My medical skills add experience

Chapter 520 Discussion with Director Xiang
"If I have the chance, I really want to visit your Tuya Hospital. I chose the direction of emergency and intensive care, and it took a lot of effort to be selected into the intensive care medicine department. But after I entered, I found that there was too much knowledge I didn't understand. gone."

The little nurse told Zhou Can about her troubles at work.

Don't look at her as just a nurse in the intensive care unit, but she is already better than many nurses.

Because if you want to work in the intensive care unit, you need at least three years of clinical nursing experience, and you need to pass many assessments and exams.

As long as you are not a newcomer who is not particularly against the sky, you will basically start working in the intensive care medicine department from odd jobs.

Stand by and watch the teachers operate, and keep learning the rescue and nursing experience of various critically ill patients.

It takes at least a year or two to fumble around before being able to be officially on duty.

If you want to be on duty independently, it will take longer.

After Zhou Can finished listening, he smiled and said, "If there is an opportunity, the senior management of the two hospitals can discuss and exchange medical staff to each other's hospital for further study and exercise. This will be beneficial to the improvement of the diagnosis and treatment level of the two hospitals."

Zhou Can came up with this idea after observing the working scene in the intensive care unit of the Provincial People's Hospital.

The two hospitals are connected to each other, so they can learn from each other.

"Yeah, this proposal is very good, but it's a pity that I'm just a nurse at the lowest level, and I'm not qualified to make this kind of suggestion to the hospital. I also have no way to get in touch with the senior leaders of the hospital. How about you find a chance to talk to Director Xiang?" Titti, he'll be here in a while."

The little nurse is not a rookie who has just entered the workplace and knows nothing.

She has no scheming, which doesn't mean she doesn't know the depth.

You can only do what you can.

Zhou Can can easily get in touch with Tuya's senior management, even hospital-level leaders, but it doesn't mean that other medical staff also have this ability.

"Haha, I'm sorry, I'm sorry, I kept Dr. Zhou waiting for so long!"

Director Xiang walked in with a haha.

"Go get busy!"

After Director Xiang came in, he said directly to the little nurse.

He couldn't even pronounce the nurse's name, this is the truest portrayal of the bottom.

It may take three to five years in that department before being remembered by the head of the department.

"Goodbye, Director Xiang! Goodbye, Doctor Zhou!"

The little nurse waved at the two of them, and when she walked out of the office, she closed the door behind her.

She is not stupid, she naturally understands that Director Xiang sent her away, explaining that the content of the conversation with Zhou Can should not be heard by outsiders.

In fact, I can guess a few points.

It is likely to discuss with Zhou Can how to treat the patients in bed 13?

As the chief doctor of the Provincial People's Hospital, this kind of thing naturally cannot be heard by outsiders.Otherwise, once it spreads, it will have a great impact on Director Xiang himself and the hospital.

After all, Zhou Can is just a young doctor in Tuya Hospital, and his rank is not high.

"Doctor Zhou, please drink tea!"

Director Xiang was very polite to him. In the final analysis, it was Zhou Can's display of strength that earned him respect.

Don't look at Director Xiang's current rank is higher than him, and he is also a chief physician and a professor.But in terms of growth potential, Zhou Can is likely to kill Director Xiang in seconds.

Don't underestimate the potential.

Don't bully the young and poor, 30 years in Hedong and 30 years in Hexi.

In just ten or twenty years, Zhou Can's status and rank in the medical field may surpass that of Director Xiang.

"Thank you for giving me this opportunity to drink tea."

Zhou Can stood up and took the tea with both hands, looking very humble and polite.

Enough respect is also given to Director Xiang.

"Dr. Zhou is worthy of being a young elite of Tuya Hospital! The cause of the 13-bed patient today was indeed deep vein thrombosis as you said. It is my honor to have the opportunity to see the true level of young doctors in Tuya Hospital. Fortunately."

When Director Xiang said these words, he already meant to lower his profile.

People are mutual.

Zhou Can has great respect for Director Xiang and is always humble, so Director Xiang has the opportunity to lower his profile appropriately.

He was able to admit in front of Zhou Can that the patient in bed 13 was indeed critically ill because of a blood clot, which was a recognition of Zhou Can's strength.

"You are being polite! Actually, I know that even if I don't tell you, you will definitely be able to find out the reason. It's just that you were anxious to save people at the time, so you may not have thought in that direction. I don't know how my colleague is doing now gone?"

Zhou Can changed the subject directly.

To avoid embarrassing conversations.

"The physical signs in all aspects are still stable for the time being, but the injury is very serious, and the situation is very pessimistic." Director Xiang's tone was heavy.

"Yeah, I saw my colleague's injury during the visit, and I felt very uncomfortable. I really hope he can survive this." Zhou Can's face was full of worry. "Director Xiang, it can be seen that you are a person with noble medical ethics and extraordinary bearing. I opened the skylight to speak frankly and asked directly."

A tall hat is placed on the head for the other party.

The advantage of doing this is to pave the way for the following conversation.

In such a closed environment, it is a great communication art to be able to quietly take the initiative in the conversation and create a favorable situation.

"Doctor Zhou just ask."

Director Xiang's expression became much more serious.

"I'm just asking this question from a personal point of view. If there is any offense, please bear with me. Does my colleague's treatment only use a more conservative method to temporarily maintain his physical condition?"

"Well, almost! You are also a doctor, so you should be able to understand the patient's current situation, and there is no way to go to the operating table."

Director Xiang admitted it.

"Can you let me see his inspection report? Sigh! I once worked with him and saw him at such an age, but because of one wrong step, he ended up in such a bleak situation. I feel really uncomfortable. I'm not afraid of your ridicule I’m not over my head, but I just want to do my part.”

Zhou Can is very clear that if he wants to persuade Director Xiang, he must arouse the empathy of the other party.

This is not difficult to say.

Playing the sad card is the easiest to get results.

And he really felt very sad and sad for what happened to Deputy Director Lu.

"I have brought the patient's examination report and the results of various biochemical examinations, you can look at it as you like."

Director Xiang directly handed the information bag to Zhou Can.

After receiving it, Zhou Can thought to himself, it seems that Director Xiang came here to discuss how to rescue the patient.The preparations have been done quite well.

This is better.

He began to carefully review Deputy Director Lu's inspection results.

After reading it, I fell into contemplation.

The injury is extremely serious. Judging from the current examination results, the brain should be damaged.And there is intracranial hemorrhage in blood vessels near the brainstem.

Well, as people get older, it is inevitable that there will be hardening of the arteries, arterial plaques and the like.

Being a doctor is a high-risk occupation, often staying up late and working overtime, with various irregular schedules.

It is easier to go wrong.

Deputy Director Lu is over 50 years old, and it is more likely that there are problems with the intracranial blood vessels themselves.

At least judging from the existing examination results, Zhou Can believes that there are problems with some blood vessels in Deputy Director Lu's brain.This time, he jumped from the building and suffered a violent blow to the head, which eventually led to the rupture of the intracranial artery.

This is the preliminary diagnosis conclusion he came to after watching the film.

Thanks to his hemostasis and pathological diagnosis, which have reached the sixth level, it is possible to have such a direct diagnosis.

A high level of diagnosis is often the result of a combination of experience, medical knowledge, observation, and judgment, and each item is very strong.

To find the specific source of bleeding, angiography is needed to find it accurately.

At present, only one head color Doppler ultrasound and CT have been checked.

For angiography, the patient's ability to bear needs to be considered, and the hospital will naturally not perform tests that are too risky.

For Zhou Can, these two inspections are enough.

The bleeding position has basically been locked.

A large source of bleeding should be in an artery close to the brainstem.There may also be three or four smaller sources of bleeding.

The most dangerous thing is the rupture of larger arteries, especially the rupture of some hidden aneurysms and atheromatous blood vessels, which are extremely difficult to stop bleeding automatically.

Basically, without surgery, it is difficult for patients to heal themselves.

The condition will continue to worsen, the intracranial effusion will increase, and then the intracranial pressure will increase, and various terrible syndromes will appear.

Zhou Can's rescue plan for Deputy Director Lu's intracranial injury was to drain the effusion by drilling.Then, the broken artery was repaired by endoscopic surgery.

The difficulty is very high, but this is also the only direct and effective rescue method.

After seeing the condition of the head, he went on to check the condition of the chest and abdominal cavity.

The head, chest and abdomen are all important organs and vital parts of the human body.Every injury can be fatal.

Of course, injuries to limbs can also be fatal, but the danger is relatively much lower.

At least it can leave some rescue time for doctors.

There was also effusion in the chest and abdomen, and there must have been a large hemorrhage.Judging from the location of the bleeding, it looks like a ruptured spleen.

The spleen is a very special organ, and it is very easy to rupture when it is hit by a large force.

After careful study, Zhou Can frowned slightly.

"It's not like a simple rupture of the spleen!"

he muttered to himself.

"Did Dr. Zhou find anything wrong?"

Director Xiang, who was sitting behind the desk, remained silent.The main reason is to worry about interfering with Zhou Can's diagnosis.

We are all doctors, and we know that when checking the examination results of patients, we need to think quietly, analyze carefully and differentiate syndromes.

"Judging from the radiographs and examination results, the patient's rupture may not only be the spleen, but I suspect that the patient's pancreas has also been affected. It is even possible that the left kidney has also been severely damaged."

Zhou Can expressed his diagnosis opinion.

Everyone is just discussing anyway, so there is no need to worry about it.Say what you find.

"The left kidney was injured, and I also discovered this. But the pancreas is just a glandular organ, and it has almost never been injured by blunt external force. Even if it is injured, it is probably only a minor injury and has sufficient self-healing ability .”

Director Xiang said so.

"It's really strange, but I suggest checking the pancreas. If it is not treated in time, it can easily lead to acute pancreatitis and even pancreatic necrosis. If..."

Zhou Can swallowed the words that came to his mouth.

"what if?"

Director Xiang asked.

"Forget it, this possibility is almost impossible."

Zhou Can waved his hand, unwilling to say.

"This is not like Dr. Zhou's style. I will rush over now and discuss the patient's condition with you behind closed doors. You don't have to have any scruples at all, just say what you want."

Director Xiang seemed a little unhappy.

He doesn't like mother-in-law's people.

"Okay! If I am operating on a patient with a bed of 13, I can take the initiative to ask for it. His spleen is ruptured and must be dealt with. It is impossible to consider normal laparotomy and thoracotomy, but endoscopic surgery should be feasible. Sex. I believe the family members are also very willing to take this risk.”

Zhou Can is only a doctor from an outside hospital, and the possibility of participating in the operation of the Provincial People's Hospital is extremely slim.

People don't know his situation, and no chief doctor dares to agree easily.

After Director Xiang heard this, his expression didn't change much.

"If you were asked to treat this patient, what would you do? You can directly talk about your plan."

From Director Xiang's eyes, Zhou Can saw sincerity.

This is a great sincerity to save lives.

People with a conscience will have empathy when facing many things.

Doctors may seem cold, but in fact most of them are kind-hearted and full of sympathy for patients.Often with a cold face, he quietly helps patients solve some difficulties.

They don't expect to reap the gratitude of patients and their families, as long as they don't complain.

"I will directly drill holes from these two positions on the head, pump out the intracranial fluid, and repair the ruptured blood vessels at the same time. Then use endoscopic surgery to enter the left abdominal cavity to repair the patient's spleen, and by the way Let’s check the damage to the pancreas, if there is any problem, we can deal with it together.”

Filming, not all problems can be found.

Using endoscopic surgery to enter the abdominal cavity for exploration is a more commonly used method of exploration in clinical practice.

For example, some tumor lesions are too small to be detected by ordinary instruments.

Surgical exploration can often achieve satisfactory results.

After listening, Director Xiang nodded slightly.

Holding the blueprint drawn by Zhou Can during his explanation, he asked meaningfully, "Dr. Zhou seems to be very good at endoscopic surgery!"

"It's barely okay!"

Zhou Can was not too modest this time, because he really wanted to save Deputy Director Lu himself.

If the Provincial People's Hospital does not have a doctor with strong surgical skills in this field, Zhou Can can go to battle at any time.

"Is it convenient to leave a contact number? The rescue plan you mentioned, I can try to communicate with other departments and report to the hospital leadership. If your rescue plan is adopted at that time, I can invite you to participate in the operation."

Director Xiang said.

"Saving people is like putting out a fire. I can go directly to the Provincial People's Hospital and so on. If the time is too long, the meaning of another operation will be much less."

It was also the first time for Zhou Can to deal with the Provincial People's Hospital.

Whether the hospital's behavior is bureaucratic or not is hard to say.

If the leadership is seriously bureaucratic, let alone less than an hour, even if there are a few more hours, it will be difficult to have a clear result.

(End of this chapter)