Chapter 07: Misdiagnosis!
Tong Zheng patted Zhao Yuan on the shoulder.
"Five minutes of charging, eight hours of insane output! Let's go, let's get to work! ”
An experienced doctor has to manage many beds, and which bed the patient is assigned to is in charge of which doctor, and Tong Zheng, as the backbone of the emergency, is responsible for more beds, so there are more patients to manage.
When he came to the ward, Tong Zheng instantly became the focus.
A middle-aged woman dressed in a fashionable fashion suddenly stopped Tong Zheng, "Director Tong, when will my daughter be discharged from the hospital?" ”
"Bed 6?" Tong Zheng glanced towards the hospital bed.
The girl was trapped by love, cut her wrists and self-harmed after breaking up, was found by her parents, her life hung by a thread, and she came to the hospital after several hours of rescue to save a life.
"Wait for a check-up, there are no special circumstances, let's go through the discharge procedures in the afternoon! However, after the trauma is treated, the wound in the heart is more difficult to heal, so it is recommended to find an experienced psychologist for counseling. ”
Inpatients in the emergency department are generally kept for observation for one or two days, and patients who stay for more than three days are transferred to specialized departments.
Tianhua Hospital is a big hospital, beds are very scarce, not only patients are in a hurry to be discharged, doctors also hope to let patients be discharged as soon as possible, so that the beds can be transferred as soon as possible, so that more patients can be admitted.
Tong Zheng is different from other attending doctors, he will not be a hands-off shopkeeper, he will follow every patient throughout the process, will not waste patients' time and money, and will not waste the hospital's medical resources.
Coming to a hospital bed again, Tong Zheng nodded at Zhao Yuan.
Zhao Yuan understood Tong Zheng's intentions and stepped forward to examine the patient.
As he examined his body, he asked, "How did you sleep yesterday?" ”
"I didn't sleep well at all, it didn't add up to more than three hours, and the wound hurt badly!" The patient, a 20-year-old student at a sports school, got into a verbal altercation with a nearby table while drinking at a food stall, and his head was scooped open by a beer bottle.
"The anesthetic is gone, and the pain is normal."
"Doctor, will there be any sequelae?"
Zhao Yuan did not answer.
The level of suturing is very high, using classic intermittent sutures, and the details are very careful, and the wound recovery should be fast.
However, the current situation is not as rosy as imagined.
Zhao Yuan truthfully explained to Tong Zheng, "The wound is edema, and it will take at least two days to be discharged from the hospital if you need to increase the medication!" ”
The ward fell silent instantly.
The level of child administration is recognized.
Zhao Yuan is actually questioning authority?
Zhao Yuan pointed out the key, "There is no problem with the operation, the problem is in the postoperative care." ”
Tong Zheng frowned, "What's going on?" ”
The nurse in charge of the ward stood up and said aggrievedly, "This patient was secretly discharged from the hospital last night and came back at about three o'clock in the morning. ”
Tong Zheng was more surprised at the moment.
Zhao Yuan actually judged by his eyesight that the patient had made a mistake in nursing, and he really couldn't be treated as an ordinary intern.
"You're derelict in your duties!" Rarely is child administration so serious.
After practicing medicine for many years, Tong Zheng has seen all kinds of emergencies, and said lightly to the patient, "Life is your own, if you want to be discharged, you can go through the procedures now." However, how to recover in the later stage has nothing to do with our hospital! ”
Seeing that Tong Zheng was about to give up on himself, the patient was taken aback, and hurriedly pleaded, "I'm sorry, Director Tong, last night under special circumstances, my girlfriend broke up, and I coaxed it for half a night to coax it." I will definitely cooperate with your treatment in the future, so as not to cause you trouble. ”
Tong Zheng didn't really give up on him, but to make him realize the seriousness of the problem.
The method was to treat him coldly, ignore him, and walk towards the next hospital bed......
Following Tong Zheng's ward rounds, Zhao Yuan also had a new understanding of Tianhua Hospital.
Unlike field doctors, emergency surgery is like an assembly line, where patients are like broken commodities and the attending physician is responsible for repairing them.
As for how to recover after surgery and how to use medication, there will be a standardized process, the attending doctors will input the patient's information into the computer system, and there will be a mature system for tracking and following up each link in the later stage.
After the ward rounds, a handsome young nurse found Tong Zheng with a folder.
"Lao Tong, do you expect to have seven or eight surgeries today?"
Tong Zheng seemed dissatisfied, "A little little!" ”
For novices, doing three or four surgeries in one night is already the limit.
But for an experienced specialist like Tong Zheng, seven or eight surgeries are just the beginning.
When the nurse's eyes turned to Zhao Yuan, Tong Zheng introduced to Zhao Yuan, "You have to focus on getting to know this little fairy-Bai Lu, the goddess nurse in our emergency operating room." ”
The nurses worked relatively early, and Bai Lu looked very young, definitely less than thirty years old, but she had been working in the emergency department of Tianhua Hospital for ten years.
1.7 meters tall, with long legs and a thin waist, as his name suggests, with fair skin and pink cheeks, but his jade face is cold, and he doesn't like to laugh very much.
It is a professional habit for nurses not to laugh, especially beautiful nurses, if they are kind and gentle to patients, it is easy to cause misunderstanding among patients.
There are many cases in the hospital where patients fall in love with nurses because of the nurse's careful care when they are seriously ill, and they can't ask for it, and finally make a big fuss about the hospital.
Bai Lu was also well-informed, and said without waiting for Tong Zheng's introduction, "He is the intern who just came to report today, Zhao Yuan?" ”
Tong Zheng's eyes narrowed into a slit and quipped, "Looks handsome, right?" Quickly wiped the corners of his mouth, the lipstick was all smeared with saliva. ”
Bai Lu rolled her eyes angrily, "It has nothing to do with Shuai, I mainly heard that he has something." ”
Something?
Zhao Yuan couldn't help but smile bitterly, "This evaluation is refreshing. ”
Bai Lu shrugged his shoulders and raised his eyebrows, "Director Xie's original words, if you are not satisfied, go to him to settle accounts." ”
Tong Zheng patted Zhao Yuan's shoulder and pretended to whisper, "Lao Xie and I, you can ignore it." However, Bai Xiaohu, you must not offend. Whether your surgery will go well or not in the future depends on her mood. ”
Zhao Yuan re-measured Bai Lu's eyes.
Bai Lu rolled her eyes and hurriedly waved her hand, "Don't hold me too high, I'm afraid of falling to death." ”
After speaking, she swept the watch on her wrist, "There is an ambulance that will arrive in the hall soon, you have to make preoperative preparations." ”
"What's the situation?"
"Suspected acute appendicitis! The patient was in severe pain, and the family agreed to have an excision. ”
Tong Zheng thought about it and asked Zhao Yuan, "Do you want to practice your hands?" ”
I didn't expect the opportunity to come so quickly, of course Zhao Yuan would not refuse, "Okay!" ”
Zhao Yuan is only on his first day at work!
Bai Lu's face was full of surprise, and she confirmed with Tong Zheng, "Are you sure to let the intern operate the appendicitis surgery independently?" ”
Generally, interns will perform appendicitis surgery independently under the supervision of their supervising physician until the end of their graduation.
Tong Zhengxian's old face smiled like a crumpled walnut:
"Hey, don't judge heroes by age, I've been doing surgery on my own since I was twenty years old. Moreover, this kid is better than me, and he can pretend to be a pig and eat a tiger. ”
Zhao Yuan was speechless.
Is this boasting about yourself, or is it scolding yourself?
……
The silence of the hall was broken by the sound of wheels crushing against the floor tiles.
Zhao Yuan came to the door in advance and waited, waited for the surgical flat car to land, and quickly moved with the car.
At the same time, Zhao Yuan questioned Dr. Sun, who was in the car, trying to understand the patient's condition.
"How's the patient?"
Dr. Sun, a resident in emergency surgery, just turned regular last year, and today it is his turn to be on duty at 120 Ambulance.
At this moment, he was excited, the director of a small operation like appendicitis would definitely not look down on him, and it was a rare opportunity to complete the appendicitis removal independently.
He quickly replied, "The patient's surname is Ye, female, 22 years old, began to feel uncomfortable at about ten o'clock last night, originally thought it was menstrual pain, took painkillers, around one o'clock in the morning, the pain was unbearable, the family dialed 120, I did a physical examination in the car, the pain in the right lower abdomen was obvious, and the pain was repeated repeatedly. The initial diagnosis was acute appendicitis. ”
Although I didn't have time to examine the patient, judging from Zhao Yuan's experience, I'm afraid it's not that simple.
Entering the operating room, the curtain was drawn, and the patient lay on a sterile mat, covering his abdomen, and kept crying out in pain.
Zhao Yuan stepped forward and began to examine the patient.
At this time, Dr. Sun had learned from Bai Lu that the operation would be handed over to Zhao Yuan, and he had no chance of doing the operation, so he was extremely depressed.
However, he did not leave, and stayed in the operating room with a thick face, holding on to luck.
Zhao Yuan is an intern, and on his first day at work today, there is a great possibility that something will happen, and he will have the opportunity to act as a substitute at that time.
Zhao Yuan first percussed the patient's painful area with his fingers, and then transferred to other parts, and with in-depth examination, his complexion became more and more solemn.
After about two minutes, Zhao Yuan stopped his movements and reported to Tong Zheng with a serious expression:
"A color ultrasound of the abdomen is recommended, and the patient may not have appendicitis, but cholecystitis."
"Nonsense, how can it be cholecystitis? I can't tell the location of the gallbladder and appendix, so I dare to make a big fuss here? ”
The intern questioned the diagnosis......
Dr. Sun, who has always had a good temper in the eyes of his colleagues, seemed to have been stepped on by the tail, and he was like thunder!