Although the emergency department is a little colder, and its strength is far less than that of the weighted department, it has a privilege that other departments do not have in this regard.

If you encounter a doctor who is unsure, you can call a doctor from any department to come for a consultation.

The other party cannot refuse.

There are also strict restrictions on the time it takes to go out of the emergency department.

This is prescribed by the hospital.

Moreover, when a specialist doctor goes out of the emergency department, he can't pick on something that he can't handle, and he can't handle it. If the specialist who goes out of the emergency department is of a low level and can't handle it, then ask a higher-level senior doctor to come over.

In the end, even the best efforts of the whole hospital could not save the patient, so there was no way.

Escalate according to the procedure.

Although other departments encounter patients who are unsettled, they can also invite doctors from other departments to come for consultation. But the nature is much different.

For example, the orthopedic surgeon receives a patient, fractures, and is suspected of internal bleeding or other serious diseases.

The orthopedic department felt that it could not be done on its own ability, and was afraid that something would happen.

So I invited a doctor in my heart to come for a consultation.

When the doctor in the heart received the request, he was somewhat reluctant. Because no doctor is easy, he has a lot of work to do, how can he have spare time to take care of other people's affairs!

But this thing can't be pushed, and the cutscene must be gone.

Everyone is in the same hospital, you helped me, and next time you have difficulties, I will also help.

Solidarity is a must.

The doctor of internal medicine passed.

At first glance, alas, this patient has such severe internal bleeding that the person is already in shock.

Then, after carefully reviewing the examination report, he decided that the patient would probably not be able to get off the operating table.

He shared his diagnosis with the orthopedic doctor and reported it to his superiors. If you are the chief physician yourself, then you don't need to report.

It may be possible to express a more positive attitude directly.

This patient is very difficult to save, and it is likely that he will not be able to get off the operating table, so you can watch it.

After saying that, pat your ass and leave.

This is the difference between an emergency department and a general consultation.

……

It didn't take long for the patient's blood test report to come in, and the white blood cells were abnormal, and sure enough, there was sepsis.

Doctors who came out of the emergency department also arrived one after another. The Department of Gastroenterology sent an attending officer, and the Department of Hepatobiliary Surgery also sent an attending officer.

This level is not low.

Regardless of the diagnosis and treatment experience or their own strength and level, it will not be bad.

"What's the problem?"

"Acute cholecystitis!"

"It's not too difficult to get sick! Didn't Dr. Xu use to be the chief physician of our surgery? It should be done! After hearing this, the attending doctor of the hepatobiliary surgery department looked relaxed.

Maybe he didn't mean to laugh at Dr. Koh.

It's just that no matter how you listen to it, it all has the meaning of contempt for Dr. Xu.

Judging by the age of this person, he should be a newly promoted surgeon in recent years.

There is still a little bit of hard work of young people.

Young and promising, it is inevitable that there will be a little pride.

This must go through years of precipitation and the beating of reality before it can slowly converge.

"Dr. Nguyen can take a look at the patient's condition first." Zhou Can stood next to him and helped the teacher speak.

The attending physician of the Department of Gastroenterology has read the examination materials and is examining the patient.

During the internal medical examination, the patient looked very carefully, and the pupils, tongue, hands, face, etc., were all carefully examined one by one. The patient is also asked about the details of diet, bowel movements, specific parts of abdominal pain, etc.

There are many cases that are not written down in the medical record book.

This is generally a simple record of the patient's symptoms, condition, reception time, etc.

Chinese physicians actually still have the shadow of traditional Chinese medicine in them.

The look and feel of traditional Chinese medicine is a little bit like that of experienced internists.

Zhou Can watched the internist examine and diagnose the patient, and secretly learned the diagnostic methods of others.

The internist finished the diagnosis and did not rush to give an opinion.

Just stood next to him with a slightly solemn face, waiting for Dr. Ruan, who was outside the liver and gallbladder to make a diagnosis.

Five minutes passed, eight minutes passed...... Dr. Nguyen frowned, looked at the examination data, and then at the patient. No diagnosis has been given for a long time.

"Doctor Ruan, you must have been treated a lot of this disease. I've read the examination report, and the patient has been examined, but I don't know what you think should be treated? ”

Zhou Can obviously saw that the other party was a little difficult, and deliberately put on a high hat for others, which was actually quite ...... 'bad'.

"Uh...... Well, I'm going to study it again! ”

Dr. Ruan's face was somewhat embarrassed.

"Didn't you just say that this kind of disease is not difficult to deal with?"

Zhou Can will be his army.

As soon as he came in, it made it difficult for Doctor Xu to step down, and Zhou Can naturally had to punish him slightly.

Let this man have some virtue next time.

"This disease is generally easy to treat, but this patient is a bit difficult to treat. By the way, what is your emergency department opinion? "Dr. Nguyen is quite resilient.

Instantly shifted the topic and the goal.

To be able to be the attending officer, it is all practiced through countless interactions with patients.

I don't have the ability to improvise, and I don't know how many times I've been beaten by family members and patients.

Zhou Can looked at the teacher.

This question should be answered by a doctor of the highest status.

He is a petty pearson and puts his position very right.

Never talk nonsense when you shouldn't.

"Our opinion is to first puncture the gallbladder to drain out part of the bile, and puncture under angiography to drain out the pus around the gallbladder, and give anti-inflammatory treatment to the patient. Wait until the inflammation has resolved, and then perform elective surgery. ”

Dr. Xu adopted Zhou Can's diagnosis and treatment opinion.

At this time, the anesthesiologist also arrived.

After saying hello, the anesthesiologist stood next to him and waited patiently for the results of the consultation with several surgeons.

"Dr. Chi, what is your opinion?" Dr. Nguyen looked at the attending doctor in the Department of Gastroenterology.

"I support the practice of emergency care. The patient had an underlying medical condition, was older, was quite frail, and had pus around the gallbladder, which made the surgery extremely risky. Moreover, the patient has vomit residue at the corner of his mouth, indicating that the fasting time should not be long before being sent to the operating room. I recommend draining bile sweat, draining pus and reducing inflammation first, and then give infusion nutritional support and fasting. Wait until the indication for surgery is met, and then it is not too late to undergo surgery. ”

Dr. Chi's meticulous observation is truly impressive.

"I would prefer laparoscopic surgery if I could. It's much less traumatic, and the risk is a little less. ”

The reason why minimally invasive surgery has become an emerging surgical trend is that it is less traumatic, the damage to patients is greatly reduced, and the postoperative recovery is faster.

Some frail patients may not meet the indications for traditional surgery, but minimally invasive surgery is sufficient.

The only downside is that minimally invasive surgery is much more expensive.

Then there are very few doctors who do minimally invasive surgery well in China.

"The preoperative fasting time is not enough, and the patient himself has a vomiting reaction, I am afraid that there is no way to anesthetize!"

When the anesthesiologist heard that the patient had just vomited, his face immediately changed.

The hospital has been tightening its grip on surgical safety recently, and he doesn't dare to take that risk.

All eyes were on Dr. Nguyen, just waiting for him to give his opinion.

"Okay, this patient will be transferred to the hepatobiliary hospitalist. I'll report to the director here, and after your emergency department has communicated with the family, I will send the patient over. ”

Dr. Nguyen picked up this 'hot potato' and brought it back to the hepatobiliary specialist.

This matter is over for the time being.

Before leaving, Dr. Ruan stared at Zhou Can and said with a smile, "The young man is very protective of your Doctor Xu, and he will also return my military mile!" When he said this, he was looking for a step to get down.

If he knew that the diagnosis and treatment opinions in the emergency department came from Zhou Can, a regular trainee, I am afraid that he would look at Zhou Can even more highly.

"Hehe, don't dare, don't dare!"

Zhou Can's careful thinking was recognized, but he was not embarrassed at all.

Dr. Xu loves him so much, he is not a plant and a tree, who can be ruthless. Naturally, he also has to give back to his teacher and protect his own teacher.

Dr. Xu listened beside him, although he didn't speak, but his serious face showed a look of relief that couldn't be concealed.

Obviously, Zhou Can's actions to defend him made him very useful.

This is ten times more powerful than the effect of Dr. Lu slapping a thousand sycophants at him.

Dr. Lu's sycophants can only make Dr. Xu happy at the time, and forget about it later. But Zhou Can's 'high-level sycophant' is about feelings, which can make Dr. Xu treat him directly as his own child.

"I'll go first, don't delay this patient, I'm afraid something will happen!"

Dr. Nguyen gave another admonition.

The patient's condition was quite serious, and no one dared to delay.

Dr. Xu personally came forward to communicate with the family, and the negotiation was quickly resolved.

The family's requirements are actually very low, as long as the hospital can cure the illness of the loved one.

"Doctor Lu, you immediately send the patient to the hepatobiliary surgery department together with the nurses outside!"

Dr. Luk's face was bitter.

"Can't you just call Xiao Zhou to go?" He's a senior resident doctor.

Running errands is a trivial matter that is usually done by the people with the lowest status.

Kim Myung-hee is undergoing surgery, so it's understandable not to ask him to go.

But Zhou Can didn't have surgery.

"You can tell me a little bit, Xiao Zhou's mouth is too stupid, so he is only suitable for surgery. Hurry up! Dr. Xu's words made Dr. Lu eager to buy a piece of tofu and die.

If Zhou Can's mouth is still stupid, I'm afraid no one in the world has a smart mouth.

Doctor Xu has said it to this point, clearly protecting Zhou Can. Dr. Lu is a very smart person, and he will never do something unwise to dislike his senior doctors or leaders.

Honestly escorted the patient to go.

"Call the next patient in!"

Soon, a new surgical patient was pushed in, his face pale with pain and profuse sweat on his forehead.

This is an acute appendicitis surgery patient.

While the anesthesiologist hasn't left.

After reading the examination report, Dr. Xu asked about the patient's condition.

Surgery is possible.

"How long has the patient been fasting?" The anesthesiologist asks the nurse who brought the patient over.

He was frightened by the sassy operation of the doctor in the emergency department.

In the last surgery patient, the stomach was obviously not empty. Isn't there any fear of accidents if such a patient is also sent to the operating room?

"It's been more than six hours."

The nurse answered honestly.

Acute appendicitis usually occurs at night.

It is estimated that the patient was sent in the evening.

"Me, I didn't ...... after having a late night snack around 22 o'clock last night There is food again! ”

The patient has significant shortness of breath when speaking.

It's for the pain.

Acute appendicitis can really kill people to death.

"What's the patient's name?"

"Huang Weiyuan!"

"Was it last night?"

"Hmm!"

The anesthesiologist took out a dozen copies of the information in his box, flipped through them, and quickly found them.

"I'm going to go to my family to sign an anesthesia form!"

The anesthesiologist went out.

It didn't take long to come back.

According to the routine, the patient was examined and there was no problem, and he was given inhalation anesthesia with a vital monitoring instrument and a non-invasive ventilator.

The patient soon fell asleep.

"Huang Weiyuan, Huang Weiyuan!"

No response to calls.

The patient's vital signs are stable.

"It's time for surgery!"

After the anesthesiologist finished speaking, he moved over the small black leather stool by the wall and sat down. Keep your eyes on the vital monitoring device.

During the entire perioperative period, anesthesiologists are the presence of escorts for the safety of patients.

However, this is only a second-level minor operation, and it is not treated as if it were a major operation.

"Xiao Zhou, is it safe to open the patient's abdomen?"

"Yes!"

Zhou Can was overjoyed.

This is the first time that the teacher has taken the initiative to let him open the abdomen of a patient.

Although the risk of open abdomen is much lower than that of open chest, it still makes him extremely excited.

"Come on! It's important to remember the principle of being bold and careful, and putting safety first. If you don't understand something, you can't operate it indiscriminately. ”

"Understood!"

Zhou Can is not the kind of person who is unstable.

In any operation, he is a lion fighting a rabbit and doing his best.

"Can you let Qiao Yu be an instrument nurse for me?"

Zhou Can took great care of Qiao Yu.

"Are you kid going to train a permanent nurse?" Dr. Xu laughed and scolded. "Liu Xia, you bring more newcomers."

This is an agreement.

Liu Xia is an old nurse with rich experience.

The qualifications are much older than Tang Ling and Tian Tian.

"No problem!"

Liu Xia readily agreed.

She is not stupid, and she can see that Dr. Xu takes special care of Zhou Can. At the same time, Zhou Can's surgical potential is also extremely amazing.

In less than a month, Zhou Can was not only able to complete various first-level surgeries independently.

Now they even have the ability to open their abdomen and cut their appendix.

It's terrifying.

She didn't dare to imagine how good Zhou Can would be in the future if he could grow up smoothly.

With such a potential doctor, she must have a good relationship.

A while ago, Dr. Lu spread rumors everywhere, saying that Zhou Can had provoked the big leaders of the hospital, and he was going to collapse, and he was going to be unlucky, etc.

Now it's over.

Everyone is a smart person, so they will naturally want to take the initiative to repair the relationship with Zhou Can.

Look at the recent days, more and more colleagues who take the initiative to greet Zhou Can enthusiastically, and you can understand.

This is the general trend.

Zhou Can took such good care of Qiao Yu.

Love the house and the house.

Liu Xia is now releasing kindness to Qiao Yu, which can not only gain Qiao Yu's gratitude, but also gain Zhou Can's favor.

Why wouldn't she?

The operation officially began.

Liu Xia also spared no effort to impart Qiao Yu's experience in preparing equipment. Preparation varies from surgery to surgery.

Qiao Yu has a certain foundation as an instrument nurse, coupled with her talent, she can basically understand everything and learn it as soon as she learns.

This also made Liu Xia love her a little more.

Teachers generally prefer students with good grades.

For nothing else, on the one hand, it is easier to teach such students to produce grades, and on the other hand, it is much easier to teach those students who are less receptive.

After Qiao Yu cleaned the skin of the surgical site, Zhou Can drew out the scalpel position.

Dr. Xu next to him checked.

After no problem, he held the scalpel, his eyes as sharp as an eagle and fierce as a wolf.

Try to find your hand and cut through the first layer of the abdomen little by little.

This cortex includes both the epidermis and the dermis.

Blood gushed out, and Dr. Xu was next to him to suck up the blood in time.

He should be satisfied with Zhou Can's first knife.

Next, Zhou Can cut through the thicker subcutaneous tissue, fascia layer, and rectus abdominis muscle in turn, and at this point, the peritoneum was exposed.

It is also the last barrier to enter the abdominal cavity.

Cutting jadeite rough stones, there is a saying that one knife is poor and one knife is rich.

If you don't cut the peritoneum layer well, you will get into trouble.

Dr. Xu dared to entrust him with such a surgical task, what a great trust he had.

Zhou Can took a deep breath and tried to keep his mind calm.

Then find the feel and slowly cut through the last barrier.

Fortunately, there was no trouble.

It's not perfect, but it's above the mark.

It's much better than a resident doctor.

[Slice experience +1.] 】

[If you successfully open your abdomen for the first time, you will be rewarded with +100 incision experience.] 】

The system is so generous.

A hundred were awarded directly.

But only this time. If you open your stomach in the future, there will definitely be no additional rewards.

For Zhou Can, it is another extremely important step in the field of surgery.

A successful laparotomy will make qualitative progress in all aspects regardless of psychology, technique, experience, and courage.

Usually, only a few senior residents with strong surgical ability can get one or two opportunities for laparotomy from the hands of senior doctors when they hit the attending physician.

Zhou Can's incision is now at the fourth level, and the main treatment is at the inferior level.

To level up, you'll need to earn 10,000 XP.

In one fell swoop, he earned 101 cutting experience points, which is countless times faster than dissecting mice.

Or is it comfortable to earn surgical experience points on the patient.

When he cut open the peritoneum, Dr. Koh's expression was actually very nervous.

Now that Zhou Can has successfully completed it, Dr. Xu is also very relieved.

"Will you look for an appendix?"

"Yes!"

Zhou Can answered categorically.

At this time, Jin Mingxi finished the operation in his hand.

Dr. Lu estimates that he will not be back for a while and a half.

After all, for a lazy person, this is a legitimate opportunity to be lazy.

Rest for half an hour on the way back, no one will say anything.

"Jin Mingxi, come over and help pull the hook together!"

Jin Mingxi walked over and saw that Zhou Candu had already undergone appendectomy surgery, and he was really envious.

He also had this kind of operation at the county people's hospital.

However, depending on the level of the hospital, the attitude towards surgery is also very different.

Cutting an appendix is like a New Year in the operating room of the county people's hospital. A whole bunch of doctors are involved.

The surgeon at the level of deputy director personally performs the surgery.

Look at Tuya again, the most popular emergency department does this kind of surgery, it's like playing.

An attending officer swept the formation next to him, and directly let Dr. Guipei take charge of the surgery.

It's scary.

Of course, it is undeniable that Zhou Can's strength far exceeds that of Dr. Guipei. How strong Zhou Can is now, Jin Mingxi doesn't know very well.

I only know that Zhou Can's surgical ability is like riding a rocket.

It's almost the same every day.

It's all the same surgery and practice together, why is the gap so big?

Jin Mingxi gave Zhou Can a thumbs up: "You cow!" ”

Then help pull the hook together.

Qiao Yu watched Zhou Can perform so well, and she also followed Zhou Can's chicken dog to heaven and reaped great benefits. It was as if he had drunk honey in his heart, and when he looked at Zhou Can, in addition to worship, all he had in his eyes was a smile.

(End of chapter)