Emergency Department Observation of Medical Records

"The heartbeat is gone!" The second line of surgery shouted, "Press and press!" While speaking, he had already started to perform chest compressions while reporting the count.Zhao Bin heard the movement from the next door, quickly put down the medical records and ran over to pick up the rhythm massage, and let the second line continue to direct. "An injection of epinephrine! What's the use of this state! The key is that the blood will arrive soon, and the blood transfusion will increase the blood volume before recovery is possible. I don't even know how much blood has been lost!"

The bedside color Doppler ultrasound in the color Doppler ultrasound room arrived, and the people in the ultrasound department didn't expect it to be like this. They hesitated whether to do a color Doppler ultrasound now.

"Let's do it now to see if there is much bleeding in the abdominal cavity. The abdominal bleeding has not gone away, which organs are the key." The second line said, "Zhou Lu, call your son and daughter, how long is it? Operation?"

The hospital always called the family members, and the head nurse went to appease the husband next door whose blood pressure was soaring again. In the mess, there was no affirmative reply from the family members. The children said they would listen to their father's decision; The quilt covered his head and yelled that he had a headache and said that he was a patient and could not make a decision.After listening to these reports, Director Zhou finally made a decision and sent him to the operating room immediately to prepare for the operation.Today's second line of surgery is responsible for surgery, and he is responsible for the safety of the ward.After getting an affirmative reply from the director, everyone took action.Those who applied for blood first went to the blood transfusion department to prepare 1000ml of whole blood, which was sent to the operating room.Zhao Bin did the compressions all the way to the door of the operating room before changing people.After pressing down, the backs of both hands were swollen.When I came back, I hurried to the emergency room and took the time to complete the paperwork and doctor's orders.

Director Zhou came and came to the office to understand the situation and see the medical records. "Write down the section on the physical examination carefully. Have you read both before and after? Please describe the trauma in more detail." Director Zhou said, "It may be difficult to save the patient's life. If not, I'm afraid the patient's family will make trouble. , he is unreasonable."

"Should our hospital call the police?" Zhao Bin asked.

Director Zhou sighed: "What is the content of the police?"

"The patient has trauma." Zhao Bin said.

"How many trauma patients are there in the emergency room every day? Have you called the police?" Zhou Qinjin shook his head, "The police usually follow the patient's own wishes, and those who are unconscious follow the wishes of the patient's family members. From what we know about the family members, I'm afraid no one will call the police." .Even if you call the police, according to the current social situation, there will probably be no results."

At this time, his mobile phone rang. It was the call from the second line of surgery today, informing him that after 10 minutes of cardiopulmonary resuscitation, he still had not recovered his own heartbeat, his blood pressure could not be measured, and his pupillary light reflex had disappeared.

"Continue to press, it can only be dragged to the family members." Director Zhou said.After hanging up the phone, he and Zhao Bin checked the medical records more nervously.

"The patient has died." Zhao Bin said, "The hospital highly suspects that the spleen was ruptured due to trauma and died from hemorrhagic shock. Shouldn't the police be called in such a situation?"

"If the family members disagree with the autopsy, do you have evidence in addition to suspicion?" Director Zhou now has grief and indignation in his eyes, "Now that the patient is dead, we can only announce the death when the family members come...the family members will not agree Call the police, and the family members will even provide a letter of understanding. It is too late for us to do anything! Zhao Bin, you may have seen less internal medicine. We have many such things every month in emergency surgery, and you know it clearly This man sitting next to her is a murderer, but you can't do anything but help a patient relieve their pain."

"Director..." Zhou Lu knocked on the door, "The one with hypertensive encephalopathy... do you want to tell him?"

"Thanks for your hard work, Xiao Zhou." Director Zhou nodded, "The son and daughter will come later, and we will talk about it after the death is announced. I will go with the head nurse. You can continue to take care of other patients in the ward and help Senior Brother Zhao for a while. , His paperwork is the most important thing right now." He stood up and patted Zhao Bin on the shoulder, "Zhao Bin, don't worry, everyone is in the same mood, but don't think about anything else now, just write Please check the medical records in the emergency department and protect yourself." After speaking, he went to the ward.

In the end of this matter, as Director Zhou said, nothing happened.

The hospital tried its best to fight for the final rights of the deceased.Director Zhou and the head nurse repeatedly confirmed the trauma to the family members. The husband always denied it, but the family members were vague. Director Zhou called the police at the police station next to the hospital, saying that the hospital was attacked and the police came. a trip.This trip brought the blood pressure of hypertensive encephalopathy to crisis again, and finally scolded the hospital in the ward for "why meddle in other people's business".

"It's only natural for me to beat that dead woman!"

Amidst the loud yelling and cursing, Zhao Bin expressionlessly explained to the police what he knew about the patient's condition. "When I checked the patient's body, there were many subcutaneous bruises all over the body. Judging by the color of the bruises, some of them had been for a long time, and some were recent. The redness and swelling on the left upper abdomen was the latest one. The size of this is about ..." Since the family members refused the autopsy, he could only describe in detail the trauma visible to the naked eye as best he could.

In the end, however, these efforts were in vain.The children really offered to forgive.As for the domestic violence husband, due to his unstable condition and high risk, he does not even need to be detained, and the emergency department will continue to treat and take care of him.

On the day the patient with hypertensive encephalopathy was discharged from the hospital, Zhao Bin had to endure the disgust in his heart to explain to him the precautions related to high blood pressure, and told him to strictly monitor blood pressure and take antihypertensive drugs regularly.

Director Zhou said helplessly: "He hasn't caused trouble so far, everyone is lucky. She... walked away very quickly, without any pain, and in the future, there will be no more pain..."

This matter has spread throughout the hospital, and there are discussions in various departments.Luo Mingyao also heard something about it.He remembered the agreement with Zhao Bin, and never dared to send a message to ask.But he knew that Zhao Bin was in a bad mood. Zhao Bin asked him to come to the house more often than usual that week, and he was a little rough on the bed.He couldn't cross that line to pay more attention to him, so he could only bear it silently, and that forbearance lured Zhao Bin even more crazy.

When the aftermath of the matter subsided, Zhao Bin remembered that he had vented his emotions indiscriminately, and when he was annoyed, he wanted to make it up to Luo Mingyao.

So the emergency department once again launched a discussion on the topic of "what major is a good choice for graduate students".This time it is more detailed, and when it is detailed, it will be expanded by "each department and tutor of the Affiliated College of C University".

In a flash, it was September. Zhao Bin approached Luo Mingyao several times, and seriously discussed the issue of choosing a major at home, and provided him with several majors and candidates. After thinking so carefully, when Zhao Bin asked him, he had no opinion at all, but Zhao Bin was so anxious that he got angry.

"How come you haven't considered it yet!" Zhao Bin knocked on the table, "You have transferred so many departments, and the internship is over halfway, which department do you think is interesting, which department do you have a good impression of the boss you have met! You have nothing at all Idea? How to do it!"

Luo Ming buried his head very low: "I'm relatively stupid, and I was scolded in every department..." Especially the month when I broke up with Zhao Bin, I was out of my mind.

Hearing this, Zhao Bin softened his heart, sighed, thought over and over again, and finally said: "Choose endocrinology." He cracked open the hospital's webpage, and called up the personnel list of the chief physician and deputy chief physician of the Department of Endocrinology. "Have you been to the endocrinology department?"

"I've been," Luo Mingyao nodded. "The teacher who teaches endocrinology said that I have suffered a lot."

Zhao Bin glanced at him sideways: "Patients with ketosis and hyperosmolarity ask you to measure blood sugar every hour. You are the best at doing this simple and mindless thing, aren't you?"

Luo Mingyao nodded obediently: "Sometimes Huang Bohuai said something was wrong, and I would help him test it. It is indeed much simpler than surgery."

"Promise..." Zhao Bin pointed his finger at his head with hatred. "The Department of Endocrinology is very good. There have been a lot of new developments in recent years. The management of diabetic patients is also a topic of concern all over the world. A large number of endocrinology talents are needed from large hospitals to local school hospitals. There are also many topics in their departments. In recent years, we The hospital has done a lot of endocrinology, so you don’t have to worry about the topic articles when you go in. The tutor, the tutor is Professor Zhou Hongbin, he was the second-line attending doctor when I was intern, and all the interns liked him. Very meticulous. But he is a good old man, and he is not very talkative in the department. I heard that there are few students recruited in the past few years. You are not enterprising. This time, try hard to choose Teacher Zhou as your tutor. Did you hear me! "

Luo Mingyao quickly smiled and nodded: "Okay, teacher."

The matter of choosing a major was settled in this way.In addition to "taking what they need", Zhao Bin began to pay attention to Luo Mingyao's review situation.On the day of pre-registration, he sent several messages to Luo Mingyao, asking him if it was done.Luo Mingyao said that the school network is not good, and everyone is anxious to browse.

"Then come directly to my house to brush!" Zhao Bin replied to him.

Luo Mingyao closed the computer and ran to Zhao Bin's house.

"You stopped, Xiao Ming? What could be more important than pre-registration?" Huang Baihuai was worried for him.

"Ms. Zhao asked me to go to his house to brush!" Luo Mingyao ran out bouncing around.

"Damn it! There is such a reward for helping to collect data!" Huang Baihuai was jealous, "Why didn't Teacher Zhao find me? I'm much smarter than Xiaoming..."

At Zhao Bin's home, Zhao Bin sat by the computer and watched him choose.Registration was still stuck twice, and Zhao Bin was so anxious that he turned on his computer to help browse the webpage.It was one o'clock at noon, and finally the matter was settled.Even the exam location was chosen to be closer to University C.The finale satisfied Zhao Bin.

The two went out for lunch.The two of them were aboveboard today, and Zhao Bin was not at all afraid to come out to meet people in broad daylight, so he waited for them to eat at the snack alley next to the hospital, and ordered a dry pot to eat.While eating, he continued to introduce his exam experience back then, which made Luo Mingyao's eyes go dizzy.

After the lecture, I put the person back, and went back to work at night.While going to work, I felt something was wrong in my heart. How many years has it been since I took the postgraduate entrance examination for the postgraduate entrance examination? Has the postgraduate entrance examination changed now?He felt uneasy in his heart, so he asked Zhou Lu again. Zhou Lu was not much later than him, and gave him a blank stare, saying that he couldn't tell whether there was any difference now.If you want to ask, you are also asking the pitifully few postgraduate emergency medicine students who have come this year.

So Dr. Zhao didn't even take a rest during the day the next day, and ran to find those graduate students in the emergency department who were elusive.These graduate students are all students of Director Zhou. They didn't go to the clinic, and they help collect data and write articles in the department every day. If they don't come to the day shift, they really can't find anyone.Several people were flattered by the brother's enquiry, and explained their respective matters for the postgraduate entrance examination last year in detail, including the need to prepare a warm baby in the examination room of a certain school in winter to prevent cold and frost.

Dr. Zhao, who was already near the top of the academic food chain in the emergency department, listened carefully and even took notes.

A younger brother expressed puzzlement: "Brother Zhao, who are you asking for? Are your relatives taking the postgraduate entrance examination this year?"

Zhao Bin said: "A student, I have taken it before, and I really like it. A few days ago, he said that he was going to take the postgraduate entrance examination and asked me to ask his senior brother about his postgraduate entrance examination experience."

"Wow!" The graduate students burst into exaggerated exclamation, "Mr. Zhao, you are too caring!"

"Woooooo back then, I just lacked such a gentle teacher as Mr. Zhao..."

"I'm jealous by my real name! Someone who can be taken care of by Brother Zhao!"

"Could it be brother's girlfriend..." Someone said suddenly.

"I don't have a teacher-student relationship." Zhao Bin warned people not to talk nonsense with his eyes. "It's not a female classmate." He added to dispel their doubts.

Everyone sighed and did their own thing.

Zhao Bin went back with his notes.In front of the computer, he suddenly felt a little crazy.what am i doingHe couldn't help thinking.He hasn't had time to revise his articles on the computer, and he has no clue about this year's subject.Director Zhou said last week that he would draft and compile a book "Common Internal Medicine and Emergency Diagnosis and Treatment in Emergency Medicine", but he didn't write a single word.Now he is looking for people to investigate for a student who has taught him to take the postgraduate entrance examination, asking others about their experience in the postgraduate entrance examination, and asking others about the precautions for the postgraduate entrance examination.Is he crazy?

While he was thinking, he had already sent out the WeChat message: "The graduate students in our department said that it would be better to do more He Yincheng's real questions, and the simulated questions are more biased, and they can't reflect the real situation during the exam."

Putting down the phone, he covered his face, some things are out of his control...