My Medical Skills Give Me Experiences
Chapter 141: Dangerous situations occur frequently, and the family members are dealt with together
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Zhou Can even suspected that this guy was a clean freak.
For him, it doesn't matter which bed he treats. Gui Peisheng himself works with the purpose of learning, and he can gain something from any illness he encounters.
The key is to handle all kinds of emergencies well without accidents.
Zhou Can quickly rushed to the ward where the 31st bed was located.
Shenwai can generally be divided into three to five wards.
The most common ones are intracranial tumors, brain trauma, functional neurosurgical diseases, and cerebrovascular diseases.
Then, intensive care can be regarded as a comprehensive independent ward.
Patients whose lives are hanging by a thread must live in the intensive care unit.
That is to say, the strength of Tuya Hospital is so strong that it can establish multiple intensive care units. There is one intensive care unit in the emergency department and three in Shenwai. Cardiothoracic surgery, neurology, and chest, these departments must have built intensive care units.
I am not familiar with obstetrics and gynecology. According to common sense, and the status of obstetrics and gynecology in Tuya, there are at least two intensive care units.
Premature babies, critically ill pregnant women, and mothers need to be sent in to save their lives at critical moments.
Many family members are very scared when they hear that they are going to the intensive care unit because they are burning money. A daily fee of 10,000 to 20,000 is a disaster for ordinary families.
But the intensive care unit really has the strength to compete with Hades at critical moments.
The patient can be snatched back from the gate of hell.
Then stay for a few days or half a month, one or two months, and finally pass the dangerous period safely, transfer to the general ward, and slowly recover.
Since the establishment of intensive care units in major domestic hospitals, the death rate has dropped significantly.
Many lucky patients survived and eventually recovered.
There are also tragedies of people and money.
Zhou Can came to bed 31. The patient was a fairly young man, probably not more than forty years old. His wife stood beside the hospital bed with a haggard face, holding a washbasin in her hand.
The patient still has vomiting symptoms at this moment.
"Do you vomit a lot?"
Zhou Can asked with concern.
A 40-year-old man is exactly the age when the upper part is old and the lower part is young, and he is the pillar of a family.
I can't imagine, if this man falls, what will happen to the family behind him?
Some experts said this, health is 1, and career is N zeros.
If the health is gone, any more zeros after it are meaningless.
"My husband complained of a headache not long ago, and it didn't take long before he started to vomit." The patient's wife relaxed her nervous expression when she saw the doctor coming.
In the minds of patients and their families, doctors are the nemesis of diseases and the life-saving straw.
Zhou Can took a look at the patient's examination materials and medical records.
"Cerebral arteriosclerosis, accompanied by cerebral aneurysms!"
Seeing the test results, Zhou Can couldn't help being shocked.
Since the patient was admitted to the hospital, he must be preparing for elective surgery.
For other diseases, vomiting may not be a serious problem.
But vomiting from brain aneurysms is a bad omen.
Even Gui Peisheng like Zhou Can, who has no similar experience, knows the hidden danger.
Doesn't Dr. Cheng Gang who manages the bed know that bed 31 is a cerebral aneurysm?
He looked at the patient's hospitalization date and was admitted yesterday.
"Did the nurse tell him to fast for food and water?"
Zhou Can asked this question because he wanted to know whether the department had made a surgical plan and time for the patient?
"No."
The patient's wife shook her head.
It seems that the doctors in the department have not yet formulated a surgical plan.
"Where does your head hurt?"
Zhou Can asked the patient directly.
"Here, and here, there are bursts of severe pain... Vomit!"
As he was speaking, the patient vomited again.
There is some acid water spit out in the basin, and there is no food residue.
"Has he not eaten since he was admitted to the hospital?"
Zhou Can asked.
If the patient ate something in the morning, what he spit out now is definitely not acid water and bile.
"I can't eat it. I bought bread to feed him, and I shook my head as soon as I took a bite. Not to mention the box lunch. From yesterday afternoon to now, I only drank a small glass of water. Doctor, when will my husband be scheduled for surgery?"
The patient's wife looked at her husband with concern.
"According to his examination report, it should be that the aneurysm in the brain pressed the nerve, which caused anorexia, nausea, and headache. The severe vomiting now may indicate that the condition is deteriorating. I will report it to the superior doctor immediately. From now on, he should not eat or drink. If the aneurysm in his brain ruptures and bleeds, he may need emergency surgery."
After Zhou Can finished speaking, he carefully checked some conditions of the patient.
The main symptoms are headache and vomiting.
In addition, the patient had significant neck stiffness in response to vomiting.
There are indications that the patient's cerebral aneurysm is extremely likely to rupture and bleed.
This matter cannot be delayed. If something goes wrong, a fresh life will be lost.
Zhou Can hurried to bed 22 to report to Dr. Cheng.
Cheng Gang is his superior doctor, and he can only report to Cheng Gang.
The hospital implements a three-level responsibility system.
The director is responsible for the attending doctor, the attending doctor is responsible for the resident doctor, and the resident doctor is responsible for the regular trainees and interns.
First level management level.
If something goes wrong, the subordinate doctor reports it in time, and that is the responsibility of the superior doctor.
When he came to bed 22, he saw the patient lying on the bed twitching crazily, rolling his eyes and foaming at the mouth from a long distance away, which was very scary.
Moreover, the patient's head was wrapped with gauze, indicating that the operation had been performed.
Most likely craniotomy.
But Zhou Can had just arrived, so he wasn't too sure.
No wonder Dr. Cheng sent Zhou Can to bed 31 to check on the patient's condition.
Compared with the vomiting in bed 31, the patient in bed 22 was more urgent and needed to be dealt with personally.
Jiang Xiaohua originally thought that following Dr. Cheng could do some easy and clean work.
At this moment, he had to frown and clean the white foam in the patient's mouth.
And runny nose.
"Is this a symptom of epilepsy? It seems to be serious."
Zhou Can asked.
"The patient developed severe epilepsy not long after the operation," Jiang Xiaohua explained.
As for Dr. Cheng, he directly ignored Zhou Can's question.
While doing various examinations for the patient, he then made a comprehensive diagnosis and came up with a treatment plan.
He has been unable to come up with a solution for a long time, obviously a little uncertain.
At this moment, the patient with violent convulsions suddenly fell into a coma.
Dr. Cheng's face changed drastically, and there was panic in his eyes. He's just a resident after all.
Generally speaking, a resident doctor who is qualified to manage the bed alone has at least two years of work experience.
This work experience is not counted from the first day of regular training, but from the time of obtaining the medical practitioner certificate and successfully registering in the hospital.
To be promoted to a doctor, undergraduates need five years of resident work experience, which is also counted from this moment.
So, strictly speaking, after getting the certificate, you can be regarded as a resident doctor.
"Don't panic, the patient should be in a coma caused by epilepsy, and he will wake up soon. But you need to ask Director Wen or Director Wu for instructions." Dr. Cheng said not to panic, but when he reached out for his phone, his hand was shaking.
The patients are all in a coma, can you not panic?
It may be inconvenient to make a phone call in front of family members.
After all, this patient suffered from epilepsy after surgery. Although the family members haven't said anything yet, their faces are already gloomy and frightening.
If any sentence is not well said, it is easy to detonate doctor-patient disputes.
"You two watch here first, and I will report the situation to the superior doctor."
After speaking, Dr. Cheng walked away.
Zhou Can followed.
"Dr. Cheng, the patient in bed 31 is vomiting violently, accompanied by neck stiffness, severe head pain and other symptoms. I suspect that the patient is bleeding from a ruptured intracranial aneurysm."
Zhou Can had no choice but to not respond to the situation.
Even though he knew that Dr. Cheng was a bit overwhelmed at the moment, he still bit the bullet and explained the matter clearly.
On the first day of working in Shenwai, I encountered so many dangers.
Zhou Can can be regarded as deeply aware of the difficulty beyond the supernatural.
Many seniors have said that persuading people to enter the emergency department to become a doctor is like a thunderbolt. It is stupid and bad to persuade people to go into a trance.
Which department is not easy to mix.
As long as doctors encounter patients with complicated conditions, they will immediately feel stressed.
"Have you had a contrast examination? The patient just vomited, and you are bluffing here, why are you so irresponsible?"
Doctor Cheng must be in a bad mood.
His temper has also grown a lot.
After admonishing Zhou Can, he didn't say how to deal with it. He left Zhou Can where he was, and walked towards the far office while making a phone call.
"Hi Director Wen!"
When the phone was connected, Dr. Cheng immediately changed his posture.
Half of the shoulders collapsed.
"I have something to report to you. The patient who underwent cerebrovascular malformation surgery last night suddenly developed epilepsy symptoms in the ward. Before I had time to deal with it, he fell into a coma. How do you think about it?"
Cheng Gang reported carefully.
Zhou Can stood where he was and heard clearly.
As for what Director Wen on the other end of the phone was talking about, he didn't know.
"Okay, okay!"
Cheng Gang seemed to have received the imperial decree, he was so determined that he agreed again and again.
I thought that Cheng Gang would report the situation of bed 31 together, but I don't know if he was afraid of being scolded or had other considerations, but he didn't mention a word.
After hanging up the phone, Cheng Gang turned around and saw Zhou Can still standing there.
He directly told him, "Who, immediately send the patient in bed 22 for an EEG examination. Then tell the family members that postoperative epilepsy is a common phenomenon. You can prescribe some medicine first to see the effect of the treatment. If the effect is not Alright, let’s consider a second surgery.”
When Zhou Can heard this, his head grew dizzy.
The patient had just finished the operation and had complications, and the family members must have found it difficult to accept it.
Asking him to be a regular trainee to explain to the family members, isn't that just to get cannon fodder to beat the family members?
This Cheng Gang is too treacherous.
"Doctor Cheng, I don't have a good memory and my mouth is stupid. I'm afraid of passing on the wrong words. Why don't you go and tell the family members yourself!"
Zhou Can is not a fool, and will never agree to such a thing.
Even if he was asked to clean up the patient's excrement and urine, it would be easier for him to accept it. He would rather be scolded by Cheng Gang for this kind of thing that might be beaten by his family members than to shirk it.
"A fool who can't do such a thing well."
Cheng Gang scolded him and had no choice but to explain to the family in person.
In fact, in many departments of the hospital, there are treacherous superior doctors like Cheng Gang.
It's not that they are not responsible, but relying on their rich work experience, they hand over some tasks that may be scolded to lower-level doctors.
Then when the junior doctors were scolded, they stood up and said a few words of comfort.
During Zhou Can's internship, he was ordered by Dr. Fang like this.
After suffering twice, he will never do such a stupid thing again.
Not long after, I heard the family members of the 22nd bed and Cheng Gang quarrel.
Jiang Xiaohua was so frightened that she hid away.
It is even more impossible for Zhou Can to be a good old man in the past.
If Dr. Cheng didn't use him, maybe he would go over to help him.
Now, he doesn't have any good feelings for Dr. Cheng.
He is more worried about the patients in bed 31. That man is the breadwinner of a family. The intracerebral aneurysm may be ruptured, why don't you rush for surgery and wait until there are irreversible consequences before surgery?
Then there is no point.
A family can also be ruined by it.
Not to mention anything else, even if the patient's life is saved afterwards, in case of cerebral palsy or limb paralysis, the patient will not only lose the ability to work. And for the rest of my life, I need my family to take care of me.
This is definitely a heavy burden for the patient's family.
Cheng Gang's quarrel skills are not very good, and he was quickly defeated by the patient's family.
He came out with a black face angrily.
"What are you two still doing in a daze? Hurry up and take the patient for an EEG."
He took his anger out on Zhou Can and Jiang Xiaohua.
Do any inspection, not empty teeth. The doctor in charge must issue an application for examination, and then the family members will pay the fee. This can be done.
This is the process.
If it is an emergency and the family members cannot come over in time, or cannot pay the fee temporarily, you can settle the arrears first.
It is generally very difficult for specialists to provide arrears treatment.
Because too many patients and their families will default on medical expenses after they are cured, regardless of whether they have money or not. If the patient is not cured or dies, it is even more impossible to collect medical expenses.
Part of this money will eventually be borne by the doctors in the department.
Therefore, no doctors in the department are willing to do such thankless things.
After Dr. Cheng left, Zhou Can and Jiang Xiaohua looked at each other.
"Originally it is the family's business to take patients for examination, we can help with it, but it is not possible to check the application form, how to do it?"
The inspection department will not violate the rules just because the two of them are doctors.
"How about I go to Doctor Cheng to get it!"
Jiang Xiaohua did not cheat this time.
I took the initiative to find Dr. Cheng and took the inspection application form.
"Did you scold you?"
Zhou Can asked in a low voice.
"I'm not afraid of being scolded by him, but I'm afraid of being asked to deal with patients' excrement and vomit."
Jiang Xiaohua was probably scolded, but she acted like nothing happened.
"Hehe, I've convinced you."
Zhou Can smiled.
"I went to tell the family members to ask them to pay the fee first."
Zhou Can has always been kind.
Against cunning people, he is more cunning than the other party. When dealing with honest people, we will never let them suffer, let alone bully honest people.
"Let me tell you! You have taken care of me many times."
Jiang Xiaohua bared her teeth at him, and walked towards the three sullen family members with the inspection application form.
Zhou Can secretly smiled, it seems that Jiang Xiaohua is not an ignorant person.
He also followed.
I'm always ashamed to ask Jiang Xiaohua to fight alone!
If the family members beat someone up, Zhou Can is a practicing family, at least he won't suffer.
"This is an application for an EEG examination prescribed by a superior doctor. Please go and pay the fee." Jiang Xiaohua looked white and clean, and she was gentle and shy, but she was not at all stage frightened when facing fierce family members.
People should not be judged by their appearance.
Each has its own advantages and disadvantages.
"What? Your hospital still has the nerve to ask us to pay more? My brother has been treated like this. It's considered polite not to ask you to pay. Don't think we are easy to bully."
"If something happens to my husband, I will sue your hospital."
"This is medical malpractice!"
"Recorded, recorded, taken to court, these are all evidence."
The three family members are like machine guns, one more fierce than the other.
"Dear family members, I understand your feelings and sympathize with the patient's experience. But I want to tell you that any operation has risks, and postoperative complications are extremely common. Before the operation, I believe the surgeon has also talked to you, and after With your consent, the operation will be performed."
Zhou Can was 1.85 meters tall, and when he stood a step forward, the natural aura of a martial arts practitioner weakened the viciousness of the three families.
"You all signed the consent form for the operation. Besides, the patient may die if he doesn't undergo the operation. Now there are only minor postoperative complications, so you have this attitude towards the doctor. What else will you do in the future?" A doctor dares to perform surgery?"
In terms of negotiation skills, Zhou Can is much better than Cheng Gang.
After all, he is a rich second generation.
I have learned a lot from my parents since I was a child.
The expressions of the three family members were obviously relaxed.
Zhou Can struck while the iron was hot.
"The earlier the patient gets an examination, the sooner the cause of the epilepsy is found out, the sooner he can receive treatment. The longer the UU reading www.uukanshu.com delays, the more unfavorable it is for the patient. The examination fee is actually not much. If the patient's treatment is delayed, that It's a big loss."
After being preached by Zhou Can, the three family members exchanged glances and then discussed a few words in a low voice.
Compromises were quickly made.
"I'll pay the examination fee right away, and trouble the two doctors to send my husband for examination. There are too many people in your hospital, and you will have to wait in line for a long time for any examination."
"Okay, we will pull the patient over immediately. Don't worry, we will take the green channel for you and make it urgent."
Zhou Can succeeded in persuading his family members, and he also breathed a sigh of relief.
Originally, the attitude of the family members might hit the doctor at any time.
Jiang Xiaohua blinked at him and secretly gave a thumbs up.
To be honest, Jiang Xiaohua's heart sank at the patient's ferocious aura just now.
I was very afraid of being beaten.
The two pulled the patient to the EEG examination room, where many patients were queuing up.
Jiang Xiaohua's routine is quite good.
Take the checklist and run to the window to hand it to the entry clerk.
"The patient is already in a coma, please arrange for an urgent EEG examination immediately."
The identity of a doctor is still very useful sometimes.
This should be regarded as aboveboard jumping the queue.
The key is that others are willing to buy it.
"Done!"
He ran back and said to Zhou Can.
"It's really you, I learned a trick from you again."
Zhou Can's words made him show a smug smile.
While waiting for the inspection, Zhou Can faintly heard the word "Director Wu" mentioned by many people.
It's like saying hello.
When he looked over, it was really the pinnacle of surgery, Wu Baihe.
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