Fang Ziye finally confirmed what Yuan Weihong once said to him today-

Most hospitals, when setting the location of the operating room, will fully consider the time from the operating room to the emergency room to participate in the emergency consultation.

Zhongnan Hospital is no exception.

It's just such an opportunity to confirm, the previous Fang Ziye only dared to occasionally hope in his dreams, and he didn't dare to imagine that it would become a reality.

Now Fang Ziye no longer needs to prove whether it is true or not, he only needs to confirm that Master's pretending to be forced still has some truth.

Fang Ziye is no stranger to the emergency department.

During the professional master's program, Fang Ziye also needs to be incorporated into the residency and training rotation plan of the Department of Orthopedics. One of the 33-month rotation plans for orthopedics is a rotation in the emergency department.

At that time, although Fang Ziye was only arranged to go to the emergency surgery ward, he also let Fang Ziye know that the emergency department of Zhongnan Hospital actually has a lot of configurations.

In the emergency department, there are not only specialized emergency medicine and surgery, but also emergency departments such as emergency cardiothoracic surgery, emergency neurosurgery, emergency neurology, emergency cardiology, and emergency respiratory medicine.

In addition, if there is a joint injury of multiple disciplines in the emergency department, an emergency consultation that requires an urgent request is a discipline other than the above.

And many diseases in these departments are more likely to be fatal.

There are so many emergency specialties that are outpatient and emergency clinics of the emergency department, not the medical and surgical wards, observation wards, emergency rescue rooms, and inpatient configurations such as EICUs.

When Fang Ziye rushed to the emergency room, the emergency doctor inside had already done intravenous access and various early rescue measures for the patient.

Moreover, even the patient's emergency medical record has been pampered by others "countless times" and has become leftovers-

"Teacher, which patient is here for urgent consultation?" In the emergency room, there were only two patients, and one of the patients had an open injury to the lower limbs, but Fang Ziye still asked one more question, making sure that he did not use his own speculation to determine the identity of the patient who was consulted.

Asking more questions won't kill you.

"Well, it's the left-hand side, the current blood pressure is not stable, the pulse is fast, we have invited multiple disciplines to come to the consultation and check and read."

"Finally, the diagnosis of intracranial, thoracic and abdominal hemorrhagic diagnosis was ruled out! Here. "The person who spoke, semi-Mediterranean, slightly chubby, of medium height, and the rest of his 'hair' was partially caked, and he didn't know how long he hadn't gone back to clean up.

"After looking at these departments, you asked us for orthopedic consultation?"

"Have you ever done a CTA?" Fang Ziye frowned slightly when he said this.

Because when the fat man approached slowly, Fang Ziye obviously smelled the smell of sweat on the other party's body, as well as the smell of grease.

"I have done it, and it cannot be ruled out that there is a cavity organ injury before."

"Moreover, in fact, this patient's open injury has been temporarily treated before, so we did not ask for an emergency consultation from the orthopedic department at the absolute first-line time."

"In addition, we were also on a rescue mission before." The fat man looked sloppy, but when answering the questions, he was methodical and logical, and he didn't give Fang Ziye any loopholes.

is even very cautious, for fear that every question of Fang Ziye has a routine, which is quite official.

"But injuries in other departments have been ruled out, and there are currently active hematomas in the lower limbs! Brother, you're going to have to pull over and start the stage. The fat man patted Fang Ziye on the shoulder, slightly closer to Fang Ziye.

Fang Ziye was a little afraid that the other party was an incomprehensible glass, so he stepped back a little distance, and after carefully reading the other party's badge, he said: "Brother Zhi, do you need surgery, I'll take a look at the opinions of other subspecialties first." ”

"If they have already dealt with the consultation opinions of the specialists, then I will immediately arrange for someone from the department to come over and talk and sign."

"Are the patient's family there?"

Deng Zhi is the name of a fat man in the Mediterranean.

His name is not special, but Fang Ziye saw that he had another layer of identity, that is, the general inpatient of the emergency department, at least on his badge.

In this way, Fang Ziye somewhat understood the other party's overtures.

Aren't the two bosses of trauma surgery and emergency department the first pair of joint curtain calls?

"It's right outside."

"Brother, are you very familiar with Professor Xie?" Deng Zhi looked at the fluctuation range of the patient's current vital signs, which was not very large, and ate melons while eating.

At this time, Fang Ziye had already read the consultation opinions of other departments, at least in the medical record book, what was written on the consultation opinions of people from other departments was that there was no indication for emergency surgery, and there were indications for elective surgery, which could be temporarily observed and treated.

With such a sentence, Fang Ziye no longer has to worry about these subspecialty matters.

Because once the sky falls, the person who wrote these words, the superiors of the department where they are located, and the professors are tall people, and no matter how much they smash it, they will not be able to hit Fang Ziye's body.

Specialized treatment.

Professor Xie is Xie Jinyuan.

Although Xie Jinyuan had temporarily left the trauma surgery department and came to the emergency department, Fang Ziye did not dare to pretend not to know him.

Associate Professor Xie Jinyuan was promoted to deputy high school, and he came to the emergency department to prepare for the promotion, who knows when he will be killed?

It is this kind of inaccurate thing that makes it more and more necessary to be careful.

"It's okay, Teacher Xie has bothered to teach me before."

"Brother Zhi, thank you for your concern for me." Fang Ziye casually snorted.

He and Associate Professor Xie Jinyuan were not very harmonious and harmonious before, they could only say that they knew each other and had dealings.

But whether it is Xie Jinyuan to Fang Ziye, or Fang Ziye to Xie Jinyuan, there is basically no private contact, even if it is a meal together, there is no such thing.

It's just that even so, Fang Ziye has to behave at least passable in face now.

"No wonder."

"I'll just say it! ~”

"Professor Xie has been persuading me lately, saying that I don't want to kill people in a department with a stick, and the young people in trauma surgery are still worthy of being trusted......" Deng Zhi then patted his chest.

"Deng Zhi, the emergency department is a big injustice."

"Fang Ziye, the follow-up inpatient of the Department of Trauma Surgery." Fang Ziye also reported his identity, of course, he was relatively conservative.

However, Deng Zhi seems to know a lot about Fang Ziye: "I know, you are low-key, and you haven't graduated yet, this belongs to running away from the main room in advance." ”

"Does this count as a junior who ascended to the position in advance?"

Fang Ziye turned his head suddenly, but he didn't expect that this Deng Zhi was quite humorous!

……

What happened next is not surprising.

Emergency surgical exploration is required to detect the presence of active bleeding from the lower extremities!

If there is bleeding during the investigation, then it will be treated immediately, and then it will be thrown to the observation ward of the emergency department to reduce inflammation and complete the treatment.

However, if there is no active bleeding in the lower limbs, then the patient will have to undergo a second round of general consultation in the operating room.

After the orthopedic surgery, the person who has been assessed in his department before has no absolute indication for emergency surgery should come to take the blame and make up for it!

……

When Fang Ziye called Jiehan this time, the other party did not hesitate at all: "Senior brother, all my tasks have been changed, and you can come to the operating room or other places at any time." ”

Jiehan swears.

Then after hanging up the phone on his own initiative, Jiehan opened his memo, added a heavy stroke to it, and began to mix clinically.

Vigorously develop clinical practice——

Previously, when Jin Hongzhou was hospitalized, most of all the emergency operations were practiced by the doctoral and master's students in Jin Hongzhou's group.

It is their group that has a total innate chance of gaining an advantage in hospitalization.

Now that the situation has changed, Jiehan naturally has to start changing his plan -

Originally, Jiehan felt that he was quite talented.

Really, Jiehan really thinks so.

There are several reasons for this.

First of all, Jiehan is the first place in the orthopedic written test and the first in the re-examination, and he has read a lot of books, right?

Second, Jiehan himself published SCI in his undergraduate, and soon after entering the master's program, he came with an article to Chengcheng.

Third, Jiehan felt that he was in the group, and he was not bad, and the relationship between all aspects was also quite good.

If there are no accidents, Jiehan feels that he should be considered a successful graduate student.

But it was his grades, starting point, talent and learning rate that he was stunned to doubt his life in just one and a half years.

Even Jiehan many times, he wondered if he was a pure fool, he shouldn't go to scientific research, he should honestly admit that he has no talent for scientific research, and doing clinical work well is his ultimate way out.

Now, Jiehan is finally honest, and no longer doubts whether he is a fool, but feels that he has no talent for scientific research, and he only has the talent for water articles.

Jiehan can't help it.

Master doesn't talk about it, Master is not bad in the first place.

At present, the focus is on the clinic, and the clinical mix is very popular.

The focus is more on scientific research, which is already excellent and green, explaining everything.

And then there is Senior Brother, Senior Brother Fang Ziye, BMJ, what else is there to explain?

Let's talk about junior brother.

Jiehan didn't want to mention his junior brother at all, I was made to doubt my life by my junior brother, me! ~~

Fang Ziye didn't know that Jiehan planned to "change careers", from a plan to dream of becoming a scientific research boss to a plan to become a clinical boss.

The patient's vital signs are already unstable, and of course there will be no nonsense and superfluous operations.

Patients' families also don't have the opportunity to tangle with it.

You have to have surgery, or you'll die.

There is no third option.

There are not many people on stage, only Fang Ziye and Jiehan.

The surgery to be done is actually not complicated, it is an open injury of the lower limbs, not even an open fracture!

"Senior brother." Jiehan called Fang Ziye.

Fang Ziye did not agree, but continued to operate seriously.

What Fang Ziye and Jiehan have to do is actually to explore and debride.

Of course, before this, Fang Ziye had already passed his level 4 physical examination, and probably knew that this patient's active bleeding was not in the lower limbs, but in other hidden places.

However, Fang Ziye had no way to explain.

People from other specialties have already given their opinions, and there is no problem with their specialties.

But orthopedic open injuries are macroscopic, evidence-based, and matched to the patient's hemorrhagic shock.

Therefore, in such a situation, if Fang Ziye wants to let people from other departments come for another consultation, he must obtain a certificate.

Prove the innocence of your subspecialty, confirm it from a more objective point of view, complete the investigation, and operate to the innermost layer!

Then, the anesthesiologist will call people from other specialties in the most urgent way.

Because, Fang Ziye didn't know which specialty had the problem at the moment, and he didn't even read the CT and MRI plain films of other subspecialties!

He only looked at the orthopedic content and had no fractures.

Then, it's gone.

This is from a sentence that his mentor Yuan Weihong warned him -

Even if you take it again, in Zhongnan Hospital or a place similar to Zhongnan Hospital, don't praise the specialty, and make decisions across specialties.

Be cautious across subspecialties.

The reason is that there are no other specialties anymore, and it is not dead, so it is not your turn to take on this responsibility!

"Senior brother." Jie Han saw such a simple exploration technique, and Fang Ziye still didn't give it to himself, it should be that he was not active enough.

"Shhhh ~"Fang Ziye didn't have time to listen to Jiehan's opinion.

He quickly exposed the open injury close to the end of the bone, and finally ruled out the presence of a hematoma.

After exploring the blood vessels of at least 5 centimeters above and below the open injury, and there was no damaging blood spurting, Fang Ziye breathed a sigh of relief in his heart.

Then tell the doctor in the anesthesiology department: "Anesthesiology teacher, there are no hematomas and vascular injuries in the open injuries of our department. ”

"The patient's bleeding should still be in another location, you can call the emergency department again, or go directly to the emergency consultation procedures in the operating room!"

"Shrimp?" The anesthesiologist is in his forties and wears a flowery headscarf.

At this moment, Ben was lying down flipping through the comics, showing his absolute control and anesthetic strength, and was immediately frightened by Fang Ziye's words, his scalp was numb, and he read the content of the comics at once.

"The patient's hemorrhagic shock has nothing to do with our trauma surgery."

"There's no hematoma in the pelvis either, and it's not a retroperitoneal hematoma, so you may need to look for something else." Fang Ziye knew that this matter was a bit oolong.

The patient's emergency medical record book is still lying in the colder medical record folder in the operating room.

The medical record book states that many subspecialties do not have an absolute indication for emergency surgery.

These words were originally the talisman of their department, but now, they have become another meaning!

Hemorrhagic shock, the cause of which is to be investigated, and orthopedic vascular injury of the extremities is currently ruled out.

The hematoma caused by the vascular damage of the orthopedic department of the limbs is the easiest to see with the naked eye, and Fang Ziye has also done an investigation, so it is really impossible to have any more problems.

"! ~"The associate professor in the anesthesiology department could no longer be calm.

The first person to call was the director of his department, and at the same time he yelled outside the door of the operating room, pulling his throat: "Tour, look for your head nurse!" ~~~”

If this is not done well, there may be a medical dispute.

He's really calm.

At this moment, he hopes that Fang Ziye is a newcomer among the new, a newcomer, and what is wrong.

It is also not necessary to be a particularly skilled hand, and then there is a mistake in the previous diagnosis, and then it is necessary to do a wide range of other multidisciplinary joint exploration during the operation.

What the hell is this patient's shock?

(End of chapter)