My Medical Skills Give Me Experiences

My medical skills can add experience points Chapter 121 Desperate opponents, Doctor Shan, let me try

I don't know how the patient was treated yesterday?

Didn't even switch back to the original bed afterward. Based on feeling, things may be more serious.

"Today I was going to arrange three of you to help in another operating room. There are two important operations that need to be taught, so let me take you for a day. My surname is Shan, and I can currently preside over the first and second levels independently. Orthopedic surgery, participated in many tertiary orthopedic surgeries, and completed the difficult part.”

Doctors who do well seem to have a common skill.

That is 'bragging'.

These days, it’s impossible not to brag. Once the patient hears how good you are and how many difficult operations you have done, he will trust you. Let you have surgery with confidence.

"The principle I follow is that those who are capable go up, and those who are mediocre go down. If you are capable, you can strive for opportunities to exercise at any time. As long as you perform well, I will give high marks. The ugly words are up front. It is not allowed to rush to practice on the patient. You did too badly, and I will not give you another chance to practice next time."

Doctor Shan first explained the competition rules to the six people.

Sounds good, fair and square.

"Next, please look at the X-ray taken by the first surgical patient today. I will give you five minutes to watch it, and then you will give your diagnosis and treatment plan. Learning to read the film is the first thing you have to do. Allow Quick answer."

As soon as she finished speaking, the assistant turned on the optical film amplifier.

A light curtain appeared on the wall.

Four x-ray pictures are shown above.

Looks like it should be the right foot bone.

Taken from multiple angles.

The patient's big toe phalanx was significantly deformed.

While Zhou Can marveled at the advanced hardware facilities in the orthopedic surgery operating room, he was also carefully observing the patient's foot bone radiograph.

Severe varus deformity of the big toe phalanx should be born or caused by some special reasons in the day after tomorrow.

The healing line after the fracture cannot be seen.

It's almost certainly a congenital malformation.

Then the patient is probably not here to be treated.

Zhou Can continued to watch carefully.

At this time, someone has already started to rush to answer.

"These four X-rays should be the patient's right foot. It can be clearly seen that the phalanx of the big toe of the right foot has a relatively serious deformity. This will affect the patient's walking. I think surgery can be performed to correct it."

When the man rushed to answer, his face was full of excitement.

Thought to come out on top.

As a result, after he finished speaking, Doctor Shan didn't say anything.

Zhou Can got a lot of guidance from Dr. He yesterday, and his level of watching movies has improved a lot.

He found a slight fracture of the patient's right foot's first bone, near the navicular bone.

"should be…"

"I think…"

Zhou Can and another Gui Peisheng spoke at the same time.

In the end, Zhou Can generously made a humility gesture, "You answer first!" The Gui Peisheng was also polite.

After all, it is related to whether orthopedic surgery training in the next three months can stay in the operating room.

This has a great impact on future career development.

"I think it is a mild fracture of the first bone of the right foot! This does not require surgery, and a plaster cast can be used for about 42 days."

If the fracture is not serious, it is perfectly capable of healing on its own.

The younger you are, the shorter the healing time.

Children's bones heal the fastest and have a high degree of stability after healing. Older adults heal the slowest.

Judging from the picture, this is the foot bone of an adult.

After 42 days of recuperation with a plaster cast, the treatment advice is very reasonable.

"Zhou Can, now you can speak."

Doctor Shan actually remembered his name.

And it was fair to him and didn't suppress him.

This surprised Zhou Can.

Many women are narrow-minded. I offended her a lot yesterday, but I didn't expect that she didn't care about it.

"The previous opinion is the same as what he said, including treatment recommendations. Then I add that the big toe bone is a congenital deformity, and the patients are all adults, so the willingness to treat should be very low. And when the patient walks, he should have adapted to this condition. Deformity. I do not recommend surgical correction."

"The Reborn Financial Giant"

The advice given by Zhou Can is obviously more comprehensive than that of the previous man.

It is also more comprehensive and in-depth.

"Well, both of your answers are correct. Zhou Can's answer is more comprehensive, and he considers the treatment plan from the patient's point of view, which is very good."

Doctor Shan probably didn't want to praise him.

But her performance is indeed excellent, she can't boast.

"Will anyone put a plaster cast on this patient?"

"I can!"

"I can!"

All six can do it.

Putting plaster is relatively simple and easy to learn. Even if they didn't learn it before entering the orthopedic surgery department, they must have learned it after spending a day in the inpatient ward of the orthopedic surgery department yesterday.

However, in only one day, I only learned the most basic operation methods.

Only some simple operations can be performed.

"You are the first person to get the answer right, so I'll let you operate it! Dr. He, take him there, and make sure he's locked up."

Doctor Shan said to one of the assistant doctors.

Zhou Can knew Dr. He.

It was the doctor who taught eighteen of them to fill out the registration form in the office yesterday.

"Look at the profile of the second patient!"

As soon as Dr. Shan finished speaking, the smile on Gui Peisheng's face froze instantly when he grabbed the cast assignment.

During the time he went out to put plaster on the patient, he would definitely lose a lot of opportunities.

Sure enough, as Dr. Shan said, everyone has equal opportunities.

Two new films appeared on the light curtain.

This time it was not an X-ray, but a B-ultrasound.

From the looks of it, it appears to be the knee.

Looking at the B-ultrasound images, Zhou Can got a lot of exercise in the emergency department. He was taught by a master like Dr. Xu.

Naturally, his ability as a disciple of the mantle is not bad.

It's easy to see where the problem is.

"The patient should have effusion in the right knee joint cavity, and it is quite serious. It is recommended to take out the effusion by puncture, and then inject medicine into it for treatment. The preferred medicine is hyaluronic acid, such as sodium hyaluronate."

At this moment, Zhou Can finally understands what it means to have accumulated a lot.

The accumulation of practice in the emergency department, coupled with the medical knowledge he has learned from reading medical books, has become his weight ahead of other regular trainees.

The other four Gui Peisheng looked at him, all dumbfounded.

Depend on! Is this really Gui Peisheng?

Why do you feel that Si's ability to watch movies is better than that of the attending physician?

It was really bad luck for their group to meet such a 'monster'.

In today's competition in the operating room, there is a high probability that they will be beaten by Zhou Can.

"correct answer."

When Dr. Shan looked at Zhou Can, the surprise in his eyes couldn't be blocked even by her black-rimmed glasses.

Gui Peisheng in the emergency department really lived up to his reputation.

Now she seemed to understand why Director Shen had that expression when he heard Zhou Can's name.

Director Shen must know what Zhou Can is capable of.

"The treatment of this patient is a bit special. It requires bone cavity puncture, which is extremely difficult to operate. Not to mention you, even I need to be careful to make the puncture successful. You just need to watch carefully and learn the operation steps in a while."

The patient came in quickly.

This is an old lady with white hair, her left knee is swollen as thick as her thigh.

It looked scary.

When he pushed in, he kept calling "ahhhhhhhhhhhhhhhhh".

This kind of joint pain is very tormenting.

It is not the kind that can kill people instantly. It's like a blunt knife cutting flesh, slowly torturing people until their will collapses.

"Grandma, we will treat you right away, please sit down and keep this position still."

For the puncture of the knee joint cavity, it is best to treat the patient in a sitting position.

This makes it easier to select the puncture point.

"Here, all of you come and take a look. The puncture point is at this location."

Dr. Shan drew the puncture point with a pen.

"This puncture point is not the only puncture point. According to the actual situation of the patient, the inside or outside of the lower patella can be used as the puncture point. If the puncture is from the outside, it should be this position."

She taught very carefully.

Kazusuke, who looked twenty-eight or nineteen years old, should be a resident doctor. It seems that he has already mastered the task of puncturing the knee joint cavity. He just watched from afar.

Didn't get close.

"After finding the puncture point, first use a 5mL syringe to puncture the joint cavity from this part. Until there is a breakthrough feeling, it means... er, the puncture is successful only if there is a breakthrough feeling."

Her expression froze for a moment, and the syringe puncture in her hand seemed to have encountered obstacles.

"Ah yo...Girl, lightly lightly..."

The patient screamed in pain.

Doctor Shan couldn't help but blush.

When is Kuang Piao bad? It had to be when she was teaching Gui Peisheng.

Isn't this deliberately embarrassing her?

The resident doctor seemed to see the predicament of Dr. Shan, and hurried forward to help.

"Doctor Shan, we men should be stronger, let me try!"

When he said that, he was obviously taking care of Dr. Shan's face.

Help her out.

"The puncture of the knee joint cavity is not easy to succeed. It is a second-level operation. Be careful and don't do it recklessly."

She was very grateful to the male doctor for his rescue.

He also took the opportunity to step aside.

The male doctor took the syringe, changed the needle and punctured again.

"Um…"

The blue veins on the male doctor's hands are showing, and he must have quite a lot of strength. The old lady screamed in pain, even the tone of her voice changed.

"Pain, pain..."

She patted the armrest of the wheelchair repeatedly.

Might have really stung her.

If it didn't hit, it hit the periosteum, and the pain would definitely penetrate the bone marrow. No one can stand it.

"Doctor Tang, take a break first, let me do it!"

Dr. Shan dared not let his resident doctors operate again.

She looked at the patient's film again, and said with a little embarrassment, "Maybe the patient's joint disease is more serious, and the difficulty of puncture is also doubled. But it doesn't matter, it's the same if we switch to the outside of the patella."

She replaced the needle with a new one, and while comforting the patient, she identified the puncture point on the outside, and then performed the puncture.

"Well…"

Judging from her expression, she must be cursing in her heart, why the **** is she stuck again.

Zhou Can has been standing by and watching.

He also watched the film taken by the patient.

Just B-ultrasound, there is no way to clearly show the bones of the knee.

As Dr. Shan said, the patient's joints may have serious lesions, so the normal puncture point will not work when punctured.

After Dr. Shan tried it twice, his face turned red and he was sweating profusely.

When teaching, one mistake was enough to embarrass her.

Who would have thought that changing to the outside puncture would still fail.

This is just a preliminary puncture.

It's really embarrassing.

"Doctor Shan, I happen to have practiced piercing too, why don't you let me try it!"

Zhou Can's injection skills are as high as level 4, and the attending physician is at an intermediate level.

When I got injections before, I thought that this medical skill might not be very useful.

I get it now.

Its use is not only for injection, but also for puncture.

Lumbar puncture, thoracic puncture, crest puncture... all kinds of puncture work should be controlled by the operating room planner.

When I was studying in school, there were often teachers who bewitched students to learn physical chemistry, and they were not afraid to travel all over the world.

Now, Zhou Can wants to tell all the doctors that the injection technique is well practiced, and all kinds of punctures are just one needle.

Doctors who need two, three, or even more times for puncture to succeed are all poorly trained in injection techniques.

Doctor Shan didn't know how to step down at this moment.

It has failed many times, so if you bite the bullet and puncture again, it may succeed. It is more likely to fail.

At that time, the face will be even uglier.

She was considering whether to ask someone to come and help.

Zhou Can took the initiative to invite Ying. Although she didn't hold out any hope, it was always a good thing that someone rescued her.

Otherwise, the first surgery patient will let her lose face, how will she teach this group of regular trainees later?

They dared not laugh at her in her face.

There is still no way to point out how to criticize it behind the scenes.

"You operate carefully, if I tell you to stop, you must stop immediately."

She exhorted a little worriedly.

"OK!"

Zhou Can took the syringe and replaced it with a new needle.

It must be said here that after the needle puncture is unsuccessful, it is best to replace it with a new one.

The main purpose is to avoid the introduction of bacteria, leading to infection of the originally sterile joint cavity. In case of infection caused by puncture, the consequences will be serious.

A needle doesn't cost much.

Anyway, it is counted in consumables.

I saw Zhou Can touched the patient's joints, and then inserted a needle.

"laugh!"

After the needle of the syringe plunged into the cortex, it encountered an obstacle and pierced quickly.

The puncture was successful with one needle.

"This, is the puncture successful?"

A few regular trainees watching, including nurses. The resident doctor, Dr. Tang, was all quiet.

He held his breath.

Waiting to see the results.

Dr. Shan's small eyes widened in an instant, until she saw clearly that the needle had penetrated deeply into the skin, and then she was sure that Zhou Can's injection was in place. The puncture of the knee joint cavity was easily completed.

"What a cow!"

Someone whispered admiration.

Several Gui Peisheng felt hopeless in their hearts. Competitors are outrageously strong, how can they compete?

Fortunately, there are six places in the operating room.

What they hope most is that among the eighteen Gui Peisheng, there is only one monster, Zhou Can.

"Don't move, let me check!"

She squatted down, and after careful inspection, she showed an expression of disbelief.

Actually, the needle was in place and the puncture was successful.

"Well, well done. After the puncture enters the knee joint cavity, the joint effusion inside needs to be pumped out first."

She demonstrated the operation herself.

"After pumping out the joint effusion, inject about 10ml of 0.25% lidocaine."

The purpose of injecting anesthetic is to facilitate subsequent treatment.

"This medicinal solution contains about 5mg of triamcinolone acetonide. It mainly injects the patient's pain points. Then it helps the patient to move the knee joint so that the medicinal effect can be fully exerted."

Doctor Shan kept observing the patient's reaction.

The drug effect should have worked, and the patient no longer complained of pain.

"Grandma, your treatment will be divided into five times. Come back to the hospital for the second treatment in a week."

she said to the old man.

The old man felt no pain in her knee now, and she seemed very happy.

"Thank you, thank you!"

The old lady thanked Dr. Shan and Zhou Can repeatedly.

Although she is old, she can tell who cured her.

"Girl, I'm getting old and my memory is bad. Can you tell my son again later, can you?"

"Okay! We will tell your son later!"

After the patient was treated, he was pushed out of the operating room.

Doctor Shan glanced at Zhou Can, and then glanced at the other Gui Peisheng.

"This kind of treatment is generally divided into five times. The first two times are the injection of the medicinal solution just now. The third time starts with the injection of the sodium hyaluronate that Dr. Zhou Can said. The difficulty in the treatment should be the puncture of the joint cavity. You need to do it yourself. Watch more, think more, practice more."

Thinking of the joint cavity puncture just now, she was still a little embarrassed.

Until now, she didn't know why the punctures kept failing.

Usually this rarely happens.

If you ask Zhou Can directly, even if you kill her, you will be too embarrassed to say so.

But this is not a problem for her cleverness.

"Doctor Zhou, please share with us the successful puncture experience just now."

"OK!"

Zhou Can glanced at Dr. Shan meaningfully.

Zhou Can naturally knew her little Jiujiu well.

I also secretly admire Dr. Shan's speaking skills in my heart.

Yesterday, Director Shen spoke very well of leadership skills, and the apprentices brought out by Director Shen are naturally not far behind.

"I was able to puncture successfully. First of all, it must be mostly luck. Then, as Dr. Shan mentioned, the patient's joints have lesions, which may lead to some changes in the bones, and even serious distortions. So I touched it with my hand, and I found her. The joint cavity is narrowed. When puncturing, deliberately choose a position close to the midlateral line."

Zhou Can rolled up his trousers and showed everyone a demonstration.

After Dr. Shan finished listening, he couldn't help but suddenly realized.

I see.

No wonder patients who encountered such severe joint lesions failed several times in puncture.

Every patient's joint disease is different.

The old lady just now should belong to one of the rarer types.

Zhou Can said it modestly, saying that it was mostly luck.

In fact, she knew in her heart that he was taking care of her face without any trace.

Her affection for Zhou Can has also improved a lot because of this.

"Okay! Thank you Dr. Zhou Can for sharing. Let's move on to the examination report of the third patient."

The patient's examination images displayed on the light curtain are examined by two types of examinations: MRI of the hand bones and X-ray films.

Generally speaking, the price of MRI examinations is not cheap, and doctors with a little professional ethics will not prescribe such examinations to patients at will.

Only when the etiology is unknown, or when the doctor thinks that further examination is necessary ~www.readwn.com~ will this examination be prescribed.

And when it is prescribed, it will be discussed with the patient.

Ask the patient for their opinion.

The inspection report showed that it had been four or five minutes, but no one answered.

Because the patient's condition is very complicated.

After two rounds of rushing to answer, everyone understood the truth that it is better to answer well than to answer early.

"Can no one understand?"

Doctor Shan seemed quite happy.

Finally, she has the opportunity to reshape her authority and chief surgeon status.

This group of regular trainees can't understand, she will explain later, which can show that her level is very high.

There was an embarrassment during the puncture just now, which was somewhat embarrassing.

"I only see that the patient's extensor tendons are ruptured, and the patient's joints seem to be accompanied by rheumatoid arthritis?"

Zhou Can was also a little uncertain.

This question involved the knowledge of orthopedics, so it was a bit embarrassing for him to answer this question from a small trainee.

"I also think it's a ruptured finger extensor tendon from rheumatoid arthritis."

Another Gui Peisheng echoed Zhou Can's opinion.

It is estimated that he, like Zhou Can, is not quite sure.

Rheumatoid arthritis in the hand is very harmful, and it can easily cause finger extensor tendon rupture.

Many patients do not lift heavy objects or perform dramatic movements in their daily lives.

There was a "chi la" sound, like a rag was torn.

Then there was severe pain in the hand and I lost the ability to grasp it.

How painful can this pain be? It's just that the strides are too big, and the crotch is pulled, that kind of severe pain like tearing. And it was a persistent, severe pain that was unbearable.

In this case, most likely the tendon is torn. +Bookmark+