"Isn't that how it should be? Han Guangyun said unconvinced.

"Guangyun, you haven't had surgery and don't know. Suddenly the patient had a high fever and stiffened body on the operating table, and the first thought must be over, whether the patient's family members on the table would sue me to death. Han Guangyun's senior brother said with some emotion, "It is rare to be able to judge the patient's condition in the shortest time and make a correct diagnosis." ”

“......”

The more Han Guangyun listened, the more uncomfortable he felt in his heart.

"First of all, it requires extremely strong psychological quality, and secondly, extremely deep medical knowledge and clinical experience. ”

"......" Han Guangyun continued to be silent.

"I'll give you two examples. I have also encountered similar situations, all of which are rheumatic heart disease, some need to have mitral valve replacement, and some have aortic valve replacement. For the first time, a friend of mine encountered a patient who suddenly had a high fever and stiffness after establishing cardiopulmonary bypass, and the whole person was stupid. ”

"This is what he said later when he drank too much at dinner. At that time, he judged that it was a malignant high fever, but they had no medicine in the local area, and if they got it, they would die. ”

"What happened later?" Han Guangyun asked subconsciously.

He was lucky enough to give an ice pack to cool down to 38.5C. At that time, I asked someone to consult on the stage, and malignant hyperthermia could not be ruled out, but I still had the operation done.

Seven hours after surgery, the patient was awake and the endotracheal tube was removed. One hour after extubation, the patient developed irritability and tremor in both hands, and the HR increased to 145 beats, T38.8C. ”

"My friend didn't dare to leave and kept looking at the patient in the ICU. If you see an abnormal change, you should immediately check your body. A bruit could be heard in the anterior neck area, and he was suspicious of the diagnosis.

Thyroid storm is suspected, and propylthiouracil 600 mg and propranolol 10 mg are taken orally immediately. On the second day, blood was drawn to measure the changes in thyroid function T3 and T4, and the diagnosis of thyroid storm was confirmed. ”

"Wait......" Han Guangyun heard that there was a problem and immediately said.

"What's wrong?"

"Senior brother, why can I only do the examination the next day?"

"At that time, thyroid function tests could not be used in the emergency department, and there was no way to check them in the middle of the night, so we had to wait for the next morning to be sent for normal testing. Han Guangyun's senior brother said, "It's much better now, we have preoperative routine screening here." ”

"......" When Han Guangyun heard the words of routine screening, he felt that countless flies were stuffed in his mouth. And some flies are not dead yet, flapping their wings in their mouths.

"Well, let's not talk about the shortcomings, let's talk about the awesome place first. Han Guangyun's senior brother said, "If you encounter an abnormality during the operation, you can judge it in the shortest time and check for rare thyroid storms, this person is a talent." ”

"......" Han Guangyun was speechless.

He felt like his stomach was full of flies, and he was sick to death. But I can't refute it yet, after all, I have something to ask my senior brother for.

"The abnormality was found, the intraoperative treatment was also very timely, and the medicine given was very accurate. Han Guangyun's senior brother continued, "The patient should now take the tube to the ICU." ”

"yes. ”

"It's okay, I'm not going to be extubated in two days, and it's over. Maybe it won't take two days, but it will come out in one day. ”

"Senior brother, it's just an ...... of hyperthyroidism It's not a big problem. Han Guangyun said unconvinced.

"Hahaha, Guangyun, how did you learn to be humble now?"

"Uh...... Am I humble?" Han Guangyun whimpered, and a lot of flies in his mouth had already emerged from another plane.

"Hyperthyroidism, there are many people with this problem, generally speaking, they will ask before surgery, this belongs to the past history. However, some patients and their families do not know that they are sick, and once they go to the operating table, they induce thyroid storm because of surgical stimulation...... What I just told you about is a successful case, and there are failures. ”

"When I was flying the knife, I heard a doctor in a prefecture-level city tell me about a similar case. It was a 22-year-old female patient who was hospitalized for rheumatic heart disease and was preparing for surgery. There was no preoperative examination of thyroid function, and the patient and the patient's family did not know that there was a problem in this regard, so there was an accident during the operation. ”

"Their level is average, and they thought it was normal during the operation, so they didn't pay attention. Persistent high temperature after surgery, accompanied by convulsions. After a day of flipping through the books, it ended up feeling like a thyroid storm and something else.

The next morning, I checked my armor and found out that something had happened. The administration was already 48 hours after the operation, but the patient's condition became more and more serious, and the IAB had no effect, and the family gave up the rescue two days later, and died clinically. ”

Han Guangyun knew that his senior brother was just gossiping about cases, but every word was like an invisible slap in the face.

"The problem in your hospital is also quite big, I don't know if it's because the artist is bold or the doctor in charge of the bed is careless. Preoperative examination could have avoided rescue and accidents on the operating table, but many screening items were missing before surgery. Xiao Han, this kind of ...... Let's put it this way, it's called self-righteousness, thinking that the level is high, and the preoperative examination is ......"

Han Guangyun was silent, and his senior brother kept nagging.

"It shouldn't be, how can a senior doctor who can tell at a glance that it is a thyroid storm ...... I guess I didn't even look at it before the operation. Guangyun, you have to tell them more, don't let them be self-righteous, and don't look at the patient or the examination before the operation. Although the level is high, it is still necessary to pay attention. ”

"Senior brother...... Han Guangyun wanted to say countless words in his heart, but he didn't know what to say when the words came to his lips.

"Hahaha, Guangyun, can't you suppress such a powerful doctor?" Han Guangyun's senior brother smiled, "Let me tell you, you can't suppress it." You have to get along with them, you are the chief of medical affairs, and they have to give you some face no matter what. ”

"Senior brother, I mean that there are so many diseases to be screened before surgery, and everything is checked, isn't that an increase in the burden on patients? ”

"Huh?" Han Guangyun's senior brother was stunned for a moment, his tone was obviously a little puzzled, "Guangyun, are you okay?" ”

"What's the matter, senior brother, am I not right?"

"Why did the patient come to the hospital?" asked Han Guangyun's senior brother.

"Heal. ”

"Yes, if you don't cure the disease, what will you cost? If you don't come to the hospital, you will save 100%. ”

"And you save money for patients, and people think it's right. If something happens, it's your responsibility. Han Guangyun's senior brother said, "This is objective, even if you want to save money for patients, it cannot be ruled out that surgical contraindications are not." ”

"But...... Now the society says that random inspections ......"

"Listen to them, you don't want to work in the hospital. Han Guangyun's senior brother said, "It's true that there are some random examinations, but it has nothing to do with surgery or hospitalization." Do you think, the doctor who can treat this disease is still short of the two jujubes for the inpatient surgery of wind heart disease? ”

Han Guangyun listened to his senior brother talk excitedly for half an hour, and after hanging up the phone, he was a little confused.

：。 ：m.x