Doctor's Life Simulator

Chapter 276 The Trainee Physician Is Confused: Qin Lang's Ward Rounds
After returning to the burn department, except for some slightly difficult operations, Qin Lang spends the rest of his time accompanying several other doctors and conducting ward rounds.

Although he is only a resident doctor, for some patients with deep wounds and patients with complex hand injuries, Qin Lang's level is far higher than that of Cui Jianguo and Huang Kaihang. Therefore, for some patients with more complicated conditions, the two deputy directors They will invite Qin Lang to go to the ward rounds together.

As for Wei Guoqiang, because of Qin Lang's return recently, the burden on his body has been lightened a lot.

Cai Qing has learned a lot with Qin Lang these days, and after completing an ordinary debridement and eschar decompression, the two returned to the office.

However, as soon as the two of them sat down, Wu Youtu hurried in. When he saw Qin Lang, he stopped and thought for a while:
"Qin Lang, I treated a patient yesterday. After the routine debridement and suturing for him, his symptoms did not improve at all today, and even other complications appeared. Would you like to come with me?"

Wu Youtu no longer regards Qin Lang as a little doctor at all. In many respects, he feels that Qin Lang is much better than him. Naturally, when he encounters some problems, he will go to Qin Lang first.

"Okay, then let's go and have a look together. Cai Qing, come with me and Dr. Wu."

Qin Lang waved his hand and let his cheap little brother go with him. Compared with the previous Cheng Yunfeng, Cai Qing, a soft and cute girl, is much better and more eye-catching.

As for Cheng Yunfeng and Huang Ping, the group of regular trainees has already been transferred to other departments.

Cai Qing picked up a medical record folder, and obediently followed behind Qin Lang.

After a few people arrived at the ward, apart from Qian Liang, the fellow doctor under Wu Youtu was also standing beside him.

Seeing that Wu Youtu had invited Qin Lang to diagnose the disease together, Qian Liang was full of anticipation, while the trainee doctor, who was a few years older than Qian Liang, had a more playful expression.

In fact, not only Qin Lang and Qian Liang, but even Wu Youtu, a senior attending physician, is quite satisfactory in the eyes of this trainee doctor.

When Qin Lang and Wu Youtu went forward to check the patients, another group in the ward, Cui Jianguo's group, You Daren and another fellow doctor were also making ward rounds.

Seeing this scene, two older trainee doctors got together and wanted to take a closer look. This Qin Lang weighed a few catties and a few taels.

In fact, they were extremely dissatisfied with letting such a small doctor come to the ward rounds together, and even put on the posture of a chief physician.

The trainee doctor under Wu Youtu even secretly called Cai Qing aside:
"Xiao Cai, you don't need to be so nervous. It's not that you are asked to follow the chief director, a small doctor, and put on airs. I really think he has unique insight, far surpassing me."

"To be honest, the condition of this patient is nothing at all. After the burn, some dyspnea, fever, and slow pulse are not a big deal. According to my experience, a chest X-ray examination has a high probability of It's empyema, just do a closed thoracic drainage. I think Dr. Wu is too cautious."

The trainee doctor commented calmly, but, after all, he is a trainee doctor, so he didn't express his thoughts.

Moreover, from the bottom of his heart, he also wanted to see how good Wu Youtu and Qin Lang were.

Cai Qing didn't comment on the doctor's diagnosis, but just looked at it quietly.

On the hospital bed, the patient was lying down, and the whole person had symptoms of nausea, vomiting, chest tightness, and difficulty breathing. Moreover, the whole person's heart rate also increased.

Wu Youtu has already conducted a preliminary examination on the patient. He has a judgment, but he still feels that there is something slightly abnormal. Therefore, he did not make a conclusion, but is going to let Qin Lang take a look together.

Perhaps Qin Lang has a new idea.

During the inspection in Qinlang, Wu Youtu introduced the previous situation in detail:
"The patient, because of a fire in the factory two days ago, fell from a high altitude in a panic, and suffered a slight bone fracture in his hand. After routine debridement and skin graft suture, the patient started today. The illness recurred, with nausea, vomiting, chest tightness, difficulty breathing, and high temperature."

After Wu Youtu finished speaking, he stretched out his hand again, and Qian Liang on the side handed over the chest X-ray film he just made.

"The patient's left breath sound is low, the percussion is a drum sound, and the respiratory movement is weakened. The chest X-ray shows that the left heart is compressed by 80%, and the fluid level can be seen in the left pleural cavity. Muscle tension, blood pressure 110 /90mm Hg”

After Wu Youtu's analysis, let's put forward some of his ideas:

"Preliminary judgment, due to the fire, the patient's respiratory tract was burned and the lungs were traumatized. It is suspected that there was empyema or left hydropneumothorax. Consider performing closed thoracic drainage, and we can perform another thoracentesis technique."

After Wu Youtu put forward his point of view, the two trainee physicians on the side agreed slightly.

Especially Wu Youtu's trainee doctor, this old fritter who once went to the Burn Department of the First Affiliated Hospital of Zijingang University and watched Director Shen Jiachen's surgery from a distance, agreed with Wu Youtu's conclusion.

"Xiao Cai, take a look. I just said that this situation is very common. I don't even need to take a chest X-ray, and I can make a good judgment."

In front of Cai Qing, Wu Youtu's point of view was corroborated. Obviously, this trainee doctor was very proud.

However, after Wu Youtu came to a conclusion that was almost the same as that of this trainee doctor, Qin Lang instead showed a trace of solemnity on his face.

Looking at the chest X-ray again, Qin Lang discovered a detail that Wu Youtu and others hadn't noticed.

After all, as a physician in the burn department, I instinctively think about burns and respiratory burns, but Qin Lang is different. After several generations of simulations, I have experienced different departments, especially the recent experience in the emergency department and thoracic surgery department, and Newly acquired skills.

Qin Lang was beyond the expectation of Wu Youtu and the trainee doctor, and asked the patient specifically:
"Do you feel any abdominal pain or bloating?"

Before, Wu Youtu and the fellow doctor did not think about it, nor did they inquire about it, and the patient did not specifically mention it. Originally, the pain was not very obvious, but only faint, so they did not say it separately.

Qin Lang's question, the patient added psychological hints, and the pain really appeared again, so he nodded:

"Doctor, I have some abdominal pain and bloating."

Qin Lang's mood sank, and he took the stethoscope directly from Qian Liang's neck, and listened carefully. After a while, he turned his head and looked at Wu Youtu:

"Dr. Wu, the patient had bowel sounds in the chest and weakened breathing, but on CT, the mediastinum shifted to the right, the diaphragm disappeared, the diaphragm surface was not clearly displayed, and the false diaphragm surface was raised, and the air-liquid level was visible in the thoracic cavity. The situation is urgent. , need to perform thoracotomy on the patient immediately.”

Qin Lang looked at Qian Liang. After cooperating with a large number of operations before, Qian Liang obeyed Qin Lang's orders. He was also surprised when he felt Qin Lang's serious face. Obviously, the patient's condition is It's not as simple as Dr. Wu judged.

"Doctor Qian, go and invite Director Zu Liang from the General Surgery Department right now. He needs to cooperate with the patient in repairing the traumatic diaphragmatic hernia!"

Hearing the unfamiliar and somewhat familiar term Qin Lang, Wu Youtu was taken aback for a moment, and then his face turned ugly!
Because, when the first patient was sent, he did describe falling from a height, but he was covered by the patient's burn wounds and bone fractures, while ignoring the patient's possible internal chest trauma.

On the other hand, Wu Youtu's trainee doctor is just a burn doctor, and he knows nothing about this rare traumatic diaphragmatic hernia, which is easily misdiagnosed by ordinary general surgeons.

"What is he talking about? Isn't it just a simple empyema, why do you want to invite the director of the general surgery department to perform the operation together?"

In front of Cai Qing, the trainee doctor still had a hard mouth, but there was a trace of panic in his heart. Did this doctor Qin really see the patient's real illness, and it was such an urgent illness.

PS: Thanks to the book friend 20201012111937953 for the continuous reward of 100 coins*6, thank you big brother~ happy

(End of this chapter)