Basic Theory of Medical Routine Level 1 3/25!

Surgical Routine Fundamentals Level 1 14/25!

Orthopedic Fundamentals Level 2 12/50!

Basic Theory of Trauma Surgery Level 2 35/50!

The next day, in the morning, Fang Xian stared at his panel and looked at it, these few skill points were really pitiful.

Medicine is a major category, there are many subspecialties such as internal and external gynecology, children's psychiatry, skin psychology, etc., and orthopedics is a small classification of surgery such as orthopedic surgery, general surgery, and neurosurgery!

Fang Xian naturally specialized in the study of trauma surgery in his previous studies, so he gradually put down the basic theory of medicine and the conventional theory of surgery, and focused more on orthopedics and trauma surgery.

16 skill points. The only thing that can be improved is the theoretical basis of trauma surgery.

After clearing your skill points.

After upgrading the basic theory of trauma surgery from level 2 to level 3, Fang Xian's idea is to fight the theory first, and strive to find more diagnoses that others cannot pay attention to in the clinic, so that it is possible to get more skill points.

This is a gambler's investment, and it is possible that the income will not be able to catch up with the operation skills first.

However, Fang Xian still felt that the most important thing was to try to improve the skill points first!

What's in a hurry, even if you take it slowly and wait patiently for the opportunity, even if you only get 1 skill point on average every day, after half a year, you can add three or four level 3 skills!

In this way, the cost of trial and error is very low, and the selectivity is very high.

Therefore, the investment of these 26 points is nothing at all, and we have to look at the longer term.

The reason why I didn't choose to add some medical and surgical foundation is because most of the trauma surgery is a specialist case, and it is still a bit wrong to select non-orthopedic diseases from the specialist cases.

Even if it is better to choose a general category such as adding a few medical theory conventions, it is also necessary to consider the frequency and probability of the skills that can be applied......

After the ward rounds on Saturday, Associate Professor Song Yu directly ordered that 15 beds should be discharged today! Fang Xian figured it out by himself.

Fang Xian is in charge of three beds, 13-15 beds.

The 13 beds were postoperatively operated for femoral bone defects, and they were basically hospitalized for one week after surgery. 14 beds had pelvic fractures and also required hospitalization for eight or nine days.

The 15 beds were patients with comminuted fractures of the tibia and fibula who underwent internal fixation. That is, the aunt who drank millet pepper fish soup, it is only the fourth day after surgery, and her diagnosis is about five days or three to seven days after surgery at the Shonan University Affiliated Hospital!

Associate Professor Song Yu ordered it, and that party could only do it!

After checking the room, he immediately rushed to his bed: "Auntie, you are in a good state now, you can get out of bed and move after the operation, and you will be discharged from the hospital today to go home to rest and perform functional exercises?" ”

Associate Professor Song Yu also said these words, but the aunt's daughter was a little unhappy when she heard it: "Doctor Fang, let's stay for a few more days, my mother is going back, and we don't know how to recover, don't worry!"

"Sister, you also know that the turnover of our hospital has been very fast, and patients who have made appointments for hospitalization are also waiting. So please understand. Fang Xian said.

The 14-bed aunt said, "Oh, Doctor Fang, there are so many patients in your hospital, don't rush me, you have one less operation and make less money." Let me stay longer. ”

"Is that okay?" She had a smile on her face, her eyes projecting longing, and she didn't want to be discharged from the hospital at all.

When Fang Xian heard this, he said, "Auntie, it's not right for you to talk like this." When you're in line, you're thinking, are we going to get you in as soon as possible, just to make your money? ”

"Think about it from another perspective, I suggested that you go to Shashi No. 1 Hospital before, but you refused to go, right?"

"The patients in the back have the same mentality as you."

"If we didn't have so many patients waiting in line, we wouldn't have sped up the turnaround." Fang Xian explained this very skillfully.

"That? Haven't I moved in yet? Auntie said with a smile.

"Auntie, your current condition is very good, it's not that you are not clear about anything, we will let you be discharged from the hospital, you just rest and exercise, and you don't need injections, you can change to oral medicine from today."

"It's more convenient to live at home, it's not as noisy as the ward. Don't you think, be more considerate of the patients in the back, they are still at a loss, just waiting for treatment. ”

……

To put it mildly, Fang Xian finally persuaded the 15-bed aunt to leave.

I thought that the newly admitted patients would come in the afternoon, but who knows, the new 15 beds were more anxious than Fang Xian expected, Fang Xian only completed the relevant procedures for discharge, and then the 15-bed aunt and daughter finished the settlement, and the nurse station pushed a cart and waited for admission.

The nurse station compared and confirmed his identity as an appointment patient, and informed the doctor on duty Li Qiu, saying that it was going to be arranged in bed 15.

"Brother Xian, the newly admitted patient in the 15th bed is here......" Li Qiu smiled, said this, and began to concentrate on writing medical records again.

Fang Xian also said with Li Qiu, he heard the words of the nurse on duty, and sighed slightly, thinking that he could go to the skill training room first, and then he needed to come again in the afternoon.

But it's okay, after the 15 beds are closed, so as not to have a worry in your heart, you can practice your skills more distractedly.

When Fang Xian walked to the door of the nurse's station, the original 15-bed aunt was pushed by her daughter in a wheelchair to the outside of the department, and after seeing Fang Xian, she also greeted her warmly.

"Dr. Fang, we have been discharged, thank you."

Fang Xian was asking about the basic situation of the eldest sister on the cart, so he just nodded to her.

The 15-bed aunt noticed that the woman in her thirties was tied with thick gauze and plaster on both sides, and there was pale green pus on the outer surface of the plaster, and her face changed slightly.

"This girl looks so serious."

"Yes, Mom, Dr. Fang is definitely right, her condition is much more serious than yours, you see how anxious her husband is......"

After Fang Xian probably asked about the relevant medical history of the new eldest sister, he said, "So, you have already undergone surgery in Huaishi No. 1 Hospital, and now you have an infection, and the fracture does not heal?" ”

"Hey, don't say it, the hospital's technology doesn't work."

"How can you get infected after surgery?" The woman's husband said.

When Fang Xian heard this, he stared at him seriously, and put down the pen and notebook: "Postoperative infections occur from time to time, especially the chance of open fracture infection is greater. Similar patients here have also had infections. ”

The young man was wearing short-sleeved shorts and sneakers, probably in his thirties, and his face was full of complaints.

Hearing Fang Xian say this at this moment, his emotions were slightly restrained: "Doctor, your hospital is definitely different from Huaishi Hospital, and your teaching skills here must be much better." ”

"15 beds are empty, so let's move in first."

"Now there is only one empty bed in the women's ward, Doctor Fang, you can explain it to the patients in the other two beds." The nurse stood up and gave a bunch of materials to say so.

"Okay! ~”

When Fang Xianyan heard this, he led the woman and her husband to the 15th bed together, and said, "You have brought all the examination materials in Huaishi First Hospital, right?" ”

"The doctor who brought it, but will you admit the test data?" The middle-aged man asked.

"Why not admit it? You've read a lot of reviews on the Internet. Fang Xian smiled casually.

……

After sending them to bed 15, Fang Xian also wore a pair of gloves to assist in helping the patient to the hospital bed, and explained to the patients and family members in bed 1314 that this was just an ordinary infection and would not be infected.

Her current situation is quite complicated, with open fractures of both lower limbs caused by a car accident, postoperative infection, and the fracture does not heal.

Even if you are just admitted to the hospital, you still need to use some medications in time.

For example, the most basic is anti-infective treatment, and then there is swelling reduction and anticoagulation, especially anticoagulation, which requires special attention!

But as he was walking, Fang Xian still felt a faint pain in his stomach, so he took a bottle of soda from the lounge and brought it into the doctor's office.

Seriously looking at the relevant medical records of the First People's Hospital of Huai City, the diagnosis was long, which made Fang Xian have a special headache.

Trauma to both lower extremities: extensive skin and soft tissue contusions of both lower extremities, multiple muscle injuries to both lower extremities, rupture of the anterior tibial artery of the right lower extremity, multiple fractures of the tibia and fibula of both lower extremities and displacement.

Left lower extremity deep vein thrombosis, bilateral lower extremity fractures, open reduction and external fixation stent infection......

This is the discharge diagnosis of the First People's Hospital of Huai City, but Fang Xian still has to re-sort it out.

The current diagnosis at Shonan University Hospital should not be so complicated.

After trauma debridement of both lower limbs, after external fixation and stent fixation of multiple open fractures of both lower limbs, multiple infections after surgery, and thrombosis of both lower limbs? Delayed Healing of Fractures: Nonunion?

At the last two points, Fang Xian put a question mark, because it has been 3 days since she was discharged from the hospital and transferred, it does not mean that there is no thrombosis in her right lower limb.

This is a routine diagnosis related to surgery, and Fang Xian initially gave anti-infective treatment according to the patient's bacterial culture and drug sensitivity in the First People's Hospital of Huaishi, and the sensitive antibiotic was piperacillin sulbatana combined with ceftazidime.

This is supported by laboratory tests and must be renewed. Consult a pharmacy department.

Venous thrombosis is followed by anticoagulation with low molecular weight heparin sodium and vascular surgery consultation.

The patient has pain and must be treated with analgesia, and how to choose analgesic drugs needs to be figured out.

Fang Xian thought so, when he was receiving patients, his thoughts suddenly opened, as if he was much more transparent and organized than before.

Level 3 skills are really easy to use!