MTL - Doctor’s Life Simulator-Chapter 273 The trainee doctor is stunned: Qin Lang rounds the room
, Doctor's Life Simulator
After returning to the burn department, apart from some slightly difficult operations, Qin Lang spent the rest of his time accompanying several other doctors to conduct ward rounds.
Although he is only a resident physician, for some patients with deep wounds and complex hand injuries, Qin Lang's level is higher than Cui Jianguo and Huang Kaihang. Therefore, for some patients with more complicated conditions, the two deputy directors will invite Qin Lang went to the room together.
As for Wei Guoqiang, recently because of Qin Lang's return, the burden on the whole person has been lightened a lot.
Cai Qing has learned a lot from Qin Lang these days. After completing an ordinary debridement and eschar decompression, the two returned to the office.
However, as soon as the two of them sat down, Wu Youtu hurried in, saw Qin Lang, stopped, and thought for a while:
"Qin Lang, I treated a patient yesterday. After routine debridement and suturing, his symptoms did not improve at all, and there were even other complications. Would you like to come with me?"
Wu Youtu no longer regards Qin Lang as a little doctor at all. In many respects, he thinks that Qin Lang is much better than him. Naturally, if he encounters some problems, he will go to Qin Lang first.
"Okay, let's go take a look together. Cai Qing, you come with me and Dr. Wu."
Qin Lang waved his hand and let his cheap younger brother go with him. Compared with the previous Cheng Yunfeng, Cai Qing was much better and more eye-catching.
As for Cheng Yunfeng and Huang Ping, this group of regular trainees have already gone to other departments for rotation.
Cai Qing picked up a medical record folder and followed Qin Lang obediently.
After a few people arrived in the ward, in addition to Qian Liang, the advanced doctor under Wu Youtu was also standing beside him.
Seeing that Wu Youtu came to Qin Lang to diagnose the condition together, Qian Liang was full of expectations, and that doctor who was a few years older than Qian Liang had a playful expression.
In fact, not only Qin Lang, Qian Liang, but even Wu Youtu, a senior attending physician, was quite satisfactory in the eyes of this training doctor.
When Qin Lang and Wu Youtu stepped forward to examine the patient, another group in the ward, Cui Jianguo's group, You Daren and another doctor who was studying were also doing rounds.
Seeing this scene, two advanced doctors of some age came together, but they wanted to take a closer look. This Qin Lang weighed a few pounds and a few taels.
In fact, they were extremely dissatisfied by having such a small doctor come to the ward together and act like a chief doctor.
The trainee doctor under Wu Youtu also deliberately called Cai Qing aside:
"Xiao Cai, you don't need to be so nervous. It's not that you are asked to follow the chief director, a little doctor, who pretends to be a man. I really think that he has a unique vision, far beyond what I can't wait for."
"To be honest, this patient's condition is nothing at all. After the burn, some breathing difficulties, fever, and rapid pulse are not a big deal. According to my experience, a chest X-ray examination is highly likely. It is empyema, just do a closed chest drainage. I looked at Dr. Wu, but I was too cautious. "
The trainee doctor commented lightly, but, after all, he was a trainee doctor, so he did not express his thoughts.
Moreover, in his heart, he also wanted to see the quality of Wu Youtu and Qin Lang.
Cai Qing was noncommittal about the diagnosis of this training doctor, but looked at it quietly.
On the hospital bed, the patient was lying down, and the whole person experienced symptoms of nausea, vomiting, chest tightness, and difficulty breathing. Moreover, the whole person's heart rate also accelerated.
Wu Youtu had already conducted a preliminary examination on the patient. He had a judgment, but he felt that something was slightly abnormal. Therefore, he did not come to a conclusion, but planned to let Qin Lang come to see it together.
Perhaps, Qin Lang has a new idea.
During the inspection in Qin Gallery, Wu Youtu introduced the previous situation in detail:
"The patient, due to a fire in the factory two days ago, fell from a height in a panic, with a slight bone fracture in his hand, and burns on his thigh and forearm... After routine debridement and skin graft suturing , The condition started to recur today, nausea, vomiting, chest tightness, difficulty breathing, and high temperature..."
After Wu Youtu finished speaking, he stretched out his hand again, and Qian Liang handed over the chest x-ray that had just been made.
"The patient's left breath sound was low, percussion was tympanic, respiratory movement was weakened, chest X-ray showed left ventricular compression 80%, and the left pleural cavity was seen with fluid level...heart rate was 110 beats/min, the rate was uniform, and no murmur was heard. , tight abdominal muscles, blood pressure 90/50mmhg..."
After Wu Youtu's analysis, he came up with some of his ideas:
"Preliminary judgment, due to the fire, the patient's respiratory tract was burned, the lungs were injured, and empyema was suspected, or left pneumothorax. Considering closed chest drainage, it is more conservative, we can perform another thoracentesis. technique."
After Wu Youtu put forward his point of view, the two trainee doctors on the side agreed slightly.
In particular, Wu Youtu's training physician, an old fritter who had gone to the Burn Department of the First Affiliated Hospital of Zijingang University and had seen Director Shen Jiamo's operation from a distance, agreed with Wu Youtu's conclusion.
"Xiao Cai, take a look. I'll just say, this situation is very common. I don't even need to take a chest X-ray, so I can tell the difference."
In front of Cai Qing, Wu Youtu's point of view corroborated, obviously, making this trainee doctor very proud.
However, after Wu Youtu came to the conclusion that it was very different from that of the trainee doctor, Qin Lang, instead, showed a dignified expression on his face.
Looking at the chest X-ray again, Qin Lang found a detail that Wu Youtu and others had not noticed.
After all, as a burn doctor, I instinctively think about burns and respiratory tract burns, but Qin Lang is different. He has experienced simulations for several generations, and has experienced different departments, especially his recent experience in emergency department and thoracic surgery, and Newly acquired skills.
Qin Lang went beyond the expectations of Wu Youtu and the advanced doctor, and asked the patient:
"Do you feel some abdominal pain or bloating?"
Before, Wu Youtu and the advanced doctor did not think about this aspect, nor did they ask, and the patient did not specifically mention it. Originally, the pain was not obvious, but only faint, so it was not mentioned separately.
Qin Lang asked this question, and the patient added psychological hints, and the pain really appeared again, and nodded:
"Doctor, I have some abdominal pain and bloating."
Qin Lang's mood sank. He took the stethoscope directly from Qian Liang's neck and listened carefully. After a while, he turned to look at Wu Youtu:
"Dr. Wu, the patient had bowel sounds in the chest, decreased breathing, and CT showed that the mediastinum moved to the right, the diaphragm disappeared, the diaphragm surface was unclear, and the false diaphragm surface was elevated, and the air-liquid level was visible in the chest cavity. Immediately, The patient needs to undergo thoracotomy immediately."
Qin Lang looked at Qian Liang. After the cooperation of a large number of previous surgeries~www.novelbuddy.com~ Qian Liang was obedient to Qin Lang. He was also surprised when he felt Qin Lang's serious face. Obviously, , This patient's situation is not as simple as Dr. Wu's judgment.
"Doctor Qian, you should immediately invite Director Zu Liang of the General Surgery Department. He needs to cooperate with the patient to repair the traumatic diaphragmatic hernia!"
Hearing the unfamiliar and somewhat familiar term of Qin Lang, Wu Youtu was stunned for a moment, and then his face became ugly!
Because, when the first patient was sent, it was indeed described that he fell from a height, but he was covered by the patient's burn wounds and bone fractures, ignoring the patient's possible intrathoracic trauma.
On the other hand, Wu Youtu's trainee doctor, who is only a burn surgeon, knows nothing about this rare traumatic diaphragmatic hernia, which is easy to be misdiagnosed by ordinary general surgeons.
"What is he talking about? Isn't it just a simple empyema, why do you have to invite the director of general surgery to operate together?"
In front of Cai Qing, this advanced doctor's mouth was still hard, but there was a trace of panic in his heart. Could this doctor Qin really see the patient's real illness, and it was such an urgent illness.
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