Great Doctor Ling Ran

Chapter 28: open wound

Views:

"Give way." Two nurses pulled the flat cart one after the other.

The senior attending doctor Zhao Le followed with small steps, and reported to Huo Congjun: "The patient was injured in a car accident, with a 20 cm open wound on the abdomen, part of the intestines and omentum exposed, and active bleeding. The intestines have been protected with sterile dressings..."

Huo Congjun followed Pingche, and Ling Ran followed Huo Congjun.

The two family members were stopped behind, at a loss and feeling cold all over.

From the perspective of ordinary people, this is a catastrophe where the sky is about to fall. The so-called exposed intestinal tube means that the intestines are all exposed.

Of course, it can’t be said that it’s a mild case in a hospital. Non-tertiary hospitals may not be able to handle it, so it’s specially sent to Yunhua Hospital.

So much for the serious views, though.

Because of the emergency department of Yunhua Hospital, similar injuries are brought in almost every month, and there are more different types of more serious injuries.

Huo Congjun listened while doing the examination by himself, and half introduced it to Ling Ran, half explained it to his fellow attendant Zhao Lexie, saying: "The 3-12 ribs on the left side are obviously dislocated, the heart rate is 105, and the bleeding is serious. Blood transfusion is needed... "

He didn't speak fast, far from the sense of urgency that can't be heard on TV.

The main reason is that the patient has not reached the level of urgency.

In the emergency department of a hospital, doctors always speak in terms of vital signs. In the grading of the emergency department, such patients belong to the second-level critically ill patients, and their urgency is not as good as that of endangered patients who just fell into a coma.

That being the case, you can think a little more about making a decision and do it slowly.

Zhao Lele has worked in the emergency room for nearly ten years. He has rich experience and is familiar with Huo Congjun. He translated his words steadily, and quickly ticked off on the emergency check-up form: "Take venous blood for emergency blood test, kidney function, Blood type, electrolytes, the first four items of blood transfusion, coagulation function... "

While he was talking, he also filled out the emergency check-up form. Huo Congjun nodded after reading it, and handed out the check-up form.

At this time, the nurse also adjusted the patient's position, started to inhale oxygen, connected the monitor and measured the vital signs.

"Build a second venous access, 500ml of Ringer's solution." Huo Congjun didn't give Ling Ran a chance to take the exam this time, and quickly made a decision, saying: "Omeprazole injection 10ml, normal saline 10ml, 1 route of intravenous push."

After finishing these, Huo Congjun looked at the blood pressure, heart rate, breathing and other vital signs, and said to Zhao Lele: "You continue to rescue, I will talk to the family members, Ling Ran, follow me."

"Yes." Zhao Le was so busy that he couldn't lift his head.

Huo Congjun took Ling Ran along, and said as they walked, "Working in the emergency room, besides medical skills, the most important thing is to handle the relationship with the patients and the patients' families. I'll tell you a lot now, and you can't remember it. First, , You must be confident, calm, and speak calmly."

Under normal circumstances, Huo Congjun would not take the initiative to do such meticulous work as talking with family members.

He is already the director of the department. If he is in a military hospital of the same level, and he happens to be a civilian title at the division level, he will not easily go into battle until he runs out of ammunition and food.

Of course, the frequency of running out of ammunition and food in the emergency department is relatively high, and Huo Congjun occasionally has to go to battle.

Seeing Ling Ran nod his head, Huo Congjun smiled and said, "Don't talk for a while, just read and memorize more."

"Yes." Ling Ran nodded again.

The two family members of the patients had already been stopped outside the emergency room, their heads stretched out, anxious.

When Huo Congjun came out of the door, he put on a gentle expression, no longer the fierce look in the emergency room.

"Hello, are you Mr. Lai Zhongde's family?" Huo Congjun had an impression of the two people who got out of the ambulance, but he still asked.

"Yes, I am his wife." The older woman wiped away her tears and asked, "Doctor, how is my husband?"

"Mr. Lai is still being rescued. I am the doctor in charge. I would like to ask you a few questions. Does the patient have liver disease or other chronic diseases?"

The patient's wife shook her head, and explained: "I have alcoholic liver disease, and my husband is a civil servant, so he has a problem with three highs."

Huo Congjun nodded and asked, "Is there any infectious disease?"

"No, we have physical examinations every year."

"Is there any problem with hepatitis B?"

"No."

"What about other infectious diseases? At this time, we need to fully understand the patient's situation."

"No." The woman answered in the affirmative.

Huo Congjun ticked off the paper and asked, "What about allergies? Are you allergic to something?"

"He has a little pollen allergy, not serious." The patient's wife tried her best to recall.

Ling Ran listened to the conversation between the two, silently memorized it, and verified it with what he knew.

There is a fixed procedure for interrogating patients, but there are probably still particularities about how to interrogate and the sequence of interrogation.

Like the patient right now, since he is a civil servant and has regular physical examinations, he should know if he has any chronic diseases or allergies. There is no need to ask too many questions. Instead, it is an infectious disease, which is often easily hidden by the person concerned. Huo Congjun also asks the most. serious.

After asking a few more questions about drinking and taking medicine, Huo Congjun said, "From our observations, the patient has lost a lot of blood and needs a blood transfusion. Do you know that he has had a blood transfusion before? Is it a special blood type?"

"He is blood type A and has donated blood before..."

Huo Congjun asked the patient to sign the blood transfusion consent form, the informed consent form and the rescue consent form, and asked the patient's family members to pay the money before he took Ling Ran back to the emergency room. On the way, he said, "You must also remember to ask the patient to sign the consent form in the future." Book, this is to protect you and the patient, understand?"

"yes."

"What do you think about the conversation I had with the patient just now?"

Ling Ran recalled the process of Huo Congjun's questioning, and slowly said: "Control the rhythm of the conversation."

"Not bad, what else?"

"A firm attitude..."

"Yes, this is very important. Don't give patients unnecessary illusions. It's hard to be amiable, and patients don't need it. The main task of our emergency department is still to cure the sick and save the patient." Huo Congjun said here. stopped.

He would not say these words to other interns or residents.

That is to say, if he likes Ling Ran, Huo Congjun will take the trouble to explain it.

The emergency department has heavy tasks and is prone to mistakes, but any mistakes cannot be compared with the relationship between doctors and patients. Nowadays, if you can't handle this well, you won't be a doctor for long.

"Director Huo." The attending doctor who was busy in front of the emergency bed raised his voice twice when he saw Huo Congjun.

"How is it?" Huo Congjun heard the anxiousness of the attendant.

"The blood can't stop." The attending doctor gritted his teeth and squeezed the words out of his throat.