The characteristics of emergency work can be summed up in three words - dirty, tired, and bitter.

Tired is a good explanation, regardless of medical and surgical treatment, as long as the patient comes, he has to pick it up. There is no rest time, as long as there is a patient, you have to rush up. And when it comes to work, it's not like you can stop if you want to—you're nervously stopping bleeding and chest compressions, and on the other end you suddenly find that it's time to get off work, and then you want to pat yourself on the ass and leave...... How is that possible?

Suffering is based on tiredness. The salaries of emergency doctors are generally not high, and many doctors also indicate "emergency medicine direction" on their medical certificates. This also means that even if you really can't do it and resign, unless you retake the certificate or simply change careers, even if you change hospitals, you can only go in the direction of emergency medicine.

The division of emergency medicine in China can be roughly divided into two directions: "emergency" and "critical". In fact, there is a very large overlap between the research content of "emergency" and "critical and severe". Multiple trauma, reperfusion injury, poisoning, post-cardiac arrest syndrome, etc., are all involved in the field of critical care medicine.

But the pay for emergency work is generally not as good as that of critical care medicine. If the attending doctor with the same background works in the emergency department of a hospital in an economically developed region, the basic salary plus miscellaneous subsidies can be about 156,000 a month. Compared to the average for the city as a whole, this income is by no means low, but it is certainly not high - doctors can save up for a toilet after working for a year without eating or drinking.

But if you can work in the ICU, it's different. Although the income of ICU doctors varies depending on the region. In general, ICU doctors are paid more than twice as much as emergency doctors, and in some places there can be a ten-fold difference.

The work pressure is high, the work content is varied, the income is not as good as that of peers, and it is even difficult to change careers. Emergency doctor, tired and bitter.

As for dirty...... Just look at Dr. Cao, just look at Sun Lien.

Working in the emergency department, being vomited, splashed with blood, and even being doused with feces are objective facts. The Fourth Academy even has the habit of "celebrating the first time that the trainees and interns were vomited". After Sun Lien was vomited when he first came to the hospital, he received a bottle of Coke as a celebratory gift.

The work of emergency doctors is dirty, tiring, and hard. This has led directly to a nationwide shortage of emergency hospitals. If you don't want to be a doctor, you will definitely not go to the emergency department, even if you are pregnant with a heart to treat diseases and save people, can't you go to surgery and internal medicine or ICU to achieve the same goal?

I have to say that the "big emergency" model practiced by the four hospitals is the model that seems to be the best hope to break this strange cycle. Under this model, the function and importance of the emergency department are multiplied, and in the end, these patients are basically re-sent to the specialist for treatment and discharge. This model allows the emergency department to dominate most of the diagnosis and treatment activities in the hospital, increasing the income level of emergency doctors, and at the same time ensuring the income and operation of other specialties.

The performance salary of the four hospitals is calculated by the hospital office and distributed to each department. This is still a little different from the previous when each department fought on its own.

However, even so, it is not easy to continue working in the emergency department.

"......" Ever since he was sprayed on his neck, Dr. Cao Yanhua has kept his mouth tightly shut. His face was pale and his expression was grim.

Even after working in the dirty, tiring and hard emergency department for so long, the experience of being sprayed with neck feces by a patient with bacillary dysentery still completely exceeded Dr. Cao's tolerance limit. Sun Lien watched him staggering out of the emergency room and going to the rest area to take a bath, and sympathized with the resident chief physician from the bottom of his heart.

I don't know if I can heal the wounds in his heart this time through things like the Eight Treasure Chestnut Pigeon.

It's about three or four o'clock in the morning, and ordinary people are already asleep in bed. During this time, the number of patients admitted to the hospital due to various traumatic injuries will be greatly reduced. Staying home and not going out will greatly reduce the likelihood of injury to yourself or others.

But it also means that if there is a trauma patient, it can be very, very, very serious.

"120 emergency center, forecast a patient with avulsion injury to his right arm. The phone on duty in the fourth hospital rang suddenly, Sun Lien grabbed the phone, and the voice of the dispatcher of the 120 emergency center came directly from the opposite side, "The patient lost a lot of blood and was unconscious. ”

At four o'clock in the morning, why are there avulsion injury patients? Sun Lien was stunned for a moment, but the long-term emergency work had already made him react to the forecast first, he stood up and began to organize the medical staff to gather to prepare for rescue, "forecast avulsion injuries...... he paused, "I'll take over, Aunt Hu, you help me arrange five nurses." ”

At this time, most of the second-line doctors are resting. Sun Lien calculated the time, and the effect of calling Zhou Jun now would definitely not be very good - Zhou Jun only fell asleep about an hour ago, and now it is the time to be sleepy. Instead of waking him up, it is better to deal with the patient's condition by himself first - anyway, Dr. Cao Yanhua has been washing for half an hour, and no matter how much he hurts his heart, he should finish washing.

"Xiao Guo, come over here. Sun Lien took out a T-shirt in his bag and threw it to the nurse Xiao Guo on the side, "You go to the lounge to find Dr. Cao Yanhua and ask him to change his clothes and come over immediately." After a slight pause, he said seriously to the male nurse who came to the rescue room to support him like himself, "If he dares to rub it, you can just drag him out of the shower room for me." ”

One patient had suffered severe trauma and was likely to be in critical condition. Sun Lien is in no mood to care about Dr. Cao's psychological trauma anymore - if he can't do it, he should buy two eight-treasure chestnut pigeons. Now it's important to save people.

The ambulance rushed to the rescue colleagues of the Fourth Hospital with the siren, and Sun Lien immediately greeted him with several nurses. Started helping to transfer the patient off the bus.

"Male, twenty-one years old. The pre-hospital first responder opened the carriage door neatly with his hands and feet, and while carrying the patient down, he quickly conveyed the basic situation to Sun Lien. "The right arm should have been wrenched in by the machine. It took a lot of effort for the firefighters to disassemble the machine. ”

Sun Lien took a quick look at the status bar on the patient's head, then didn't say anything, turned around and began to push the ambulance to the hospital.

Zheng Xin, male, 21 years old. Comminuted fractures of the ulna, radius and humerus of the right arm (00.48.32), small skull defect of the humerus (00.46.22), skin defect of the right arm 40% (00.46.22), musculocutaneous nerve, median nerve, ulnar nerve and radial nerve damage of the right arm (00.46.22), ulnar artery, radial artery and brachial artery defects of the right arm (00.46.22), deep vein and superficial vein defects of the right arm (00.46.22) and blood loss (00.36.22). ”

It's not a right arm avulsion at all. Sun Lien ran fast on two legs, and shouted to the rescue room as he ran, "Prepare the blood to be finalized, and the prepared RH negative O blood will be transfused into two units immediately!"

Where is this the manifestation of an avulsion injury? This is obviously a ruined injury!