Back in 2002 as a doctor

"Oh?" Zhou Congwen asked with a smile, "Is it not going well?"

"Oh, I don't know why it's so difficult until I start writing." Shen Lang said helplessly.

Zhou Congwen really wanted to memorize a few paragraphs of "Infinite Horror" and ask Shen Lang to copy it down and send it out, but in the end he held back.

"Can I read what you wrote?" Zhou Congwen asked.

"Don't." Shen Lang immediately shook his head like a rattle, "It's not good-looking, I'm still thinking about it. After writing, I found that the style of writing might not be suitable for the editor of Science Fiction World Magazine, so I'm still changing it."

Zhou Congwen smiled, and was about to discuss with Shen Lang when suddenly a nurse ran to the door and shouted, "Orthopedic emergency consultation!"

Shen Lang subconsciously jumped up from the chair.

"Slow down." Zhou Congwen said.

Shen Lang ignored Zhou Congwen's words and ran straight out, "I'll go to the consultation first."

"Tell me about the situation. If we need to have surgery, I won't leave."

"it is good."

Shen Lang left a word and rushed to the orthopedics department in a hurry.

A 45-year-old female patient with a height of 164cm and a weight of 70kg was admitted to the emergency department due to multiple injuries in a car accident.The patient was lying on a flat car with clear consciousness, a passive position, and a little listless spirit.

Complaints of dizziness, multiple pains all over the body, especially severe pain in the right leg, which is unbearable.

The chest X-ray was taken in the supine position, and the sixth rib of the right chest was fractured.When Shen Lang came to the orthopedics department, he asked a few words first, and then glanced at the film, and then he was relieved.

It has nothing to do with chest surgery, just a broken rib.On the film, there was a little pneumothorax, and the lung tissue was compressed by up to 5%, so closed drainage of the lower chest was not needed.

False alarm, Shen Lang communicated with the orthopedic surgeon according to the procedure, and returned to the ward after writing a consultation.

"What patient?" Zhou Congwen asked when he saw Shen Lang came back before he left.

Shen Lang explained the patient's situation, "It's okay, you can go back, I see that the patient's right thigh is deformed, and the diagnosis should be a fracture of the right femoral shaft."

"Lying down, didn't you write a letter for the patient to have a CT?" Zhou Congwen asked.

Generally speaking, the judgment of pneumothorax requires an upright position. The air is above the chest cavity, and it is easier to judge how much lung tissue is compressed.Chest radiograph in supine position is extremely difficult to judge a small amount of pneumothorax.

"No need, the patient has a fractured femoral shaft, and it was a pain to carry. I told the orthopedic doctor to watch more, and if there is difficulty breathing, there is still time to take an X-ray." Shen Lang also considered this point.

But no matter how it was a small amount of pneumothorax, it was nothing serious, Zhou Congwen didn't refute Shen Lang's opinion, he stood up and went home to practice surgery.

I have nothing for a few days.

Li Qinghua never gave Zhou Congwen any final information, and he didn't know what he was doing.

But Zhou Congwen didn't urge Li Qinghua very urgently, the opportunity has already been given to him, if the prince of the thoracic surgery department of the People's Hospital really regards himself as a prince, and doesn't even have the ability to grasp the opportunity, then forget it.

Zhou Congwen didn't have a clear idea in his previous life. Although he has become the top doctor, he has been thinking about what he should do back then, and he has already figured out Wang Chengfa.

There are plenty of ways, if Li Qinghua misses it, he can get another one, which doesn't matter to Zhou Congwen.

Three days later, Zhou Congwen went to work early in the morning.As soon as he entered the ward, a figure ran towards Zhou Congwen, rushing towards Zhou Congwen without any intention of avoiding it.

It was Shen Lang, there must be a patient in the emergency department, Zhou Congwen made a judgment immediately.

Turning sideways to make way for Shen Lang, Shen Lang ran out in a hurry without even saying hello.

Zhou Congwen complained in his heart.

Coming to the emergency room early in the morning, especially seeing Shen Lang's hasty appearance, the patient must be seriously ill.

Generally speaking, there are few people and cars in the early morning. Especially in 2002, there were not many cars. In addition, people have not woken up or slept in the early morning. Once the speed is soaring, if there is a problem, it will be a big deal!

It is possible that no one can be saved.

After changing his clothes, Zhou Congwen asked Nurse Daye, "Why did Shen Lang go to the emergency department?"

"Brother Zhou is here. It's not the emergency department, but an on-table consultation in the operating room." The nurse replied.

Operating room?

Consultation on stage? !

Zhou Congwen frowned, "Which subject?"

"orthopedics."

"..." Zhou Congwen was a little puzzled. It is said that the patients in the orthopedics department are all stable, but the key is that the orthopedics department does not accept them if there are other organ injuries.

Generally speaking, the procedure for receiving patients in the Department of Orthopedics is to park the patients in the treatment room, determine which department they may be related to, and then call them one by one.If there is something wrong, whoever's business will take it away; if there is nothing wrong, the orthopedics department will take it in.

Consultation on the orthopedic surgery table, what can happen.

In doubt, the little nurse continued, "I have already called Director Wang, and he went directly to the operating room. The shift will be later in the morning. After the shift, the head nurse will have to test the operation of the ventilator. When will I be able to go back to the hospital after the night shift?" ..."

The little nurse was still nagging, but Zhou Congwen had already left the ward quickly with his hands behind his back.

Zhou Congwen doesn't like gossip, but Shen Lang's anxious expression just now told Zhou Congwen that something big must have happened.

Still fucking orthopedics.

Generally speaking, the smaller the department, the bigger the accident, because as time goes by, both doctors and nurses will slack off.

For example, in the anorectal department, Zhou Congwen remembered that the first private surgical hospital in Jianghai City was the anorectal hospital.The surgeries were performed by doctors from the People's Hospital, the Second Hospital, and the Third Hospital.

For hemorrhoids, those who dare to admit in private hospitals for surgery must be the kind of particularly mild patients, as long as they are a little serious, they will be transferred to public hospitals.

Around 2005, a patient died in the anorectal hospital.It is said that the patient was fine at 8 o'clock that day, but he was already cold when he got up in the morning.

Zhou Congwen guessed that the thread knot that ligated the blood vessel was loose, causing bleeding.Because of the bleeding in the middle of the night, the patient was still asleep, so he didn't notice it.By the time he felt something was wrong, he was already in a state of hemorrhagic shock, unable to call for help.

The same goes for orthopedics.

Now the Orthopedics Department of the Third Hospital cannot perform hip and knee replacements, cervical spine and lumbar spine surgery, and can have woolen on-stage consultations.

Zhou Congwen smelled a hint of danger, so he rushed to have a look.

If something serious happened, Shen Lang probably wouldn't be able to handle it.As for Wang Chengfa... who knows.

After changing clothes and walking into the corridor of the operating room, 3 hurriedly shouted, "Methoxamine 2mg!"

Chapter 0198

Methoxyamine is a drug commonly used in surgery to maintain or restore arterial pressure, especially in cases of decreased blood pressure caused by spinal anesthesia.

It should be the anesthesiologist yelling, Zhou Congwen stepped up to the door of the operating room.

The closer it was to the operating room, the louder the frantic alarm of the monitor would be, with an anxious breath that made people's breathing difficult.

"It must be about your chest department!" Director Sui's voice came from the orthopedics department.

Director Sui is a second-generation doctor, and his father was the head of the logistics department at the People's Hospital.Director Sui graduated from university and worked as an internist for one year before taking the postgraduate entrance examination and then switched to orthopedics.

After graduating, his family arranged for him to be transferred directly to the Third Hospital, and the head of the department like Wang Chengfa was pushed aside, and he suddenly became the director.

Hearing what Director Sui said, Zhou Congwen's eyes narrowed, and a wave of disgust rose out of nowhere in his heart.

Many people have the same problem-the first thought when encountering a problem is to blame the blame instead of solving the problem.

In his last life, he had little contact with Director Sui. Zhou Congwen's only impression was that after his femoral head had aseptic necrosis, every time he met Director Sui, he would look at himself with strange eyes.

That kind of gaze seemed to see a prey, which made Zhou Congwen very uncomfortable.

Director Sui also talked to Zhou Congwen twice in a soft-spoken manner, suggesting that he undergo hip replacement surgery.But Zhou Congwen did not agree to have the operation done in the Third Hospital, and later went to the provincial capital for the operation.

"Shen Lang, how do you know how to diagnose!" Wang Chengfa's voice came.

Zhou Congwen's eyes narrowed into a slit, and the cold light flickered.The heart of protecting the calf was remembered by Wang Chengfa, and a sneer appeared on the corner of Zhou Congwen's mouth.

Shen Lang made a mistake?That guy is less courageous than a mouse, because he was afraid of accidents and went to see it two or three times in the past few days, how could it be his fault.

Walking quickly into the operating room, Zhou Congwen saw Wang Chengfa standing up straight with a stethoscope on.His face was pitch black, stiff as a stone, and he scolded Shen Lang with his iconic squinting and disdainful eyes.

Shen Lang had been terrified a long time ago, standing on the side with his hands tied, not knowing what to do.

Zhou Congwen glanced at the monitor, blood pressure 59/36mmHg, heart rate 92 beats per minute, blood oxygen saturation 90%.

The patient's right thigh was deformed and had traces of disinfection.

It should be the car accident injury that Shen Lang consulted three days ago, why did he suddenly go into shock?Several possibilities flashed through Zhou Congwen's mind.

Guessing that Wang Chengfa was thinking about delayed pneumothorax, Zhou Congwen frowned and went to the viewer, found the film from three days ago and inserted it into the viewer.

No one noticed that there was an extra Zhou Congwen in the operating room, and everyone else was busy rescuing or glaring at Shen Lang viciously, as if he had done a heinous mistake.

Shen Lang lowered his head, and there was a faint bad luck on the top of his head.

There is no obvious pneumothorax on the film, and the fracture of the sixth rib on the right is of the nature of a bone fracture. There is a high probability that the broken end of the fracture will not puncture the lung and cause a pneumothorax.After watching the film, Zhou Congwen picked up the medical records and scanned the test sheets.

The test results were also normal.

"Shen Lang, what the hell do you think? If you don't understand, you won't come to me!" Wang Cheng scolded Shen Lang angrily.

Shen Lang's legs trembled a little, and it could be seen that he had exhausted all his strength to stand in the operating room.

"Hurry up and get the chest bottle! What are you doing in a daze!!" Director Sui shouted, "Hurry up, don't be so dazed. How can you be a doctor if you can't even see a pneumothorax!"

Zhou Congwen turned around and came to the anesthesiologist.

Today, Liu Wei is in charge of anesthesia, the only one in the Third Hospital who can do single-chamber ventilation.

He is instructing his assistant to give methoxamine, and traces of sweat can be seen near the forehead of the sterile cap.It is estimated that Liu Wei was also confused, and Zhou Congwen felt that Liu Wei should judge the shock caused by anesthesia, but he did not say.

It's good that the shit bowl is on Shen Lang's head, at least someone is taking the blame, isn't it?

"Director Wang, the breath sounds are weak on both sides, you may also consider pneumothorax." Director Sui asked immediately.

Wang Chengfa's face was even darker, and he cast a vicious glance at Shen Lang's position just now, as if Shen Lang was still there.Because Shen Lang was not there, his gaze almost pierced the floor tiles.

"Hurry up and close the drainage, see if you want to puncture the intercostals."

One way to rescue tension pneumothorax is to insert a 50ml syringe needle into the second intercostal space on the midclavicular line, because the pressure in the chest cavity of tension pneumothorax is high, and the gas will "spray" out along the needle to relieve the urgent need.

Wang Chengfa hesitated for a moment.

"Clap~"

"dong dong~~"

Zhou Congwen walked to the patient, put his left hand on the right chest wall of the patient, and tapped the index finger and middle finger of his right hand on the fingers of his left hand.

Percussion, very standard percussion.

The sound struck everyone's hearts like morning bells and evening drums.

Wang Chengfa was startled, and immediately realized what he had missed.

Wang Chengfa didn't know the patient's condition. He arrived at the hospital early in the morning and before he got out of the car, he was told by Director Sui that the patient's pneumothorax worsened just after he came to the stage and hurried over.

Because of the preconceived impression, Wang Chengfa subconsciously began to scold Shen Lang after auscultation, and even missed a pneumothorax, what the hell!

But Zhou Congwen's percussion reminded Wang Chengfa.

Normal people perform chest percussion, because the lung is an air-containing tissue, and the percussion sound of the lung is usually unvoiced.

If the lung is consolidated or infarcted due to infection, the percussion sound is usually dull or solid; if the lung contains too much air, the percussion sound is usually overvoiced.Where the lungs overlap with the liver and heart, the percussion sound is usually dull.

When a pneumothorax occurs in the chest, due to the large amount of air contained in the pleural cavity, it usually appears as a drum sound on percussion of the chest.

The sound of Zhou Congwen's percussion just now is a slightly solid voiceless sound, not a drum sound!

Wang Chengfa felt ashamed in his eagerness. As an old doctor and the head of the department, he forgot to percussion and made a hasty diagnosis of pneumothorax, which is a bit unreasonable.

"The percussion is voiceless, and the urgent blood gas analysis pH7.33, PO290mmHg, PCO246mmHg, Lac0.8mmol/L, K+3.2mmol/L, Ca2+1.01mmol/L, BE-3.3mmol/L; the shock index is 1.55, Consider it neurogenic shock." Zhou Congwen said lightly.

"..."

Director Sui froze for a moment, turned his eyes away from Wang Chengfa, and stared at Zhou Congwen.

But Zhou Congwen didn't bother to take care of this kind of nonsense. The patient suffered from neurogenic shock and had to be rescued immediately. If he couldn't be rescued, Shen Lang would definitely die.

"Methoxamine 2mg intravenous injection, dopamine 5μg·kg-1·min-1 intravenous pumping."

"Micro pump?" Liu Wei reminded in a low voice.

"Intravenous infusion, calculate the amount of fluid, you know." Zhou Congwen corrected, "following kindness", without changing expression.

Liu Wei also felt numb in his hands and feet. When he heard that someone gave a doctor's order and no one objected, he immediately followed the doctor's order.

"Epinephrine 1 mg intravenously."

"Prepare for endotracheal intubation and turn on the ventilator."