To be honest, what he did was actually a bit unruly.
Because Li Jingsheng was a doctor outside the hospital, he was not registered at the Second Hospital. It is definitely not allowed to wear work clothes for clinical operations in the second hospital.
"It's a good thing that we have multiple helpers in the orthopedic clinic! At least when we have to hold the injured in the future, we have an extra man to help!"
The female nurse said with a smile.
"Hello, handsome man, my name is Li Li, an outpatient nurse. I'm glad to be your colleague."
This female nurse seemed very enthusiastic.
"Hello, please take care of me!"
Li Jingsheng's answer is a universal formula.
This female nurse is petite, with thin eyebrows and exquisite makeup. She has a sharp look in her eyes. I wonder if she is easy to get along with? When he first arrived, the interpersonal communication strategy he chose was not to have deep friendships, not to offend, not to alienate, and to maintain a friendly appearance.
The doctor named Chen was a little aloof. When Li Jingsheng's eyes met, he just nodded and did not talk to Li Jingsheng.
"Li Li, call the first patient in!"
Dr. Xu sat in the 'coach seat', ready to fight.
"Xiao Li, when you touch the bones, you must carefully feel the bones, muscles, and tendons, and then pay attention to distinguish the patient's bone condition. The patients treated here basically have trauma, but occasionally they are also accompanied by other bone diseases. .If these bone diseases cannot be discovered, bone setting is likely to fail and even cause trouble."
Before going into battle, this was the last reminder to Li Jingsheng.
In fact, it can also be regarded as a kind of special care.
Doctor Chen next to him couldn't help but look at Li Jingsheng with a little jealousy.
Obviously, he had never received this kind of special care.
The first injured person was brought in, with bone injuries at the level of Wang Zha.
The hip joint was dislocated,
The person could no longer stand or sit. He was lying on the stretcher and kept groaning. The injured looked pale and dying.
Seeing this situation, ordinary doctors would tremble in their hearts.
Who dares to reset his bones? What if the injured person is stimulated and loses his breath during the operation?
Moreover, the treatment for hip dislocation is often incision and surgical reduction.
"How did this happen?"
Dr. Xu did not rush to examine the patient, but conducted a consultation first.
"I was hit by a car while riding a motorcycle."
The family members seemed a little angry when they answered.
The middle-aged man helping to carry the stretcher next to him had an expression of apology for having done something wrong.
Li Jingsheng knew at a glance that the middle-aged man carrying the stretcher was probably the driver responsible for the accident.
Under ordinary circumstances, when a car hits a motorcycle, regardless of whether it is wrong or not, the big car is in a weak position. Unless the person who was hit ran a red light, which is clearly stipulated in the current traffic law, it is possible to hold the other party fully responsible.
"We also heard that the Second Hospital's orthopedic and reduction medical skills are very good, so we came here specially to seek treatment. Please be more considerate."
The driver who caused the accident took out a pack of good cigarettes from his pocket and secretly gave it to Dr. Xu.
Li Jingsheng snickered to himself. Those things in society are often brought to hospitals. In fact, this is because they don't understand doctors.
Serious hospitals attach great importance to the construction of medical ethics and will not accept gifts at all.
Some people swear that they must give red envelopes to the surgeon, anesthesiologist, and nurse before the operation. They also say that they did not give red envelopes to the anesthesiologist, and they woke up from the pain in the middle of the operation.
I don’t dare to say that this kind of thing never happens, at least it is very difficult for this kind of thing to happen in regular hospitals.
The medical department and the disciplinary inspection and supervision office are not just decorations.
As long as the roots of that hospital are not rotten, a complaint phone call will immediately make the doctor involved feel miserable.
"I will definitely treat you with all my heart, don't worry. Our hospital stipulates that you cannot accept gifts, so please don't do this. Otherwise, you will be harming me." Dr. Xu said in a serious tone.
The driver who caused the accident put the cigarette back into his pocket angrily.
Dr. Xu looked at the patient on the stretcher.
"What's your situation now? Can you still move?"
Before bone setting, you must conduct a consultation and understand all the necessary information before starting treatment.
"I can move my hands, but I can't move my legs. It hurts in my butt... I feel like I'm going to die."
The patient is a thin man in his fifties who speaks weakly.
When the driver next to him who caused the accident heard this, he was almost frightened and stood beside him with a worried look on his face.
"Can you feel me touching your leg?"
"able!"
"Did you do a full body check-up?"
Dr. Xu asked the family members this time.
"It was done, and they said it was nothing serious elsewhere. It was just skin abrasions on the arms and other places. The right hip joint was dislocated."
The driver who caused the accident rushed to answer.
Dr. Xu took the film from the family and looked at it carefully.
Li Jingsheng stood nearby and watched along.
He was pleasantly surprised to find that after reaching the proficiency level in general surgical diagnosis, his ability to read pictures seems to have improved.
When looking at a chest X-ray, you will have a more accurate insight into whether there are bleeding points, fractures, etc.
Some bleeding points are very hidden and may not be discovered by doctors in the medical laboratory.
However, experienced chief physicians can sometimes detect doubts from clues and avoid medical accidents.
The chest, abdomen, and head were all checked, and there was nothing serious.
Only the right hip was dislocated.
The injured person looked like he was dying, and he was still shouting that he was going to die. This looked a bit like 'blackmail'!
At least it has the intention of scaring the driver who caused the accident.
Everyone has their own little Jiujiu, who just wants to get a little more compensation.
"Xiao Li, please take a look at the X-ray of the hip joint."
The patient took many films, including not only X-ray examinations, but also CT scans.
The reason why I didn't do an MRI examination should be that the doctor was more conscientious and didn't issue this application.
After all, MRI examinations are valuable medical resources.
If it is in a larger hospital, MRI examinations are often given priority to patients who really need it.
For example, tumors that cannot be diagnosed, or diseases whose causes cannot be found, etc.
Dr. Chen next to him looked at Dr. Xu with resentful eyes as he gave the hip radiograph to Li Jingsheng. It feels like the difference between biological and non-biological.
Li Jingsheng took the film and looked at it carefully.
"Remember the location of the hip dislocation bones in the radiograph, and then you examine the patient's hip joint."
Dr. Xu calmly gave Li Jingsheng an extremely precious opportunity to touch the bones.
Dr. Chen next to me was completely stunned.
What the hell, where does this new Dr. Li come from? Could he be a relative of Dr. Xu?
I have never seen Dr. Xu take such care of a junior doctor.
After watching the film, Li Jingsheng squatted down and began to recall the key points of bone touching.
First light and then heavy, first far and then close...
He began to carefully feel the patient's bones.
Because of the special position of the hip joint, where the fat layer is extremely thick and the muscles are rich, it is not easy to feel the bones.
"Ah yo yo... it hurts, it hurts..."
The patient screamed.
This time he no longer sounded weak, but much more energetic.
Movie king!
The family members stood nearby and watched, with worried faces and anger in their eyes.
"If you don't want surgery, you have to endure it. Manipulation and bone reduction here are not only low-cost, but also recover quickly and have no sequelae. Surgery and reduction are much more painful than this."
Doctor Xu stood by and helped Li Jingsheng speak calmly.
After hearing this, the family members' expressions became obviously more natural.
The patient gritted his teeth and endured it, no longer so 'delicate'.
His hip joint is dislocated, and it is certain that there will be pain when touching the bone. After all, Li Jingsheng is a novice. He has just learned the theory of bone touching, and he has not even reached the basic level yet.
It was unlucky that the wounded man fell into his hands.
It’s no wonder that many patients who go to the hospital for treatment are most afraid of encountering intern doctors and intern nurses who use them as guinea pigs for training.
Of course, neither the intern doctors nor the intern nurses will tell the patients and their families that I have just started an internship and I want you to test my clinical practice skills.
If you really say that, no family member will agree.
After Li Jingsheng felt the bones, he gradually gained some insights.
The X-ray image remembered in the mind corresponds to the actual bone position after touching the bone, and then slowly summarize and correct the deviation.
After touching for seven or eight minutes, several layers of cold sweat broke out on the patient's forehead, which was painful.
The family's tolerance is gradually approaching its limit.
Li Jingsheng also stopped when he was ready. He had almost mastered the bone-touching technique, so he stopped and stood up.
"No fracture was found. The patient's muscles are tight. You should find a way to loosen the muscles around his hip joint before reduction."
Dr. Xu nodded slightly after listening.
"Oh, are your muscles tight? Let me take a look."
After saying that, he took action himself.
Compared with Li Jingsheng's unfamiliar operation, he is obviously much more experienced.
After only touching it for less than ten seconds, he stood up and said to his family members, "I'm afraid I need to take an anesthetic before the bone is set and reset. The muscles may be very tight due to pain and tension, so this operation is impossible."
"Okay, okay, as long as I can help my brother reposition it properly and give me some anesthetic, it's totally fine."
The family members happily nodded in agreement.
"The anesthesia is very good, and there will be no pain during the manual reduction."
"The technology here is indeed very good. Both hospitals said that surgery would be required to restore the position."
Several family members talked about it one after another.
The driver who caused the accident stood aside honestly without speaking and fully cooperated with the patient's treatment.
In addition to blocking nerve conduction so that patients cannot feel pain, anesthetics also have another function, which is to relax muscles.
The hip joint is a very special part, located at the junction of the trunk and the lower limbs.
Local anesthesia is not available in this place.
Unlike the arm, the brachial plexus can be anesthetized directly.
General anesthesia or epidural anesthesia is often used for manual reduction of the hip joint.
Dr. Xu has asked the nurse to invite the anesthesiologist.
It’s important to mention that epidural anesthesia is not spinal anesthesia. The former is commonly used, while the latter is rarely used.
Because spinal anesthesia may damage spinal nerves.
It may even cause local infection.
Because of the strong side effects, doctors rarely use spinal anesthesia based on the principle of seeking good luck and avoiding bad luck.
After the anesthesiologist arrives, anesthesia is quickly arranged.
"Here, lift the patient onto the treatment bed."
Dr. Xu directed Li Jingsheng and Dr. Chen to lift the patient onto the treatment bed.
This treatment bed is reinforced and extremely strong.
A little higher than a normal hospital bed.
It should be to facilitate bone setting operations.
Relatively speaking, epidural anesthesia is much safer than general anesthesia. The operation is also more convenient.
The anesthesiologist and nurse appeared to be very cautious when working together.
After the puncture is successful, give a small test dose first.
Then wait patiently and observe the patient closely.
After more than ten minutes, the patient was asked if there was any numbness in the waist, and then a sufficient amount of anesthetic was injected.
Li Jingsheng watched them operate, feeling very envious.
A seemingly easy puncture is actually very risky and highly technical.
Although anesthetists are taciturn and extremely low-key, they are called the patron saints of patients during operations.
Since ancient times, there has been a saying that the surgeon cures diseases and anesthesia saves lives.
In preoperative risk assessment, the anesthesiologist has veto power.
The surgeon thought the operation could be performed, but the anesthetist thought the risk was too great, so he had no choice but to give up. For this reason, quarrels between the surgeon and the anesthetist are often heard in the consultation room.
In fact, they are a pair of close comrades.
"Lao Yu, is it almost done?"
Dr. Xu asked the anesthesiologist.
"Well, that's it."
The anesthesiologist named Lao Yu is about forty years old, with a beard all over his face. He is about 1.8 meters tall. He is quite tall, but not strong.
From the time I came in until now, I have said only four sentences in total.
"Is he the one who's going to get the epidural?"
The patient is then examined and evaluated, and the nurse asks the patient whether he has a history of drug allergies and underlying diseases.
"No problem, please ask the family members to sign."
"You must not move while the anesthesia is being administered to you."
These are the four sentences the anesthesiologist said after he came in.
Li Jingsheng always feels that many anesthesiologists who don't like to talk are because they are highly stressed for a long time during work and then develop mental and psychological diseases, which is why they have cold faces and don't like to talk much.
Of course, you would never dare to say this in front of an anesthesiologist.
Dr. Xu walked to the left side of the hospital bed and said to Li Jingsheng and Dr. Chen, "For this kind of I-type hip injury reduction, it is necessary to relax the muscles first, then apply anesthesia, and then perform manual reduction."
"During the reset, you can have the patient lie on his back on the hospital bed or on the ground. Doctor Chen, hold the patient down with both hands and stabilize his body."
"okay!"
Dr. Chen finally had a sense of presence, and a happy smile appeared on his face. Thousands of people
Not to mention him, few of the attending physicians in the department could perform hip joint reduction skillfully.
I basically understand the general method, but the actual practice is completely different.
If you haven't learned the art of bone palpation, it will be difficult to succeed in a slightly more complicated bone setting reduction.
"Xiao Li, look carefully."
Dr. Xu's next words made the smile on Dr. Chen's face freeze instantly.
Biological or biological.
Wild or wild.
In addition to envy, he also wanted to know what the relationship between Li Jingsheng and Dr. Xu was?
Dr. Xu didn't even give him the respect of the dean, but he guided Li Jingsheng carefully in every aspect. It was so jealous.
"When setting the bone for reduction, you should stand facing the patient, let the patient's joints flex, and then hold the patient's knee behind with both hands and continue to stretch. At this time, you need to feel the patient's muscle relaxation, and when the conditions are met, slightly rotate outward... …”
Click!
A bone ringing sounded, and the patient's right leg looked much more natural.
Doctor Xu looked at Li Jingsheng, "Do you understand?"
"Well, I probably understand."
Li Jingsheng nodded.
"Check the patient to see if the hip joint has been successfully restored."
This is another chance to touch the bones of Li Jingsheng!
With the teacher's approval, the treatment is different.
Li Jingsheng remembered that when he used to work in another big hospital, the superior doctors didn't even use him to pull the hook, and now he was given every opportunity, which was completely a double treatment.
He bent down and felt the patient's bones.
It is obvious that the patient's leg muscles are in a relaxed state, and the position of the bones has also changed.
It feels more natural.
From far to near, touch the hip joint and carefully feel the position of the bones at the joint and the shape of the joint. Not satisfied with this, he felt the patient's left hip joint for comparison.
The family members didn't say anything this time, but looked nervously, hoping for a good outcome.
The driver who caused the accident was even more discordant.
If he really needs hip surgery, he heard that the more expensive treatment costs more than ten or two hundred thousand, and the cheaper one costs more than thirty thousand.
Even the cost of treatment for a baby under 18 months old costs more than 6,000.
The key is also the patient's lost wages, nutrition fees, and nursing fees. The total sum will definitely make the driver faint in the toilet.
If the manual reset can be successful, many costs will be greatly reduced.
Everyone looked at Li Jingsheng expectantly, waiting for him to give the result.
Dr. Chen stood nearby with envy.
"The bone positions of the hip joints on both sides are basically symmetrical, the right bone position is natural, and there is no dislocation at the joint, indicating that the manual reduction has been successful. However, if you want to be more precise, it would be better to take an X-ray."
Li Jingsheng added one last sentence.
Taking an X-ray is not expensive and can reduce disputes.
If the reduction is not successful, but it is not found out, and femoral head necrosis occurs over time, the responsibility will be huge.
The driver and family members all had smiles on their faces, including the patient himself, who also showed joy in being reborn after the disaster.
"Dr. Chen, please take the patient and his family to take a X-ray. If the reduction is successful, the patient will be hospitalized. He will need to stay in bed for skin traction and wear anti-rotation shoes."
Dr. Xu's words made Dr. Chen feel sad again.
Why can't the new Li Jingsheng be asked to go?
He glanced at Li Jingsheng with a small, resentful look, and then honestly took the patient to take the film.
The anesthesiologist Lao Yu packed his toolbox and prepared to leave with the anesthesia nurse.
He stared at Li Jingsheng, and then asked Doctor Xu, "The new disciple?"
"no."
Dr. Xu denied it.
"Hmph, I'm afraid only disciples can get this kind of treatment. Let's go."
Lao Yu looked at Li Jingsheng meaningfully again and left with the treasure box.
The most mysterious person in the hospital is probably the anesthesiologist.
They can often be seen in operating rooms, wards, and emergency rooms. When he appears, he always carries a treasure chest with a green leather and yellow cover, and comes and goes in a hurry.
Dr. Xu pretended not to hear and was not in a hurry to call new patients in. Instead, he asked Li Jingsheng, "What did you get from touching the bones just now?"
"You can feel the position and shape of the bones, as well as the surrounding muscles and fat layers."
"It's not enough. What you feel is relatively superficial. You need to go deeper and discover some details."
After hearing what he said, Dr. Xu's eyes clearly flashed with satisfaction.
There was no expression on his face.
There was no praise in the words spoken, only encouragement.
"When you go back, you must fully understand the whole process and details of the hip reduction. This kind of reduction is relatively rare." After saying this to Li Jingsheng, he turned to look at nurse Li Li. "Call the next patient in!"
