The genius doctor starts from the game

Chapter 146 I was herded when I first arrived!

Huang Yu continued: "That's no problem. After you enter the department, I will give your phone number to the chief resident of our department. You have to help him."

"You have just arrived, so let me tell you about the basic situation of our department."

"Our department is now a complex of joint surgery and sports medicine. There are two groups. Professor Xu Changsheng and I lead the groups respectively. Both of our groups have patients from joint surgery and sports medicine."

"In our group, besides me, there are two associate professors, one is associate professor Qin Qiguo, and the other is associate professor Zhou Ren. In our group, the two of them usually take care of the patients."

"Because there are two associate professors, there is no attending doctor in our group for the time being, and there is Zheng Liu, the chief inpatient. He is the chief inpatient. In addition to managing the patients in our group, he is also responsible for the daily patient management in the department. , to assist the lower-level physicians on duty, and we have a total of four general inpatients here, who are on shifts, and whoever is their turn will be on the emergency department and the consultation system."

"After you come, just help him temporarily."

"It just so happens that when you are on duty, one of you can go to consultations and the other to surgery."

"Then in Professor Xu's group, there is an associate professor and an attending physician. The associate professor is Liang Linqi, and the attending physician is Chang Ren."

"You don't have to worry about Professor Xu's affairs, unless the doctor on duty on their side has something that can't be handled, they will call the chief hospital."

When Huang Yu said this, he was a little embarrassed and said: "Forget it, you haven't done training yet, and you probably haven't managed patients yourself in the clinic, right? Then you are only in charge of surgery for the time being, and the things in the ward should be handed over to you first." Let Zheng Liu handle it himself."

After Huang Yu finished speaking, he felt a little depressed.In fact, if it wasn't for improving the scientific research strength of the Orthopedics Department of the Second Hunan University Hospital, he really didn't want to accept someone like Lu Cheng who was excellent in academics but basically inexperienced in clinical practice.

It’s like the eight-year doctoral students. They have never been to clinical practice, nor have they experienced regular training. ability.

And Lu Cheng's resume is even more terrifying than theirs.

He graduated with a Ph.D. in six years, and directly jumped from undergraduate to doctoral level. Although it took five years to settle down, Lu Cheng only took the exam for a doctor's qualification certificate. I don't know what he thought in the past five years, nor I know that I should do the regular training first.

After a year of regular training, no matter how bad it is, I can gain more clinical experience.

It is very dangerous to put people like Lu Cheng directly in the clinic!
"Okay, Director Huang." Lu Cheng could only listen to Huang Yu's arrangements. He had made up his mind that he was here for a trial job.

As for his own resume, it seemed that apart from his good-looking resume in scientific research, there was nothing special about it clinically, so Lu Cheng didn't feel angry, let alone surprised, when Huang Yu underestimated him.

"Then let's do this first. I have already greeted Zheng Liu. I will give you his phone number first. He is on duty today. Follow him first. Get familiar with the environment of the department first. Take your time." , don’t worry.” After Huang Yu finished speaking, he suddenly discovered another thing and asked:

"By the way, how old are you this year?"

"29, it's almost full." Lu Cheng replied straightforwardly.

Lu Benke, in the sixth year, graduated with a Ph.D. at the age of 24, and then traveled across the country for five years, at the age of 29.

Huang Yu nodded inwardly.

The age of surgery is very important. The younger the age, the greater the plastic space and development prospects. Lu Cheng is only 29 years old now.

Ordinary people, even if they go to university, they have to graduate at the age of 29.Therefore, he can completely treat Lu Cheng as an ordinary academic doctoral student, so he is not so afraid.

"Okay, this age is still very young. In surgery, you can't even count as the beginning. Everything has just begun. I sent you the phone number. You should call Zheng Liu first. He is probably going to the operating room now. .”

Lu Cheng made a phone call to Zheng Liu, and after explaining the purpose of his visit simply and directly, Zheng Liu naturally knew about this in advance, so he hurriedly called him to go directly to the third floor of the surgery building, and he went to the door of the third floor of the surgery to wait. with him.

When Lu Cheng took the elevator to the third floor, he saw a big fat man who was about 3 meters five, but at least 1.7 kilograms, waiting for him there. His thinning hair had already covered his eyebrows, and it lay casually on his face.It looks quite chic.

When Lu Cheng saw him, Zheng Liu was also waiting for him.Said: "You are Lu Cheng, I have heard of you a long time ago, you are a brilliant student."

It doesn't sound like Lu Cheng is praising others, but Lu Cheng still said with a smile: "Where are the top students, they will be tough with Mr. Zheng in the future, take care of them in the future!"

Lu Cheng will need regular training in the future. In the orthopedics department, Gui Peisheng is mixed with the general hospitalist. There is nothing wrong with that.

But Zheng Liu didn't know this.

"Today, there are six operations in total. When Associate Professor Qin Qiguo and Associate Professor Zhou Ren will split the stage, I will be alone. If only junior doctors and graduate students follow them, I will probably go crazy on stage." Zheng Liu As he spoke, he brought Lu Cheng into the operating room.

The orthopedic operating room is divided into 123456 rooms, a total of six operating rooms, four wards, one ward occupies one room, and the other two are spare operating rooms, ready to allow patients in the four wards to be separated at any time And set.

There are three main operating rooms in the third orthopedic ward.

Lu Cheng and Zheng Liu walked in, and Zheng Liu immediately started the preparations for the operation with the subordinate doctors.

Zheng Liu didn't speak and called him to come on stage, and Lu Cheng didn't know what he was going to do, and in different hospitals, there were subtle differences in the pre-surgery preparation process, Lu Cheng felt that it's better not to rush to help, just wait a day, Familiarize yourself with various routines so as not to be told by a superior doctor.

just.

Before Lu Cheng could stand still for a long time, the mobile phone on the table for unused items in the operating room rang.

It was Zheng Liu's consultation phone that rang.
There are four departments of orthopedics, four general inpatients, four-day consultations in rotation, and there is no limit to the types of diseases consulted.

Zheng Liu looked around for a few times and then spotted Lu Cheng: "Xiao Lu, help me press the answer button on the Bluetooth headset. It's probably a consultation."

The duty phone of the general hospital cannot be turned off for 24 hours, so it is an old-fashioned Nokia phone for the elderly, which can only answer calls and has Bluetooth function.
Just for the convenience of being on the operating table, you can also answer the phone without much help from others.

Lu Cheng has done this kind of thing more than once before. After Zheng Liu's call was connected: "Hello! Orthopedics."

"Oh, is there an emergency consultation in the emergency department?"

"The emergency surgery ward is still the surgery clinic."

"okay, I get it."

After answering the call, Zheng Liu looked at Huang Yu and said, "Professor Huang, I may be stepping down, urgent consultation."

Hearing this, Qin Qiguo and Associate Professor Zhou Ren were expressionless, but looked at Zheng Liu with complicated eyes.

Seeing the expressions of the two of them, Lu Cheng felt a little puzzled.

The consultation system in the hospital is one of the [-] core systems, that is, when patients in other departments are in the hospital or emergency patients are just admitted to the hospital, if they need assistance from other departments for diagnosis and treatment, they can use consultation to let the consulting physician run away to reduce the pain of the patient Also tired.

It also avoids some unfavorable things happening to some immobile or comatose patients because they get out of bed.

Among them, the consultation is divided into general consultation and emergency consultation.
General consultations must be conducted within 48 hours, and general consulting physicians will complete the consultation within 24 hours.

For emergency consultation, the consulting physician must arrive at the consultation location within 15 minutes, without any reason!
The physician in charge of emergency consultation shall be arranged by the department itself.

In other words, now that Zheng Liumo said he was undergoing surgery, even if he was being operated on, the orthopedic department had to arrange for another person to rush to the emergency surgery clinic within 15 minutes.

Professor Huang raised his eyebrows slightly and said, "What are you doing stepping down?"

"Lu Cheng from our department is now your valet chief inpatient. The valet chief inpatient is also qualified for emergency consultation. What's the matter?"

In fact, the qualification requirements for emergency consultation are not high, and a resident doctor is enough, as long as he is authorized.

Deal with sudden situations such as life-threatening or disability.

Ordinary consultations are only eligible for those with the title of attending physician or above.

Zheng Liu was taken aback for a moment, but soon realized that Professor Huang obviously wanted to train Lu Cheng in advance.

Lu Cheng's theory must be very good, otherwise he would not be able to graduate early, Zheng Liu had to admit this, but didn't he hear that his clinical level was limited?
If you want to say when the doctor stage trains you the most, it is the bed management stage and the consultation stage.

It can quickly let you see different diseases and different types of patients, so as to accumulate the foundation of orthopedics.

Is Lu Cheng's knowledge reserve enough to run a consultation?
I'm afraid that the reason why Professor Huang set Lu Cheng in advance as a follower in the hospital is to 'override' himself.

Zheng Liu was so moved that he cried, although the general inpatient can take care of the resident doctors, they are actually the bottom of the hospital. Then he has to keep working until someone takes over.

There are even people with poor character who have reached the stage of associate professor before leaving the position of chief inpatient.

Zheng Liu wished he had been ignored by Lu Cheng earlier.

Zheng Liu said: "Lu Cheng, hurry to the emergency surgery clinic. There is an emergency consultation there. I heard that there are wounds and fractures. You should check the situation first."

"First look at the mind, if the mind is not clear, just throw it to the neurosurgery department, don't worry about it. Their first priority is to deal with it."

"Secondly, look at the chest and abdomen. If there is trauma to the chest and abdomen, please help write an opinion."

"Thirdly, check to see if the wound oozes blood, and if there is bleeding, check to see if it has been stitched. If the stitches are too long, stay in the emergency department and wait for a bed in the Department of Orthopedics."

"If there is no stitches, I will be sent from the emergency department to emergency surgery immediately, and I will explain the blood coagulation function, the four items before blood transfusion and blood routine."

Zheng Liu still felt that it was necessary for him to ask Lu Cheng to explain the matters that Lu Cheng needed to pay attention to before the emergency consultation for him. Although Professor Huang and the others had been in the general hospital before, how many years had it been, and they probably forgot the current general. The principle of survival in hospital is over.

"Thank you Mr. Zheng, I understand." Lu Cheng returned and walked out of the operating room.

But hearing what Zheng Liu said, Huang Yu immediately frowned and said, "If you're not sure, call me anytime."

Lu Cheng had just arrived, and Huang Yu was still not at ease, so he treated Lu Cheng as a calf and put him in the clinic directly, and gave him a solid foundation.

When Associate Professor Qin Qiguo heard Huang Yu's words, he couldn't help frowning even deeper, and thought to himself, this Lu Cheng is another Zheng Liu, and there will be riots in the department from now on...

Lu Cheng leads the second district.

The operating room is on the third floor of the surgery building, not far from the emergency department, and you can definitely get there within 3 minutes.

Professor Huang and others continued to perform the operation, and they didn't seem to worry that there might be something bad about Lu Chengqu.

The Second Hunan University Hospital is one of the most well-known hospitals in Hunan Province. Whether it is an outpatient clinic or an emergency department, it is always crowded with patients, family members of patients, and doctors from various departments who come and go for consultations walking outside the emergency department.

The emergency department is adjacent to the outpatient building, and a part of the outpatient building is still being rebuilt. I heard that it will be able to move to the new outpatient building in the near future, but I don’t know how long it will be.

In the outpatient clinic, Lu Cheng himself couldn't find the direction. On the contrary, the emergency department is independent from the outpatient clinic, so it is very easy to find.

Although the emergency department is independent from the emergency department, in the emergency department, it is actually divided into five parts: surgical emergency outpatient department, internal medicine emergency department, emergency observation ward, emergency inpatient ward and emergency intensive care unit.

Among them, some emergency departments that are common in surgical emergency clinics and internal medicine emergency clinics have corresponding doctors, such as general surgery, neurosurgery, cardiothoracic surgery, respiratory medicine, and cardiology.

Once encountered in these emergencies, it may be fatal,
On the other hand, the orthopedics department, if it is not a particularly urgent emergency, is rarely fatal, at most it is only disabled, so there is no separate orthopedics emergency department for the time being.

Once the corresponding complications of orthopedics occur, they are mostly dealt with by other medical and surgical departments.

However, this does not mean that orthopedics is not important.

In addition to life, people must also have life.

Quality of life is very important.

Lu Cheng came to the emergency department wearing a surgical mask, surgical gown, and shoe covers.

Although he didn't have time to wear a badge because he was wearing a surgical gown, it was a very iconic doctor's wear, so he asked, "Which one is here for an emergency orthopedic consultation, and where is the patient?"

Hearing the sound, a white coat without a badge came up and asked, "Is it the orthopedic teacher? The trauma patient just now has been sent to the emergency room."

"I'll take you there."

As he spoke, he opened the way forward and said briefly; "The patient was injured in a car accident. The knee joint of his right lower limb was degloving, and there was a lot of bleeding. He also had head trauma and chest trauma."

"The relevant departments have been called for emergency consultation, and the patient is currently in a coma."

"The amount of bleeding on the leg was very large. My teacher was afraid that the patient would go into shock due to blood loss, so he invited the orthopedic department for consultation to see if emergency surgery was needed."

When Lu Cheng heard the word "car accident injury", Lu Cheng frowned.

Traffic accident injury is a very broad pronoun, it can be big or small, it can be disabled or dead, and it is the most dangerous cause of emergency surgery.

none of them.

In light terms, there are soft tissue contusions, avulsion fractures, ligament injuries, backbone fractures, mutilation injuries, and even cardiac arrest directly on the way to rescue.

"Has the patient had a head CT scan, how is his consciousness and vital signs?"

"What about the CT of the abdomen and the CT of the chest?"

Lu Cheng asked three questions in a row, but in fact there was only one question, how is the patient's vital signs?
"Deep coma. I was injured for an hour and a half. In the ambulance, the doctor who followed the car performed a simple bandage to stop the bleeding. At present, the dressing is oozing a lot."

"Head CT and thoracic and abdominal CT have been done, and the teachers of Shenwai, general surgery, and chest surgery are all reading the films. I don't know the specific situation."

"But it's definitely not okay to bleed like this now!" The intern in a white coat without a badge spoke quite clearly, and his thinking at the moment was not disturbed.So the medical history is very detailed.

Lu Cheng soon saw the patient. The patient's right knee joint was obviously swollen, covered with a lot of gauze and cotton pads.

After the bandage was applied, there was still a lot of oozing to the surface, the amount of bleeding was very large, and it must be active bleeding.

If you continue to lose, you will definitely go into hemorrhagic shock.

Lu Cheng immediately made a judgment and said: "The current situation requires immediate emergency surgery, but the patient may not even be able to go to the operating table now!"

"The status of the head and thoracoabdominal trauma is unclear."

"Has someone from their department come to see it? Do you have any comments, I am from the orthopedics department."

Lu Cheng introduced his identity at the end, and first talked about the treatment, just to point out the point that surgery is necessary.

"We called the emergency department to see the external surgery and chest surgery, and they all said that the operation should be done immediately. However, the general surgery department saw the CT and said that the situation is fine for the time being, and there is no active bleeding, but the contusion of the right spleen, There is a high probability of delayed rupture of the spleen at any time."

"People outside of the mind and chest also suggested immediate surgery."

"But they are afraid that the person will bleed to death during the operation. It is best to stop the bleeding at the same time as they perform craniotomy, decompression, and closed chest drainage."

"It's just like this, the patient is hit by three places at the same time, and people may not be able to recover!" The doctor in charge answered, a young man in his 28s, with deep dark circles under his eyes. Although he was tired at the moment, his words were also All on point, no nonsense.

This situation seems to be a dead end.

"What's the family's opinion?" Lu Chengcheng asked.

In this situation where there is no way to choose, only the family members can choose. If the family members are unwilling to deal with it, no one dares to touch it.

The doctor in charge's dark circles were in stark contrast to the white coat. At this moment, he said helplessly, "The family members haven't come yet, and the driver who caused the accident has fled."

"Even the money for doing CT is paid for by the chief on duty who asks for instructions."

no family.

The patient will die immediately.

This is an unsolvable problem that emergency departments face all the time.

At this time, the staff from the Department of Surgery and Thoracic Surgery rushed over almost at the same time, and said at the same time: "The patient needs emergency surgery immediately, family members? Ask a family member to pay the money, and a family member to sign!"

"Immediately call for emergency surgery and ask someone to complete the medical records."

It was a neurosurgery doctor who spoke; "He now has a massive subdural hematoma, and surgery must be performed immediately, otherwise he may be brain dead on the spot!"

There are only two cases of brain death, one is complete physiological death, and the other is vegetative state.

"No family members, no payment! Do you want to call the general on-duty authorization?" The doctor in charge also asked directly.

"Hit! Tell the person who sent him to contact his family as soon as possible."

"I can't delay."

"At least no matter what, the head window should be decompressed."

"Contact the anesthesiology department and the ICU, and prepare for anesthesia and tracheostomy at any time." The neurosurgery staff just gave their own suggestions.

"Where is the medical record? I'll write a consultation opinion first."

The doctor in charge frowned slightly upon hearing this.

When the patient is admitted to the hospital, the first consultation is responsible, regardless of whether the patient registered the wrong number or whether he has money.

Now that the patient's family cannot be contacted, the patient has not paid the money, and someone outside of God recommends immediate surgery, then he will bear all the responsibilities.

If the patient goes there in the end, and the family members of the patient refuse to pay the money, then all expenses such as first aid, blood transfusion, and anesthesia have to be borne by the hospital itself.

The doctor in charge hesitated for a moment, and immediately called the chief on duty: "The chief on duty, I want to report a situation."

"Correct!"

"It's the same patient as before. Emergency surgery is needed for both the surgery and orthopedic consultations. The patient has no family members and has not paid the fee. You need to authorize me!"

"Okay, I see. I'll arrange for someone to contact the operating room immediately."

After making the phone call, he said, "The chief on duty has authorized you. You go back to the operating room first. I will send the patient up here immediately. The patient with the first four items of blood transfusion and blood type will be drawn as soon as he arrives. Please arrange someone to contact the blood bank." "

"I'm really busy here."

Hearing this, Lu Cheng and the thoracic surgery doctor didn't move a single step, only the god who had finished writing his opinion hurried back.

He just stared at the medical record, writing his opinions in a leisurely manner.

Seeing this, the doctor in charge could only helplessly say: "Forget it, classmate, you call the blood bank. It says that the emergency department needs a lot of blood! Then contact the anesthesiology department for an emergency consultation!" He hurried out and went again Contacted the kind person who sent the patient.

But when he went out, the good-hearted man was gone.

He didn't scold anything, and quickly returned to the computer again to quickly open the doctor's order and write various signed materials for the conversation.

The consulting physician in the white coat of the thoracic surgery department saw that Lu Cheng waited quietly for him to finish writing, and then he took the medical record and wrote his opinion in a leisurely manner, so he asked, "Brother, you are new to the orthopedics department?"

"It used to be a bit unfamiliar!"

The chief resident consultant doctor was actually very familiar with him, but Lu Cheng didn't recognize him, he could only be a newcomer and a remote department.

Orthopedics is obviously not a remote department.

"En. I'm just here." Lu Cheng nodded and replied.

"It's okay, I'm not in a hurry, and I haven't been tricked by the two of them."

"If you just went straight to the operating room after listening to that big brother, then if the patient bleeds to death, you will be in big trouble."

"These people just like to dig holes for us hard-working brick-and-mortars." He finished writing cursingly before handing it over to Lu Cheng. By the way, Lu Cheng was wearing a surgical gown and didn't bring a pen. I lent it to Lu Cheng.

Lu Cheng nodded, and said while writing; "Yes, I have invited a consultation and I have no objection, which is equivalent to acquiescence or no need to deal with it! It's all wrong."

(End of this chapter)