Back in 2002 as a doctor

But now is not the time to ask questions. The anesthesiologist gradually moved the laryngoscope to the center and pushed the tongue to the left.

Slowly insert the mirror body to the junction of the epiglottis and the base of the tongue, straighten the left side, and pull the laryngoscope forward and upward about 45 degrees to see the edge of the epiglottis and expose the glottis.

The endotracheal tube was brought to the front less than 1 second after exposure of the glottis.

The anesthetist holds a pen in his right hand and inserts the catheter along the lens from the right mouth corner of the patient. The beveled end is aligned with the glottis and sent into the trachea. The incisors are about 22±2cm.

perfect!

Inject air into the airbag, touch the airbag as elastic as the tip of a nose, and inflate 8mL.

There was water vapor on the catheter, which was connected to a simple breathing skin bag, and artificial ventilation was squeezed to see bilateral chest rises, and the breathing sounds of both lungs were present and symmetrical on auscultation.

"Ventilator……"

Just said three words, the endotracheal intubation has been connected to the ventilator for assisted breathing.

That's the end of it? !

The anesthetist thought in surprise while fixing the endotracheal tube with a large white tape.

This...was too smooth.

The ventilator, Mr. Zhou Congwen probably won’t be able to use it, the anesthetist fixed it as quickly as possible, and turned around to prepare to adjust the ventilator.

However, he soon found that he had nothing to do.

Ventilator mode: auxiliary control ventilation volume control mode A/C, tidal volume 500ml, respiratory rate 16 times/min, peak flow rate 40L/min, inspired oxygen concentration 50%, positive end-expiratory pressure 5cmH20, inspiratory time 0.2s, trigger Sensitivity 3.0L/min...

Even the two rarely used modes of departure sensitivity and positive end-expiratory pressure are set!

The anesthetist stared blankly at the ventilator, feeling a little bad all over.

Few people pay attention to the value of positive end-expiratory pressure, and not many anesthesiologists in the anesthesiology department understand this value.But a little chest doctor did it so perfectly. Could it be that what he said was true?

impossible.

Zhou Congwen let out a long breath. Seeing the patient's blood oxygen saturation go back, he possessed himself and said, "You can hear what I'm talking about. If you understand, just blink."

The patient blinked vigorously, afraid that Zhou Congwen might not see it, so he blinked a few more times.

"I know it's a bit uncomfortable, but this is to help you breathe. Don't fight, breathe along the ventilator! The feeling of being out of breath just now will become lighter, you know?"

The patient blinks.

"Relax, it's okay." Zhou Congwen patted the patient's head.

The patient blinks.

Zhou Congwen patted the patient's arm to show comfort, and the patient blinked again.

The fear of death made him extremely obedient.Especially when the eyes turned black just for a moment, and the feeling of being out of breath made the patient very close to death.

But before he could see what Naiheqiao looked like, he was pulled back.

"Brother Wenbo, it's hard work. I'll trouble you to write a consultation later."

"Do you use it?" The anesthetist was relieved this time, and asked while carefully checking to see if there were any omissions.

Chapter 0112 Discuss Director Wang's mistake ([-])

"Hehe, it's definitely necessary." Zhou Congwen said with a smile, "Emergency rescue requires rescue records and discussion of critically ill patients."

The anesthesiologist didn't care what Zhou Congwen said, and the rescue was successfully completed, which is the best.But as soon as he thought about it, he realized that there was something in Zhou Congwen's words.

What Zhou Congwen said were the most common words, every sentence and every word was so normal that there was no other meaning at all.

For emergency treatment, there must be a rescue record, and the medical record writing standard requires that this should be discussed.This is the rule, and all doctors know it.

But rules are rules, who has time to discuss this in the clinic?

If there are occasional people talking about the death cases, how about talking about wool after the rescue is successful?

And even if it is a death discussion, the doctor in charge of the bed usually writes a few random strokes, just to fool around, just to complete the medical record.

The anesthesiologist instantly realized that Zhou Congwen was going to make trouble for Wang Cheng.

He looked at Zhou Congwen helplessly, "Xiao Zhou, calm down."

"I'm very calm." Zhou Congwen said not only calmly, but also coldly, "everything follows the normal procedure. If Wang Chengfa doesn't want to discuss it, I'll go to the medical department. If the medical department disagrees, I'll go to the deputy in charge of the clinic." Dean."

"..." The anesthesiologist was surprised.

Zhou Congwen didn't say anything anymore, the ice melted on his calm, indifferent and cruel face, and a smile appeared, "Brother Wenbo, thank you today."

"You're welcome...Xiao Zhou, it's good that the matter is over, don't make a fuss."

"It mainly depends on Wang Chengfa. If he doesn't want to make a fuss, he can just discuss it. If he disagrees, I haven't figured out how to do it. Follow the normal procedures, and the regulations in the hospital will never be fart.

Emmm, I made a mistake, most people talking in the courtyard are farting.But I don't believe that Wang Chengfa covers the sky with one hand, and the people in the agency always want to give face. "

Seeing Zhou Congwen's resoluteness, the anesthesiologist couldn't persuade him, so he could only write the consultation records.

All the test sheets were prepared, and Zhou Congwen arranged them neatly and orderly in chronological order, and the anesthetist complained while writing.

He didn't want to get involved in the internal conflicts in the thoracic surgery department. The most important thing was that he didn't think Zhou Congwen could win, so he described everything fairly and objectively in the text, trying to make sure that no one could make mistakes.

A few minutes later, heavy footsteps were heard in the corridor.

"What's going on?" Wang Chengfa's voice came.

"Director Wang, the patient suffered from cardiopulmonary failure. He received an emergency consultation from the anesthesiology department. He was intubated again and was assisted by a ventilator. He is now out of danger." Zhou Congwen's voice also came in.

The head anesthesiologist sighed, if it were him, he wouldn't dare to be tough with the director.

Nothing is the best result, calling the director from home in the middle of the night like a dog, and discussing why Lao Wang made a mistake...

What did Zhou Congwen think?

He probably really thought that he could bring down Lao Wang by himself.

Although the other directors in the hospital didn't like Lao Wang very much, after all, he had offended too many people in those years, but he was the director of the department after all... No, he was the person in charge of the department, and he didn't mention the director yet.

But that's not something a little doctor like Zhou Congwen can bring down.

His thinking is too naive.

Technical level does not determine who will be the director. No matter how skilled you are, as long as the director does not make principled mistakes, crucifies people without solid evidence, and has no major medical disputes, the department director has an inherent advantage.

"The tube inserted by the anesthesiology department?" Wang Chengfa's voice came in again, interrupting the anesthesiologist's thoughts.

"Yes, Dr. Li Wenbo consulted and intubated, and the patient's condition is stable now..." Zhou Congwen began to report his condition, his voice getting weaker and weaker, and he probably went to the small intensive care unit with Wang Chengfa.

The anesthetist hurriedly took the time to write the medical records. He didn't want to meet Wang Chengfa at all.

I was caught in the middle of this matter, although Zhou Congwen apologized to himself twice in a row with cryptic words, the anesthetist was still prepared to refuse to help.

Swiping and brushing, the pen moves like flying, but after all, writing is not as fast as Wang Chengfa's seeing patients. Before he finished writing, he heard footsteps coming straight to the doctor's office.

"Huh? Li, why are you still here?" Wang Chengfa asked in surprise when he saw the anesthesiologist sitting at the table.

"Write the consultation record." The anesthesiologist said helplessly.

Wang Chengfa paused, and then gave Zhou Congwen a vicious look.

Dog days know how to write medical records, how can there be a clean and refreshing look of a surgeon!

But these words are slander at most, Wang Chengfa is like a mirror in his heart, and he will be challenged by this little doctor again.

Normally, he wouldn't care about a little doctor's provocation at all, just raised his hand and pressed him to death.

But the strange thing is that since Zhou Congwen broke his medical records that time, he directly slapped the textbook in front of him and turned on the provocative mode, and then he moved his mind to beat him to death.

But the strange thing is that with my own eyesight, I can't find the slightest mistake of Zhou Congwen.

Not only can't find any mistakes, can't pick out faults, but Zhou Congwen slaps him in the face one after another.even!Even Wang Zhiquan let Zhou Congwen beat him up, but he didn't even dare to fart.

Wang Chengfa was thinking about something, but forgot to put down his raised leg, and kept standing at the door of the office in a sculpture-like posture.

The anesthetist looked at him blankly, Wang Chengfa had a serious face, raised one leg, drooped the corner of his mouth, his face was blue...

"Director Wang?" the anesthesiologist called softly.

Wang Chengfa flickered and almost fell to the ground.In just a few seconds, his brain seemed to have lost control of his body, and he was like an old man with dementia.

"Xiao Li, let me see what you wrote." Wang Chengfa stabilized his mind, went to the anesthesiologist, picked up the unfinished consultation notes and read them all the way.

The more he watched, the more terrified he became.

Because Wang Chengfa couldn't understand the blood gas analysis value at all, he could only know which value was wrong based on the positive and negative signs, but he didn't know what it meant or how to treat it.

The anesthesiologist's consultation records were not particularly detailed, but the key abnormal indicators were all there. Although the conclusion was not stated, it was clear—tracheal intubation and ventilator-assisted breathing were recommended.

This conclusion slapped Wang Chengfa's face like a big mouth. He felt his ears buzzing and his face burning.

What I said to Zhou Congwen in the small intensive care unit a few hours ago echoed in my ears like Hong Zhong Dalu.

How arrogant I was then, how embarrassing I am now.

Write what I said in the medical record if you are capable... Wang Chengfa remembers what he said very clearly.

But it turns out that I was wrong, and the patient was intubated again a few hours after being offline.

And Zhou Congwen... Wang Chengfa glanced at him.

Chapter 0113 Discuss Director Wang's Mistakes ([-])

"Director Wang, take a look at the doctor's order. Is there anything else that needs to be changed?" Zhou Congwen didn't seem to know what Wang Chengfa was thinking, and asked meekly like an ordinary little doctor holding the doctor's order.

Wang Chengfa glanced at it. He was dazed about the medicine for cardiopulmonary function, and he didn't know what to do.

Wang Chengfa knew all the words in the doctor's order book, but those medicines and surgeons basically didn't use them, and he couldn't change them even if he wanted to.

If it was in the past, Wang Chengfa would not have such great psychological pressure.

Ever since Zhou Congwen slapped the textbook in front of the general practitioners that day to show himself what it means to live within his means, he has become much more cautious.

"Xiao Li, I think it's all right. Take a look. After all, you have a lot of contact with the anesthesiology department." Wang Chengfa glanced and handed the doctor's order to the anesthetist.

"Director Wang, I've seen it, and it's pretty good." The anesthetist was relieved when he saw that there was no imaginary tension, stood up and said with a smile, "The patient's condition has stabilized. It will probably be fine in 2 days."

Wang Chengfa nodded, put the doctor's order book on the desk, and picked up the medical records as if casually.

Zhou Congwen has no records.

Is it because I don't have time, or I don't want to offend myself?Wang Chengfa was a little puzzled.

But when he thought of the words he said domineeringly when he got off work, Wang Chengfa felt guilty.

I can deny it myself, but the medical records have to be filed and kept for a long time.

One book or two is fine, if the books are like this... These are hidden mines, who knows when they will explode.

The key is that the provinces, cities, and hospitals will come down to check the medical records like a convulsion. What will they think when they see such medical records?

He thought a lot of things in his mind, but he remained calm on the surface, did not try to "provoke" Zhou Congwen, but walked slowly back to the director's office.

Seeing Wang Chengfa leave, the anesthetist laughed in a low voice, "Xiao Zhou, so you were joking."

"hey-hey."

"Just kidding, don't get so stiff with the director, it won't do you any good." The anesthetist said earnestly.

"Yeah." Zhou Congwen nodded casually, "Brother Wenbo, just write it down and put it in the medical record. I'll go and see some patients."

"Going to the bedside?" the anesthetist asked.

"Sigh." Zhou Congwen sighed, "The nurses in the department have never seen similar patients. They are too young and inexperienced. If I don't stare at them, I feel weak, and I can't sleep well."

This is right... the anesthesiologist thinks every word is correct, but after thinking about it carefully, the whole sentence is nonsense.

The little nurse in the department doesn't understand, neither does Wang Chengfa, so you understand?

Zhou Congwen didn't accompany the anesthetist either, he didn't know that his unintentional words had already caused the anesthetist to stiffen.

Back to the small intensive care unit to continue to take care of the patients. The family members of the patients who were gossiping outside the door had no idea what happened. They just praised Wang Chengfa, saying that he is dedicated and has noble medical ethics.

Wang Chengfa sat in his office and pondered for a long time.

It was already late at night after the patient with kidney failure came back from dialysis, but Zhou Congwen's medical record was written without any flaws. He came here early in the morning, and he stood in front of him with the medical record and slapped himself in the face with the data.

But this time Zhou Congwen did not write the medical records.

It shouldn't be impossible, but that Zhou Congwen was softened, knowing that challenging the director as a small doctor would definitely have no good fruit, Wang Chengfa thought to himself.