. Due to the fetters of his own surgical mastery, the healing rate and pain of patients are not universal and generalizable for burn patients. If they do it by themselves, the data in subsequent papers will be questionable.

It would be best if other people could do this, so as to be scientific and rigorous.

After thinking deeply, Tang Lou said, "Doctor Qing, I think what Wang Daquan said is very reasonable. After all, I can't use two things at the same time. If so, he will be responsible for changing the medicine for the burn. I have already sorted out the steps of the medicine. Lin Nurse Jia cooperated synchronously, and Wang Daquan is more experienced than me, which is conducive to better completing the research of the project."

"Tang Lou, you!"

Wang Daquan looked at Tang Lou in disbelief, and roared in his heart: I have never seen such a brazen person!
"Since that's the case, then it's settled. There is a way to change the dressing, and whoever does it will not affect the final conclusion. Then you should study appendectomy well."

"Doctor Qing, I didn't mean that..."

Wang Daquan wanted to resist, but seeing Qingping's serious expression, he withdrew it abruptly, raised the corner of his mouth with difficulty, and gritted his back teeth: "Okay, Doctor Qing, I promise to complete the task."

Qingping nodded approvingly: "The meeting is over!"

Looking at the back of Qingping leaving, Wang Daquan twitched his mouth lightly, telling you to talk more, let you talk more...

Ma En patted Tang Lou's shoulder lightly, and it seemed that he would discuss with his peers in the future: "Congratulations!"

Tian Linsheng is like a dead pig who is not afraid of boiling water.

...

Just as everyone was digesting their emotions, Dr. Qingping hurried back to the office half an hour later.

A postoperative appendicitis patient from a lower-level hospital was admitted to the Department of General Surgery.

Qingping once again convened the whole group meeting.

Qingping held a pile of medical records seriously, frowning.

"Wang Daquan, prepare for the projection. Ma En, you go and invite Director Cheng. Tian Linsheng, you go to the Internal Medicine Department to find Fang Qing, and Tanglou, you go to the General Surgery Department to find Song Yang. I need to start a departmental consultation."

Several junior doctors couldn't believe it. What's going on?
What a big deal!

Naturally, several people quickly went to find someone according to Qingping's order.

Twenty minutes later, at the large conference table in the middle of the general surgery meeting, Cheng Jian, director of general surgery, Fang Qing, senior attending internal medicine, and Song Yang, another attending general surgery, were all present.

As for Ma En and others, they were naturally not qualified to sit at the big conference table, so they all stood aside and listened.

Qingping presided over the meeting, and he was not polite. He just played a series of inspection films when he came up.

While playing, introduce the patient's situation:
At noon today, I received a post-appendicitis patient who was transferred from a lower-level hospital.

Patient: Hu Jindong, male, 24 years old

Brief medical history: Metastatic right lower quadrant pain for 3 days, accompanied by intermittent fever, with a maximum body temperature of 40°C. The local hospital received anti-infection and antipyretic treatment, but the effect was not good. Emergency CT showed acute appendicitis, surrounding exudative inflammation, and mesenteric lymph node reaction Sexual enlargement, a small amount of pelvic fluid.

Physical examination: body temperature 39°C, flat and soft abdominal muscles, right lower quadrant tenderness and rebound tenderness.

Auxiliary inspection: wbc14-5*109/L, N93%
After reading the preliminary information, Qingping continued to briefly describe:
After the clinical diagnosis, the local hospital proposed two options, one was conservative treatment and the other was laparoscopic appendectomy.

Considering the symptoms, signs, and auxiliary examination results, the indications for surgery are clear, and there are no surgical contraindications.

After communicating with the patient, the operation was performed on the same day. Under laparoscopy, the mesenteric lymph nodes of the terminal ileum were found to be enlarged. The appendix was about 10 cm long and slightly swollen without pus. .

Qingping cut out the corresponding photo on the projection, and the swollen appendix can be clearly seen in the photo.

Several experts also nodded, approved the practice of the local hospital, and performed appendectomy.

Qingping continued: After the appendectomy, the patient was flushed with saline and a drainage tube was placed. The operation went well.On the first day after the operation, the abdominal pain was completely relieved, the abdominal muscles were soft, the right lower quadrant was mildly tender, no rebound tenderness, and high fever was still present intermittently.

When talking about this, the expert was a little confused. Appendiceal lesions are not enough to cause a high fever of 40°C.

Qingping naturally reacted like all the experts, and continued:

"On the second day after the operation, the patient still had a high temperature of 40°C."

Qingping turned another page of patient information, looked at the experts, and said in a serious tone:
"On the third day after the operation, the patient's white blood cells continued to rise, and the antibiotic was upgraded to imipenem. After three days of use, the patient still had intermittent high fever!"

The faces of several experts also became gloomy all of a sudden, the high temperature is too unusual!
(End of this chapter)