Doctor's Life Simulator

Chapter 7 Intractable diseases, why don't you let Qin Lang talk about it?

A man in his forties, Wang Qiang, was lying on bed No. 13.

"The patient Qin Lang will be handed over to you to take care of the bed. If you have any situation, you can contact me directly."

Qian Liang ordered that because of the special situation of this patient, this time he will personally come to inquire about the patient's condition.

"Wang Qiang, how do you feel now?"

The patient was lying sickly on the bed, his entire face was dull, and his lips were even more chapped and rough.

Seeing Qian Liang coming to ask, he opened his eyes slightly, but his whole body exuded a sense of resistance.

"It's still the same as before, the whole body is very uncomfortable, and it looks like it has been bitten by countless ants on the calf. Doctor, can you find out the problem?"

Seeing Wang Qiang's pain, the family members on the side began to question him:
"The doctor at the town hospital said at the beginning that it was all right, it was all right, debridement and disinfection, and the use of antibiotics could reduce the infection, but look, how many days it has been. Finally, I was transferred to the first hospital in the city. It's getting serious."

Hearing the doubts from the patient and family members, Qian Liang also felt distressed. Indeed, this patient is very abnormal.

Common sense, such debridement, intravenous antibiotics should have relieved the symptoms long ago.

Qian Liang could only continue to check with patience.

While Qian Liang was doing a further physical examination, Peng Yun who was on the side also came over.

Peng Yun is 30 years old this year. He is a very talented young doctor in the No. [-] Hospital of the city. He graduated from Peking Union Medical College and is very hopeful that he will be promoted to attending physician by the end of this year.

Peng Yun signaled his two little doctors to stand aside, and they came to Qian Liang's side.

"A patient transferred from the county hospital yesterday?"

Seeing Peng Yun approaching, Qian Liang nodded, and naturally handed the various auxiliary inspection materials in his hand to Peng Yun.

After the latter took it, he looked at it: "According to the current situation, the patient has a fever, and the general condition is slightly worse. It has reached at least grade 2 skin and soft tissue infection. If further complications are detected, it will reach grade 3. "

Peng Yun stepped forward to look at the patient's wound again: "The local area is red, swollen, hot and painful, which is a typical manifestation of inflammation."

"There are sinus tracts and secretions in some parts, it seems that the situation is worse than I thought."

Hearing Dr. Peng's analysis, Qian Liang also smiled wryly. He had already used conventional debridement and intravenous antibiotics since yesterday, but the situation didn't improve at all.

While the two residents were talking, Cheng Yunfeng and the other two young doctors showed puzzled expressions on their faces.

Therefore, Cheng Yunfeng turned his head and looked at Qin Lang habitually. The habit he developed these days:

"This is the 2014 guidelines for the diagnosis and treatment of skin and soft tissue infections in the United States, which divides the degree of infection into 4 levels."

"Grade 1, there is no fever, and the general condition is good. Grade 2, there is fever, and the general condition is poor, but there are no unstable complications. As for grade 3, there are severe symptoms of poisoning or at least one complication."

Naturally, Qin Lang would not disappoint Cheng Yunfeng, and added a lot of his own analysis:
"Originally, the patient was only an open fracture with a mild soft tissue injury of Gustilo type I, and the treatment was very simple, but unfortunately, he was an employee of a chemical factory and was soaked in toxic liquid, so it was possible to develop into a grade 3 fracture. Even if he did not heal for a long time, it was more likely Initiated sepsis and reached a life-threatening grade 4 infection."

"I see."

Also while listening in, Qin Lang was able to analyze so much, but he and the others were at a loss.

Peng Yun's two little doctors both had a feeling of astonishment, followed by a sense of frustration.

It was Cheng Yunfeng who secretly smiled, it seemed that he couldn't be hit alone.

In front of Qin Lang, all the Gui Peisheng present are trash!

Cheng Yunfeng became thick-skinned, and continued to ask:
"Hey, Qin Lang, can you explain what Gustilo I is?"

The two little doctors on the side also pricked up their ears.

"Type I: The length of the wound is less than 1 cm, generally a relatively clean puncture wound, the bone tip pierces through the skin, the soft tissue is slightly damaged, no grinding contusion, the fracture is relatively simple, transverse or short oblique, and no comminuted."

"Type II: The wound exceeds 1 cm and the soft tissue is extensively damaged, but there is no avulsion injury, and no tissue flap is formed. The soft tissue has mild or moderate grinding contusion, and the wound is moderately polluted."

"Type III soft tissue extensive injury, mostly high-energy injury, severe pollution, fracture comminuted, unstable."

Qin Lang didn't care, they were all colleagues, so of course he was happy to share.

The three of Cheng Yunfeng kept nodding, and raised their postures again!

While several young doctors were trying to digest, the two residents also started their own analysis and discussion.

"It seems that we can only continue to use conventional debridement first, and at the same time conduct bacterial cultures on sinus secretions and deep tissue extracts to find pathogenic bacteria."

Peng Yun thought for a while, but couldn't find a solution for a while, so he could only check further:
"In this way, Wang Qiang, we need to go for another B-ultrasound examination, an X-ray examination, and an MRI examination to see if there are any abnormalities before we can confirm the next treatment plan."

Qian Liang and Peng Yun exchanged glances. Under such circumstances, only experienced doctors dare to make a direct judgment. With their current clinical experience, they can only analyze it after waiting for the examination.

Although it can be judged comprehensively, the disadvantage is that it takes a lot of time and the patient may be further infected.

"It's going to be checked again, and we're made to wait? Can you guys do it?"

The patient's family and Wang Qiang heard the two doctors discussing for a long time, but they still couldn't find a good treatment plan, so they immediately lost their temper.

Qian Liang and Peng Yun could only persuade the patient with wry smiles:
"The pathogenic bacteria is unknown now, and after all, it is a fracture accompanied by venom soaking, we can only determine the cause by further inspection"

The two of them have already decided to show the patient's condition to the superior doctor later and discuss the treatment plan. Now they can only treat it in a conservative and conventional way.

Just as the two were about to leave, an untimely voice sounded.

"I think the patient's treatment plan should be adjusted now. If the conventional debridement is continued, it is likely to lead to aggravated infection, and the patient may have the possibility of amputation."

Qin Langshi's shocking voice sounded.

Qian Liang was not too surprised, and looked at this doctor who had surprised him many times.

Another resident doctor, Peng Yun, didn't have such a good temper. He glanced at Qin Lang. Their superior doctor was discussing a problem. How could it be his turn to intervene, especially in front of the patient? It is very irresponsible to say that the treatment plan is changed.

Moreover, it is also slapping them in the face.

Peng Yun sneered: "This is your trainee doctor, so he doesn't know the rules?"

Among the same generation in the city's No. [-] hospital, Peng Yun has always been talented and far ahead, so he speaks very forcefully. Even Qian Liang will be angry if his performance is not good, let alone this little doctor.

Seeing her superior doctor go crazy, her two little doctors shrank their necks, like quails, very cute.

Although Peng Yun has a hot temper, she can't stand her high level.

Regarding Peng Yun's reprimand, Qin Lang was neither humble nor overbearing, after all, he knew the patient's condition well in the simulator world.

Moreover, the next debridement of this patient will also fall into their own hands. If according to their judgment, after debridement, the patient will be seriously infected and eventually lead to amputation.

At this time, whether it's for the mission, the safety of the patients, or his own future, Qin Lang will do his part.

When Peng Yun scolded Qin Lang, Qian Liang beside him also had a headache, but he still liked Qin Lang very much, so he still said good things for him:
"After all, Qin Lang is a trainee doctor from the community hospital. In the community hospital, he and a senior doctor have to deal with various patients, so he has developed the habit of asking patients. Moreover, he is quite accomplished in debridement. To be honest, the last time, it was Qin Lang's suggestion to let the 18-bed uncle heal earlier."

"Would you like to let him talk?"

(End of this chapter)