The road to the rise of great doctors

Chapter 27 Two emergencies
On the Friday of the third week of urology surgery internship, Liu Dong came to the ward early with a computer on his back.

He is a very serious person. Since he has chosen to be on duty (auxiliary) class, he must take it seriously.I prepared my equipment before going to bed last night, preparing to be in the hospital all day today!
Because there are several outpatient clinics in the Department of Urology during the day, and the clinics and emergency departments of the outpatient clinics are upstairs and downstairs, so except for patients who are inconvenient to move, even if they have gone to the emergency department, they will be advised to go to the surgical outpatient nurse station for triage arrangements. see a doctor.

The usual situation is that emergency consultations during the day are basically in the morning and noon when the outpatient clinic is not open.In the morning and noon time, you can basically go to the outpatient clinic and wait for treatment.

Zhu Guoliang's duty this time is a microcosm of most duties.There was not a single call during the day, and Liu Dong, the supplementary class member, naturally had little workload.

After the day's shift, Liu Dong went to the cafeteria to get a meal and brought it back to the ward duty room for dinner.

When passing by the nurse's station, I could vaguely hear the nurses who were taking over shifts talking and laughing, "Dr.

The sound stopped suddenly, and it turned out that a nurse who was taking over had pushed her back.

"There are some things that cannot be said..."

"Yes, yes, there are some things I can't say. If I want to say anything, I have to say it after work..."

Liu Dong ignored these gossips.

After opening the meal in the duty room, he finished it quickly in a few mouthfuls.Then turn on the computer and prepare to continue reading the literature.

He heard footsteps coming over. It turned out to be Zhu Guoliang. He was walking and talking on the phone, and said, "Is there an emergency department? Now? How many people?"

Then, with a bang, the door of the doctor's duty room was opened by him, "Xiao Liu, follow me." After Zhu Guoliang said that, he walked over.

Liu Dong quickly picked up the white coat hanging aside, put it on, and hurried out, following closely behind Zhu Guoliang.

He asked, "Mr. Zhu, what's the matter?"

Zhu Guoliang replied: "There are two emergency consultations in the emergency department, probably requiring surgery. Have you finished your meal?"

"Yeah." Liu Dong nodded and said, "What's the disease? Did the emergency department tell you?"

As Zhu Guoliang walked, he said: "One of them had a broken kidney on one side. He had an examination in another hospital. The broken kidney was quite serious and he probably couldn't save it. As soon as he heard that the kidney was going to be removed, the family asked to be transferred here."

"Another one, I drank beer with my friends last night until early in the morning. I didn't go to the toilet along the way. When I was almost at the door, I fell down. I woke up today and felt a stomachache. When I urinated, I found some blood in the urethra, but the urine was very painful. few."

After listening to it, Liu Dong said, "Did you fall while holding your urine? If the bladder holding your urine hits something hard, it will hurt you easily?"

Zhu Guoliang said, "I think so too. After a while, you listen to my instructions. We will prepare at the same time after seeing the patient."

"it is good."

The two walked into the emergency department. Liu Dong was no longer unfamiliar with this place.After greeting the nurse, I learned that both consultation patients were in beds near the emergency surgeon's office.

The two walked over alone.Because the condition of the broken kidney seemed more serious, they decided to see this patient first.

When he was approaching the patient, Zhu Guoliang said to Liu Dong: "You go ask the family members about their medical history first, and I'll look at the contrast-enhanced CT films first." Liu Dong responded and asked the patient's family members for specific information, such as injuries, past medical history, and allergies. Wait, and record it in the notebook.

After questioning, it was found that the patient had a clear history of trauma to one side of his waist. There was no break in the skin and it was a closed trauma.After the injury, his colleagues promptly drove him to a nearby hospital, where ultrasound and enhanced CT scans were performed. The diagnosis was basically clear, that is, a fragmented kidney.

The extent of kidney damage should be examined with contrast-enhanced CT scans.Under normal circumstances, if there is only one person, you should finish collecting the medical history after watching the film, and some may leave the film for last.

Liu Dong's current task is to fully collect medical history, assess the patient's general condition and common precautions.So, he continued to ask and learned that the patient had just passed his 33rd birthday and was injured at work, so the unit would pay the expenses first.He had never been hospitalized, had no major surgery, and had no history of infectious diseases.

Liu Dong collected the medical records, collected all the test orders and imaging reports, and after a preliminary look, he found that basically all the examinations that needed to be done were done.

Taking these materials, he walked to Zhu Guoliang's side and said, "Mr. Zhu, the preoperative examination is basically complete, and the medical history is not special."

Zhu Guoliang nodded after hearing this, inserted the enhanced CT film on the screen, and then said to Liu Dong and the patient's family: "Look, this is the normal kidney on the other side, and this is the kidney on the injured side. The one on my hand has been broken into many pieces. It cannot be preserved and needs to be surgically removed, otherwise it will become infected or continue to bleed or leak urine, and the consequences will be more serious."

The patient's family members wiped away tears. At the hospital before transfer, the doctor also said similar words. Out of consideration for their loved ones, they insisted on going to a large hospital for surgery.When he came here, he still heard this conclusion. He didn't have any projects, so he nodded in agreement.

Liu Dong issued a hospitalization note and asked his family members to apply for hospitalization.At the same time, I also told the nurse on duty in the emergency department that someone could be arranged to send me to the ward after I was admitted to the hospital.

After dealing with a patient, a line of words suddenly appeared in Liu Dong's mind.

Mission: Treat patients.

Task content: Participate in twenty operations and at least independently close the abdomen or suture independently.

Mission reward: Proficient level abdominal ultrasonography...

Ultrasound examination is the surgeon’s other set of eyes.Once you master it, in addition to determining the gender of pregnancy, many other operations can be completed more safely with the assistance of ultrasound.Surgeons have many excellent surgical skills, but they are not very good at surgery and ultrasound.

Liu Dong was stimulated. Ultrasound is as attractive to surgeons as Transformers are to young men!
After taking care of this patient, Zhu Guoliang briefly described the situation to the operating room attendant and made an appointment for emergency surgery.At the same time, I also called the second line on duty today.

Today's second line on duty is Deputy Chief Physician Fan Hai. He is a handsome and lively young and middle-aged doctor. He is very patient with students and junior doctors. He is very good at various bladder surgeries and is also involved in other urological surgeries.He lives in the family home and can reach the hospital in 5-10 minutes.

Liu Dong and Zhu Guoliang walked to another patient.

This is a middle-aged man, half sitting and half lying on the bed, with a bulging belly and a somewhat painful expression on his face.There is a urine bag on the body, which shows that a urine catheter has been left, but after asking, it has not been emptied, but the total urine volume in the urine bag is very small, and the color of the urine is slightly red.

Liu Dong picked up a pen and paper and asked while recording the time of injury, how he was injured, how long the stomach pain lasted, and other information.He also opened the quilt covering his body and checked that there were no open wounds.

Zhu Guoliang took the ultrasound report form of the urinary system and brought the family members to the side. He told the family members that the patient was diagnosed with suspected bladder rupture and needed surgery.

After successfully communicating with his family, Zhu Guoliang picked up the phone and started contacting the imaging department.Patients undergoing emergency surgery can make an appointment through the green channel and go directly when they are ready.

(End of this chapter)