medical simulator

Dong Qiansheng's face jumped at this moment, and he said helplessly: "Director Cai, I explained to the patients and their families and asked them to transfer, but they just refused to transfer."

"If you want to be hospitalized, we don't have the right to refuse the patient to be hospitalized. I also acted according to the regulations and admitted the patient."

"Then you put yourself in the group, why did you put me here?" What Dong Qiansheng said made sense, but Cai Dongfan continued to question.

Dong Qiansheng continued to explain: "Our group is full of patients, and it happens that your group has vacant beds, so I can only admit the patients first."

Cai Dongfan didn't listen to this, and said to Dong Qiansheng: "Don't tell me there is nothing wrong with it. You took this patient yourself, and you let Yan Haihan handle it by himself."

"You want me to wipe your ass? Is there no one in your group?"

Dong Qiansheng hurriedly said: "Director Cai, isn't it like this? The beds in our group and Director Hu's group are full!"

"Just yesterday, your group had vacant beds, and your group's turnover is also the fastest. This is according to the rules of the department for treating patients this month."

"Just fill up the empty bed first."

"Director Cai, this rule was set by your directors. If you mess with it again, won't it go back to the original one?" Dong Qiansheng swallowed his saliva at this moment.

In fact, he also felt that he was not kind, but the patient refused to leave, so what could he do?

It just so happened that Cai Dongfan's group had an empty bed, anyway, this was a new rule set in the department this month.

Of course he was happy to be thrown into the other groups. If there was no bed, that would be another story, and he could only consider himself unlucky.

Yan Haihan motioned for the itinerant nurse to take the phone and said, "Cai Dongfan, we made this rule together. You can't trouble Dong Qiansheng. When your team is on duty, you also assign patients to us. "

"I know this patient is very difficult to deal with. You can just send him out of the hospital or transfer him, or talk about amputation."

"Our department has the ability to do as many things as possible, let the patient choose by himself, and they can't force us to operate on him."

"And yesterday, Dong Qiansheng asked the doctor on duty not to draw blood for the patient's pre-operative examination. He just took an electrocardiogram and didn't even take a chest X-ray. He didn't plan to make arrangements for the surgery."

Yan Haihan's words are quite kind, if Dong Qiansheng really talked to the patient about something and asked him to wipe his ass, he would definitely not do it.

Cai Dongfan hung up the phone cursing, and muttered intentionally, "Damn, I'm guilty of f*cking crimes against the turnover rate of patients in a department by myself."

"I have scabies on my head, right? Throw all the mess on my head?"

Cai Dongfan's muttering immediately made Yan Haihan's face darken!

The patient turnover rate is an assessment indicator, which is actually the average hospital stay. The hospital has set standards for each department, and if the standard is exceeded, money will be deducted.

In the past, the average length of stay in the Second Department of Orthopedics was above the standard. Last month, it dropped below the average point. The performance of each person in the department increased by 2000!

It was all done by Cai Dongfan.

……

After hanging up the phone, Cai Dongfan pondered for a while. Although he was still puzzled, the patient had already moved in, so he still had to find a way to solve the problem.

Such a large bone defect cannot be dealt with by the Eighth Hospital. Looking at the whole country, there are not many hospitals that can deal with it.

Half an hour later, Cai Dongfan took the initiative to call the patient's wife to the director's office to talk.

The patient's wife said good things to Cai Dongfan as soon as she entered the door: "Director Cai, you have to find a way for us. My husband is only 43 years old this year. We are also from the countryside and don't have much money."

"Don't dare to go to those big hospitals, and we don't want to amputate, so you can think of a way if you are tired?"

"We still have two children who are in junior high school. The man in my family can't fall down." She almost knelt down to Cai Dongfan.

Maybe it's really overwhelmed.

Cai Dongfan smiled wryly at the moment, looked at the woman in front of him, looked at her sincerely, and said, "I really can't help it."

"What else can I think of? Huh?"

"Look, I gave you two suggestions, but you didn't accept them, so aren't you embarrassing me?"

"But do you have a third-party responsible person? If so, you have to let them find a way to raise money. Don't come here to embarrass us."

Cai Dongfan can't figure out the exact cost of this patient right now, if you don't think of a way to raise money to save the limb, as long as I think of a way, then what can I think of?The missing bone must always be filled.

The middle-aged woman faltered and said: "Director Cai, my confused husband just can't find who hit him."

"You are a tertiary hospital here, a big hospital, Director Cai, you must have a solution. Just save my husband!"

"Our whole family will be thinking of you well."

Cai Dongfan was very calm: "No matter how much you lift my sedan chair, it's useless. The only way I can save your limbs is to transfer to a higher-level hospital. They should have a way. Our level is limited."

"If you want to save your life, we can do amputation!"

"Anyway, I've already explained to you what I should say. Either transfer to another hospital or amputate."

"Think it over, and explain to me that we haven't done any tests yet, and you only need one or two hundred yuan to be discharged from the hospital. It's a little bit of savings."

"If you want to save your limbs! Really, you should transfer to another hospital, we don't have the ability here."

"I can't do it."

Cai Dongfan didn't dare to say anything more about how capable and arrogant he was.

The middle-aged woman was about to cry immediately, she looked at Cai Dongfan: "Director Cai, you can't be so heartless, you can still bargain when shopping outside, you must think of a way for us."

"I still have two children, the elder and the younger, you are a living Bodhisattva, you have to help us figure out a comprehensive solution, Director Cai, you can't just ignore it!"

"We can't afford to go to other hospitals."

Although she realized the seriousness of the matter, she never thought it would be so serious.

"I'm sorry!" Cai Dongfan still apologized decisively.

"If you have decided, tell me the final decision, don't waste time, you are useless, I can't help it." Cai Dongfan spread his hands, "Even if you force me to death today, I can't help it."

"I am just a human being, not a Bodhisattva or a god."

"The level of our hospital is limited to this. It's useless for you to make things difficult for us. It will only make your husband's situation worse."

As he said that, Cai Dongfan saw that the woman was about to kneel, and he stopped immediately: "Don't kneel! If you want to kneel, let's kneel together. I also said that there is nothing I can do."

With runny nose and tears, the woman said to Cai Dongfan with red eyes: "Director Cai, we don't have that much money, but I will definitely find a way to raise money. You operate on my husband first, and we will pay you back later, okay?" OK?"

"You must save my husband's leg."

He said bitterly, "Director Cai, we have no money, so what should I do? What else can I do?"

In fact, Cai Dongfan already had the answer in his mind, either to raise money to transfer to another hospital, or to have his limb amputated.

Otherwise, you can wait to die?

In such a situation, if you don't do anything to deal with it, it will be too late to deal with it later.If it is delayed any longer, another blood clot will occur, and the person will be wiped out by then, which will be even bigger.

"Calm down first, you have to find a way to make a decision, it's no use begging me!"

"This is what happens now, it has already happened, and there is no way to reverse it."

"I also want to give him the best treatment plan, but I can't do it. I can't waste your money for nothing!"

"And you have no money, and I have no money. If I don't have the money to hand in, I can't get the surgical instruments, so what do you want me to do?" Cai Dongfan could only helplessly say to her, eyes full of, you Just let me go, big sister!

At this moment, Luo Yun and the others were outside the office without saying a word.

This is Director Cai, and it is also the director's trouble. When the subordinate doctor can't find any solution, even he can't find a solution, the patients only come to him, because he is the person who leads the group.

He is the director.

The middle-aged woman left the director's office shortly after, walked back to the ward, rubbed her hair, and tore out a few strands.

Although this picture looks quite sad, but also helpless...

After finally sending the patient away, Cai Dongfan probably still couldn't bear it, so he called Yang Yifeng to the office again.

"Director Cai." Yang Yifeng was quite polite to Cai Dongfan.

"Yi Feng, your teacher, Professor Ding, has he had any experience in treating such large bone defects?" The patient felt that the medical expenses to go to the Affiliated Hospital of Shonan University were too expensive, so Cai Dongfan still wanted to ask if Ding could be treated. The professor invited the Eighth Hospital, and then tried to save them some money.

When Yang Yifeng heard this, his eyelids twitched instantly, and he hurriedly said, "Director Cai, if the bone defect is less than 15cm in the lower part of the femur, then it's better, just do a tumor-hinge knee replacement."

"But in his case, the bone defect in the upper part of the femur is not far below the greater trochanter, which is too long!"

"And all the bone is gone. Even with a hinged knee replacement, it won't help."

Yang Yifeng was also helpless.

This patient almost perfectly missed the indications for limb salvage surgery for large fractures, which is very difficult.

Although it is possible to use external fixation brackets and then use membrane grafts to crawl, but with such a long defect, is this thing easy to use?

Even for bone transport?

In fact, strictly speaking, the conditions are not the best.

Cai Dongfan sighed: "Professor Ding can't do anything? If this patient wants to save his limbs, he has to go to Shanghai or Kyoto."

As Cai Dongfan said so, he glanced at Yang Yifeng, thinking in his heart that Yang Yifeng must be speaking conservatively, but he didn't want to cause trouble for Ding Changle, and Ding Changle must have a way, but he was not sure, so Such patients will not be taken rashly.

……

However, while Cai Dongfan and Yang Yifeng were still thinking of ways to help the patient, suddenly a few people in police uniforms found Cai Dongfan's office.

The conversation between Cai Dongfan and Yang Yifeng was interrupted.

Then he knocked on the door and asked: "Hello, Director Cai, my name is Ding Meng, and I'm from the criminal police team. Are you the doctor in charge of the 27-bed patient Luo Sangen?"

Cai Dongfan hurriedly interrupted Yang Yifeng, stood up, and nodded: "Ang, I am. The patients in bed 27 belong to our group."

"May I ask who you are looking for?"

Cai Dongfan's eyelids were twitching, and he suddenly had a bad feeling in his heart.

This 27-bed bed is already enough for him to have a headache, why did he provoke the criminal police team?

Yang Yifeng stood up and stood aside, looked at Cai Dongfan and Yang Yifeng, and thought to himself, could it be that Director Cai went to the river to watch the clouds and rain transpiring, and forgot to shine his shoes?So he was caught up in the department?

There were three people who came in, and the leader took out his police badge, and after identifying himself to Cai Dongfan again, he said, "That's right, Director Cai, we are from the Criminal Police Brigade, and we received the police yesterday, saying that it was Ben There is a missing child in Lu Township in the county."

"We searched for surveillance along the road, only to find that the child finally entered a small road into Mingcun, which was not monitored. We went into the mountain to search, and then found his body at the bottom of a slope!"

"And at about the same time, we checked all the intersections into the mountain, and found that only Luo Sangen rode a motorcycle into the mountain."

Speaking of this, the scalps of Cai Dongfan and Yang Yifeng suddenly went numb.

Cai Dongfan asked in astonishment: "Did the child get hit? Didn't he survive?"

Was the other child killed?I thought in my heart, if this is the case, it would be a crime!

Ding Meng closed his eyes for a while, and after he had stabilized his emotions for about five seconds, he said, "Whether the child was hit or not, it's hard to say right now."

"But when we found the child, he already had no vital signs. According to the forensic doctor's examination of the child's body, it was preliminarily determined that he should have died of excessive blood loss and multiple fractures all over his body."

"There are many abrasions on the whole body, and there are also blunt trauma to the internal organs!"

"It is possible that the injury was caused by accidentally falling off the cliff, but it is not ruled out that there were other injuries before falling off the cliff. We are currently checking the fingerprints."

"Currently the only suspect lives in your hospital. One of our colleagues asked about it, and he categorically denied seeing the child."

"As for his current condition, he does indeed need treatment, so it's not easy for us to take him back for interrogation."

"What I want to ask is, Director Cai, is this Luo Sangen seriously ill now? How long will it take for him to be discharged from the hospital?" Ding Meng did not explicitly say that the child was hit by Luo Sangen, but he almost pointed to it. at this point.

Cai Dongfan said: "His current situation definitely needs to be dealt with, and the sooner it is dealt with, the better."

"The only troublesome thing is that the patient is now asking for limb-salvage surgery, and our hospital can't do it, but we all recommend that the patient and his family members transfer to another hospital."

"They also felt that the medical expenses in the Affiliated Hospital of Shonan University were too expensive, and they refused to transfer to another hospital, so they dragged us to find a way."

"Then if you keep procrastinating like this, it's hard to say when you can be discharged from the hospital." Cai Dongfan explained his difficulties clearly.

Hearing this, Ding Meng frowned slightly: "Is there any other faster treatment plan for his current situation? We need to interrogate him in time so that the case can be closed!"

Cai Dongfan pondered: "If it's just to save life, an amputation can be performed, and the patient can be discharged from the hospital in a few days."

"But the attitude of the patient and family members is very clear, they just refuse to agree to the amputation!"

"Officer Ding, we are only doctors, and we cannot reverse the personal wishes of patients and family members. Therefore, it is difficult for me to give you an accurate answer." Cai Dongfan did not add too much personal emotion to it.

When he said this, Cai Dongfan had already figured it out in his heart. It is estimated that this patient did it on purpose, that he wanted to stay in the No. [-] Hospital, and he only chose limb salvage instead of amputation, which could save his life faster. delay.

Although I don't know what is the use of their delaying time, but there must be this purpose.

Hearing this, Ding Meng frowned fiercely and rubbed his head.Then he glanced at Yang Yifeng, and Yang Yifeng said to Cai Dongfan very sensiblely: "Director Cai, then I'll go out first."

Yang Yifeng knew that Ding Meng probably didn't want him to hear what he said later. In fact, he really wanted to eat this melon, but after all he was not in charge.

After Yang Yifeng left, Ding Meng covered the notebook and said to Cai Dongfan, "Director Cai, when we surveyed the scene, there were almost three such scenes."

"The first is where the child's body was, the second is where the motorcycle fell, and the third is where we found the broken bone."