When doctors have a simulated operating room

The patient was still alive, but the doctor was still alive.

Zhang Yi was too lazy to pay attention to Chen Feng. The doctor from the Department of Nephrology came to consult.

The emergency department admitted a patient with abdominal pain. When the ambulance was pulled over, his face was pale with pain.

He had a history of kidney stones, so it was not ruled out that this was a recurrence of the old disease.

"Where is the patient for consultation? Take me there to see him."

The doctor who came to consult the Department of Nephrology was Bai Tang, an attending physician, and it was said that he would soon take the examination for deputy director.

Chen Fang understood and hurriedly took people to the emergency room.

"53 years old, reported left side waist pain for a week, aggravated with chills for 1 day, and emergency hospitalization with aggravated waist and abdominal pain two hours ago."

"He had a history of open left kidney parenchyma incision and stone removal surgery ten years ago, extracorporeal shock wave lithotripsy three years ago, and elevated blood sugar a year ago, but never went to a regular hospital for treatment. Currently, CT and B-ultrasound have been done, and the test results will be out soon."

In front of the rescue bed, a male patient was lying on the bed and groaning in pain.

Another emergency doctor, Xu Yuanjian, reported his situation to Bai Tang.

After listening to Xu Yuanjian's report, Bai Tang immediately nodded and began to conduct some basic medical consultation and palpation on the patient.

In Zhang Yi's sight, the patient's hospitalization this time was far more than just a relapse of the old disease.

Although there was only abdominal pain on the left side, stones appeared in both kidneys, accompanied by water accumulation, and obvious gas accumulation in the renal pelvis.

If Zhang Yi remembered correctly, this should be a very typical emphysematous pyelonephritis.

It is necessary to perform ureteroscopy and left ureteral stent placement immediately to drain the accumulated gas and water, otherwise the patient will be in danger!

"It should be stones and inflammation. You should bear it for a while. You can go to the operating room after the test results come out." Bai Tang comforted the patient on the bed.

"I think you should notify the Urology Department. He is in so much pain that it should be stones. He needs surgery."

Just as Chen Fang was about to call the Urology Department, Zhang Yi stood up and said, "Teacher Chen, I think this patient is not only suffering from a relapse of the old disease, but the relapse of the old disease is not so serious. I feel like it has developed into pyelonephritis!"

"Ah?"

Chen Fang was slightly stunned, and then watched Zhang Yi walk to the patient and stretch out his hand to press on the patient's left abdomen.

"It's very hard, not like the palpation of stones." Zhang Yi said while pressing, "It is likely to be gas accumulation!"

"Gas accumulation? Do you mean emphysematous pyelonephritis?" Bai Tang was the first to react.

At this time, the examination report of this patient also came out.

Ultrasound: bilateral kidney stones, hydronephrosis of the left kidney, and dilatation of the upper left ureter.

Routine blood test: WBC 24.3×10^9/L, neutrophil ratio 84%.

Routine urine test: WBC++.

Blood sugar: 15.6mmol/L.

A trace of surprise flashed in Bai Tang's eyes: "It's really emphysematous pyelonephritis!"

Chen Feng, who was following Bai Tang, was also stunned, and then he held his mouth with disdain.

Tsk, what's the big deal?

Isn't it just guessing the disease?

I can do it too!

Zhang Yi glanced at Chen Feng's expression and knew what he was thinking.

Too lazy to care about this lunatic, he quickly asked the nurse to get the surgical kit for ureteral stent placement.

Generally, this kind of minor surgery is done directly in the emergency department, and only after it is done can it go to the operating room, which can play a role in drainage and prevent postoperative urinary incontinence in patients.

The nurse moved quickly and brought the things over in less than a minute.

Although Zhang Yi is just an uncertified doctor, everyone in the department knows that he is awesome, and the nurses listen attentively to his medical instructions.

"Doctor Zhang, the surgical kit is here!"

Seeing this scene, Chen Feng felt unbalanced again.

They are all interns who have been transferred to regular trainees, so why is it so easy for Zhang Yi to order the nurses around?

When he asked the nurses in the Nephrology Department to help him, the nurses were still hesitant, or they had to ask Bai Tang's opinion again.

Unexpectedly, Zhang Yi is doing well in the emergency department? !

The nurses take whatever they are told?

They don't even ask the instructor's opinion?

The more he thought about it, the angrier he became, and Chen Feng disliked Zhang Yi more and more.

On Zhang Yi's side, after taking the surgical kit, he began to put on gloves and unpack the surgical kit to prepare for drainage immediately.

Chen Fang stood behind Zhang Yi and watched. Chen Feng couldn't help but ask: "Doctor Chen, Zhang Yi hasn't received his certificate yet, so you... can you trust him to operate?"

Chen Fang said with a look of confidence: "It's just a stent placement. What's there to worry about? Besides, I can't wait to see Zhang Yi's operation more.

. "

Zhang Yi can even do heart valve replacement, so what's a mere urinary stent?

This sentence seemed to hit Chen Feng hard.

What's going on?!

Aren't they all interns who have just been promoted?

Why does Zhang Yi get such treatment?!

Not only the nurses, but even his teaching teacher is willing to listen to him?!

Of course, if Chen Feng knew that Zhang Yi now has performance, he would be even more angry.

Stent placement is a very small emergency operation in the emergency department, which is slightly more complicated than catheterization, but Zhang Yi has done it many times in the past month at school and in the emergency department.

So even if he has not practiced in the simulated operating room, he can complete it familiarly.

"OK, done, give the patient anti-inflammatory drugs first, the white blood cell and neutrophil counts are so high, the inflammation must be very serious."

Zhang Yi took off his gloves and ordered.

Chen Fang nodded, turned around and told the nurse: "Tianeng 1.0 once every six hours."

"Okay. "

After a while, the urology doctor came over. After checking the situation, the patient was admitted to the urology department for hospitalization and a follow-up operation was arranged.

On the way back to the Nephrology Department, Bai Tang couldn't help but ask: "Chen Feng, is that Zhang Yi also an intern who turned into a regular trainee?"

"Yes, what's wrong?"

"Well, I think that guy is pretty good. He can actually feel that there is gas in the stomach."

Chen Feng was speechless immediately.

Are you kidding me?

Why are you praising Zhang Yi?!

The more others praise him, the more he hates him.

When he thought about the fact that Zhang Yi's family lost 100,000 yuan, and his own brother lost his job, Chen Feng wanted to kick Zhang Yi out of the hospital.

"By the way, we are on night shift tonight."

Looking at Chen Feng's thoughtful look, Bai Tang patted his shoulder and reminded him.

"Oh, okay, I know. ”

……

At noon, Zhang Yi and several colleagues from the emergency department came to the cafeteria to eat, and opened their mobile phones to entertain themselves.

Suddenly, Zhang Yi found that Wang Haiqing had bombarded him with several WeChat messages.

Zhang Yi clicked on it.

"Brother, look at the group!"

"Is Liu Zifei a woman with a problem? What do you mean you should stop bothering her!"

"Hey, I have a bad temper! Hurry up and scold her back in the group!"

"Why don't you reply to the message? Are you at work?"

Zhang Yi slowly sent a question mark, and then he opened the classmate group.

The messages in the classmate group are usually too noisy, so Zhang Yi usually blocks them.

When he opened it, he found that after he sent the message wishing her a happy wedding and a long-lasting marriage, she actually replied to him!