Back in 2002 as a doctor

"Get the defibrillator ready."

Zhou Congwen's eyes were fixed on the ECG monitor, and the doctor's orders continued to be issued.

Chapter 0199 scolded like a grandson

"Hey!" Director Sui was a little angry, but he didn't bother to argue with a junior doctor in another department, but looked at Wang Chengfa forcefully, "Are you the director or is he the director? Let a junior doctor Host the rescue?"

Wang Chengfa was stunned for a moment, he had actually been scared long ago.

He hadn't woken up early in the morning, and he was in a daze when he encountered such a shitty incident just after he came to the hospital.

And many recent things show that Zhou Congwen seems to have matured unconsciously, whether it is emergency first aid or surgery.

Although Wang Chengfa didn't know the reason, he still wanted to be quiet at this dangerous moment and let Zhou Congwen preside over the rescue.After he succeeded, he made a final decision and pretended that the rescue was done by himself.

If it fails, it will follow Wang Chengfa's will.

But director Sui couldn't bear the sand in his eyes, he didn't care what Wang Chengfa was thinking, and asked directly.

Wang Chengfa sat on the wax all of a sudden.

"You can directly point out what is wrong with the diagnosis." Zhou Congwen stared at the numbers on the monitor, and directly replied Director Sui's words, "Dexamethasone 10mg intravenous injection."

The anesthetist was stunned for a moment, looked at Director Sui, then at Wang Chengfa, and finally his eyes fell on Director Sui.

"Why do you direct the rescue, get out!" Director Sui opened his mouth and scolded.

"Director Sui, first aid, if you are not sure, shut up." Zhou Congwen kept his eyes on the monitor, "I will record everything you say in the medical record."

"..." Director Sui had never met such a young doctor before, and he was stunned.

"As a director, you can't even diagnose neurogenic shock, so you're not ashamed. Standing there and beeping, you're ashamed. Graduated from graduate school, is this what your professors at Bai Medical University taught you!"

Seeing Liu Wei's assistant pushing adrenaline along the tee, Zhou Congwen coldly pushed Director Sui to the corner.

"you……"

"What about me? If you knew how to rescue it, you would have rescued it long ago. You wouldn't have said such a ridiculous diagnosis of pneumothorax. Can't percussion? How did your teacher teach you!"

Zhou Congwen stared at the monitor, and instantly switched to the state of a top doctor and academician of the two academies, and said calmly, indifferently, and coldly.

Director Sui was dumbfounded. He didn't know who gave this little doctor the guts to yell at him like this.

"Methoxamine 2mg was injected intravenously, oxygen was inhaled by a mask, and pure oxygen was given."

"Rehydration, colloid, the speed can be faster."

"Give me the dopamine faster."

Zhou Congwen was also distressed. In 2002, he didn't even have a micro pump, so there was no way to pay attention to the details of the rescue.

There is no number, so he can only use faster and slower to explain, which makes him very helpless.Just like cooking, how much is a little?It can only be determined based on experience, which is particularly unfriendly to engineering students.

Although he can tell the anesthetist how many drops per minute, but... No matter how precise the human eye is, it is impossible to be as accurate as the micropump.

Distressed, Zhou Congwen simply ignored Director Sui's anger.

There was a sound of footsteps, and Shen Lang ran in panting heavily, carrying a chest bottle.

Can't fit the chest bottle, this is a problem, and it is immediately placed in front of Wang Chengfa.

Director Sui glanced at the breast vase, then at Wang Chengfa, and snorted coldly.

"Prepare the salt water, I'll put in the chest bottle." Wang Chengfa said in a deep voice.

"Do you want a chest bottle for patients with voiceless percussion?" Zhou Congwen glanced at Wang Chengfa and said coldly.

For a moment, everyone subconsciously had hallucinations.

It seemed that the person standing by the operating table was Wang Chengfa, and that glance was full of disdain and strength, which was Wang Chengfa's signature action.

And when this gaze fell on Wang Chengfa, even he was stunned.

"Do you think it's enough to just write in the medical record that there is a moderate amount of gas after the chest bottle is removed?" Zhou Congwen said indifferently, still staring at the ECG monitor.

"..."

Wang Chengfa and Director Sui were speechless.

That's what they think.

Closed thoracic drainage has less damage, and the tube should be inserted first regardless of whether there is a pneumothorax.What if?

If there is a problem, the gas can be drawn out to avoid the death of the patient due to tension pneumothorax.

If there is no problem, anyway, it is only a 1.5cm incision, and there is almost nothing wrong.

But this "hidden rule" can only be felt, not stated.

Now Zhou Congwen said it out loud...

"Shen Lang, go push the bedside X-ray machine." Zhou Congwen said, "If you have a pneumothorax, you can tell by taking an X-ray."

"If the patient dies due to tension pneumothorax, you will be responsible!" Director Sui's anger finally broke out uncontrollably.

Zhou Congwen turned his head slightly, and glanced at Director Sui with a strange look.

"As a doctor, can you be more professional."

"As far as your level is concerned, let your postgraduate tutor come to see how you rescued him. He has to jump off the stairs."

"Although orthopedics is relatively rough, you should be able to understand the most basic percussion. If there is too much earwax affecting your hearing, go dig it out. If you don't understand, go back to school and study hard."

A sentence pierced Director Sui's heart like a sharp knife.

"Responsible. If you were really responsible, you wouldn't have diagnosed right tension pneumothorax." Seeing that the patient's vital signs were gradually stabilizing, Zhou Congwen said indifferently, with his hands behind his back and his waist straightening up unconsciously, "Wang Director, Director Sui is unprofessional, and you are the person in charge of the chest department, so you are not professional at all."

"..."

Sensing the tense atmosphere in the operating room, Shen Lang shuddered, immediately bowed his head, turned around and left.

He immediately went to push the X-ray machine beside the bed. Although the machine was heavy and heavy, it was better than being tortured here.

The two directors were scolded, but before Zhou Congwen finished speaking, he glanced contemptuously, "I will record all this in the medical record, don't ask me if I am qualified, consultation on stage, discussion of critical medical records, if you don't understand Go to the medical department and ask."

Wang Chengfa almost didn't cry.

The consultation on the stage is always done by the director, especially when encountering a patient who goes into shock for no reason, how could the little doctor stand up and discuss the condition with the director even if he had no time to hide.

But today Zhou Congwen stepped forward and directly took over the rescue and scolded the two directors including himself like his grandson.

For a split second, Wang Chengfa even felt that Zhou Congwen was the director.

"Why do you..." Director Sui just said four words before being interrupted by Zhou Congwen.

"Why? Then I'll tell you why." Zhou Congwen said lightly, "The vasomotor center sends out sympathetic vasoconstrictor nerve fibers to maintain the blood vessel tension of the whole body. When stimulated by severe trauma, severe pain, nerve damage, etc., the blood vessels Inhibition of the motor center or blockage of efferent vasoconstrictor fibers, loss of small vessel tone..."

This is not pointing the nose and cursing, but the most professional explanation.

Wang Chengfa was stunned for a moment.

Chapter 0200 Zhou Congwen moved away the ladder and scattered a handful of thumbtacks

"Stress causes the release of certain vasoactive substances in the body, such as amine, bradykinin, 5-hydroxytryptamine, etc., to increase the release of peripheral blood vessels, and the resistance drops rapidly. shock."

"Due to the decrease in tissue perfusion leading to cellular hypoxia and insufficient cerebral blood flow, patients often experience transient disturbance of consciousness. The pathological basis of this type of shock is relatively simple, and the clinical symptoms are obvious. If it can be detected in time, the prognosis is often relatively good. "

Zhou Congwen looked at Director Sui and said word by word.

"As a doctor, after an accident, the first thing to think about is how to rescue and recover instead of blame. Please be professional, even if you blame the blame. Seeing a doctor is not a fortune-telling, and even the most basic physical examination is not done. How did you become a doctor?"

Director Sui clenched his fists and looked at Zhou Congwen angrily.

If it weren't for the alarm sound of the monitor that disappeared at some point, he really wanted to go up and punch Zhou Congwen at this moment.

Uh, of course, the more important thing is that Director Sui felt that he couldn't beat Zhou Congwen.Moreover, as the chief director, he fought with a junior doctor, and was ashamed to be thrown at his grandma's house.

"Director Wang, it is said that you are the most protective of the calf. What's wrong today? Didn't wake up?" Zhou Congwen looked at Wang Chengfa with a smile on his eyes and asked, "As the head of the thoracic surgery department, you can't even touch the voiceless and drum sounds. If you can’t hear it, just say it’s a consultation.”

"..." Wang Chengfa gritted his teeth.

creak~~~

"You are the head of the department like this? I'm afraid the chest department will be finished in a few years."

creak creak ~

"Neurogenic shock, how do you diagnose it?" Director Sui clenched his fists and asked forcefully.

Zhou Congwen smiled, and Director Sui was probably also confused. He didn't talk about this matter from the position he was good at, but walked into the place he was good at.

If Director Sui was messing around, it would be a bit tricky.

But when it comes to diagnosis basis, who is Zhou Congwen afraid of?

"The patient is a middle-aged woman with no special medical history in the past. The trauma of the car accident caused a certain psychological blow to the patient, and she was afraid and nervous before the operation.

In addition, the aggravated pain stimulation when moving is used as an incentive to cause sympathetic disturbance in patients, manifested as pale complexion, transient disturbance of consciousness, dyspnea, sudden drop in blood pressure, slow or slow heart rate and other symptoms. "

"It was found that the patient's condition was not right, and he was immediately given symptomatic treatment such as vasoconstrictor drugs. After the blood pressure rose, his vital signs gradually returned to normal and he recovered well after the operation. Therefore, he was diagnosed as neurogenic shock."

"Do I need to say something about the differential diagnosis?" Zhou Congwen's language was full of sarcasm and ridicule.

After symptomatic treatment, the patient's vital signs have returned to normal values.Objective facts prove that Zhou Congwen is right, so should we continue?

Isn't this a slap in the face?

The sound of heavy wheels crushing the ground came from the X-ray machine beside the bed, and Wang Chengfa's face suddenly turned cold.

Shen Lang pushed the X-ray machine in, Wang Chengfa asked coldly, "Who told you to push the machine?"

"Director Wang, who told you to undergo closed thoracic drainage just now." Zhou Congwen asked sharply without waiting for Shen Lang to speak.

"..." Wang Chengfa didn't expect that Zhou Congwen didn't save any face for himself, and he was a little flustered when he questioned him in public.

Can you say that whether it is true or not, anyway, drainage can avoid tension pneumothorax?

Of course not.

This is an unspoken rule. What kind of unspoken rule is it if you can say it in public?

"I want to do a bedside chest X-ray for the patient. You can't understand percussion, so I can only take a X-ray. Is there a problem?"

Zhou Congwen's words slapped Wang Chengfa and Director Sui's faces like a slap in the face.

Can't understand percussion...

To a doctor, an old doctor, or a director, this sentence is equivalent to pointing their noses and scolding their mothers.

But they couldn't fight back.

Indeed, there was no percussion. If Zhou Congwen hadn't percussed first when he came in, everyone would have thought the patient was in shock caused by severe tension pneumothorax.

The diagnosis is wrong, the treatment is wrong, and what else is there to say when people point their noses and scold their mothers?

The key is the lack of the most basic operation of percussion.

If this gets out, the faces of the two directors will really be lost.

Wang Cheng was full of anger, but he had nowhere to release it.

"Push it back." Wang Chengfa looked at the ECG monitoring, the value on it was stable, Shen Sheng and Shen Lang said.

"Don't take a film? I'll write the rescue record later, please sign Director Wang and write down the reason for not taking the patient's film."

Zhou Congwen beat the dog in the water.

The anesthesiologist lowered his head and performed busy rescue without any real objects.

The patient's vital signs have stabilized, he pretended to travel back to 20 minutes ago, and had a busy meal.

It's so embarrassing, if I was pointed at by a little doctor and said that I can't see a doctor, and I don't even know about percussion, I guess it's like what Zhou Congwen said, even thinking of jumping off a building.

Wang Chengfa really thought so, he really wanted to bang his head against the wall.

Zhou Congwen pushed his nose to his face, caught a mistake and attacked again and again.Not to mention the steps, he had already admitted that he was cowardly, and brought a ladder with him. Zhou Congwen removed the ladder without hesitation, and sprinkled a handful of thumbtacks underneath.

Is there anyone who does this!Wang Chengfa wanted to cry but had no tears.

Director Sui snorted coldly, turned and walked out of the operating room.

"Director Sui, I'll send you to your office after the filming is finished." Zhou Congwen was still relentless, "After you finish watching, sign the rescue record!"

Director Sui staggered for a while, and left without looking back.