"Jiehan, you are in the operating class today! ~”

"Bring me to the emergency room." After looking around, he couldn't find the right person to help, so Fang Ziye could only use the general authority of the hospitalization and call Jiehan to come to the emergency department.

When the hospitalization always encounters emergency surgery, the operation team arranged by the department needs to participate in the emergency surgery as an assistant, and such a schedule has a duty schedule, and the targeted person must be found every day.

When Jie Han heard this, he knew that Fang Ziye really didn't find anyone to help, although he was on the operating table, but on the operating table, without him, he could still operate normally.

There is no need to take leave with the superior, the itinerant nurse turns on the mobile phone, and everything is clear.

Jiehan was immediately passively ousted, and then Yan Zhiming, who was originally fully armed and watching from the side, immediately came to the assistant position where Jiehan was standing.

And when Jiehan left the operating room, it was only a few minutes.

Yuan Weihong also lowered his voice and said to Professor Deng Yong: "Professor Deng, why don't I take a temporary leave today?" Xiao Fang is the first day ......"

……

After Fang Ziye finished making the call, he hurriedly went to the emergency surgery room to read the film, and after seeing the fracture, he was slightly relieved!

According to the evaluation of one's own ability, such a fracture has the indications for manual reduction, and can be treated by manual reduction!

This is the case with an open wound that requires a simple debridement plus a subcutaneous tetanus antitoxin.

Moreover, the environment in which he was injured was relatively poor, and it was seriously polluted, so he definitely needed antibiotics and anti-inflammatory treatment for a few days......

Another important factor is whether the patient's fracture is considered an open fracture, and if it is an open fracture, then the final treatment mode will be completely reversed.

In addition, there is a more important thing that he has damage to his chest and abdominal organs, so the treatment of fractures is actually elective surgery.

How is it possible not to save a life first and treat a fracture first?

The fracture did not cause major arterial and vascular damage, which Fang Ziye is very sure of, because Fang Ziye's current X-ray and CT reading can see the general shape of the blood vessels.

It is also possible to discern the presence of an active hematoma.

Therefore, his handling opinion is......

When Fang Ziye was still reading the film carefully, Jiehan, who hurried from the operating room, arrived.

The operating room is connected to the orthopedic inpatient building, which is very close to the emergency department, so it doesn't take long to get from the operating room to the emergency department.

Even in the operating room, many inpatients can calmly rush to the consultation position within 15 minutes when they encounter an emergency consultation.

"Senior brother! ~" Jiehan just spoke at the door.

Fang Ziye said: "Jiehan, you go and put a forearm sling on the dislocated patient first, and then talk to another fracture patient to sign." ”

"When the time comes, I will do the reduction, and you will take him up for a plaster cast for external fixation and minor debridement."

"Can you do it?"

In the event of an emergency, everyone's operation opportunities can be full, Jiehan now has to be jacked up, the fracture must be fixed after reduction, the external fixation of the plaster cast is also fixed, and the simple debridement surgery, Jiehan must have no problem operating in the practice room!

Then he also has to start to live and apply in reality.

Today's inpatient trauma surgery is always Fang Ziye, so the subordinates of Professor Deng Yong's group can eat all the small operations of emergency minor surgery.

Even if Lan Tianluo does not have a physician qualification certificate, but in the emergency, Lan Tianluo has to do a first-level operation such as debridement!

"Okay." Jiehan nodded, slightly nervous and excited.

If you grasp the opportunity today, then when you are on duty alone in the future, you will have more opportunities to operate!

There is no need to report to Qin Geluo and others, and there is no need to encounter small debridement sutures, and you have to report to the teachers, and your senior brother will complete the large-scale feeding.

This is another closed loop, a small benefit that belongs to the teacher.

Fang Ziye has become the general manager of hospitalization, and his own small teacher will usher in a wave of small climaxes of clinical operations......

Jiehan hurriedly left the consultation room, went to the door of the emergency X-ray room, and received the person who had done joint dislocation manual reduction to the operation room.

Fang Ziye looked at the people who were consulted in other departments, and first said to the doctor in the emergency surgery: "Our orthopedic department does not have an absolute indication for emergency surgery for the time being. ”

"Fracture is an indication for surgery, but it is not an indication for surgery that needs to be treated at present, the patient is currently in a coma, blood pressure is unstable, and it is estimated that there is active bleeding in other parts, and after the treatment of active bleeding, our department can follow up to deal with the fracture."

Fang Ziye is explaining, don't continue to call the orthopedics. Saving the patient's life first is a matter for thoracic surgery and general surgery, and our orthopedic department can do a good job in fracture surgery.

Active bleeding in the chest and abdomen is not properly treated, and in the end it is useless.

The doctors in the emergency department and the other consulting doctors all glanced at Fang Ziye, and then looked at each other, as if they had seen the expressions of the newcomers in their respective eyes.

Fang Ziye didn't look for so much, he carefully completed his procedures, and then wrote down all the consultation opinions clearly.

That's when I got out of the emergency room.

The emergency department of this one patient, the real emergency is not in the trauma surgery, so Fang Ziye has no pressure at all and can leave calmly!

In Zhongnan Hospital, there is no interdisciplinary management and no interdisciplinary treatment.

It's called not crossing the line.

The rules dictate.

"Doctor Fang, in my current condition, is there a fracture, I need to have surgery, and I will be hospitalized......" After Fang Ziye went out, he was asked again.

The young man with the fracture who had spoken and signed with Jiehan had returned to the operation room. He has thick hair, a big nose, small ears, and the wings of his nose are flickering non-stop at the moment!

looked nervous, as if he was afraid of being taken away by Jiehan, a younger-looking baby.

Relatively speaking, Fang Ziye looks a little more embarrassed than Jiehan's old age.

"Debridement is done in the operating room in the emergency department, and now that the operating room is empty, your wound is relatively simple. To do a small debridement, for this fracture, we choose manual reduction and external fixation with a cast. ”

"If there is no reduction, surgical reduction is required. Of course, if you want to be more secure, go straight to the surgical reduction! ”

"If you sign it, you'll be fine." Fang Ziye didn't hear another 120 coming outside, so he patiently explained a few more words.

"Then let's reset it first." This big-nosed young man also knew the cost difference between surgery and manual reduction, so he hesitated and made such a decision.

"Your family is not here, you have to sign it yourself! I finished writing her medical records first, and then we did the reset. Fang Ziye wrote the medical records while mentally assessing.

"Okay."

……

A few minutes later.

When Jiehan and the young man with the dislocated joint walked into the emergency room again, they found that Fang Ziye was reducing the fractured patient.

The patient with the broken big nose closed his eyes there at this moment, and asked a little nervously, "Doctor Fang, have you started?" ~”

"It's almost over, you wait a minute!" Fang Ziye's hands were straining, his muscles were raised, and his voice was choked.

"You said it hurt a little bit, but I didn't feel any pain? I thought you hadn't started yet. "The big nose was a little panicked.

Hearing this, the young man with a dislocated joint asked Jiehan, and muttered in his voice: "Why doesn't his reduction hurt?" ”

"Huh?" Jiehan turned his head to look at him, but he didn't react for a moment.

"Nothing. It's nothing. The young man glanced at the student badge of the graduate student, as if he was not to blame.

Fang Ziye's badge is a doctor.

Jiehan felt that he was being scorned and wanted to explain a few words, but thinking of Fang Ziye's operation, he couldn't bother, so he had to pretend not to hear it for the time being.

When the young man saw that Jiehan was speechless, he recognized his inner thoughts even more.

Soon, Fang Ziye's side was relieved, and then it could be seen that the lower limb deformity that had existed in the middle age had roughly returned to normal.

In the process of realigning the broken end of the unloading fracture after the traction of the fracture was completed, the middle-aged man felt a slight pain: "It's a little painful now, but it's okay!" ”

Fang Ziye's side was relieved!

looked at Jiehan and asked with a smile, "Jiehan, do you know the answer to the question asked by this patient?" ”

Jiehan knew that his senior brother was an opportunity to show himself, so he hurriedly explained: "The reduction process of the fracture is not painful in the process of traction, but will separate the broken end of the fracture during traction, without causing touch and friction, and will not cause the induction of nerve endings, and will feel relaxed and comfortable. ”

"Therefore, even if it is my senior brother who removes you, one is a joint dislocation and the other is a fracture, the effect of the reduction process and the nature of the duration of the pain are completely different."

After Jiehan finished explaining, he stood up straight, enjoying the stunned gaze conveyed by the patient next door.

I thought to myself, just kidding, I'm also a master's student at Zhongnan Hospital, okay, in terms of knowledge reserves, it's not something you can bully arbitrarily.

Besides, manual reduction, we have been studying manual reduction since last year, and many people's understanding of manual reduction is not as good as our group.

Especially the theory.

Fang Ziye explained in detail this time: "Now the fracture should be basically aligned, and it only needs to be reviewed by taking a picture." Then go upstairs to the surgical ward, let Dr. Jie do a debridement treatment for you, and then go through the hospitalization, okay? ”

"Okay, okay. Listen to you, Dr. Fang. The big-nosed youth nodded hurriedly.

Now the relaxation and comfort after fracture reduction, compared with the pain before, is like entering a hot spring, the whole body is warm, and there is an indescribable sense of comfort.

After this, Jiehan was quite excited to take his middle age to start his journey of debridement and plaster external fixation.

Of course, Fang Ziye still couldn't leave, but continued to read the dislocated young man.

The young man walked in again, and Fang Ziye was showing him the flat film after the reset: "Oh, look, now the dislocation here has been dealt with." ”

"The humeral head is in place, you can move, the pain is relieved, and there is no special treatment in the future. You're feeling a lot better. ”

"If you feel any more pain in the future, you can go for another MRI to see, if there is no pain, you can do it for the time being." Fang Ziye patiently explained again.

The young man looked around and found that Jiehan had left, so he asked again: "Doctor Fang, why did I die of pain when I was reset just now, but it didn't hurt after the reduction?" ”

"Didn't my junior brother talk about it just now?"

"Originally, the pain mechanism of fracture and joint dislocation is different, and the process of joint dislocation traction will further affect the tense and compressed muscles, and the pain will gradually intensify before the joint is completely released."

"After successful reduction, all the muscle retraction, entrapment and other symptoms are relieved, which is immediately different, but in the process of traction, the muscles become more and more tense, and the pain will increase, and the principle is different."

"You have been wearing the forearm sling, and after a month, you can find a hospital to review the plain film, and then take off the forearm sling according to the situation, during this time, there are some taboos, you have to remember ......"

"Okay, thank you Dr. Fang!" The young man was convinced.

Being able to know how to do it, why to do it, and why it hurts.

That's pretty professional!

Who's that?

It doesn't seem to be unprofessional.

……

When Huang Yan pushed the middle-aged man out of the CT clinic, the middle-aged man still spoke with a Sichuan accent: "I can scan the code and pay the money." ”

"Don't worry, we'll talk about the cost later." Huang Yan replied, and then walked into the consultation room again.

"Doctor Fang, this patient's head, chest and abdomen have no obvious injuries for the time being, you can have a follow-up from a surgical point of view!"

"The patient's vital signs are unstable and his heart rate is arranged, so I'll go over and take a look." Huang Yan hurriedly walked in the direction of the emergency room.

"Okay, Senior Sister Huang." Fang Ziye replied, but the other party didn't seem to hear it.

To cure a disease is simple, Fang Ziye can cure a lot alone, but if you want to save your life, a group of people may not be enough!

After Huang Yan left, Fang Ziye communicated with this slightly witty middle-aged man in Sichuan Province, the other party had a strong sense of humor, and he had been joking with Fang Ziye for fun.

"Doctor Fang, how do you train these muscles? I've always envied you for having muscles like this, and I think men should have muscles. The other party is like a chatterbox.

Sitting in a wheelchair, it doesn't stop at all.

"Does it hurt?" Fang Ziye asked.

"What is this pain, let me tell you, Doctor Fang, when I was young, it was popular to fight, fight, punch and kick, what kind of pain is this pain......" The middle-aged man bragged proudly, as if showing off that he was once a social person.

It's just that now everything has changed.

"Uncle, are you still fighting?" After Fang Ziye finished his dislocation reduction and fracture reduction, he was stunned to find that although this middle-aged man was funny, he could really endure the pain.

He asked curiously.

"Hey, when it comes to fighting, it's better to be unilaterally beaten by my tigress."

"It's so fierce, I'll tell you." Said the middle-aged.

Marry a woman from Sichuan and Chongqing, and enjoy the life of the back.

Fang Ziye secretly gave a thumbs up, worthy of being the male silver of Sichuan Province!

"Do you have a girlfriend? Where is your girlfriend, let me tell you, don't look for ...... in Chongqing City or Sichuan Province" The middle-aged man gave Fang Ziye a warning so biased.

Fang Ziye was stunned when he heard this.

Good guy, isn't Luo Tingzhu from Chongqing?

Of course, Fang Ziye did not reply to his words positively, but first asked him to scan the code and pay the fee, and then spent more than ten minutes to complete the forearm sling and plaster external fixation for him.

Then he took a serious look at it and said, "Uncle, it's been dealt with, if you have a fracture, you can only fix it temporarily, and then you will have to perform surgery and fix it internally with intramedullary nails!" ”

"The external fixation of the plaster cast is only a temporary fixation, and it does not play a particularly large fixation role."

Fang Ziye explained again.

In fact, he has already explained that there are indications for surgery in middle age, and the current treatment is a temporary treatment for pain relief.

Even if the fracture cannot be fixed by plaster cast, it should be temporarily fixed after entering the hospital to avoid displacement and aggravation of pain!

This makes it easier for family members to take care of them.

"That's it, huh?" The middle-aged man felt that he was not yet happy, and sighed.

Fang Ziye joked: "Uncle, we can also reset it again after re-misalignment, anyway, there are no patients coming now." ”

"Maybe I could have reset the wrong one?"

The middle-aged man's face immediately changed suddenly, and he hurriedly protected his arm: "Don't talk nonsense~"

"Just kidding, uncle, you have to call home, someone has to take care of it later, I'll take you to the ward first." Fang Ziye was naturally just joking.

It's mainly a joke made by the other party first.

Then, Fang Ziye issued a hospitalization certificate to the other party and asked him to go to the trauma surgery department to go through the hospitalization procedures, as for how the other party went to the trauma surgery, there was no way, the other party could only figure out his own way.

……

Finally, Yuan Weihong couldn't help it.

He hid in the shadows of the emergency department and had to show up.

Because he was sitting at about ten o'clock, at the door of the consultation room, Yuan Weihong saw five or six people standing inside, three people were queuing, and the other three were moving their joints.

It looks like it's all dislocated joints!

Even Yuan Weihong, who had seen Fang Ziye take over a batch of patients at once, was taken aback.

In front of them, Fang Ziye sat in the operation position, and was clicking to send away a disobedient joint dislocation patient who was out of the joint surface again.

He said, "Your reduction is fine, you can rest next to you, and I'll give you a plaster cast later, and you can slightly move the internal and external rotation of the wrist joint, that's it." ”

Fang Ziye gave him a demonstration, turning his forearms from side to side.

He also learns slowly.

The two people in the queue behind looked at him with some envy and got out of the pain again, and said with a smile: "Doctor Fang, it's my turn this time, right?" ”

Yuan Weihong walked in, Fang Ziye also saw Yuan Weihong, smiled at Yuan Weihong, and then continued to calmly receive the next patient with shoulder dislocation.

Fang Ziye explained: "You are a rare posterior shoulder dislocation, your dislocation, with a high probability of soft tissue injury, the current diagnosis belongs to type II, which is relatively mild, and manual reduction can be performed, but you have to ...... after reduction."

"Okay, well, I'm sure I'll listen to you, doctor, you're a professional?" He looked at some other people who had been reset, and they were all lax at the moment, and only urged Fang Ziye to hurry up.

But Yuan Weihong was stunned when he heard it beside him.

In fact, when Fang Ziye was doing the manual reduction of wrist dislocation just now, he felt that it was not appropriate, after all, although the wrist joint is small, but facet joint dislocation does not mean that it is easy to deal with.

Fang Ziye was reset.

Now, the posterior dislocation of the shoulder joint, such an atypical reduction, Fang Ziye still has to get started?

But Fang Ziye said everything, and he couldn't stop halfway, so he just watched patiently.

……

Four minutes.

In just four minutes, Yuan Weihong's heartbeat accelerated four times.

Every time Fang Ziye carried out a reset, Yuan Weihong's heartbeat flickered suddenly, first, he felt that the disease of joint dislocation that Fang Ziye dealt with was a bit strange, and secondly, the speed of Fang Ziye's method of resetting.

Why the hell did you reset someone so quickly?

Finally, after everyone was reset, Yuan Weihong directly 'raised' Fang Ziye in front of everyone!

Of course, he didn't really mention it, Yuan Weihong knocked on the table first.

"You come out with me!" Yuan Weihong's tone was serious.

The man who turned from dark to light seemed to want to be angry.

(End of chapter)

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