medical simulator

"We went to the outpatient clinic yesterday and saw that it was 05:30 in the afternoon. Under such circumstances, unless a fatal emergency patient came to the department and had to be operated on immediately, otherwise, we would also have to take a rest on weekends to continue our lives."

"What are you? How did you get hurt?"

The tattooed man also said politely to Zhou Cheng: "It was hit by a motorcycle yesterday. Originally, we went to the county hospital and went to the operating room."

"But the doctors there said that all my bones were gone, that my fracture was very special, that it might not be seen in decades, and they couldn't handle it, so they sewed up my opening and sent me to another hospital. "

"I'm here for you."

I don't know if it's his big heart or what, when he said that his fracture was rare in decades, he was quite proud, and he didn't realize how serious his condition was.

I also felt that I was injured very special, as if I was very dragged.

Before Zhou Cheng and Yang Yifeng said anything, his wife scolded: "What's the use of you?"

"Really." Then he looked at Zhou Cheng: "Doctor, what should I do with my husband? His bones are gone, so how will he walk in the future?"

"Also, is he numb in pain here? So he doesn't know the pain? I think he seems to be more relaxed than the post-operative patients in the other beds."

The patient immediately said: "Yes, I really don't feel any pain except this foot is weak."

"They all say I'm not afraid of pain, and I think so too." The tattooed man was a little complacent.

Yang Yifeng's eyes rolled white.

Zhou Cheng explained: "Your fracture has a large defect in the bone, so the fracture end does not have the friction of other people's fracture ends, forming a large discontinuous defect, so there may not be much pain. , plus we've already taken analgesic treatment."

"So the feeling of pain is actually okay. It doesn't feel particularly painful."

Speaking of this, Zhou Cheng continued to ask: "You just said that you had an operation in the county hospital before? Then why don't you continue to be hospitalized with them?"

Although this patient is rare, rare cases must be difficult to deal with, and the consequences are even more unpredictable.

In addition to hard work, it is also troublesome to admit and treat rare patients, which is far less easy than common cases.

The man with the tattoo said, "That's the county hospital over there. The medical skills are poor. After seeing that my bones were gone, I didn't dare to do it anymore. I suggest that I transfer to another hospital."

"Then I was transferred to you. The doctor on duty yesterday also transferred me to the Affiliated Hospital of Shonan University and the Second Affiliated Hospital, so how could I go?"

"The last time my mother was hospitalized there, it was also an orthopedic department. It only took three or four days. After reimbursement, I still had [-] yuan. It was a waste of money. If I don't go, I believe that you can do a good job here."

"You are all top three hospitals, but the cost is too low!" the tattooed man murmured.

When it came to [-] yuan in three or four days, he made a gesture to Zhou Cheng and Zhou Cheng in a very exaggerated way.

Yang Yifeng continued to roll his eyes when he heard this.

They are all tertiary hospitals, why is there a difference in charges?Don't you have any compulsion in your heart?

But he didn't open his mouth to speak, and gradually began to set up a person for the patient in his heart.

Upon hearing this, Zhou Cheng continued: "Your current situation is very serious. Although our hospital is also a third-class hospital, there is a big gap with the Affiliated Hospital of Shonan University and the Second Hospital."

"Besides, most of our other patients' conditions are only fractures, so an internal fixation is enough to fix the bones."

"Your bone is gone, have you thought about the possible consequences? Where do you go to get this part back?"

"If you can't find it, you will never be able to walk again in the future, and you may even lose your legs!"

Zhou Cheng felt that this big brother was really too big, and he didn't know if he was really not afraid, or if he was ignorant and fearless.But Zhou Cheng had to explain the seriousness of the matter to him. If the patient and his family had always had this mentality and thought it was a minor illness, then there would definitely be problems later on.

Zhou Cheng didn't simply scare them, but his femur started from 3cm below the lesser trochanter to 4cm above the medial and lateral femoral condyles, and there was a gap of at least ten centimeters in the middle.

Maybe even twenty centimeters!

Other people's bone defects are usually only one or two centimeters.

Then do an internal fixation and bone grafting.

But he?

Even if Zhou Cheng has a perfect level of bone defect transplantation, he still finds it very troublesome.

The middle-aged man said carelessly: "Doctor, didn't your doctor come to find a solution for this fracture?"

"That's why we came to you, otherwise why would I come to you?"

"Fractures aren't too scary. I've checked online and they say it's one of the few diseases that can be fully recovered. There's nothing wrong with it."

"I don't want to go to the Affiliated Hospital of Shonan University. The doctors and nurses over there are very concerned. It's fine to ignore them. It's too expensive!"

"It's better here. Since I was admitted to the hospital, at least seven or eight waves of people have come to see it. How enthusiastic is this?"

Zhou Cheng immediately realized that Yang Yifeng was looking at him with complicated eyes.

It seems that I don't know what to ask, but when I gently touched the middle of the thigh with my hand for a simple physical examination, I felt limp.

The patient was still a little scared, and kept blowing on his thigh from a distance, for fear of being hurt by Yang Yifeng.

Seeing this scene, Zhou Cheng and Yang Yifeng called the patient's wife out, thinking that it was better for his wife to tell him about it. The two of them seemed to have some communication barriers with the patient.

After leaving the ward, the patient's wife said: "Doctor, just tell me directly. I found out yesterday that my husband's situation is very serious, but he is still like a child, and he doesn't realize the seriousness of the problem at all." !"

"He, is he really going to amputate?" The middle-aged woman straightened her slightly messy hair expressionlessly.

Also very helpless, with such a heartless husband, usually more funny than happy, but even if he doesn't remember things, he can't handle things, as if he is here to make fun of the gods in the world.

When she was in the county hospital, someone also came to her and said that his situation was difficult to deal with.When I came to the hospital yesterday, the doctor on duty talked to her a little bit and said it was difficult to deal with.

Amputation is possible.

It's just how she is willing to have her husband amputated like this, what will the family do?Do you support yourself alone?

Then she must not be able to bear it.

No matter what, men can earn more than women with the same conditions.

Zhou Chengcheng said: "His situation is very complicated!"

"I wonder if you paid attention to what I just said?"

"With such a big bone defect, the original bone is gone, and I can't use my own bone to fill it up. To put it bluntly, it will take a lot of money to fill her up!"

"And, even after it's patched up, it's impossible to perform the physical activities that normal adults can do, only normal walking and aesthetic functions. You know what I mean?"

"This is a very thankless task." Zhou Cheng vaccinated the patient's family members in advance.

Anyway, the patient's wife is considered a sensible person and can listen to others, otherwise, she really doesn't know how to communicate!

With a hippie smile, I always feel that doctors are gods, and such gods are scary.

"How much will it cost?" The middle-aged woman asked the most concerned question.

"If you want to do limb salvage surgery, and it's the kind of limb salvage surgery that can't restore function, you have to consider at least hundreds of thousands."

"This is not a small amount, and how much it will cost can only be known after a careful evaluation before the operation."

"The final specific value has to be determined according to the actual situation during the operation."

"Bone grafting materials are very expensive. For ordinary people, only a small amount of bone grafting costs more than 1 yuan!" Zhou Cheng made a metaphor while talking.

Compared with a small defect.

How expensive are artificial allograft bone graft materials?A pack of several thousand yuan, with a clearly marked price, can fill a bone defect that is not as big and deep as a spoon!

After Zhou Cheng said a huge number, he said again: "It's very rare for him to be in such a situation."

"And it's not going to end up being a great outcome."

"Hundreds of thousands?" This sentence immediately scared the middle-aged woman?

After taking a few steps back, he leaned against the wall as if he had collapsed.

With a look of horror on his face: "Then where do we have so much money?"

Seeing this, Zhou Cheng said again: "However, if you want to know how to treat it later, you can still ask our superior doctor for details during our ward rounds. There are also cheap treatments."

Zhou Cheng didn't want to talk to death, he still escaped, and he still wanted to leave a glimmer of life for others.

It's just that if the missing bone is to be filled with bone graft, it's really not something ordinary people's families can afford.

Even if the fibular bone is transported, a lot of fillings are required to build up the skeleton. In the end, this foot only has the function of beauty and walking, and has no other abilities.

If he hadn't seen that the patient himself was too optimistic, Zhou Cheng would not have said so much!

I just hope that they can make good psychological preparations, and the patient's wife will also do some psychological construction for her husband earlier.

Amputation, cheap.

It took a few thousand yuan to do it, but the consequence was that I lost a leg completely.

Even with prosthetics, it is difficult to find a job.

Limb salvage costs a lot, and the consequences are not necessarily good.

And not necessarily anyone dares to do it.

If patients and their families are unable to realize the seriousness of this, medical disputes that should not have occurred will surely follow.

But in the end, how to do all of this will depend on Cai Dongfan's final decision during the ward rounds.

I just came here to take the lead.

The middle-aged woman walked back to the ward with a heavy heart, without thanking Zhou Cheng and Yang Yifeng.

……

On the way back, Yang Yifeng suddenly asked curiously: "Brother Zhou Cheng, why didn't you directly talk to the patient about the amputation? What kind of surgery do you have in mind for such a bone defect?"

Such a large bone defect, where can you get such a bone support?

Hearing this, Zhou Cheng frowned slightly.

Secretly thought that he just wanted to find a solution just now, and entered the state of possessing the skills of bone defect transplantation, but forgot that such bone defects may not be considered by current medicine.

Yes, although there is already a certain foundation in bone defect transplantation.

However, the transplantation skills that Zhou Cheng has obtained now are not comprehensible in reality.

Yang Yifeng is a really knowledgeable person, and he is also a specialist in orthopedics.

So he might be curious about what he thinks.

But Zhou Cheng didn't know how to explain it for a while, so he said: "Actually, I just said that casually, but I can't wipe out the patient's only hope of limb salvage."

"Let Director Cai and the others figure out a solution for such a complicated problem. I don't dare to think too much about it." Zhou Cheng became very honest.

But Yang Yifeng was not as easy to fool as Du Yanjun and Zhang Zhengquan.

Still smiling, he asked: "Brother Zhou Cheng, you should have some ideas, you are not the kind of person who speaks casually."

This was a chatter left by Zhou Cheng. If the communication was good, Yang Yifeng might still be able to find Zhou Cheng's loophole.

Medical confrontation, no matter life or death.

If the master fights, the one who strikes first will be slightly disadvantaged!

Zhou Cheng turned his head and said, "Brother Yifeng, it's not that I don't want to talk about it now, but it's hard to say. It's getting late now, so let's talk in detail later, after the shift checks are over?"

Zhou Cheng didn't mean that he didn't want to reveal the skills he knew at all, but that he couldn't explain clearly.

Moreover, if he talks too much, Yang Yifeng will be a special existence at that time. If he said a few words to Cai Dongfan during the rounds, then Zhou Cheng would say something about such a patient. To be cured or not to be cured?

If there is a cure, who will perform this operation?

Do it yourself, this is a Super IV surgery, which is a serious leapfrog.

Cai Dongfan going?

Even Cai Dongfan couldn't do it. The best plan in Zhou Cheng's heart was to either suggest that the patient be transferred to another hospital, or invite someone to come over for a consultation operation.

Because such a super-level IV operation is a minefield in the Eighth Hospital.

I don't know what Dong Qiansheng, who was on duty yesterday, was thinking. He took this patient in, and instead of letting them go to his group, he assigned him to his own group.

"Okay, that's right!" Yang Yifeng also looked at the time, and it was true that the shift was almost over, so he resolutely didn't ask Zhou Cheng.

I was just thinking secretly in my heart, if I was going to be the chief surgeon, how would I choose...

However, no matter how Yang Yifeng thought, he still felt it.

For such patients, the benefits of amputation will be even greater.

With such a large and long bone defect, can that thing still be preserved?

Could it be that Zhou Chengcheng really wanted the patient to spend hundreds of thousands of dollars to have a useless leg for this operation?Just plain good looking?

If you want to look good, you have to spend a lot of time and effort to install a prosthetic limb and put on pants, isn't it different?