"Tell me. Zheng Ren placed his left hand flat under his armpit, his right elbow on his left arm, supported his cheek, squinted his eyes and looked at the film hanging on the reader, concentrating.

"Here, it is the most typical imaging manifestation of traumatic wet lung. Su Yun tapped the piece with the knuckle of his right index finger, "However, with such a serious fracture, there will be more or less hundreds of milliliters of bleeding, accompanied by a small amount of pneumothorax." ”

"You think it's strange that the patient doesn't have a hemothorax?"

"Hmm. Su Yun did not shy away from it, if he was hypocritical and polite, he had to say it from the perspective of hoping that the patient's condition would be as mild as possible.

But

He didn't.

All due respect

Don't mince words.

"There is indeed a problem. Zheng Ren groaned, and followed Su Yun's train of thought and said: "The patient's blood pressure is not high, according to his age, normal blood pressure should fluctuate between 120-130. Multiple rib fractures, severe pain, and maintaining blood pressure at 150-160 are all appropriate. However, the patient's blood pressure is 90-100, which is worth pondering. ”

Decreased blood pressure means bleeding.

However, intrathoracic hemorrhage, whether a ruptured lung or an intercostal artery, can cause imaging findings of pleural effusion.

However, this finding did not appear on the CT scan of the patient's lungs.

Even the big pig's trotters in the system did not indicate any serious traumatic complications. A ruptured lung, which is a diagnosis, can be severe and may heal on its own.

Under normal circumstances, the patient can now be sent to the thoracic surgery ward for observation. Take a step at a time in the future, and if there is a problem, deal with it at any time.

But Zheng Ren and Su Yun are worried that once there is a problem, it will be a big problem, and if they want to solve it, now is the best time!

"Su Yun, this kind of disease, you also come to me for a consultation?" The two were struggling when a voice came.

Looking back, it was Cao Guozhen, the resident chief of cardiothoracic surgery.

He was tall, strong like a black bear, and he walked in a hurry.

Talking......

It's also a general wind and fire.

There was a thorn in his words, probably because when he rescued Yang Lili, Su Yun and Zheng Ren swept the face of cardiothoracic surgery on the operating table, and their mood is still not smooth.

He glanced at the film, a disdainful smile on his lips.

"The most typical traumatic wet lung, that's it, you have to study the two giants of the emergency department together?"

Zheng Ren recalled countless possibilities in his mind, and Su Yun didn't pay attention to Cao Guozhen's provocative words, frowning and pondering.

"You're trying to keep patients in the emergency room. Cao Guozhen sneered, "Just stay, no problem." Brother told you, first use hormone shock, then 10mg of dexamethasone per day, plus anti-inflammatory, nebulizer, and phlegm treatment. Mu Shutan don't give according to the instructions, 100 a day, and the intravenous pump is pumped in, no problem at all. (Note 1)

Zheng Ren and Su Yun are still pondering.

"According to the instructions, Mu Shutan, there will definitely be serious pneumonia in three days, don't say that my brother didn't remind you. Cao Guozhen chattered.

He has a point, and it is a suggestion of conscience.

Su Yun knew that Mu Shutan, an imported drug, was cheaper and had almost zero side effects. He was in the imperial capital, and the maximum number was 300 a day, and the intravenous pump lasted 24 hours.

After that, pay attention to turning over and knocking on the back to cough up sputum to prevent pneumonia, and the patient can be discharged from the hospital in 1 week.

However, the problem is that Zheng Ren and Su Yun do not consider that the patient is simply a multiple rib fracture on the right side and a traumatic wet lung.

Whether in the emergency ward or in the cardiothoracic surgery ward, if this time is missed, patients ......

There is a possibility of danger.

But, it's only possible.

Medicine is both empirical and evidence-based.

There is no evidence, why did you tell me that you want to open your chest, are you afraid that the patient will die after surgery?!

After a few minutes of judgment, Zheng Ren suddenly thought of the reason why Su Yun came back from looking for himself this dog.

He wanted to open his chest, but he didn't have the permission.

Just like I find Director Pan to carry the thunder every time, this dog is looking for myself to carry the thunder!

"Patients can't be treated like that. Zheng Ren's hand was lowered, he looked back at Cao Guozhen, and said, "At the very least, we must do an emergency fracture internal fixation operation." ”

Su Yun was stunned.

Zheng Ren's words are simply too shameless.

The patient's fracture alignment is well aligned and does not require re-fixation at all.

But...... That's a particularly good reason and excuse, isn't it?

"Well, you look at this, the misalignment is obvious, and the bone stubble may puncture the pleura and lungs when the patient turns over and knocks on the back, causing secondary hemopneumothorax. Su Yun pointed to a tiny break point on the film and swore that he said.

In general, CT of the lungs is a tomography scan and is not used to see fractures.

To see the fracture, a chest x-ray and a 64-slice CT 3D reconstruction of the chest are required.

But every fault in the CT of the lungs can see a little bit of the situation in the tube, so Su Yun grabbed one of the positions and said that the fracture was particularly severe.

Cao Guozhen was stunned......

In the emergency ward, in order to rush the operation, it was so shameless?!

Paralyzed, no wonder the general surgery can't do them.

According to them, this operation must be done urgently, and if it is not done, the patient will have something to say in the future.

Cao Guozhen's mind also turned quickly, and then said: "Then take it and I'll do it." ”

"You?" Su Yun said with a mocking smile on the corner of his mouth, "Will you have surgery? Have you cut the lobes of your lungs? Have you had a sleeve excision?

"You ......" Cao Guozhen really wanted to go up and kill Su Yun.

I've always spoken politely, although there was a bit of sarcasm in my tone, but I didn't say dirty words at all.

Su Yun actually sprayed himself directly, is he a wild dog?

"Rib clips, send ten. Su Yun blew the black hair on his forehead and said lightly.

"Why!"

"Do you want to find the medical office? or do you want to find Director Pan? Thoracic surgery, we don't have time to do it. If he finds Director Pan, he will definitely leave the chest emergency department by the way. Su Yun smiled and said, "Isn't it just the next chest bottle, even the nurse will work, and you are embarrassed to say that it is an operation?"

What is the ...... It's so choking.

Cao Guozhen realized that what Su Yun said was true, if they took the opportunity to leave all the chest emergency departments, the director would know, and he would not be surprised to death.

Holding his breath, Cao Guozhen turned around and left.

"Admit to the hospital, I'll inform them to prepare for emergency surgery. Zheng Rendao.

"Hmm. Su Yun nodded, and when he saw Zheng Ren turn to leave, he suddenly said, "Boss, thank you." ”

"It's fine. Zheng Ren waved his hand, "I believe you." ”

……

……

Note 1: This usage of Mu Shutan was taught by Mr. Chen Houkun of Medical University fifteen years ago. Mr. Chen is very good, and has cured several patients with very serious trauma + traumatic wet lung + pneumonia with this off-label dosage method. One of them gave up and threw me on the hospital bed. After 26 days, he was discharged from the hospital and went home. Later, the patient came to see me once on crutches.

Note 2: This surgery was performed by a patient I took in '09. Looking at the film, there is no indication for the need for surgery. I watched the film for 1 hour, made 3 phone calls to the director, and finally brought the director from home for surgery in the middle of the night. Fortunately, the operation was done early, thanks to Dahlia, who was in the intensive care unit at that time.

Note 3: Thank you to the Red Dust League, please wait, don't worry.

bq