Fang Ziye's own affairs had been dealt with, and he stood up as soon as possible, but he didn't leave in a hurry, but asked: "Brother Lei, was the doctor on duty running for the emergency consultation in our hospital before?" ”

If Fang Ziye heard it right, it should be such a model.

Guo Yunlei got the doctor's qualification certificate last year, and officially participated in the duty after registration.

"Yes, Brother Ye." Guo Yunlei nodded, moved the keyboard slightly, and leaned in the direction of Fang Ziye to show respect.

"Are there any matters to be paid attention to in this emergency consultation? If not, I'll just go over. Fang Ziye asked casually, and he didn't waste time.

Guo Yunlei's eyes flashed slightly, and he thought for a while before saying, "If the patient has been seen before, Brother Ye, you may have to pay a little attention." ”

"Because whether it is Enshi People's Hospital or Minmin University Hospital, the transferred patients may be tricky patients, but if it is the first time, it is relatively simple."

"Generally, routine emergency patients are directly called to the ward by the emergency department, and such emergency consultations are mostly multidisciplinary joint injuries, and there are indications for treatment in our department, so it is recommended that other specialties consult and assess vital signs before hospitalization."

In fact, Fang Ziye's inquiry surprised Guo Yunlei, but considering the Zhongnan Hospital where Fang Ziye was before, it was basically difficult for the little doctor to get permission.

Don't say that it is a master's degree or a doctor like Fang Ziye, even a mature doctor who has studied in the past, it is impossible for you to be on duty, and even the opportunity to come to power can only wait and fight.

"Okay, thank you Brother Lei, if there is a problem, I may call you, Brother Lei, don't fool me, what I said about mutual learning is not business mutual blowing, I will really ask you." Fang Ziye explained, and then walked out.

From Jiehan and Luo Tingzhu, Fang Ziye learned a little, if he doesn't understand, he asks, if he doesn't have a face, he can't be embarrassed, if he can learn something, what kind of face do he want.

Fang Ziye glanced at his chest, he hadn't had time to do the badge yet, but it didn't matter, he was going to a doctor with practicing authority, and he didn't necessarily have to ask for a badge, even if he hung a badge, he could only be a resident doctor.

Fang Ziye is very familiar with En's Central Hospital, and Fang Ziye has been to the emergency department once before. Although it is some distance from the inpatient building, it is fine.

The speed of the elevator could not be accelerated, and after Fang Ziye got off the elevator, he hurriedly trotted.

In case of emergency consultation, the consulting doctor must arrive within fifteen minutes, which may not be such an absolute limit, but if it can be done, Fang Ziye still tries to hurry up as soon as possible to save time.

What if it's a large hematoma or trauma?

Then you have to call the operating room quickly and ask the superior to take the time to send the patient to the operating room.

It's just that before seeing the patient, Fang Ziye can only speculate from the general procedure.

Fang Ziye soon arrived at the emergency department, which was still slightly cluttered.

Supporting the patient's family members and patients, carts, wheelchairs, patients with their hands covered and holding small openings, nurses pushing carts, and white coats trotting in and out are difficult to see at a glance......

Fang Ziye quickly ran to the door of the surgical emergency room and asked inside: "Teacher, which emergency consultation patient is in the orthopedic department?" ”

The surgical emergency room, with an area of more than 20 square meters, is slightly larger than the room in the ward, facing the door is the workbench, and then on the left and right, there are cart beds.

There are two patients lying on the left, and three on the right, each with a white coat to handle or read films, and there are also emergency medical records.

Fang Ziye inquired about the white coat sitting at the doctor's workbench, approaching.

"Orthopedics? Urgent consultation? He was also stunned for a moment, obviously he didn't correspond to the five beds outside, which one needed orthopedic consultation.

"Oh! ~”

"Orthopedics, you come with me."

"Brother Yu, can you help me take a look......" After he stood up, he said into the distance.

Although there was no sound to respond, Dr. Yu, who was debrideing the patient, had already nodded.

"Mr. Du, are you going to the operating room?" When Fang Ziye heard this, his heart tightened slightly.

Fang Ziye saw that the doctor in front of him with a very oval head was called Du Gaozhong, so he politely called Teacher Du.

Du Gaozhong was wearing a mask and a hat, and shook his head when he heard this: "No, this patient and his family are a little difficult, they are transferred from the Minmin University Hospital, and there are already opinions on how to deal with it in the medical records." ”

"This hospital is transferred, we will definitely give priority to the opinions of the outer hospital, and hope that after he does an MRI, we will ask your orthopedic department to come and see, but the patient does not agree, I have to say whether the Minda Hospital has called to say hello, we are complicit."

"I was noisy in the emergency room before, and I was taken aside by our director."

"You have to be careful." Du Gaozhong saw that Fang Ziye was young, so he kindly reminded him.

He is probably in his thirties, calm and unhurried.

I have been in the emergency department, and the number of dead and injured people I have encountered is not a few, and if I panic, I will definitely not be able to stay.

"Thank you, Mr. Du, then I understand." After hearing this, Fang Ziye followed Du Gaozhong to a deputy director's office that seemed to be relatively private.

Before he arrived at the door, Du Gaozhong was about to knock on the door, when a voice came from inside: "Director Ning, don't talk to those doctors in Minda Hospital anymore." ”

"You just said that there was something wrong with them, I just twisted it, and I did an X-ray, and I did an MRI, and I had to say that if I didn't do an MRI, I wouldn't be treated, and even recommended that I be hospitalized."

"What kind of doctors are these?"

Du Gaozhong's hand froze slightly, but he was stalemate for three seconds, and he still knocked on the door with his left hand and pushed it open with his right hand: "Director Ning, the orthopedic doctor has arrived, and I will bring him over directly." ”

Fang Ziye was next to Du Gaozhong, and he didn't stay, and after Du Gaozhong opened the door, he walked in directly.

The orthopedic department and the emergency department are parallel units, and there is no upstream and downstream department, and Fang Ziye used to be in the trauma surgery department of Zhongnan Hospital, and the first education he received was that when he met a patient, he should go to see it first, and then he would see it, don't hesitate, don't hesitate.

It's an art of getting along.

"Hello, who is the patient, and where is it uncomfortable?" After Fang Ziye walked into the office, he first smiled at Director Ning, and then asked the two people directly opposite Director Ning's square table.

A man and a woman, probably in their forties, should be husband and wife.

"Well, see for yourself. Let's ask one person, come one person and ask once, I said, what's going on in your hospital now? ”

The injured man directly used the arm of his right healthy hand to push the medical record book on the table.

The palms of his hands are still carefully protecting his shoulder joints.

Director Ning immediately said: "Doctor Fang, it is this gentleman who is injured, and the family member next to him is his wife, which should be a dislocation of the shoulder joint." ”

"I have been treated at the Minmin University Hospital before, and it is recommended that after the MRI, surgery may be required, you are a professional orthopedic surgeon, you can also take a look."

Director Ning didn't pay attention to Du Gaozhong, who brought Fang Ziye over, but a seemingly ordinary sentence projected a huge amount of information to Fang Ziye.

It is difficult for patients and their families to entangle, and they have seen it in the Minmin University Hospital before, and they need to be examined and operated.

Fang Ziye's voice and tone were full of gentleness, and while opening it, carefully looking at all the data and medical records, he said, "I have seen it in the Minmin University Hospital before, why don't you choose to deal with it there?" ”

"The trauma surgery at the University Hospital is excellent."

Fang Ziye didn't say that the trauma center in his hospital was not good, and he didn't dare to say such a thing.

"That's all blown out, watch people cook, and those who have a relationship will reset and leave, like us, ordinary people, who have nothing to do with it, then stay and open a knife."

"It's the same problem, and the solution is completely different."

At the same time, Fang Ziye saw the signature on the medical record book, and his heart tightened again.

Wu Xuanqi.

Then he quickly scanned the medical records written by Wu Xuanqi, which can be said to be refined and spicy.

It has been two hours since the injury, because Dr. Wu very professionally recorded the time when the medical record was written, which was written at 9:50 in the morning, and the time recorded was 30 minutes ago.

Give out the diagnosis of posterior shoulder dislocation moderate, rotator cuff injury?

Anterior dislocations, followed by inferior dislocations, are the most common dislocations of the shoulder joint, and later dislocations and upper dislocations are the rarest.

The reason why it is rare is that the violence of the injury is large, and generally such violence often occurs fractures, which are not manifested in dislocation. Only in very rare cases can it be in the form of dislocation, but the possibility of rotator cuff injury is as high as more than 95%.

Probably 95 percent of the time is still relatively conservative.

There is no need to check the physical examination, there must be a dislocation polycouplet, Fang Ziye just glanced at it, and he probably knew what was going on.

Then he asked: "Uncle, just now you said that the Minmin University Hospital has also reset a dislocation." Can you be sure that the patient who was manually reduced before the National University Hospital also had the same moderate posterior dislocation injury as you? ”

"It seems that I am lonely and unheard, and I have never heard of a moderate posterior dislocation, and I can still reset it by hand!"

First of all, Fang Ziye can be sure that the complications of posterior dislocation must be 100%, and the reason why there is a few percent probability that there are no accompanying symptoms is just that he doesn't want to talk to death.

Second, Wu Xuanqi is a professional doctor, and his professional operation and diagnostic ability of manual reduction must be better than his own, he does not perform reduction and pain relief at the first time, but recommends doing MRI, which must be a big problem.

"What do you mean? You think I'm lying to you? The middle-aged man turned his head, and his tone and expression were a little fierce.

Because he knows that if he is not fierce, then he will face the indifference of doctors.

"That's not it, it's just that my personal understanding is this, you are a posterior shoulder dislocation, this form of dislocation is rare, basically it is rare to use manual reduction to completely solve the problem, at most it is temporary pain relief."

"If you want to solve the problem, you must still need surgery." Fang Ziye explained slowly.

I was about to ask if there was any film.

The man roared again: "You know everything, you don't even look at me, you can know what kind of reset I am, are you here to see a doctor, or to read a book, what do you believe in what he writes?" ”

Fang Ziye was not angry, and knew that at this time, he must not add fuel to the fire: "Uncle, you have wronged me, I wanted to ask you directly at the first time, you said that you are too lazy to say, let me watch it directly?" ”

"Yes, this aunt can also call the shots for me."

"You only show me medical records, so I can't just give you a physical examination."

The middle-aged woman glanced at Fang Ziye, Fang Ziye's eyes were smiling, but it was a little amiable.

It's just that he was a little angry and said: "Doctor, don't nag so much, just say something, when will it be treated?" ”

"My husband has been injured for almost two hours. Until now, no one has dealt with it, how to solve this problem. If your hospital is so perfunctory and avoids the serious, then I can only report it. ”

When Fang Ziye heard this, his eyes flashed, he forcibly suppressed the anger in his heart, and calmed down: "This, treatment is the scope of treatment, after accurate diagnosis, I have not been more than fifteen minutes since I received the call for emergency consultation." ”

"It took eleven or twelve minutes to get on the road. Right? ”

"I don't even know what the diagnosis is, so what can I do? I can't even make suggestions. ”

"If you don't give me a chance to diagnose, then it is unreasonable and unreasonable for you to complain to our hospital. We're not unreasonable people, we wouldn't do such things, would we? "It only took about a minute for Fang Ziye to enter the door.

"That must be unreasonable." Fang Ziye's praise is slightly effective.

"I'm here to heal, not to complain. I'm still in a lot of pain here, I don't have time to complain about anything, you can show me how to deal with it. The man's left shoulder, on the affected side, trembled slightly, apparently in pain.

"Okay."

Fang Ziye touched it lightly as he approached, and after asking a few words about his medical history and injury history by the way, he asked, "Have you printed out the films you took before?" Or you can check the results on your phone. ”

"According to the preliminary consideration of the physical examination, the posterior dislocation of the shoulder joint must exist, otherwise you would not be in such pain, but the degree of dislocation is ......"

"Can it be reset?" The man didn't listen to Fang Ziye's explanation so much.

"It also depends on the situation, I don't know the extent, I don't know if it can be reduced, if you ask me to believe the medical records, then I tell you, it can be reduced surgically, not manually." Fang Ziye replied without leaking.

"Hey, who are you? There are no senior doctors in your department? What about your director? ”

"Isn't the director coming for a consultation?" The middle-aged woman didn't find any loopholes in Fang Ziye's words, and was slightly annoyed.

Director Ning will come to work now: "Sister, this is really like this." ”

"In an emergency department like yours, the director is not directly involved in the emergency consultation, unless it is a problem that the junior doctor cannot solve, the junior doctor will ask the senior doctor to come and inspect."

"Then please! He can't handle it, he can't handle it when he looks at it. The woman tapped the table gently.

Director Ning's tone froze instantly.

Fang Ziye took the words: "Is this good, in your case, go back to the orthopedic ward first, and then I will call our director, after the director is resigned, he will come over to take a look, this process may take an hour or two." ”

"Because the director ......"

"An hour or two? Are you kidding, you make us wait an hour or two for an emergency room like this? What's that called an emergency department? When the man heard this, he seemed to think that Fang Ziye was a strange thing.

"Uncle, the emergency is not the emergency you understand."

"Our hospital also has not only emergency services, but also outpatient and surgical procedures. Now the director is operating, and the patient on the operating table needs our director to solve the problem with surgery, so in terms of priority, you will be further in line. ”

"It is impossible for the director to step down and come directly because of an emergency department of shoulder dislocation." Fang Ziye also had a little more temper.

"Then I don't care, if you can't solve it, you will call your director over, otherwise I will complain to you, what kind of bullshit rules are you, surgery here, where surgery, the business of your hospital is the best, right?" The man began to play tricks and turned his head away, as if he had decided on this bite.

"Then there's nothing I can do, and if you want to complain, I can't do it."

"Then I'll write it, and you refuse to cooperate with my suggestion. Senior professional titles are strongly required to receive treatment. That's what it means, right? Right? Fang Ziye was also very decisive, and he picked up the pen directly and started writing.

"When did I refuse?"

"You lad, don't talk nonsense, okay?" The woman didn't let Fang Ziye put pen to paper, and snatched the medical record book.

"If you can't solve the problem, just ask your superiors to come over, do you want me to teach you such a simple thing?"

Fang Ziye said: "Thank you, no need, but I won't call either." None of my teachers have taught me that dislocation patients have to call their superiors directly. ”

"There are only a few choices you can make now, the first is to let me diagnose and give you a more reliable recommendation from my qualifications."

"Second, you can transfer to another hospital, and third, you just wait for the senior physician to come and check on you."

"If you want to solve the problem, there are only these ways, no matter how you choose, your power is the greatest."

"You don't listen to my advice, you don't listen to my opinions, you want me to call my superiors, that's absolutely impossible. Our superiors won't come, they will only ask you to wait in the ward, and I have already analyzed the approximate waiting time for you. ”

"Do you think there are any more questions?" Fang Ziye asked patiently.

"Do you really think I don't dare to report it? Do you believe it or not, I'll go now? The middle-aged man said to Fang Ziye with a horizontal face.

"It's your freedom to go or not, and if you want to go, I can't restrict your personal freedom, and I've done my duty. It's just that you rejected my diagnosis and advice, what else can you report. ”

"Report me for not agreeing to your unreasonable request?"

"In addition, I still have to use your emergency medical record book, and I have to write down my suggestions clearly and understand." Fang Ziye explained like this, and he didn't break out, and he was relatively calm.

Hearing Fang Ziye say this, the middle-aged man held back a sentence: "You give a word, is there a misdiagnosis in the Minda Hospital?" ”

The original intention was exposed.

(End of chapter)