(Thanks to my friend Silence529 for encouragement)

In fact, Liu Banxia's hands are very itchy.

As a surgeon, and especially a surgeon who loves to operate, can you not be greedy for the opportunity to operate, let alone stop working for so many days.

It's like a child who loves to ride a rocker car when he passes by the rocking car, it's obviously empty, and the rocker still shouts "little brother, little sister, come and play", this feeling is almost the same.

But you have to abide by the rules, even if Zhou Shuwen is his teacher and the director of the emergency center. It is for his own good not to let him go to surgery, and he has to insist on this order when it is issued.

After explaining to the patient's son, he walked back to the lobby on the first floor. As soon as I came here, I saw Qiaoqiao waiting here with a smile on his face.

"Why are you here?" Liu Banxia said happily.

"Looking for you to eat, my uncle and aunt were taken away by Uncle Qiu and my dad to eat, and I didn't mean anything myself. Jojo said.

"Hehe, wait a little longer, and then we'll be able to eat." Liu Banxia said.

"I just sent a patient to the operating room, what happened last night? I didn't sleep well, and I was worried. ”

"Of course it's nothing, my uncle and my dad and Uncle Qiu had a lot of fun. Jojo said.

"Actually, I was very worried at first, but they talked and talked very closely. Otherwise, we wouldn't have hung out together today, so don't worry. ”

Liu Banxia nodded, "Then I'm really relieved, I'm a little busy these days, and I'm not sure when I'll be off duty next time." ”

"Mr. Liu, there was a truck driver sent by the traffic police immediately, who had acute abdominal pain and was sent directly from the highway. At this time, the dispatch nurse shouted.

"Okay, leave it to me. Liu Banxia responded, and then looked at Qiao Qiao, "Good, go to the lounge and wait for me, patients with acute abdominal pain can't be delayed." ”

"Oh, it's annoying, I think I'm like a child. Wait for Qingkova and Liang Xiaolin to eat together at noon, if you are busy, the three of us will eat. After Qiao Qiao finished speaking, he went to the lounge with a familiar way.

Qiaoqiao is a little naughty, but now there is no time to think about falling in love, and patients with acute abdominal pain really can't delay.

After waiting for less than three minutes, the traffic police sent the patient over.

"What's the situation?" asked Liu Banxia to the traffic police who were holding the patient.

"He's a truck driver? Ask us for help in the service area. Stomach ache and panting? We'll just send it over. The traffic police said.

"It's better now, I have diverticulitis? I forgot to bring metronidazole with me when I got out of the car this time. The patient said with a little effort.

"Then you have to check it first? Otherwise, these two comrades will send you here for nothing. Liu Banxia said.

"And even if it's a diverticulitis attack, most of you just have abdominal pain and other manifestations? Now you still have symptoms of breathlessness, you must not be negligent. ”

The patient nodded? Lying on the consultation bed.

Although the patient self-reported home? said that there was diverticulitis, but Liu Banxia's examination also followed the process. I also had to rule out appendicitis and cholecystitis first, and even if it was a kidney stone, he helped to do a compression examination.

"Just auscultated that your lung sounds are not normal, and we also need to do a chest X-ray and a barium enema X-ray. Liu Banxia said.

"Doctor? Just prescribe me medicine. Hurt before? Just eat it. The patient said.

"Otherwise, the inspection will be too delayed, and I will rest for a while after taking the medicine, and I will be able to continue the delivery. The owner of the goods has time requirements, and if it is not delivered, the money will be deducted. ”

"I know you're in a hurry, but in the absence of a clear diagnosis? I really can't prescribe you medication. Even if I'm a doctor, I don't have that power. Liu Banxia explained patiently.

"yes? We can't let you drive on the road like you. What procedures do I need to go through? We can help you issue a certificate. Otherwise, you will suddenly get sick halfway, and it will be dangerous on the highway. A traffic policeman who accompanied him said.

"Am I just the old problem? cough cough cough ...... Poof......"

Halfway through the patient's speech, is a series of violent coughs? In the end, a mouthful of blood spurted out.

Liu Banxia hurriedly hugged the patient and reclined on the bed? "Even the monitor, the mobile ultrasound pushed me over. ”

After that, he holds the patient's head and examines the airway.

"The airway is clear and there are no foreign bodies. Now the blood oxygen is very low, give oxygen, adjust to 5 liters. After a closer look, Liu Banxia continued.

"Mr. Liu, the patient's heart rate is a little fast, and the blood oxygen is decreasing. At this time, the nurse also finished connecting the monitor.

"I'll do an ultrasound first. Liu Banxia said.

The two traffic police comrades who accompanied him were a little nervous, for normal people, seeing people squirting blood is a serious illness.

"If there is fluid in the lungs, you still have to be intubated, 100 units of succinylcholine, 20 units of etomidate, intubation kit. After doing the ultrasound, Liu Banxia said.

Tearing open the intubation bag, Liu Banxia carefully intubated the patient.

Don't look at how he usually doesn't do this job, he leaves it to others to do, but his skills in this area are not picky. But just as he pulled out the catheter core, a stream of lymphatic fluid erupted from the catheter.

"Maybe it's because the chest tube is broken, diverticulitis doesn't cause such symptoms. Blood test, push the patient to do an expedited chest MRI. Liu Banxia said.

"Comrade policeman, it would be better if you could reach his family. Do you know if this patient has suffered a recent blow to the chest?"

The traffic police shook their heads, "We don't know very well, but we will contact the family as soon as possible." Doctor, did he bruise this?"

Liu Banxia shook his head, "I just looked at the fact that there were no bruises on my chest, which almost ruled out the possibility of bruises." The cause of a ruptured chest duct may be an infection or a tumor, wait until the MRI results are available. ”

In fact, there is another reason caused by heart failure, but he just heard the heart sound normally, and the patient's blood pressure is also within the normal range, so this can be ruled out for the time being.

"Emergency patient?" At this time, Shi Lei walked over.

"Well, I was talking about diverticulitis, but before I could get checked, I coughed violently, vomited blood, and suddenly had chylothorax, which I guess was a ruptured chest duct. Liu Banxia said.

"Let's take an MRI first, and then I'll consult with someone in my heart when the film comes out. It could be lymphoma or sarcoidosis or something, diverticulitis is secondary. ”

Shi Lei nodded, "You can remove the stitches tomorrow, right?" I'm tired every day, I'm busy, you're lazy. ”

Liu Banxia glanced at him helplessly, "There was a ruptured abdominal aortic aneurysm just now, and my hands itched." Qingkova, let's go to the lounge, Jojo is here. ”

"OK, you didn't even tell me. Qingkova muttered a word and ran in.

"I'm also anxious, there are now a backlog of ten small incision appendectomys, and five gallbladder removals. Liu Banxia said.

"In fact, I advise patients with gallbladder removal to choose other doctors, that is, laparoscopic routine operations, and they have to recognize me. It's also a sequelae of being on TV, it's not so easy to deal with. ”

"I'm more familiar with you, or I'd have been able to show off for you. "Shi Lei is happy.

"Anyway, you can do the operation quickly, it's lined up, keep the operating room, and show the energy you used to sweep the operation, no problem. Anyway, we can add some profits to our emergency center, otherwise it seems that we will have to lose money this month, right?"

Liu Banxia also had a headache when he mentioned this matter, and it was true.

Some patients have to wait for the medical bills, and some are really unable to pay them temporarily. And then there is the female college student lying in the ICU now, although she also has medical insurance, but there will still be expenses.

Not to mention that she also had cardiopulmonary bypass, and she didn't know how long she would lie down in the ICU. Everyone is happy if they are saved, but if they can't be saved, it will be another ending.

This is the particularity of the emergency department or emergency center, and the meaning of its existence is to save people for the first purpose.

This is also a patient who takes the initiative to come to the doctor, otherwise it is always the person who is sent by ambulance, I am afraid that it will not last for a few months.

At this time, Liu Banxia's mobile phone rang, the patient's chest MRI had been completed, and he hurriedly operated it on the computer.

The MRI showed a clear lump in the lungs that needed further investigation.

Ding! Completion of the consultation

Gain 200 XP, 200 Diagnostics Skill Proficiency, 200 Dressing Change Skill Proficiency, and 2 Glory Points

Now there is really no way, I can only find a doctor outside the heart to come for consultation, and the symptoms in this area are no longer within the scope of Liu Banxia, a general doctor.

"It's very likely to be a sarcomoma, so let's do a biopsy first. At present, the only thing to be thankful for is that it does not infringe on the central nervous system, whether it is conscience or malignancy, it leaves us a chance. Wu Xiaoyue, who came for a consultation, said.

"The next step is to have a biopsy and to admit you to the hospital. Liu Banxia looked at the patient who pushed back and said.

The patient raised his hand and pointed to his breathing tube.

Liu Banxia hesitated a little and pulled out the intubation.

"Doctor, is it lung cancer?" the patient asked, with some difficulty.

"In layman's terms, yes, but we can't be sure if it's benign yet. Liu Banxia thought for a while and said.

"If it's benign, we only need to do a very simple operation to remove it. Even if it is malignant, it can be controlled by chemoradiotherapy after resection. ”

"We couldn't be sure until we had detailed results, so we needed to do a biopsy. In view of your current physical condition, I recommend that you find a colleague to help you deliver the goods. ”

The patient fell silent.

"I don't have health insurance, can I make it up to the cost of health insurance?" the patient asked after a moment of silence.

"This one still needs to be biopsied, and if it's benign, we only need to do a regular minor surgery. Liu Banxia hesitated and said.

He can only say that, even if his medical knowledge tells him that the malignancy may be very high, for the absence of a definitive biopsy result, he chooses the mildest symptoms to describe.