medical simulator

"The patient's healthy upper limb is receiving intravenous infusion, so it is impossible to compare. However, the passive range of motion is within the normal range." Luo Yun explained to the patient after professionally completing the physical examination.

Zeng Yi, Li Changhong and the others breathed a sigh of relief when they saw Luo Yun demonstrating the speed of movement for them and adding explanations one by one.

After resetting, it is already very good to have such a good passive range of motion, at least we can look forward to it.

But when Zeng Yi was about to say something, Luo Yun's hand continued to move, and at the same time began to dictate:

"Finkelstein test uncooperative due to anesthesia."

When Zeng Yi heard this, the expression under the mask froze, what was Luo Yun talking about?What Finkelstein?

Cai Dongfan and Li Changhong also opened their mouths slightly.

And Luo Yun chose to continue:

"Kirk Watson sign (negative)."

"Lane-Kirk Watson sign (-)"

Luo Yun spat out two extremely professional terms again, and seemed to see the blank embarrassment in the eyes of Zeng Yi and others, while Zhou Cheng looked a little calm, as if he really understood.

Luo Yun instantly understood.

Experts will know if there is one as soon as they make a move. Joint surgery has its own very professional knowledge system and system.

Zhou Cheng's expression showed that he understood the location and purpose of his inspection. He really did his detailed homework, not some wild way.

Zhou Cheng's bottom was revealed.Luo Yun felt that there was no need to continue to embarrass Zeng Yi, Cai Dongfan and others, so he directly added an explanation in the following physical examination:

"Carpal radial and mid-wrist drawer test (-), there is no laxity in the mid-wrist joint."

"Medium wrist displacement test (-), no ulnar deviation of the affected limb."

"The fulcrum shift test (+), the planar structure between the cranium and lunate was restored."

"No relaxation and crepitus (-) in the Reagan test: no abnormalities in the planar structure of the lunate, triquetrum, and pisiform bone."

"Chris-Bain test (-), the stability of the lunate, triangular, and pisiform bones was restored."

"Piano key test (-): no dorsal subluxation."

"Radioulnar drawer test (-)"

"Sag test (-), no DRUJ (dorsal subluxation of radioulnar joint)."

After doing this, Luo Yun fiddled with it a bit, but he seemed to shake his head before turning his head and said: "Director Zeng, Director Li. There are also some other special signs. The patient currently has no pain, and the examination cannot cooperate. I think It’s time for the next step.”

"Do the directors feel the need to add anything?"

Luo Yun has his reasons for doing this. It is not just to show off his knowledge, but to improve Cai Dongfan. He is really a very professional joint surgeon. Our second orthopedic department can start to accept some joint surgeons. Surgical specialist patients.

Second, even though Zhou Cheng is just a small resident now, he has done manual reset for dislocated joints. In fact, in your heart, you are not sure whether Zhou Cheng's manual reset is good or not.

I can be sure, I don't mean sure, but really sure, because I am a professional.

The above are the results of the joint stability and stimulation test that I can do now after a systematic physical examination. These test results support my current argument.

As early as Luo Yun started to talk about a lot of awkward medical examinations, Zeng Yi and Li Changhong became nervous because they couldn't understand!

They are no rookies anymore, but as Luo Yun said, they are too professional.

For example, if joint surgery is a palace, Cai Dongfan and the others have only walked around the palace at most, and Luo Yun has lived in it, so when it comes to understanding it, it is naturally not as good as living in it. People are so familiar.

As soon as Luo Yun said this, Zeng Yi immediately looked relaxed for a while, shook his head and said, "I don't think there is any need to add, your physical examination is already detailed enough, let's use the C-arm X-ray."

Rao Zeng Yi's self-cultivation is not bad, when Li Changhong and him shirked responsibility before, he didn't scold his mother in his heart.

But at this moment, I also cursed in my heart, Luo Yun, let me add to your grandma and ancestors, you definitely did it on purpose...

"Changhong, Dongfan, do you think so?" The matter was more than half settled, Zeng Yi relaxed a bit, and naturally felt that the sword Luo Yun handed over cannot be picked up by himself, and I want you to feel it sharp.

Cai Dongfan immediately shook his head, blinking his small eyes, and replied: "What Xiao Luo said is what I think, the joint patients in our group were previously in charge of Xiao Luo."

After finishing speaking, Cai Dongfan felt that he had to speak more safely, and added: "Xiao Zhou also assisted in handling it."

"It depends on whether Director Li thinks there are other inspections that need to be supplemented?"

"After all, the patient belongs to Director Li, so it's not easy for me to do it for me."

Cai Dongfan felt good at the moment, this Luo Yun really gave him a face.

When Li Changhong called him before and said that Luo Yun didn't need to come again, Cai Dongfan actually had a problem in his heart.

You are in trouble, I sent someone to you immediately, and you still call me to say that I am not, did I perfunctory you?

These words are not easy to say, but at this moment it can be used as a metaphor, giving you a look and you can experience it yourself.

What is a professional?

The two people that Lao Tzu took care of were very professional.

Li Changhong didn't have the time to figure out what Cai Dongfan was hiding at the moment. As Cai Dongfan said, the patient belonged to him, and he just wanted to solve the patient's dislocation as soon as possible. The professor from the outer hospital was the solution, and the internal solution was also the solution.

Quickly said in a low voice: "Since Luo Yun is a professional, let's listen to the evaluation of professionals, push the C-arm, and see through."

"After the X-ray, the result is OK, so I'll explain it to the patient's family as soon as possible."

This is already a different kind of confession and convincing.

When Cai Dongfan heard this, he didn't want to say much. Zeng Yi immediately asked the roving nurse to prepare for X-rays, and then went to push the C-arm machine himself.

Seeing this, Li Changhong immediately volunteered to push the C-arm.

Call everyone out and go to the separate isolation room next door.

……

The fluoroscopy is very fast, and the result comes out in seconds.

After reading it, Zeng Yi breathed a sigh of relief, thinking that the post-operative plain film looks like what a normal person's wrist should look like.

But he didn't dare to speak first, but looked at Luo Yun and asked, "Luo Yun, is the result okay?"

Zeng Yi was also a little apprehensive. Luo Yun's previous physical examination could no longer be simply described as a professional. It can be said that Wang Yaoxiang said that he knew how to perform joint surgery.

After watching the flat film, Luo Yun pursed his lips and patted Zhou Cheng on the shoulder.

He cursed in a low voice: "What is the pestle doing here? You are the one in charge. No matter whether it is good or not, you have to give an explanation for the plain film after the postoperative review. Remember this habit in the future."

This is a habit in the large teaching hospital, that is, when Luo Yun was studying in the past.

Regardless of the results of the intraoperative re-examination, whether it is good or not, the surgeon must explain it first. To evaluate where a surgery is good and where it is not.

If you don't do well, you can tell it. Naturally, a professor will explain it to you.

Of course, if the professor at the top also finds that there is something wrong with his operation, then there is no way to do it. We can only bite the bullet and continue to do it together.

Such cases are rare, but they do happen.

This is an objective fact, and it is also a cruel thing.

Even my own teachers, including the team of academicians, including the world's top orthopedic team, will have cases and diseases that exceed the team's capabilities.

Less, but also present.

Zhou Cheng immediately gave an explanation: "Director Zeng, Director Li, Teacher Cai, Teacher Luo. I think the result of the reexamination is good, because you see, this is the DRUJ..."

After Luo Yun said so, Zhou Cheng took the initiative to explain the plain film of the postoperative review, and explained in detail which places to look at, and what is the use of looking at these places.

(Note 1: I can’t put the flat film, so I won’t explain the word count in detail. The professional physical examination above has shown its professionalism.)

(Note 2: If you have orthopedics-related professional friends, you can send the clips to pretend to be forceful, and ask what these are for. But I was asked back, and the author is not responsible for answering questions. Go to Baidu or check professional information by yourself and literature.)

(Note 3: Tsundere face.)

"Here, we can see."

Zhou Cheng quickly entered the 'status', instead of Zhou Cheng reporting to Zeng Yi and Li Changhong, the style immediately changed to Zhou Cheng giving lectures to four people.

Explain what joint dislocation looks like, and then what it looks like after reset. After the joint dislocation is reset, there will be differences from the normal joint structure due to edema.

Zhou Cheng spoke in too much detail, mainly to convince Zeng Yi and the others.

This is also learned from Luo Yun.

But after talking for a while, Luo Yun rolled his eyes again.

Touched Zhou Cheng, said: "It's almost done, why are you so blah? Get over it quickly, Director Zeng and Director Li still have their own affairs."

Luo Yun cursed inwardly, "Zhou Cheng, we're almost done. I'm just showing off. You're better off, just come to class as a teacher."

I only dare to click to the end. If you do this, it will backfire. Didn't you see that Li Changhong and Zeng Yi will soon reach the critical point of impatience?We are all subordinates after all.

Zhou Cheng immediately concluded: "Director Zeng, Director Li, I think we can tell the family members that we have succeeded in the conservative treatment."

This is what Li Changhong was waiting for. He didn't agree with the manual reset of joint dislocation in the department. He also estimated that this was the second joint dislocation patient in the Department of Orthopedics, and it would be the last one.

Where did he have the heart to listen to Zhou Cheng's persuasion, the reason why he listened politely and patiently was because Zhou Cheng treated him difficultly and did not dare to lose his temper as a superior doctor.

As the director, he can use the trick of drawing salary from the bottom of the pot.

But after all, Cai Dongfan was facing him face to face, so if he messed with Cai Dongfan like this, he would definitely not understand him.

He immediately said politely: "Okay, the rest is just another plaster cast, right? I'll call someone to put a plaster cast on right away."

Zhou Cheng has helped so much, even if Li Changhong thinks he is the director again, it is not easy for Zhou Cheng to do the finishing work of plastering.

Wang Yaoxiang and others are doing emergency surgery, just call anyone to put on a plaster cast.

Zhou Cheng scratched his neck and said, "Director Li, let the patient's family members buy a wrist brace online? Plaster is not easy to use."

Although gypsum is a basic and practical auxiliary tool in orthopedics, the fact that it is widely used does not mean that it is easy to use.

For joint fixation, the best thing is to customize the brace. Customizable braces are too expensive, and you can buy retractable braces online. (I hope that the knowledge points that book friends will not use.)

"Okay!" Li Changhong nodded hurriedly.

Wrist braces, he still knows.

Fractures of the upper limbs, there are also finger braces instead of plaster casts made of aluminum plates...

That means there is nothing to do, and the matter is over.

Luo Yun took the initiative to take Zhou Cheng away, while Li Changhong went into the operating room and told the patient the good news first.

The patient was stunned for a moment, then she was shocked and disbelieving at first, but immediately burst into tears with excitement. She really didn't want to have an operation. Like a roller coaster.

Now, although she was told that she could not have the operation, she felt that Li Changhong was simply too inconsistent, but this was a good thing, and she would naturally not be concerned about Li Changhong's face-slapping thing of saying that he would have an operation, but not having it... …

Zeng Yi left with Cai Dongfan, leaving before Luo Yun and Zhou Cheng.

After going down to the dressing room downstairs, the two of them didn't change their clothes, but hid in the 'relaxation room', and each of them ordered a stick, wanting to relax.

Today, because of this patient, whether it is Zeng Yi or Cai Dongfan, it is quite a headache.

There was no one in the smoking room at the moment, so Zeng Yi moved a stool, leaned against the doorknob to prop it up, sat on it, held a cigarette in his left hand, and kept flicking it back and forth on the ashtray.

Then he looked at Cai Dongfan and said, "Dongfan, it seems that Professor Ding called me and said that we should routinely carry out conservative treatment of fractures and dislocations. Our department may not be able to get involved. Please help me relay it to Director Yan at that time." , this matter may have to be handled by you in the Second Department of Orthopedics.”

"After all, your department still has the brand of joint surgery. It's not that we don't want to help Professor Ding."

Speaking of this, Zeng Yi pecked hard again, and then said, "Professor Ding, I'll call him and explain myself."

Zeng Yi didn't say clearly that he actually wanted to take advantage of Cai Dongfan's popularity. Although he meant that, he couldn't say that.

Cai Dongfan nodded naturally. He never thought that the Department of Orthopedics would do dislocation of upper extremities with manipulative reduction and conservative treatment of fractures. The reason why he mentioned Zeng Yi and Yan Haihan was mainly because he hoped that they would agree to his group to do this matter.

It was Zeng Yi and Yan Haihan who insisted on interfering.

"Okay, Director Zeng, I will tell Director Yan about this." Cai Dongfan didn't gloat.

Although the orthopedics department is divided into departments, and each department is divided into treatment groups, they still break the bones and connect the tendons, and all are prosperous.

If something happened to Zeng Yi today, the hospital would definitely suspend all conservative treatments in the orthopedics department.This is not what Cai Dongfan wants to see.

Zeng Yi nodded, took a long breath, and the smoke in front of him was like an arrow.

His eyes were rather profound: "Dongfan, Luo Yun in your group, and Zhou Cheng, are rare talents."

"The joint surgery department of our eighth hospital is currently in a rather blank state. Only Director Wang's group will occasionally receive some joint replacement patients. Neither Li Changhong nor I have such energy to be distracted. For spine and upper limb patients, just That's enough of a headache for us."

"You have to take good care of these two people, maybe they can give our hospital a good start in joint surgery."

"Now the major hospitals in Shashi are highly competitive, and simple fracture surgery is becoming more and more routine in the province, and there are almost no fracture patients transferred. Our two departments do not have too many patients today."

"We have to find patients by ourselves, and make full use of the sources of diseases in outpatient clinics. It can also save them from traveling."

Speaking of this, Zeng Yi asked calmly: "Does Luo Yun intend to develop with Professor Ding? You can talk to Luo Yun in private about this!"