However, Luo Tingzhu did not reply again. It's not early, and Luo Tingzhu is estimated to be resting.

Fang Ziye charged the mobile phone, threw it to the side, pillowed the back of his head with his hands, and looked at the knowledge points with a daily income of more than 40 points, and felt beautiful.

Yesterday, I spent more than 60 points on the manual reset technique, adding points to level 3, and now I have returned to more than 40, which is quite half a prostitute.

It's a pity that it can't be like this tomorrow, if you need to be on duty, the emergency surgery is also an emergency operation, and it has little to do with you, and tomorrow night, Senior Brother Gu Yi has another experiment, and he has to be absent......

There's still not enough time, far from it.

When can you get rid of the regular training, you will be relatively freer, and at that time, you must be the largest source of knowledge points.

Take your time, don't worry, if Senior Brother Jiehan can really apply for a small topic, then he will have experiments to do, experiments to do, articles, and new knowledge points, and he will be able to make a bigger contribution to staying in the hospital.

Clinical practice can not be relaxed, try to catch up before the doctoral graduation, no, try to rush before applying to go abroad, just break the first practice room, so that Professor Deng Yong has a deeper memory of himself, so that after he goes abroad, he will never forget, otherwise when he comes back from abroad, what should Professor Deng Yong do if he forgets himself?

If you still have to go abroad, take a look at the clinical atmosphere in foreign laboratories......

And if you apply to go abroad, you also need scientific research ability to get a full scholarship, otherwise you won't add this pressure to your parents by relying on your own expenses!

Come on! ~

Fang Ziye fell asleep.

Thursday, November 17, is the second day of the National Orthopaedic Annual Meeting.

Fang Ziye washed his face and brushed his teeth early, and after eating a hot dry noodle in the cafeteria, he rushed to the department.

At this time, the group members who stayed in the department had already arrived, only Shu Lang, who was not seen yet, Senior Physician Qin Geluo, Gu Yi, Luo Tingzhu and Lan Tianluo, were already busy in the doctor's office.

Gu Yi was chatting with Qin Geluo and the others, while Luo Tingzhu was checking and reviewing the corresponding medical orders of the patients in this group to ensure that nothing went wrong.

Fang Ziye happened to walk into the office in a white coat, tidied up his badge a little, and then pulled out a chair in front of the computer, intending to sit down.

After Jin Hongzhou saw Fang Ziye come in, he suddenly had a flash of inspiration, and after looking at Fang Ziye a few times in a slightly stunned look, he changed the topic: "By the way, Brother Nuo, Brother Luo, you can help me take a look at this joint dislocation." ”

"How do I look at it, this anterior dislocation is not so simple, it seems to be close to moderate."

Yesterday, there were two anterior shoulder dislocations, and Jin Hongzhou didn't take it seriously, but after Fang Ziye sent the plain films before and after the review to Jin Hongzhou, Jin Hongzhou suddenly realized that the dislocation of the aunt yesterday was not a particularly simple mild dislocation.

Later, Jin Hongzhou planned to ask, but because of other things, it was delayed, after the emergency consultation, the emergency consultation, and the flat consultation ran until ten o'clock, and Fang Ziye and Luo Tingzhu went to Shashi to take cells, so Jin Hongzhou was not easy to disturb.

As soon as Fang Ziye flashed at the door, Jin Hongzhou suddenly remembered that there were two big brothers in the department, both of whom had just been hospitalized, and they should not forget the emergency disease with the highest incidence of dislocation such as anterior shoulder dislocation.

When Fang Ziye heard this, he was a little nervous, and after he skillfully logged in to the account password, he turned his head to look over.

It seems that in the emergency room yesterday, I did a reset by myself, could it be that I made a mistake in my assessment?

Although Fang Ziye is confident in his theory and operation, the person who spoke was Jin Hongzhou, and the general inpatient physicians like Jin Hongzhou basically passed the practice room 801, and in terms of the attainment of manual resetting, they would not be worse than themselves, but only better.

If you make a mistake in judging because of your own limited knowledge, it is not impossible to happen.

After Jin Hongzhou handed the mobile phone to the two elder brothers, he looked at Fang Ziye: "Ziye, don't be nervous, you are doing it, it's not that you didn't reset well." ”

"You know what I mean, right?" Jin Hongzhou's eyes were deep, as if he was hinting at Fang Ziye.

Qin Geluo was hospitalized for a year and a half earlier than Li Nuo, and his qualifications were longer, but after a few glances, he said very professionally: "According to the distance of the dislocation, it belongs to mild to moderate dislocation." ”

"Relatively speaking, it's not that easy to reset, right?" Qin Geluo's tone was a little playful, and with a smile on his face, he also looked at Fang Ziye.

As if to say, you kid, silently.

Li Nuo's voice was a little thicker: "Ziye, have you taken a fancy to the 'chicken blood conditions' given to you by Professor Deng, this is planning to leave the customs early and graduate early?" ”

Out of the practice room, there are rewards in the department, which is a condition for all professors and directors to hang on the bright side.

For master's degree and residential training, you can go out of the master's stage to the standard practice room and directly arrange reading.

If you go out of the first practice room at the doctoral level, try to arrange employment, but it depends on the luck component, that is, whether there are other people who also go out of the first practice room in your year.

If not, then unless his scientific research accumulation is too rich that you have to give way to him, it is you who have the advantage, which is the recruitment rule of Zhongnan Hospital that has lasted for many years.

Hearing Li Nuo's rough voice, Luo Tingzhu, who was checking the doctor's instructions, moved his ears and looked at Fang Ziye from the side, but Fang Ziye did not look at her direction at the moment.

But even so, Luo Tingzhu was still thinking in his heart that if Senior Brother Fang Ziye could graduate early, he could stagger her graduation year.

To form a competitive relationship with Fang Ziye in employment, it is Senior Brother Yan Zhiming and Senior Brother Xue Cao, who have just entered the first year of the doctorate, if this is the case......

"Brother Nuo, there is really no such thing, I only dare to think about it, but I don't dare to really do it."

"If you can run for three years, why bother to finish the study stage in two years? Take your time. When Fang Ziye spoke, he touched his stomach, with a smile on his face, and he was modest and cautious.

Just kidding, after graduation comes employment, which is much more brutal than the doctoral entrance exam.

If you can accumulate one more year in the reading stage, you need at least one or two more articles, and your clinical skills will be much deeper.

The impact factor of the article in the first district that my teacher gave me was as high as 6 points.

The impact factor of 6 points is not low in the field of article.

The reality is not a comment area, nor is it a six-point article in the TV series, and it is the result of the publication of basic experiments, and only those who know how to know how to do it know what the gold content is.

In real terms, according to the degree of contribution and the workload of scientific research, a six-point article is much more formal than a ten-point meta-analysis or a bio-letter.

"It's only been a long time since I saw it, Ziye is in the practice room, tinkering with that mannequin, and he can get out of the customs."

"It seems that Viagra is right, if you don't put pressure on Ziye, draw a cake for him, the explosive power is like a mule, that is called a fierce one." Qin Geluo generously made an analogy at this time.

Senior Brother Gu Yi looked at Fang Ziye's face full of envy: "Ziye's talent is really good, whether it is clinical talent or scientific research talent. ”

"I'm really sorry." When Gu Yi said this, he stopped and didn't continue.

Therefore, Lu Zhefu has already walked in, Lu Zhefu is a first-year doctorate, and he only entered the department this year.

Although there will definitely be no competition between Fang Ziye and Gu Yi, Gu Yi can look at Fang Ziye's growth in a big way, but Lu Zhefu is different.

If Fang Ziye thinks about graduating early, it will be in the same class as Lu Zhefu, and Lu Zhefu will definitely feel a lot of pressure, and there is no need to sell anxiety to him.

"Brother Nuo, Brother Luo, Brother Zhou, what are you looking at, am I not washing my face?" Lu Zhefu is tall, 1.8 meters, slightly handsome, and extremely talkative and joking, and at the same time rubs his face, and then slides around.

Li Nuo changed the topic first and joked: "We are discussing, Zhefu, how can you fight for 30 years less?" ”

Lu Zhefu's temperament was more outgoing, and he whispered: "Brother Nuo, I'll send you the rich woman's address book in Han City later!" ”

At the same time, he also winked at Li Nuo, not excluding making fun of himself.

Li Nuo couldn't stand it first: "Don't, brother, you are my eldest brother, don't say that you are sending me an address book now, you can send me a call, it is best to make a note." ”

"Damn, your sister-in-law is a vinegar jar, I'm too lazy to coax."

Qin Geluo leaned back at this time, and said with a smile: "Who let Master Nuo become a chic master back then, and finally collect the mountain?" ”

"If you don't take the mountain, you are still the master of our hospital."

"Rise better than a chicken!"

Li Nuo coughed directly, and touched his chin at the same time: "Brother Luo, save face for your brother, you are also a junior senior doctor, so many junior brothers are watching......"

After Li Nuo confessed, everyone laughed and waited for the start of the shift.

Small attendance, just out of the general hospitalization not long ago.

He was hospitalized and had just graduated from his doctorate.

Everyone is a person who still remembers the hard days, so the sense of distance between them and their subordinates is the smallest moment, and they get along more harmoniously.

said that it was a shift change, but because the superiors were not there, it was actually a simple medical record report.

Deng Yong and other professors are not there, Qin Geluo, the attending officer, does not dare to directly confront a leader like the head nurse, what the other party says is what it is.

After checking the ward, Qin Geluo took Lan Tianluo, Gu Yi and Luo Tingzhu down to the operating room, while Fang Ziye and Shu Lang needed to be in the ward to chase the results of the preoperative examination and sign the conversation with the patient because there was a surgical patient tomorrow.

And ah, today's emergency department is estimated to have little to do with Fang Ziye, because Fang Ziye still has to be on duty in the ward, and he can't leave the ward.

Naturally, although there were no emergency surgeries and operations to do, Fang Ziye found that there were as many as a dozen new patients with minor diseases who were admitted to the hospital yesterday, and the empty beds were almost full, all of which were minor trauma.

It just so happens that there are not enough people in the department now, and Fang Ziye can polish them carefully without any scruples for the pre- and post-operative medical orders of these cases.

Clinical wards, operating rooms, outpatient clinics and emergency departments, including laboratories, are treasure troves that are more or less a problem as long as there is time to dig them.

No matter how bad it is, if you drill into the practice room, you can increase your knowledge a little bit in a day.

No matter how small a mosquito is, it is still meat.

After Shu Lang finished signing the conversation, he looked at Fang Ziye with a little nervousness, clenched his fists slightly, and asked, "Senior brother, today Brother Luo arranged for me to go to the emergency operating room to follow Senior Sister Luo for surgery, can you help me track down the results of the examination of the bed in charge?" ”

Shu Lang is a student of Professor Deng Yong, and he is also in the second year of the master's degree, and he has a relatively good talent.

A long time ago, when Fang Ziye's suturing technique had not yet reached level 2, Shu Lang's suturing technique had already surpassed Fang Ziye and reached level 2, and it was also quite valued after passing the level of suturing orange peel.

Now, although Shu Lang has not yet passed the level of suturing tofu, he has also been immersed in it for several months, and now that his superiors are not there, it is normal for him to think about fighting for more clinical operation opportunities.

In the past, Shu Lang was called Brother Fang Ziye, although Fang Ziye was also a senior brother in the third year of the master's degree, but in fact, it was more natural to call Brother Ye to get along, but after Fang Ziye was recognized as a student by Professor Deng Yong, he had to change his words.

"Go ahead, Shu Lang, I think you still call me the same way before, it's more cordial."

"Senior brother and brother, they all mean the same thing." Fang Ziye nodded and agreed.

Shu Lang hurriedly thanked him, and carefully tore off a page of paper, on which were written the more important inspection results to be traced: "Then, senior brother, I'll leave first?" ”

Fang Ziye clipped the paper that Shu Lang tore off into his notebook and made an OK gesture.

After Shu Lang left, Fang Ziye took a closer look at Shu Lang's notes, and his heart was dark: Sure enough, the brothers and sisters in the hospital are actually very careful and reliable in doing things. This is a duty, not something to be praised.

As soon as the things were collected, only ten minutes later, Fang Ziye made a discovery.

Patients with a minor debridement suture had an elevated white blood cell count and an increase in erythrocyte sedimentation rate (ESR) and C-reactive protein.

At present, when there is not enough manpower, the doctor in charge of the bed cannot be so meticulous, so it is not discovered by others, and such a small debridement suture, under normal circumstances, is not directly treated with antibiotics.

Routine pain relief only.

Moreover, the results of the postoperative blood draw and re-examination were not lazy on the part of the bed-keeper, but the results were indeed not available this morning, but there were not enough manpower, and the bed-keeping doctors were all pulled to the operating room by their superiors.

But now, with indications, it is natural to get up.

Fang Ziye hurriedly prescribed a cefuroxime, and took notes, and asked Lan Tianluo to fill in the medical records when the time came.

Seeing this, Fang Ziye put away the notebook first, walked out, and saw the nurse on duty: "Sister Xia, I will add some medical advice, it will end at about half past ten, and you will implement it uniformly at that time, and you don't need to implement it little by little." ”

"Good work."

Liu Mengxia is only in her thirties, with a good figure, probably in the prime of her life, and she is kind: "It's okay, Ziye, you don't have to come out to tell us, there are few people in the department now, and you can understand." ”

"If you want to add antibiotics, remember to do a skin test."

How many years has Liu Mengxia worked in the department, and she has encountered battles in the past few days, I don't know how many times, there will be one at the National Orthopedics Annual Meeting, and there will be one more at the Orthopedic Annual Meeting in Hubei Province.

That's normal.

"Okay, hard work! ~" Fang Ziye clenched his fists slightly, after explaining like this, he would add more medical advice later, so that he would not be asked by the nurses why the sheep, one by one.

In the next hour, Fang Ziye completely turned into a hard-working little bee in the department, looking at a bed of medical records, looking at a bed of patients, and then making occasional changes, mainly to assess whether it was necessary to strengthen analgesia or add antibiotics and anticoagulant and swelling drugs.

In such a wave, after Fang Ziye modified the last parecoxib sodium to celecoxib orally, Fang Ziye's knowledge points increased by a total of 12 points.

Fang Ziye looked at this harvest and immediately felt beautiful!

Such a big benefit, even in the operating room, can't be worth it.

In the operating room, it is the contribution of the operation, and in the ward, the amount of new patients is full.

After the doctor's order is revised, Fang Ziye can start to change the dressing for his bed, the dressing change is routine, and each doctor in charge of the bed takes care of himself, if it is really too late, Fang Ziye will help.

After changing the dressing, Fang Ziye talked and signed for the two beds he was in charge of.

These are two simple closed fractures, which are required for elective surgery, and it is best to wait until the swelling has subsided to avoid skin swelling and increase the chance of infection and skin necrosis.

If it is an open fracture, then there is no way, it is already open, and there is a greater chance of infection if it is not done, but if it is not an open fracture, then wait for mannitol swelling and preventive anticoagulation to go up first.

Fang Ziye explained all this to the patient clearly, why not do the operation immediately: "There is no way to completely avoid surgical infection, and any doctor, no matter how big an expert or professor, if he tells you that he has undergone surgery, it is absolutely impossible to get infected." ”

"This is pure, because if there is a doctor in the world who has never been infected after surgery, it must be that he has not been in contact with enough patients."

"Therefore, for the sake of insurance and to reduce the risk of infection to a greater extent, it is still necessary to wait for elective surgery after the swelling has subsided, which is the most scientific surgical arrangement and planning. It is also a clinical guideline recommended after big data statistics, which is not a deliberate delay for our doctors. ”

"You can also look up the relevant information."

"The second one, proper analgesic treatment after surgery will not damage the gastrointestinal tract, which you should not be superstitious by popular science. Pain belongs to the fifth major vital indication, and the management of painless ward is very scientific, so that your postoperative rehabilitation training will be more active. ”

"After intramedullary nail fixation, get out of bed and walk the next day, isn't it good?"

The patient's family was stunned: "Get out of bed the next day?" The orthopedic doctors in Douyin all said that it is best to get out of bed four or five days after surgery? ”

"That's a different situation, people are complex fractures, comminuted fractures after internal fixation, then five days or even a week later, it is normal to get out of bed and move."

"But your fracture type is different, it is a relatively simple fracture, and it is an intramedullary nail internal fixation, and if the fixation is reliable, early getting out of bed can reduce the risk of thrombosis."

"What we expected was this, when the time came to get out of bed, we would definitely inform you, right, the actual situation, the actual analysis, and it is not necessary to follow the advice of experts from other hospitals."

"The advice of experts from other hospitals is certainly correct, but the prefix they describe, you may not have noticed. All right? Fang Ziye patiently explained.

After all the words were in place, the patient and his family asked about the approximate cost.

"You pay about 10,000 yuan first, now the steel plates are all centrally purchased, more refunds and less compensation, the final cost should be about five or six thousand, whether it can be reimbursed, it depends on what kind of injury mechanism you have."

"If there is a third party, you can't take insurance, if it's a work-related injury, it's work-related injury medical insurance, you can go to the medical insurance department to consult, our clinicians have a relatively limited understanding of the medical insurance system."

After Fang Ziye got the signature and consent, he confessed like this.

"Okay, thank you Dr. Fang!"

"It's okay, if you have any other questions, you can contact me at any time today, I am on duty today, and that's the case, if you think the risk of surgery is relatively large, you can contact me at any time before tomorrow morning, cancel the operation, and then arrange it at a later date."

"But if it's after entering the operating room, it may be too late!" Fang Ziye continued to explain in such detail.

……

And, as soon as the conversation was signed, Fang Ziye found that he no longer had the time to lie down and rest.

At the door of the doctor's office, there was a trainee nurse, who stood there timidly, and said, "Doctor Fang, there are two emergency patients in the emergency department, and Sister Xia said to let you take a look, and now I am waiting for you on the opposite side of the nurse's station." ”

Fang Ziye signed the consent form for the conversation between the two, returned to their respective positions, and compared the names of the bed numbers, and then pinched the medical records in his hand: "Okay, I'll put the medical records and read them immediately." ”

"The patient has been waiting for about ten minutes, or I'll put you in the medical record book, Sister Xia said, these two emergency patients and their families are quite qualified, don't let people wait too long." The little nurse replied and reached out to take the medical record folder.

"Thank you!" Fang Ziye understood what Sister Xia meant.

Gifts are still exchanged, you respect me by a foot, and I am still a foot.

Sometimes, it's not that the more you push and the more fierce you are, the more priority will give you.

On the contrary, such patients will delay their own diagnosis and treatment, you wait quietly, and the doctor will come to deal with you as soon as he is free.

People are mutual, and only by respecting each other can we understand each other.

Walking to the door of the nurse's station, Fang Ziye found that the two patients, one was elbow dislocation and the other was shoulder dislocation.

Both patients were not very old, and the younger one was exactly 14 years old and avoided going to the pediatric clinic.

Fang Ziye politely invited both of them to the doctor's office, and after checking and checking the dislocations of the two people one by one, he was diagnosed with shoulder dislocation as a mild injury of anterior dislocation, which can be treated by manual reduction.

The child's posterior elbow dislocation is also a mild injury, but if the posterior dislocation has ligament damage, further verification may be required.

The program can't be messed up, one by one.

The patient with shoulder dislocation is an eldest brother in his thirties, who should be a worker at a nearby construction site, with cement ash on his body, no family members, and a person carrying the affected limb by himself.

He came first, and Fang Ziye could only receive him first: "Big brother, in your case, you can still reset by technique, but manual reduction has a certain risk, and it may not be able to be reduced, you are in vain, and you have to have surgery." ”

"Did Dr. King tell you this?"

The eldest brother bared his teeth: "I said, you doctors don't pack tickets, the first few times I sent patients here to see a doctor, it was the same rhetoric, but I believe you can definitely handle it." ”

"I asked my nephew when I came, generally speaking, you say that what is possible is what can be done, otherwise, if the failure rate is high, I will be in the operating room early, right?"

Fang Ziye did not refute, but he did not agree: "The established risk is inherent, the degree of your dislocation is indeed mild, if it is moderate, or moderate or above, you will have to check the MRI." ”

"This is the ...... of the Informed Consent Form"

"Mom, when are you going to see me? I'll have to go back to class later. The little boy asked.

And as soon as he called this, the young brother was a little unbearable, so he licked his lips, and his eyes were full of pampering: "Doctor, why don't you show the child first, I'll bear it, this looks as big as my daughter." ”

"Big brother, you can be. But you took the initiative to let it?! You can't report me for favoritism, show it to others first. Fang Ziye's voice was correct.

Fang Ziye has to explain this kind of thing clearly, because this is the lesson of the previous teachers.

During the general hospitalization, Nuo Ye was like this, although it was harmless in the end, Li Nuo still symbolically wrote a report and reported the incident to the medical department......

Fang Ziye immediately seriously assessed the degree of the child's posterior elbow dislocation, and then hissed softly.

Posterior elbow dislocation, where patients may experience significant pain and swelling due to changes in joint structure. The elbow joint is elastically fixed in a semi-flexed position of about 45°, and it is a boot-shaped deformity.

At the same time, the posterior cubital triangle is changed: the cubital fossa is full and full, and the inverted isosceles triangle relationship composed of the medial and lateral condyles of the humerus and olecranon is changed.

This is a clear sign of posterior elbow dislocation.

There is nothing wrong with post-diagnosis dislocation, but from the plain X-ray, the degree of dislocation of the child's posterior elbow dislocation is a bit ruthless.

Although there are no concurrent humeral fractures, ulnar nerve injuries and ulnar collateral ligament injuries occur, particularly in the anterior fascicle, depending on the degree of dislocation.

As for ligament injury, either a physical examination is done to confirm it, or an MRI is required.

"How about the doctor, my child, this condition is not serious, is it?" It was her mother who brought the child to see the doctor, she was dressed in formal clothes, she should be a white-collar worker, but she didn't know what occupation she was engaged in, although she was in a hurry, she was also quite polite.

Fang Ziye explained: "The dislocation situation is a bit serious, and the reduction must be reduced as soon as possible, but there is a problem, he is likely to have a ligament injury now." ”

"Now there are two options, the first is to do an MRI first, and then do a reduction, and before the reduction, the ligament damage should be detected."

"The second option is to do a reduction to relieve the pain, and then an MRI to determine if there is a ligament injury and to assess the extent of the injury."

"However, there is a problem, that is, the reduction process may also be accompanied by the possibility of ligament damage."

"My suggestion is to do an MRI first, and then an MRI, which can be more intuitive and avoid some misunderstandings between us! ~”

Fang Ziye's explanation is relatively clear.

In other words, in your child's case, ligament damage is almost certain, but it is necessary to do an MRI first to fix the evidence to prove that it was not caused by our doctor's reduction, which is a key point.

"Isn't that troublesome?" The woman's brow furrowed.

"It's more troublesome, but you also know that you must be holding a certain fluke in your heart right now, what if there is no ligament injury? Right? What if our doctors made it up? Fang Ziye tore this fig leaf very bluntly.

"But in fact, according to statistical probability, the probability of posterior dislocation of this degree accompanied by anterior bundle injury of ulnar collateral ligament is at least 80 percent, but the degree of injury is different."

"It may or may not require a ligament injury that needs to be treated, and that's something you need to decide."

"If you believe us, then we can reset it first and check it later for the sake of the child being less guilty, but you will need to sign and write down the fact that I have fully informed you of the situation."

"Otherwise, you might as well follow Dr. King's advice. I think that's what Dr. King is advising you with, right? Fang Ziye said with a smile.

Jin Hongzhou wrote clearly in the emergency medical record book, and suggested that MRI examination should be carried out first, and then manual reduction treatment should be performed.

But it is estimated that it is the child's mother, who went to make an appointment, even if she went to the emergency department, she still had to make an appointment until noon or after the afternoon, and she couldn't wait, so she came to the ward again to try her luck.

"Oh, how can it hurt your tendons?" The young man's face twitched a little distressed.

"The school held a sports day, and during the 100-meter sprint, he tripped and fell and put his hand on the ground." The woman was also full of distress, and she couldn't pay attention to it all of a sudden.

The boy felt a little guilty and did not dare to speak.

Fang Ziye said: "Sister, if this is not the case, you think about it a little more, I will make a reset for this eldest brother first, and then he will go for a review, or you can also discuss it with the child's father." ”

"You also have to understand that in the current medical environment, it is true that our doctors need to explain to you before and after things. While we can now speculate on ligament injuries, there is no evidence that it can be absolutely fixed. ”

"After you operated, you said that our doctor made it, then we can't argue! ~”

The eldest brother signed directly and straightforwardly, and no longer gave any advice to the woman, and followed Fang Ziye to the operation room first.

After Fang Ziye clicked a few times and the pain was relieved, his eyes lit up and he asked, "Doctor, your reduction technique is so good, can you directly deal with that child?" ”

"If that's the case, don't you embarrass their mother and son?"

Fang Ziye replied while demonstrating his movements: "Big brother, that's really not a difficult thing!" ”

"It's like, in a place where there is no surveillance, someone hits someone else's electric car and scratches it, but you don't have monitoring evidence, how can you prove that your car was scraped by someone else, not yourself?"

"You can't call the police? Right. Fang Ziye finished speaking.

Only then did he say: "Well, your pain symptoms have been relieved now, the square shoulder deformity has disappeared, and your range of motion has been restored, just hang a forearm sling and rest for a while." ”

"But be careful, don't go to work, especially heavy work, you must rest strictly for at least half a month, and then come back for a review, before you dare to rest assured, otherwise, it is very easy to dislocate again."

"Be clear about this, I'll write you a leave note." Fang Ziye instructed carefully, and at the same time got 5 points of knowledge, and he was in a better mood.

"Well, there's no way around it, I can only listen to your doctor's advice." The young man no longer persuaded him, and let Fang Ziye give him a forearm sling.

Then he asked in a low voice, "Doctor, do you want me to take some medicine out to eat?" ”

"Actually, it's not necessary, but if you have to insist, you can take a little swelling medicine appropriately. But I don't think it's necessary. Fang Ziye knew that the other party was injured at work and had to be reimbursed.

But taking medicine is not a good thing, and it is best not to take it if you can, so as not to hurt the gastrointestinal tract.

After Fang Ziye explained the precautions after the reset to the young man, and put on the forearm sling, when he walked out of the operation room, Jin Hongzhou also hurried back from the emergency department at this moment.

Without him, because Fang Ziye took a photo of the child's illness and sent it to Jin Hongzhou, Jin Hongzhou was worried that Fang Ziye was a bit of a newborn calf, so he did the reset directly.

However, when I entered the office and saw that the woman was embarrassed, I was also relieved.

Fang Ziye explained: "You go to the review first, and then the review will come up directly to see the results of the review, and if there are no other problems, you can go back to rest." I still have patients to deal with here, so I don't have much nonsense. ”

"The doctor's order on this reflects the rest time and review time, you show it to your unit, you should be able to grant leave, you can call your unit, if the doctor's order is not good, you go to the comprehensive management office of the emergency department to take the medical record book, ask a professional leave note to come."

"Okay, Dr. Hardship." The young man nodded in understanding.

After this, Fang Ziye returned to the door of the office, and seeing that Jin Hongzhou did not disturb the woman's call, Fang Ziye said: "Brother Zhou, this child's dislocation is a bit serious, and it will definitely be accompanied by collateral ligament injury." ”

"Well, I've already explained to her, I'm going to do an MRI first, but I didn't expect her to come directly to the ward, and blame me for not telling you, but fortunately you were cautious enough and didn't reset it directly, otherwise it would be a big trouble."

Jin Hongzhou had some chills in his back.

In case the newborn calf is really reset without fear of the tiger, then the responsibility is Jin Hongzhou's, and Jin Hongzhou is responsible for the emergency consultation.

Naturally, Fang Ziye will also have a little bit of responsibility.

In this way, Fang Ziye is not only at the level of manual reduction, but also familiar with the diagnosis, diagnosis and treatment process, etc., and is a very reliable person, who does not have a hot brain to do it directly.

This posterior dislocation technique is simple to reduce, and it must be reduced regardless of whether there is ligament damage or not, but the procedure must not be messed up.

After a while, the woman's call ended.

Stand up: "Doctor, I'll sign, let's reset my child first, it hurts so much that I feel distressed." ”

"If you say sign it, sign it."

"I'll do an MRI after it doesn't hurt." is also quite helpless, although the voice is not choked, but the eye circles are red.

Women are weak, mothers are strong, at this time, her husband really can't leave, there is a big project to discuss, can only be contacted by phone.

Jin Hongzhou said: "Sister, it's not that we embarrass you, but the actual situation is like this, you say that we will directly diagnose ligament injuries, that's our foolishness, even according to experience, it is very certain, 99.9% possible to speculate." ”

"You can't mess with the diagnosis."

Fang Ziye prepared the corresponding informed consent form for operation as early as possible, and deliberately added a posterior dislocation, the risk of lateral collateral ligament injury is very high, and the patient's family has a strong desire to do manual reduction with knowledge, and has been informed of the corresponding risks, and still requires manual reduction treatment......

In fact, the significance of this sentence is not great, mainly because the patient himself should write it clearly, already know, the doctor has informed that the risk of ligament injury is extremely high, and manual reduction may also lead to ligament injury, and is willing to accept the corresponding risks.

After signing, there is nothing to say, Fang Ziye and Jin Hongzhou are the main operators, and Jin Hongzhou is the assistant, and the child's technique is reset.

For two people, the method of pulling and extending and flexing the elbows in the sitting position is a very classic choice of reduction techniques.

The patient takes a sitting position, the assistant stands on the back side of the patient, holds his upper arm with both hands, the surgeon stands in front of the patient, holds the wrist with both hands, puts the forearm in the supinated position, and the assistant is relative to traction for 3~5 minutes, the surgeon holds the wrist with one hand to maintain traction, the thumb of the other hand is against the lower end of the humerus and pushes back, the remaining four fingers are placed at the olecranon, the front end is lifted, and the elbow joint is slowly flexed, if the molarization sound is heard, it means that the dislocation has been reduced!

When the patient went for a follow-up examination, Jin Hongzhou took off his examination gloves and looked at Fang Ziye: "Yes, it can be seen that there is kung fu." ”

"Your clinical talent is comparable to viagra, and it is very likely that you will be out of the first practice room before you graduate from the doctorate."

"Thank you Brother Zhou for the compliment, and thank you Brother Zhou for giving me the opportunity." Fang Ziye's tone was sincere.

Good guy, this elbow joint manual reduction, because it is medium to severe, after the reduction is successful, even with an assistant, he still gets 15 points of knowledge, which is three times as much as the previous big brother.

If there is no Jin Hongzhou as an assistant, it is estimated that it can soar to 20 o'clock.

"You earned the opportunity!" After Jin Hongzhou washed his hands and dried them, he patted Fang Ziye on the shoulder.

"It's very good, I'll get you in for all the dislocations you encountered today, so that you can have a good time."

"In the future, when you are on duty, tell me too." Jin Hongzhou said this meaningfully.

Fang Ziye was stunned for a moment, and smiled even more happily: "Thank you, Brother Zhou!" ”

Fang Ziye decided from this moment that he was going to fall in love with being on duty.

(End of chapter)