My medical skills add experience

Chapter 578 One more thing is worse than one less thing, deep investigation of the cause
After Zhou Can and Fu Chachun got into an argument last time, they basically only kept their superficial politeness.

There is a saying that reconciliation is so easy, but it is too difficult as before.

The two didn't have a deep friendship. At the critical moment when Zhou Can was promoted to the deputy team leader, Fu Chachun jumped out and stabbed him.Since people didn't take Zhou Can seriously, he naturally wouldn't have the heart of the Virgin Mary.

Clearly using the power of the deputy team leader to retaliate against Fu Chachun, that would not be the case.

He still has this kind of mind and bearing.

It is also impossible for him to wipe Fu Chachun's ass, take care of him in various ways, and repay kindness with kindness.

To put it bluntly, it is business.

He remembered Fu Chachun's day shift today, and he should have come home from get off work by now.

Call the person directly.

Connected soon.

"Hello, Team Leader Zhou! What's the matter?"

Fu Chachun asked politely.

Of course, this kindness is only superficial.

He said Hello, Team Leader Zhou, not Hello, Team Leader Zhou. This detail can reflect that he doesn't have much respect for Zhou Can, the deputy team leader, in his heart.

Many old comrades are like this tune, clinging to that little face, unwilling to let go of their figure.

"There is a patient here who had a toe splitting surgery by you the day before yesterday. Now he has some problems. I would like to invite you to come over!"

"What happened to the patient?"

"Her third toe on her left foot was numb and almost lost touch."

"This is not a big problem. Toe splitting surgery itself has considerable risks. It is very common to injure nerves after splitting the toes. As long as the blood supply of the patient's toes is smooth and the wound heals well, it is already considered a problem." A successful operation."

Fu Chachun said it lightly.

He didn't care much about the patient's numbness in one toe.

In clinical operations, patients experience numbness in a certain finger or toe, because few doctors are willing to take care of it because it involves nerve problems.

Because of this 'minor problem' most patients can accept it.

There is no need to add extraneous branches.

Everyone is afraid of trouble, let alone more trouble.

If you tell the patient, the nerve may have been injured during the operation.

Who is responsible for this?
"The patient told me that she had the operation to dance ballet better. After the operation, there is a problem with the third toe, which will definitely affect the motor function of her left foot. Dr. Fu, do you think this is okay? Please come and join us Study the cause of the numbness of the third toe of the patient's left foot, and try to help her if it can be solved."

The hearts of doctors and parents.

Zhou Can is unwilling to deal with patients' problems with such an irresponsible attitude.

"No need! Surgery is inherently risky, and the family members signed it, directly telling the patient that the third toe of the left foot can try to exercise more in the future to see if it can recover gradually. If it can't recover, the doctor can't help it."

The solution given by Fu Chachun is more in line with the interests of the hospital and the surgeon himself.

Usually encounter similar situations, basically solved in this way.

"That's right! The family members signed the signature before the operation, and the possible risks of the operation have indeed been informed to the family members and patients before the operation, and their consent has been obtained. If we don't deal with it, the family members and patients can only admit it. But I I think there is a better way to deal with it. At least it is worth trying."

Zhou Can could only do Fu Chachun's ideological work earnestly.

"Humph! Team Leader Zhou wants to be this good guy, so he can do it himself, and I won't accompany you. If you just want to retaliate against me, you can do whatever you want. My attitude is only one, and you don't need to deal with it. If you are not convinced , You can find the department leaders, the medical department leaders, and see what they say."

beep...

A busy tone came from the phone, and Fu Chachun had already hung up the phone.

What a day.

Doctor Fu actually thought that he was taking personal revenge.The conscience of heaven and earth, Zhou Can really never had such an idea.

"Doctor Zhou, the patient's surgery record has been retrieved from the operating room. Here it is!"

Jiang Shuangshuang's service is really thoughtful.

Not only did I find the operation room to transfer to the operation record, but I also printed it out.

Surgical records are generally managed in two places, the operating room and the medical department.It is not as easy as imagined to adjust the operation records of a certain patient, let alone anyone can adjust it.

Zhou Can is the deputy team leader of the operating room, and has a special status in the emergency department. Jiang Shuangshuang told the operating room that Zhou Can wanted to adjust the operation records of a certain patient, basically it was just a matter of one sentence.

"Thank you! You can go to work."

After receiving the newly printed surgical records, he carefully checked them one by one.

Surgical records are usually written by the surgeon himself and must be signed at the end, which has a certain legal effect.Relatively speaking, it is fairly rigorous.

Sometimes, the chief surgeon is really overwhelmed, and the first medical assistant will write it.

It is very likely that medical records and course records will be written by interns and regular trainees, but surgical records are often not written by interns.

If the surgical records are written in a standardized and true manner, professionals can directly restore the entire surgical process by viewing the surgical records.

Zhou Can was not in a hurry to go to the cardiothoracic surgery department.

Instead, he took the operation records and logged in to his personal account in the emergency department to call up the patient's preoperative examination data.Including the patient's preoperative toe photos are recorded.

After some research, not much to gain.

Judging from the operation records and preoperative examination, this is a very simple operation.There is no complicated operation such as reconstruction of phalanges and blood vessels.

Just separating the two toes from the middle normally, how can it hurt the nerves?
Zhou Can couldn't help recalling the patient's postoperative wound condition again in his mind.

Is the nerve distribution of the third toe of the left foot on the side of the adhesion with the fourth toe?Then during the separation process, the nerve was severed?
This possibility is relatively large.

Of course, it is also possible that the skin of the wound was pulled too tightly when suturing the wound, which compressed the nerve.In addition, the possibility that postoperative local hematoma may compress the nerve also exists.

Before the operation, the patient knew that the touch of the third toe of the left foot was clear, but now there is numbness, which must be caused by the operation.

After half a day of research, there was no major progress, so Zhou Can decided to check the situation tomorrow morning after checking the ward.

I hurried to the cardiothoracic surgery department to help complete two major four-level surgeries.

When I got home, it was past 40:[-]. After taking a shower, Su Qianqian was already wearing a beautiful lace pajamas and urged him to go to bed early.

"I found that there seems to be a problem with the quality of the recent surgeries in the emergency department, so I asked the nurse to send me the statistics report of the surgeries for the past three months. You go to bed first, I have to check it in detail."

Zhou Can said apologetically.

His girlfriend deliberately wore such beautiful pajamas after taking a shower. If he didn't understand her intentions, he would be too stupid.

It's just that there is no way, the work pressure is huge, and I am afraid that I will be powerless today.

He sat on the sofa in the living room, turned on his laptop, logged in to his mailbox, and opened the email from Ye Tingting.

"Patient Wang Jian, 17 years old, male, underwent ureterostomy tube replacement last Thursday. The patient called on the third day after the operation and reported hematuria. The surgeon Tang Wangnian."

"Patient Zhou Yongbo, 54 years old, male, had facial bone sequestration surgery on September 9, and returned to the room one month after the operation. The patient reported facial paralysis. The surgeon Fu Chachun."

……

I don't know if I don't read it, but when I look at the return questionnaire given by Ye Tingting, it's shocking.

Patients are dissatisfied with the curative effect after operation, and various minor problems abound.

Doctors in almost the entire department are involved.

Including the surgery performed by Zhou Can himself and Dr. Xu, the satisfaction rate of the follow-up visit is also not [-]%.

It's just relatively much better than other doctors.

Zhou Can's return visit satisfaction rate ranked first, and Dr. Xu was squeezed to the second place, and the gap between Dr. Xu and Zhou Can was quite large.Ranked third is Dr. Cui.

The surgical satisfaction rate can also reflect the doctor's surgical level.

Only with a high level of care, enough care, and rich experience can the surgery cause as little harm as possible to the patient.Avoid a large number of sequelae after surgery.

It seems that the operating room of the emergency department still has a long way to go if it wants to become bigger and stronger!

A long way to go.

Surgery, whether it is now or in the future, will become the core competitiveness of the emergency department.

To improve the quality of surgery, Zhou Can alone is too weak.

Because if you really take care of it, you will offend almost all the doctors in the operating room.

Even if individual doctors who are close to Zhou Can don't hold grudges against him, other doctors will definitely be dissatisfied.

Therefore, this matter needs to be discussed with the department leaders.

……

At around [-]:[-] the next morning, Zhou Can came to the emergency ward for rounds.

The female patient in bed 1 of the emergency department is recovering well in other aspects. The only problem is the numbness of the third toe of the left foot and the extremely weak touch.

"Well, are you feeling better today?"

Zhou Can asked the patient concerned.

"It seems to be the same, still numb, and I don't feel anything."

She looked rather worried.

"The nurse hasn't come to change the dressing yet, has she?"

"No, I only come here to change the dressing every morning at 08:30."

"I'll check again for you."

Zhou Can put on thin disposable sterile gloves, and gently opened the third and fourth toes of her left foot.

"Ah... it hurts, it hurts!"

She immediately let out a cry of pain.

"Honghong, hold on, Doctor Zhou is examining you, and he also wants to help you find out the problem and treat it." The patient's mother comforted her daughter beside her.

The mouth is so comforting, but the eyes are fixed on Zhou Can's movements, which seems to be more nervous than the patient himself.

Pity the parents of the world.

A mother's love for her children is greater than the sky and thicker than the earth.

"Come on, try to flex your toes."

During the inspection yesterday, Zhou Can just did some simple touch tests with cotton swabs.

Because after reviewing the operation records and preoperative examinations, there was no answer.So we must step up inspections today.

Every examination a doctor gives a patient has a strong purpose.

It's definitely not like a child's play house.

She bent the toes of her left foot according to Zhou Can's request, and as a result, all five toes bent down together.

Due to the lack of special exercise on weekdays, the toes are more often like a pampered princess, wearing socks and shoes, and are heavily protected.

This also makes it far from being as flexible as a finger.

If you study the ancient apes, you will find that their toes are about as long as their fingers.After human beings learned to use tools and developed to the stage of stone civilization, their feet gradually became more comfortable.

The toes are also degenerating.

Therefore, the toes are much shorter than the fingers.In addition, after training, the toes can actually grasp as flexibly as fingers and perform various difficult movements.Some disabled people who unfortunately lost their arms fully proved this point through acquired efforts.

They can use their feet to dress, eat, write and more.

In this case, his toes will be as flexible as his fingers.

Zhou Can held her other four toes with two hands, leaving only the third toe on her left foot.

"Try to bend again, don't be afraid of pain."

She tried to bend the third toe of her left foot, and Zhou Can could clearly feel the other four toes exerting force together.But he got caught.

He found that the third toe of the patient's left foot could not be flexed well.

"Okay! Try the fourth toe of the left foot again!"

Next, Zhou Can tested the bending of the other toes of her left foot one by one.

His mood became extremely heavy, and the flexion and extension ability of the third toe was obviously abnormal.If you just don't feel pain and you can bend and straighten, that's pretty good.

Now, even the flexion ability is lost, and the injured nerves include motor nerves.

"Next, I will press your feet. You close your eyes. If you can feel it normally, don't talk. If you find that your perception becomes weak or disappears, you should tell me immediately."

Zhou Can first pressed on the back of her foot, approaching the third toe all the way.

"Stop, stop, the touch is getting weaker, getting weaker."

She hastily yelled to stop.

At this moment, Zhou Can pressed her third toe nearly one-third of the way from the root.

After some more tests, he had a bottom line in his mind.

"Thank you for your cooperation. I will continue to follow up or arrange for further inspection."

After checking in detail, Zhou Can began to check other beds.

When encountering problems, he will carefully record in his notebook, which bed, what operation was performed, and what the problem is.

After checking the house, when I came out, I saw Fu Chachun coming to work.

The two had a face-to-face meeting.

When Fu Chachun saw others, he always greeted them with a smile, but when he saw Zhou Can, he glanced coldly, pretended not to see them, and went straight into the office.

Should have changed clothes.

It seems that Zhou Can called him yesterday because of the toe numbness of the patient in bed 1, which made him very unhappy.

I must think that Zhou Can is deliberately punishing him.

Zhou Can didn't explain either, there was no need to explain.

As a leader, if you want to accomplish something, you will definitely encounter a lot of resistance.As long as he is sincerely for the development of the emergency department, I believe everyone will understand him in the future.

Look at the time, it's almost eight o'clock.

He had to go to the operating room to work quickly, but before that, he was going to talk to Director Lou and Dr. Xu first, and report the situation.

At this moment, his cell phone rang.

He took out his mobile phone and saw that it was the call from Vice President Bai.

Usually during the New Year and holidays, Zhou Can took the initiative to send a message to send blessings to the other party.Vice President Bai almost never took the initiative to call him.

There must be something important.

(End of this chapter)