"Then I won't be polite to you. Considering that there is a slight fracture and the joints are seriously dislocated, give him an anesthetic!"
Li Jingsheng's last words were to Li Li.
"Is it okay to have local anesthesia?" Li Li asked.
"Brachial plexus anesthesia is enough. Doctor Chen, please make a temporary medical order."
Li Jingsheng is not a doctor at the Second Hospital and has no authority to issue medical orders.
This kind of temporary medication is not prescribed by a doctor and will not be reimbursed by the hospital.
According to hospital regulations, many will require doctors to write medical orders, and then nurses to sign for confirmation.
The anesthesia process went fairly smoothly.
Dr. Chen and nurse Li Li are very cooperative.
After all, the family members looked quite savage. Dr. Xu was not present and they did not respond well. If the family members really caused a scene in the outpatient clinic, the hospital would definitely hold them accountable.
After the anesthesia took effect, Li Jingsheng began to seriously adjust the patient's bone and reset it.
This type of minor adduction fracture of the external neck of the humerus is very difficult to achieve, let alone manual reduction, even open reduction.
It not only has high requirements for ordinary bone-setting techniques, but also requires rotation, flexion and extension to reach a very high level before bone-setting reduction can be successful. On the contrary, the requirements for pulling and pulling are lower.
I believe many orthopedic surgeons have had an experience when performing incision and surgery. They just find it a bit difficult to look at the film. Isn’t it a simple matter to perform surgical reduction after incision?
Just put the fractured ends together, and nail them when it's time to nail them.
If you want to get on the stand, get on the stand.
In fact, it is found that the difficulty of reduction after incision is much more difficult than imagined.
This is actually due to a method issue.
Without understanding the bone quality and bone image, the bone position can only be judged by looking at the radiograph. The difficulty of repositioning them after incision will be reduced, but the difficulty still exists.
Moreover, if the treatment is not in place, it is very easy to cause joint degeneration and malunion of fractures, affecting the patient's normal movement functions.
Even more serious, osteonecrosis occurs directly.
For example, the femur is one of the sites most prone to necrosis.
The treatment of orthopedic injuries, even now, is still second to none among many specialty orthopedic hospitals in the country. Not to mention the top tertiary hospitals, at least the market recognition of these hospitals is higher than that of the top tertiary hospitals.
These specialty orthopedic hospitals basically have the heritage of traditional Chinese medicine in bone setting and bone injuries.
For example, the very famous Shuangqiao Granny, Ponzi and so on.
After diagnosis at a large hospital, it was said that surgery would be required to cure the disease, and there was no guarantee that all motor functions would be restored.
Then I found a special orthopedic hospital and met a really smart doctor who would perform manual reduction without incision or surgery. You may have to be hospitalized for a period of time with traction, external application of bone injury ointment, and oral administration of bone rejuvenating medicine.
He was finally able to recover and be discharged from the hospital, and his motor function is as normal as before.
There are not one or two such cases, but very many.
Li Jingsheng's search for a famous bone-setting master did not have much ambition. He just wanted to learn the techniques of bone-setting and reduction so that the small clinic would not close down. From now on, I can make a living wherever I go.
It would be even better if it can increase the popularity of small clinics and drive the sales of health care drugs and the development of surgical business.
At this moment, he had upgraded the rotation, extension, flexion and extension techniques to the proficient level, and the idea of manual reset was naturally in his mind.
"First adduct and internally rotate the traction, then abduct, then bend forward, lift up, then internally rotate to fasten the fracture surface, and slowly lower the lifted affected limb down..."
He had a serious face and a solemn expression, and his eyes were staring at the patient's shoulder.
Click!
The sound of bone ringing was heard, and the child snorted, but did not scream.
The effect of brachial plexus anesthesia is okay.
Although it is a local anesthesia, there are still risks.
Li Jingsheng observed a detail. Even in large third-level hospitals like the Second Hospital, children still need to do a skin test before injecting local anesthesia.
It seems that his small clinic is not the only one who is cautious!
Human lives are at stake, so everyone is cautious.
If something goes wrong, not only may the patient's life be lost, but the career of the doctor or nurse involved will basically be terminated.
Even if your license is not revoked, the probability of being benched in the future is very high.
"Is this connected?"
the child's father asked eagerly.
"I'll check again and make sure. Hold the baby and don't move."
Li Jingsheng checked it again using the bone palpation technique.
The dislocated shoulder joint has been reset.
The fractured area has also been aligned and restored to a fitting state.
In fact, this child's fracture was not serious, it was quite minor.
But there are fractures.
Without treatment, it only needs to be maintained for two to three months and it will heal on its own.
And basically there will be no sequelae.
If care is not taken properly, such as not wearing a sling and allowing the fractured arm to continue to be damaged by external forces, it will be difficult to say.
"The manual reduction has been successful. However, the child's arms need to be suspended around the neck for a period of time. Also, he has a fracture and needs to be prescribed some medicine and taken good care of..."
With that said, Li Jingsheng explained the care precautions to the children and parents in detail.
He also told them to check back at the hospital in a month.
Dr. Chen had already fetched the bandage, and he lowered his body to Li Jingsheng's hand, helping him handle the next steps together.
Ten minutes later, the bandage was applied.
Li Jingsheng's examination was correct, and Dr. Chen prescribed the prescribed medication, and then asked the family members to pay for the medication themselves.
This patient is considered finished.
Li Jingsheng's doctor level experience increased by 1, his proficiency in ordinary bone setting increased by 5, his bone touching technique increased by 1, and the most exaggerated one was the rotation, flexion and extension technique, which had a proficiency of +10.
The health value has also been increased a lot, by 11 points.
10 of them should be bonus points.
He found that the health bonus mechanism in the attribute panel was particularly mysterious.
It's a big surprise out of the blue.
Sometimes, the rewards given are very small.
For example, this time only 10 health points were awarded.
Of course, there are quite a few.
Normally, he would need to treat at least five patients to earn this much.
We have to ensure that all five patients recover.
It only diagnoses and treats. If the patient does not recover, he can only gain 1 health point.
It feels a bit like taking half of the payment as balance.
After he cures the patient's disease, he will automatically pay the balance.
After the family members left with the patient, Li Li looked at Li Jingsheng with a completely different look this time.
"Dr. Li, is that okay? I usually watch you studying with Dr. Xu, and I thought... you don't have the ability to treat independently yet!"
She was very careful when speaking, for fear of making Li Jingsheng unhappy.
In any department, medical skills are the core element that can quickly improve a doctor's status.
After seeing Li Jingsheng's unique bone-setting ability, nurse Li Li had automatically moved Dr. Chen to the back in her mind, and then promoted Li Jingsheng to the second level after Dr. Xu.
"I've only learned a little bit about it. I can handle the simple ones, but I definitely can't handle the ones that are too difficult."
Li Jingsheng is very humble.
With more than nine months and nearly ten months of experience in opening a clinic, and having received countless beatings from society, this also makes him obviously more mature and stable than Dr. Chen and Li Li.
He acts calmly and calmly, but has the ability to calm things down at critical moments.
A famous fortune teller once said that to see whether a man is calm and reliable, you only need to look at his walking posture.
Those who shake their shoulders and legs when walking are probably unreliable. Only a man who walks as if he is carrying a mountain on his back, with his waist slightly hunched, is the most reliable and responsible.
Because this kind of man walks like a burden is always on his shoulders. Most of them have experienced hardship and have a sense of responsibility to achieve this kind of appearance.
If you think about it carefully, it does make some sense.
Youngsters around the age of twenty are mostly frivolous, with the exception of a few mature and stable ones.
Only after reaching the age of thirty or forty and having experienced the world, that kind of man will be particularly mature and stable.
Compared with Dr. Chen at this moment, Li Jingsheng belongs to the latter group.
Able to take on tasks and have real strength, yet humble in appearance.
"Dr. Li, we have been working together for a while. Dr. Xu is not here today. This is a rare opportunity. How about you teach me!"
Dr. Chen shyly approached Li Jingsheng and got close to him.
"Stop making fun of me! I've only been learning for a long time, and it's not enough for you to teach me."
Li Jingsheng refused to even teach Xiao Gao, so how could he possibly teach Dr. Chen advanced bone-setting skills?
He is really not familiar with Dr. Chen.
Even though Li Jingsheng has been here for 'further studies' for some time, he has spoken very little to Dr. Chen.
Moreover, Dr. Chen's attitude towards him was not friendly at first.
For a while, there was even overt hostility.
Only with Dr. Xu watching over him, Dr. Chen did not dare to make any mistakes.
But it can still be felt from his words and directing Li Jingsheng to do things.
"I'm really not making fun of you. I know that Dr. Xu must have taught you some real skills, but he never taught me..."
While Dr. Chen was speaking, he saw a figure walking in and looking at him with cold eyes.
Subconsciously he turned his head and looked over.
"Ah... Doctor Xu, you are finally here! There are many patients waiting for you outside!"
Dr. Chen is very capable of adapting to the changing circumstances!
In the workplace, everyone has a desire to survive.
Dr. Chen didn't dare to make Dr. Xu unhappy, otherwise, replacing him would be just a matter of words.
"Hmph, can't you handle it if I'm not around? Hurry up and get to work, there's so much nonsense."
Dr. Xu scolded Dr. Chen with a cold face.
This scolding was really unfair.
He obviously didn't make any mistakes.
Li Jingsheng and Li Li secretly laughed. It was probably because Dr. Chen just said that Dr. Xu passed on his true skills to Li Jingsheng but did not teach him, and Dr. Xu heard it.
Just scolding him a few times was considered an understatement.
"Dr. Xu, you were not here just now. There was a family member who was making quite a fuss, so we brought him in and worked together to finish the matter."
Li Li honestly reported on her previous work.
"Isn't this great? The patient's bone injury is not serious, right?"
Dr. Xu treats female nurses relatively gently.
At most, when you are in a bad mood, you will keep a cold face and say nothing.
Li Jingsheng has been studying here for many days and has never heard Dr. Xu scold Li Li.
Even if she did something wrong sometimes, she would only say a few words in a serious tone.
Young female nurses and doctors usually have fragile minds, and they may cry when they are scolded.
Even if Dr. Xu is fearless, scolding a nurse girl to tears has a bit of a bad reputation, so it's better not to do it.
"The patient's shoulder joint is severely dislocated, and there seems to be a minor fracture."
Li Li replied.
"Is there a movie? Let me take a look."
"Yes, yes!"
Dr. Chen quickly called it up from the computer.
After seeing it, Dr. Xu asked in a cold tone, "Who set and reset the patient's bones?"
"Dr. Li did it."
Dr. Chen noticed that Dr. Xu's face was a little dark and his tone was not right, so he quickly pushed Li Jingsheng out as a shield.
"Can you treat this kind of bone injury?"
Doctor Xu stared at him with cold eyes.
"I felt a little confident, and you were not around at the time, so I took action. Fortunately, I didn't damage your sign. After the reset was completed, I checked his bones. The bone position was normal and the fracture line was tightly closed. He needs to be cured for a period of time. It should be no big deal in time.”
Li Jingsheng is not afraid of him.
He answered very calmly.
"How did you reset it?"
Dr. Xu's face still didn't look good.
The main reason is that he is afraid that Li Jingsheng will act blindly and delay the patient's condition.
"I asked the child's father to hold the child and restore it to a sitting position. First, adduction, internal rotation and traction, then abduction and forward flexion..."
Li Jingsheng explained the treatment process.
After listening, Dr. Xu's originally dark face turned clear again.
"Well done! Remember, you can be bold and careful when treating patients, but you must do what you can. You must not do things that delay the patient's condition if you show off your abilities blindly and enjoy your success."
After listening to his reduction process, Dr. Xu knew that Li Jingsheng had probably achieved a successful reduction based on his rich experience.
"I'm not that kind of person either!"
Li Jingsheng curled his lips.
After practicing medicine for so many years, he had never done such an irresponsible thing before when his medical skills were poor. What's more, now that I have opened a clinic, it is even more impossible.
"It seems that you have practiced pull-out, extension, traction, rotation, flexion and extension to a certain level, which shows that you work hard and work hard. Do you remember the four kinds of displacement of the broken end of a fracture?"
Doctor Xu was very pleased to see this 'apprentice' making such rapid progress.
The look in Li Jingsheng's eyes has become much softer.
"Overlap, rotate, angle and shift sideways!"
"Yes, these are the four conditions. When one or two of these conditions exist at the same time, it is necessary to use a combination of pull-out, traction, and rotation, flexion and extension. Only in this way can the axes of the far and near fracture ends be consistent and the overlapping displacement can be corrected. "
These are the essence of advanced bone-setting techniques.
Dr. Xu said it in front of Dr. Chen without hesitation, not afraid of him learning to walk.
After hearing this, Li Jingsheng nodded repeatedly.
He already has a certain degree of understanding and understanding of these manual reduction techniques.
If you want to go further, you may have to upgrade all the extension, traction, rotation, flexion and extension to the minor level.
Don't think about it for now.
Because after he had just upgraded the rotation, flexion and extension technique to mastery, his health points were only 43 points left.
Later, he successfully set the patient's bones and earned 11 points, which added up to only 54 health points.
This little bit of health is of little use to him now.
Because after many medical skills are upgraded to the proficiency level, 500 proficiency points are required to advance to the next level.
Doctors are destined to be a slow-growing profession.
This is still the case even with the properties panel.
But this is also related to his improvement in multiple lines at the same time.
It is the diagnosis of intestinal fear, and it is also general external, respiratory, and cardiac... There are too many medical skills that need to be improved.
This is also the reason why many medical seniors do not recommend that young doctors take the path of general practice development.
Energy and time are limited, so it’s good to be able to master one field.
Bit off more than you can chew.
You want to learn this, you want to learn that, but in the end it’s easy to accomplish nothing.
Li Jingsheng can completely ignore this taboo because he has the attribute panel as an 'upgrade tool'.
"Xiao Li, have you mastered the lifting and pressing that I taught you two days ago?"
Dr. Xu directly regarded Dr. Chen as air.
In fact, Dr. Chen listened to him teaching Li Jingsheng as if he was listening to heavenly scriptures.
"I'm already practicing. There's no problem with the basic essentials. It's just that I need to practice more when it comes to specific operations." Li Jingsheng took the chance to practice openly.
"Well, as long as I have the chance, I will naturally help you. Today I will teach you two techniques: lifting and squeezing."
Doctor Xu began to teach him new skills again.
Each time before teaching advanced bone-setting techniques, these most basic bone-setting techniques will be taught.
Li Jingsheng has already achieved proficiency in ordinary bone-setting techniques, which allows him to get twice the result with half the effort when learning these more complex basic bone-setting techniques.
This ability is beyond Dr. Chen's reach.
At the same time, it also made Dr. Xu appreciate him even more.
Teachers like students with good grades. This is nature.
…
At about ten o'clock in the morning, it was time for Li Jingsheng to return to the clinic.
He has already learned the two more advanced bone-setting techniques of squeezing and pulling.
Combined with the two techniques learned earlier, it is to lift, press and squeeze.
This is the fourth advanced bone-setting technique.
Once you learn it, you can not only reset the patient's limbs and treat more complex bone injuries such as side limb fractures, but also treat some bone diseases in the cervical spine, lumbar spine, back and other parts of the body.
He himself can feel that as long as he learns the fourth bone-setting technique, he is already qualified to become an ordinary master in the field of manual bone-setting and reduction.
Sunshine Clinic should be able to officially list manual bone-setting treatment.
Much earlier than he expected!
So far, his small clinic has treated only two patients with joint dislocations.
After the official listing, there should be opportunities to receive more cases in this area.
In the future, the clinic will have another source of income.
"Xiao Li, you must practice more when you have the chance to go back. Your talent is very good. You are born to do this. I really hope you can close the clinic and come directly to work with me. I estimate that within three years, your bone setting skills will be better." The reset ability will exceed mine."
Doctor Xu looked very reluctant to see him go back to the clinic again.
Doctor Chen and Li Li next to them couldn't believe their ears when they heard this.
As long as he studies for three years, he can surpass Dr. Xu. Dr. Li's talent is so monstrous that it's scary.
"Doctor Li actually still runs a clinic! If I have time another day, I'll come and play with you!"
Dr. Chen is obviously still evil-minded.
Unable to learn advanced bone-setting techniques from Dr. Xu, he was ready to find a breakthrough from Li Jingsheng.
In the past, Li Jingsheng just said that he had something to do and had to leave, and never revealed his true identity.
This time, Dr. Xu said it.
"Yes, it's just that my small clinic is old and shabby, and it's usually very busy. I'm afraid you won't be well received when you go there." Li Jingsheng did not refuse.
"Xiao Li is so busy every day, so don't bother him. Don't you think you have nothing to do? I'll say hello to Director Hua and ask him to take on more work for you. Our orthopedic surgery department is always short of people on the night shift. I see you It’s quite appropriate.”
Doctor Xu said with a cold face next to him.
"Ahem...I was just joking with Dr. Li just now. I'm writing a thesis recently and want to participate in a project. I'm actually quite busy. Dr. Li, I'd better come and play with you later! I've been busy recently. not going."
Dr. Chen was so frightened that his face changed.
In the hospital, as long as you want to work overtime, there will never be enough overtime.
Especially the night shift is very torturous.
Many young doctors work three to four night shifts a week.
It’s not impossible that it can run for 36 hours continuously.
Dr. Chen followed Dr. Xu in the outpatient clinic, which was quite relaxing.
Basically, he can get off work at a certain time, and the inpatient department never arranges work tasks for him.
Doctor Xu made it clear that he would not be allowed to go to Li Jingsheng. If he did not follow the rules, he would definitely be worked overtime until he died.
Thank you to the book friend Sword Soul Platform for your support. Thank you very much.
(End of chapter)
