This surgery made Li Jingsheng feel the shortage of manpower and inadequate equipment. If the number of surgical patients we receive increases in the future, we will definitely need to purchase some other equipment.
As for manpower, there is no need to worry about this.
As long as business increases, new medical staff will definitely be recruited.
Boss Zhao’s Kuai Kang Clinic has multiple medical staff.
As a large amount of pus was sucked out, the patient's abscess area obviously collapsed a lot.
The incision he chose was on the lower edge of the mandible, parallel to it, and the length of the incision was about 1.5cm.
These surgical techniques require the doctor to read a lot of books and have a certain amount of practical surgical experience. Li Jingsheng has little surgical experience, but he likes reading.
With proficient general surgical diagnosis and skin incision methods, you can naturally understand some surgical techniques and appropriate knife position selection during surgery.
Just like a skilled worker, he knows how to do the job when he sees the raw materials.
General surgical diagnosis is mainly about etiological diagnosis. Unexpectedly, it can also be helpful in surgical operations, which made Li Jingsheng pay more attention to this medical skill.
In the future, when the health value is sufficient, you can consider raising it by another liter.
"I didn't expect there was quite a lot of pus!"
The oral mucosa has been incised at this time, but there is no way to properly insert the rubber drainage strip.
He picked up the vascular forceps and used blunt dissection along the mucosal incision to the abscess cavity.
The entire operation is done with great care.
He has initially mastered sharp separation and reached the entry level. Blunt separation has only mastered theoretical knowledge, only seen how the teacher operates, and has not reached a high level of practical operation.
It's a bit of a rush at this moment.
However, he had prepared and predicted before the operation.
Because this separation is not very difficult.
It is equivalent to giving him a good practical training opportunity.
Under limited conditions, he must work hard to create opportunities for himself to practice this basic surgical skill. As long as the risks are well controlled, there is generally no big problem.
The ideal thing is to successfully reach the entry level after practicing once or twice.
With the help of the vascular forceps, he gently followed the parotid duct and facial nerve to separate them little by little.
I'm definitely still a little nervous inside.
After a while, the abscess cavity was successfully isolated.
You can see most of the true appearance of this abscess cavity.
The suppuration was severe, the fishy smell was offensive, and all the superficial tissues in the abscess cavity suppurated. It's almost like a piece of rotten white flesh, with a light yellow surface and full of sticky pus.
After continuing to suck out some of the pus remaining in the abscess cavity, the next task is to establish drainage.
He began to flush the entire abscess cavity with saline.
"Ah...it hurts!"
The patient's pronunciation was unclear and there was a slightly painful expression on his face.
In clinical nursing, medical staff will judge the degree of pain based on the patient's expression, body movements, etc.
This patient's pain level should be around 4 points at most.
Normal saline flushing may cause some pain to the patient.
After all, the nerve-blocking effect of local anesthetics used on the face and mouth cannot reach 100%.
"Just be patient! The operation will be over soon."
Li Jingsheng was not only comforting the patient, but also giving Tang Ping a reassurance.
After repeatedly flushing the abscess cavity until it was clean, he inserted a rubber drainage strip.
When inserting the drainage strip, I didn't do it well the first time and it got bent, so I had to replace it with a new one.
Because the drainage strips are folded when enclosing them, it is very easy to cause poor drainage.
At that time, the operation may fail.
It is not as easy as imagined to operate the drainage strip all the way through.
The second time, he had figured out the direction inside the abscess cavity, and the skin incision method had been upgraded to a proficient level, which made his judgment of hand feel even more acute. At this time, when inserting, operate by feel, and carefully learn the reasons for the failure of the first placement.
Finally the placement was successful.
After the inspection, no problems were found, and the drainage strips were fixed, and it was considered completed.
The specific effects of the surgery are still unclear.
It depends on whether the drainage effect and inflammation can be controlled in the next few days.
"Okay, the operation is over. Let's take her to the infusion room for infusion! I'll prescribe the medicine right away and observe her for a while before giving her the infusion."
Li Jingsheng checked it correctly and said to Tang Ping.
The patient should be in a state of confusion at this moment.
After all, I just had surgery.
When prescribed, antibiotics are mainly used to control inflammation and prevent further infection and suppuration.
With Xiaocheng-level medicinal efficacy and pharmacodynamics, doing this kind of thing is simply killing a chicken with a knife.
Even so, he remained extremely cautious.
Every case must be treated with all-out effort.
When a ferocious beast captures its prey, even if it captures a prey that is many times weaker than itself, it still remains cautious and goes all out. Because they have a survival rule called injury avoidance.
Just try to avoid getting hurt.
In the cruel nature of nature, injury means the risk of death.
Li Jingsheng's survival rules for opening a clinic to treat people are similar to those of hunting wild beasts.
Any accidents must be avoided.
Because even a small mistake can have catastrophic consequences.
After prescribing and mixing the medicine, and then observing that the patient had no abnormal symptoms after the operation, Tang Ping was asked to give her an infusion.
For Li Jingsheng, this is a big job.
He summarized the entire surgical process and carefully wrote medical records and course notes.
Many doctors like to use templates to write medical records, but this is definitely not good.
It saves trouble, but it loses the meaning of medical records and also loses a good summary opportunity.
When writing medical records, he had a lot of experience with blunt dissection during surgery and the insertion of drainage tubes.
Check the properties panel subconsciously.
Doctor level experience +10, general surgical diagnosis +1, drug efficacy and drug metabolism +1, superficial skin incision +10, health +61.
The above gains pale in comparison to the two additional skills in the skill bar.
Introduction to Blunt Separation 1/10.
During surgery, knife handles, hemostats, dissectors, and even fingers can be used for separation.
It can be used with sharp separation or alone.
For example, when there are many small blood vessels in the subcutaneous connective tissue, blunt dissection is suitable.
There are also some special tissue parts or organs that also require blunt dissection to deal with lesions.
At this point, he has no worries in the field of surgical separation.
Both 'soft and hard' can be eaten.
Introduction to implantation surgery 0/10.
This is a special medical skill. Many people have the impression that the role of implantation surgery is to insert a urinary catheter into the patient, or to drain abscesses or chest cavities. I think this is a relatively advanced surgical skill.
In fact, it is not only closely related to puncture, but also often used in high-precision minimally invasive interventional surgeries.
For example, inserting vascular stents, emergency opening of blocked heart arteries, pulmonary arteries, venous blood vessels, etc., rescuing patients with cerebral thrombosis, inserting metal spring coils to solve patients' intracranial hemangioma, etc.
This medical skill is not simple.
'The small can bring order to the family, the powerful can bring peace to the country. '
Such a powerful medical skill is definitely qualified to be called one of the top skills in surgery.
It’s really surprising that Li Jingsheng was able to elevate the implantation technique to the entry-level level in one fell swoop.
Although there are not many opportunities to use the implant now, he is still very satisfied.
There is a foundation here, and you can improve its proficiency if necessary.
If you master the implantation well, in this era when minimally invasive and interventional treatments are the trend, you may even be qualified to become a hot commodity in top hospitals.
Important departments such as cardiology, neurology, neurology, extracardiology, and thoracic surgery are all lacking surgical talents who are good at interventional surgeries.
In fact, in addition to the lack of talents in this area, these departments also lack doctors with strong diagnostic capabilities.
If you can do both diagnosis and interventional surgery, you will basically be a king-level existence.
Many experts who are good at diagnosis may not necessarily perform surgery, and doctors who are good at surgery may not be suitable for consultation.
Li Jingsheng can infinitely improve his medical proficiency, which is like a 'bug'.
Sunshine Clinic seems to be ushering in spring today.
Diagnosis and treatment have been a success.
Over the counter medicine sales are also very busy.
Xiao Gao is already too busy.
Li Jingsheng was about to go on stage in person. He went over to help, and another patient came for treatment.
There was no other way but to wait for Tang Ping to finish her work and go over to help Xiao Gao.
Today's Sunshine Clinic has successfully 'overcame the tribulation' and has become stronger and stronger than before.
Actually this is a good thing.
As a clinic grows from weak to strong, it will inevitably experience many setbacks. The most serious of these is when patients make trouble.
Li Jingsheng used to be particularly afraid of patients making trouble, so he would try his best to compromise if he could.
Now, his mentality has become more mature, more rational and stable.
Faced with troublesome patients, or even a medical accident, he should now be able to remain calm and then deal with it calmly and rationally.
"Doctor, my boyfriend has severe stomach pain, please check on him!"
A young girl with a rather slender figure helped a young man in his twenties to the front of the consultation table.
This girl is quite beautiful, with watery peach blossom eyes, long black eyelashes, beautiful eyebrows, thin red lips, and long shawl hair hanging casually. Even if she only wears a very ordinary white round-neck T-shirt, a pair of black three-quarter shorts, and a pair of cheap light pink slippers, she still can't hide her beauty.
She supported the young man, her expression anxious, and her eyebrows full of worry.
Li Jingsheng really wanted to look in the mirror and look at himself. Where did he lose?
This guy is definitely not as handsome as him. He is of medium height and thin, and his hair is still in the shape of a messy bird's nest.
Why did you find such a beautiful girlfriend?
And she was particularly concerned about him.
"Come, sit down here and I'll check it for you."
Li Jingsheng must be several years older than this young man, and he is still single.
Marriage is something no one can explain clearly.
"Is your stomach hurting suddenly?"
"No. He went out to drink with friends last night and came back very late. He was very drunk at the time, so I took a taxi to take him home. As soon as he returned to the rental house, he vomited all over the floor. When I helped him change After I took off the dirty clothes and wiped the dirt off his face, I let him lie on the bed first. Then while I was mopping the floor, he held his stomach and said he felt a little pain."
The girl answered the story of the onset of illness on behalf of her boyfriend, who had been covering her abdomen.
The information that can be obtained now is that the young man drank a lot last night and then developed abdominal pain.
The abdominal pain has lasted for more than 12 hours since last night.
After she took her boyfriend back to the rental house, she didn't let him lie on the sofa in the living room, but directly on the bed. He even vomited filth all over the room.
It shows that the financial situation of the two people is average and they only rent one room.
"I quickly poured a glass of warm water for him to drink."
It's really good to have a considerate girlfriend.
When you are sick, someone will greet you and take care of you.
"After I finished cleaning, he still said he had a stomachache. I quickly went to the pharmacy to buy painkillers and gave them to him at home. It seemed to have some effect, and he fell asleep afterwards. When he woke up this morning, he still said We had a stomachache, and we originally wanted to go to the health station to see a doctor. When we got here, we really didn’t want to leave, so we happened to see a lot of people in your clinic. The medical skills must be good, so we came in. "
The girl didn't have any scheming intentions.
No one with a little bit of scheming would tell the doctor the following sentence.
"What's the painkiller you take at the drug store?"
"It seems to be called...aspirin!"
The girl thought for a while before coming up with the name of the medicine.
Black lines appeared on Li Jingsheng's forehead. It's really hard to describe the level of pharmacists in the pharmacy. They range from high to low.
Commonly used painkillers, ibuprofen, aspirin, acetaminophen, etc.
As long as the patient has a headache, leg pain, or stomachache, the universal formula can be administered. They pay special attention to medication contraindications, but basically don't care about anything else.
In a word, it is best if the patient takes it and it is effective. If it does not work, then go to the hospital as soon as possible.
The biggest advantage of the pharmacy business model is that it takes almost no risks.
Unless the medicine the patient takes has expired, or there is something wrong with it, or something goes wrong, then there is nothing you can do. Compensate as you should.
"The blood pressure is a little high, the body temperature is 38.6 degrees, and the heart rate is a little fast."
After measuring the patient's three basic signs, Li Jingsheng realized that the patient's problem was no small problem.
"You just vomited once after you got home last night, right?"
"No, he also vomited today. It's just that he probably didn't eat. He retched twice and what he vomited was yellow-green bitter water."
After the stomach contents are almost vomited, only gastric juice can be vomited out.
If it's green, it's probably due to bile.
The color of bile spit out is not fixed.
It could be yellow, white, grass green, or even red.
This patient vomited gastric juice and bile, further proving that Li Jingsheng's judgment was correct.
It's definitely not a minor illness.
What disease could it be?
He couldn't help but think hard, and made a preliminary diagnosis based on the patient's cause, symptoms, and course of the disease.
At present, his gastroenterology diagnosis has reached Xiaocheng level, which is still very advantageous.
The gastrointestinal diagnosis level of senior doctors can basically sweep away most diseases in this field.
Acute gastroenteritis? Gastrointestinal perforation?
"Go and lie down on the examination bed inside, and I'll check your stomach."
he said to the patient.
"Can it be cured?"
the patient asked, glaring at him.
"Only when the cause of the disease is found can we prescribe the right medicine. I can't answer you now."
Li Jingsheng could understand why this young man spoke a little hastily.
When you are suffering from pain, you will inevitably feel a little impatient.
Clinically, it is very common for some patients with neuropathy to have drastic changes in temperament and not cooperate with doctor's examination and treatment.
Often it is necessary to use sedatives or even tie people up for treatment.
"After checking for so long, we can't even find any disease. What kind of shabby clinic is this? Forget it, we won't treat it."
The young man suddenly became angry, which made Li Jingsheng feel a little baffled.
"If you don't trust the technology of my small clinic, you can go to a big hospital. But you must not become a doctor yourself and buy some medicine to take at home. His illness is not like a minor illness. Now the fever is very serious. I'm afraid something will happen if I drag it on."
Li Jingsheng was not angry because of the patient's bad attitude.
Instead, they were advised to go to a large hospital for treatment as soon as possible.
The girl mentioned that she originally planned to go to the health station for treatment, indicating that they were familiar with the terrain and environment here.
Although the health station is not weak, it may not be able to treat this patient based on its feeling.
When measuring the patient just now, Li Jingsheng listened to the patient's bowel sounds, which were about 8 times/minute.
It shows that intestinal peristalsis is in good condition.
The patient then covered his abdomen slightly to the left.
Li Jingsheng judged that the real source of pain was probably not in the abdomen.
The most common and reliable way for doctors to percuss and palpate the area of abdominal pain is to have the patient lie flat on the bed.
Sometimes patients are also asked to lift their legs, turn sideways, raise their hands and other movements to cooperate with the examination.
"Doctor, I'm sorry, my boyfriend may be in a bad mood. How much do you want here?"
The girl is very submissive to her boyfriend.
But she acted politely.
"Our clinic provides free consultations and there is no charge. You should take him to the hospital as soon as possible. Don't delay his condition."
Acute cholecystitis and intestinal perforation can lead to death.
The young man is still so young and has such a beautiful and considerate girlfriend. It would be a pity if he lost his life.
"thank you!"
She clasped her hands on her chest and thanked and apologized to Li Jingsheng repeatedly.
"Why are you talking to him so much? Let's go!"
The young man had already gotten up and walked to the door.
It can be seen that the whole person looks extremely manic.
Li Jingsheng secretly deduced that either the young man had a bad temper to begin with, or the pain increased a lot during the examination, which caused the young man to lose patience.
Seeing the patient leave, he didn't feel any pity.
Because if this patient does not have a minor illness, even if the cause of the disease is diagnosed, he may not be able to eat.
In the end, they still have to go to a large hospital for treatment.
If you leave now, you can avoid all subsequent risks.
For small clinics, the most important thing is stability, not gluttony.
Outside the clinic, Boss Zhao happened to come to see Li Jingsheng for something.
Finding that Li Jingsheng's clinic had a new sign, Boss Zhao stared at it for a while.
Seeing the young lovers coming out, his eyes swept over the girl's body without leaving any trace.
"Hey, little brother, are you sick?"
"Hello, Boss Zhao!"
The young man actually knew Boss Zhao.
Li Jingsheng in the clinic just observed the three people secretly.
Boss Zhao said that he would never do evil things to him again. Who knows whether it is true or not?
Besides, it was not impossible that Station Chief Qiao asked Old Zhao to teach Li Jingsheng a lesson after he refused to be admitted to the health station yesterday.
Li Jingsheng would rather judge a gentleman's heart with a villain's heart.
Because he has suffered too many losses.
"What's wrong with this?"
"I drank some wine yesterday and had a stomachache. This shabby clinic examined me for a long time and didn't even know what the disease was. It's much more reliable for me to go to your Kuaikang Clinic for treatment."
The young man seemed to be familiar with Boss Zhao.
"Do you have a fever?"
"The doctor measured me and said that the fever was severe. He also threatened us, saying that my illness was very serious and that I should go to a big hospital for treatment as soon as possible. I don't want to listen to his tricks."
It seems that this young man was quite restrained when he spoke inside.
I have tolerated Li Jingsheng for a long time.
But he didn't think about it, how could a serious disease be diagnosed quickly?
Even if you go to a large hospital to register as a specialist, you have to do various examinations first and then make a diagnosis based on the examination data, symptoms and medical history.
It only took about fifteen or six minutes from the time Li Jingsheng received the diagnosis to the time the young man got angry and left.
(End of chapter)
