medical simulator

In the process of walking towards the mediation room, Mao Yuxuan suddenly felt a little dignified.

Then when Zhou Cheng was about to open the door, Mao Yuxuan pulled Zhou Cheng back, and frowned his short eyebrows between his brows: "Zhou Cheng, can you handle it alone? There won't be any problems, right?"

"This patient is difficult to deal with."

Zhou Cheng smiled and said, "It's okay, Mr. Mao."

"By the way, Mr. Mao, the chief resident has the normal authority to diagnose and treat, right?"

Zhou Cheng first asked clearly in advance that if ordinary I and II operations in the Ninth Hospital required special authorization, then he would have to deal with it separately.

"You are currently in the general hospital, and you can decide the right to perform level I/II surgery on your own. However, for some more difficult level II operations, you still need to ask the higher authorities for permission."

"what are you going to do?"

"This patient didn't bleed, didn't he have emergency surgery?" Mao Yuxuan's brows twitched, and he suddenly had a bad feeling.

However, Mao Yuxuan still couldn't believe that Zhou Cheng would send this patient to the operating room for surgery.

As far as fractures are concerned, as long as they are not open fractures and there is no damage to blood vessels and nerves, they are all elective surgical treatments.

Zhou Chengcheng went into the mediation room, and after he went up, he first reported his identity: "Hi, I'm an orthopedic doctor, may I ask if you were careless before..."

Zhou Cheng is very experienced. He was a general inpatient when he was in No. [-] Hospital before, and he also encountered many patients with fractures.

So, he knows how to greet such patients.

Even though there are regional differences between the patients in Modu and Shashi, the patients' psychology should be similar.

When the patient heard this, he immediately stood up and began to curse: "What are you doing, I've been here for almost half an hour, you know."

"Hey, how can you be such a doctor?"

"No one came to see it, just call me and tell me to go to another hospital..."

After patiently listening to the patient's complaints, Zhou Cheng took the initiative to interrupt: "Auntie, we are not driving you to another hospital, but to inform you of the situation in our hospital in advance."

"Now all the beds in the ward are full, we are doctors, we can't drive people away."

"Then we must tell you about this situation. We can't. I will tell you after you have decided to be hospitalized and all the examinations and other procedures have been completed. We have no beds here, so you can't stay in the hospital."

"Then how wronged are you? Do you think I'm justified?"

To be honest, Zhou Cheng seldom said this kind of thing. When he was in the No. [-] Hospital, the patients were dissatisfied and the source of disease was far from enough. Wherever there would be no beds, there were only a few times.

When the patient heard Zhou Cheng's words, he still said, "Then you are such a big hospital, can't you make an arrangement?"

"Look, look, look, there are thousands of employees in such a big hospital."

"Ouch, ouch, ouch." Perhaps because of emotion, she touched the broken bone and began to moan.

Zhou Cheng hurriedly said: "Auntie, don't worry, the injured body is your own when you are angry, is this good? I haven't seen your condition before, let's see how it is."

"Then, according to the specific situation, the subsequent processing and analysis will be carried out."

"We see the doctor face to face. I only heard about your situation on the phone before. Although the times are developing rapidly, it has not yet developed to the level of technology such as online medical treatment. What do you think?"

The patient only cared about his painful hand, and Zhou Cheng took the opportunity to look at the plain film.

Mao Yuxuan also stretched his neck, and after seeing the results of the plain film, he frowned slightly.

Double fractures of the radius and ulna, and there are bone fragments, which is not easy to deal with.

This is the middle limit between indications for manual reduction and indications for surgical reduction. According to the guidelines, the mode that should be dealt with in such a situation is——

After manual reduction, switch to surgical reduction.

But what is a little difficult is that the manual reset failed, and there are no beds in the department.

According to Mao Yuxuan's own experience, the success rate of manipulative reduction for this patient is only about 20.00% to [-]%. If it is a small hospital, it may be treated directly according to the surgical indications.

"Auntie, there are two ways to deal with your situation..." While Mao Yuxuan was still thinking, Zhou Cheng had already started communicating with the patient.

But when Mao Yuxuan heard that Zhou Cheng said that the patient could try manual reset, Mao Yuxuan's brows twitched fiercely.

Just as he was about to speak, Zhou Cheng glared at him. Mao Yuxuan was startled by this warning look.

It was the eyes warning Mao Yuxuan to understand the rules and not to overstep at will.

Such eyes usually only appear in the teacher Huang in the group, and Teacher Huang is the associate professor in the group.Du Ge's attitude towards himself has always been very friendly and easy-going.

MD?

Mao Yuxuan was a little terrified, and held back all his words.

What do you like!

Soon, Zhou Chengcheng settled with the aunt.

Then Zhou Cheng printed the informed consent form and gave his aunt a doctor's order, but it seemed that the doctor's order here was different from Zhou Cheng's previous doctor's order in the No. [-] Hospital.

So after consulting Mao Yuxuan, I reset the method and opened it, and asked my aunt to scan the code to pay the fee.

Zhou Chengcheng got ready.

When Zhou Cheng was about to start the operation, Mao Yuxuan wanted to speak again, but Zhou Cheng pushed him back with his eyes, and then Mao Yuxuan completely gave up struggling, pretending to be dead all the way, pretending that he didn't see anything, nothing hear.

Anyway, it was Mr. Zeng who called, anyway, Zhou Cheng is now in the 'general hospital', and Zhou Cheng is responsible.

No matter how bad it is, there is an old Zeng behind him. As for whether Zhou Cheng is dead or not, it has nothing to do with him.

He has fulfilled his responsibility.

After the reset and the plaster cast, Zhou Chengcai said to the aunt who was in pain and was about to cry: "Auntie, it just hurts for a while, eh, now after the plaster cast, it won't hurt so much."

"I'm not lying to you, right? When the manipulation is reset, there is a little pain. In fact, it can be done without pain at all. I told you before the operation."

"If you want no pain, let's go to the operating room and get a nerve block anesthesia. You also find it troublesome. And, I didn't lie to you before, there is pain, but it's very limited, right?"

"If I didn't tell you about the pain in advance, if I told you that there was no pain at all, I would be lying to you."

Zhou Cheng explained that at the same time, he showed his aunt that he is completely in control of the disease and all the processes, which will give the patient a sense of trust. If you are a doctor, you always ask the patient what to do and what to do .

Then she will panic.

Although the choice is for the patient to choose, the pros and cons are for the doctor to say, how to say, what degree, and whether he can explain clearly and do it clearly.

The treatment process is the same as the preoperative communication, which is the source of peace of mind for patients.

The aunt took a deep breath, and then took another breath, before saying, "Little doctor, you cured me before my husband came."

"This fracture is too painful..."

Zhou Cheng: "..."

Mao Yuxuan: "..."

What is this all about?

Soon, my aunt was sent for a review of plain X-ray films.

The treatment of fractures is the same no matter in all places. In principle, after the treatment is completed, a re-examination should be done to evaluate whether the treatment effect is up to standard.

Only now did Mao Yuxuan come forward and touched Zhou Cheng: "Do you know what you were doing just now?"

Zhou Cheng turned around, looked at Mao Yuxuan strangely, and nodded: "I know, Teacher Mao, didn't I ask you?"

Zhou Cheng finds it very strange that his current status is to replace your chief inpatient, and he is polite to you because he hopes that everyone will get along well.My current authorization and positioning are the same as yours.

Manipulative reduction of fractures is a type I operation, and I can't decide yet?

"Where did you ask me?" Mao Yuxuan's short eyebrows twitched again.

"Mr. Mao, you said that the general hospital has the right to diagnose and treat routinely. This case is a double fracture of the radius and ulna. Closed reduction and plaster external fixation are multiple options for treatment." Zhou Cheng deliberately concealed the condition.

Because in fact, strictly speaking, this patient's fracture is a multi-segment fracture, and it also belongs to the category of comminuted fracture, which is not in the ranks of strict closed reduction.

However, Zhou Cheng felt nothing.

Mao Yuxuan looked at what Zhou Cheng said as a matter of course, and his eyes widened: "Xiao Zhou, have you understood the film?"

"The treatment of double fractures of the ulna and radius is multiple closed reduction and plaster external fixation. However, it also depends on the type and the specific situation. The indications for surgery are..."

Mao Yuxuan is a very solid and down-to-earth person, otherwise it would be impossible to be the chief resident of trauma surgery in the Ninth Hospital.

It is the basic operation to memorize the conventional indications and apply them flexibly.

Zhou Chengcheng smiled and said: "Mr. Mao, yes, I know, but you can also try it. After all, the failure of manual reset is the sign of surgical adaptation."

After listening to Zhou Cheng's words, Mao Yuxuan felt creepy.

Because from the beginning to the end, he didn't perceive from Zhou Cheng that Zhou Cheng wanted the patient to undergo surgery.

Zhou Cheng definitely rushed to reset his skills from the very beginning.

"you?!"

Mao Yuxuan took a deep breath, "Xiao Zhou, when we are clinicians, it's better to be steady than anxious and eager to show off."

"I know how you feel now, and I really hope to gain my approval, and I really want others to know that you are very capable."

"You even felt my vague hostility towards you."

"However, we are doctors, we have to be more objective."

"If you made such an outrageous decision so rashly because of me, then I can apologize to you."

"Medicine is not a discipline to be pissed off."

Of course, medicine is not a subject of anger, but Mao Yuxuan's frankness makes Zhou Cheng feel that this teacher Mao with short eyebrows is not so short-sighted.

And it's quite generous.

This made Zhou Cheng look at Mao Yuxuan again: "Mr. Mao, why don't you say these words after seeing the patient's reexamination film later?"

Review?

What could be so good about this?

It's not that Mao Yuxuan has never done manual reduction of fractures. Moreover, when he was first admitted to the general hospital, he realized that the operations he could perform were very limited, so he studied alone for a period of time.

It's just that Mao Yuxuan's thinking at the moment is like this.

When that aunt, with her husband hugging her very "caringly", walked this way, Zhou Cheng quickly refreshed the background of the film reading on the computer.

Nowadays, in large tertiary hospitals, the image reading systems are all connected, so the report may not be out yet, but once the inspection is completed, the inspection results will be available here.

Zhou Cheng scanned it a few times before giving up his seat.

"Ms. Mao, would you like to evaluate the postoperative plain film?" Zhou Cheng issued a formal invitation.

Mao Yuxuan didn't care about it at first, but after sweeping his eyes on the flat screen, his eyes suddenly became straight, and his pupils expanded at a speed visible to the naked eye...

Then I sat down on the stool, held the mouse in my right hand, and slowly dragged the flat film up and down, zooming in and out deliberately, looking at the details.

The aunt and her husband who loved her very much raised their heads and couldn't understand, so they asked Zhou Cheng: "Well, doctor, how is my wife's fracture?"

"Where's the medical record? It's the one I wrote before." Zhou Cheng didn't answer, but asked.

The patient and the aunt quickly brought the emergency medical records, and Zhou Cheng continued to write on it the precautions after returning.

"There are a few things to pay attention to. First, don't get hurt and pay attention to protection."

"Second, remember to come for a re-examination. After two weeks, one month, or two months, you must come to the clinic for a re-examination."

"third……"

Zhou Cheng explained while writing, and after both his aunt and uncle understood, they turned their heads and left.

When leaving, the aunt asked a little reproachfully, "Why did I arrive at the hospital so late? I'm dying of pain."

"I want to ask for leave, and then I rushed here without waiting for the boss's consent. There was a traffic jam, you know that."

"Does your hand not hurt now?" The man took extra care.

"it's better now."

"This won't affect your work, ouch, the doctor here told me that I'm going to have an operation and I won't be able to stay in the hospital. It scared me to death."

……

Listening to the conversation between the two, Zhou Cheng only found it a little funny.

How should I put it, auntie, it's a little pretentious, but it's okay, it's not unreasonable.

Uncle, he dotes on his wife a bit, but he's still a good man.

After the two of them had walked a long distance, Mao Yuxuan just finished watching the plain film of the postoperative review, and then looked at Zhou Cheng with a strange look.