Chapter 14 Gallbladder Perforation
In fact, there are not many complicated cases in the emergency observation room.
Most of the complex patients have already been sent to the specialist department the moment they enter the emergency department. Those who can stay here are either patients that the emergency department wants to retain, or they are too complex. Diseases from multiple specialist systems are gathered in the body, and each specialist is trying to pass the buck. There is no way to send it out, and it needs to be dealt with after multi-disciplinary consultation.
Then there are those who are making trouble, such as patients injured in car accidents. Because the claim settlement is not yet clear, in order to protect their own interests, they can only stay in the hospital until the claim settlement is clear before leaving. This kind of thing, Specialist beds are in short supply, so they are generally not admitted. They can only be observed in the emergency department first, and these are also included in the cases at this time.
But this is not Wu Xiaofu’s focus. He just goes through the cases and remembers them.
The focus is on the first two.
Especially for those patients who want to be detained in an emergency. The First Affiliated Hospital of Donghai Medical University has its own emergency operating room, and there are three surgical teams to perform surgeries. Some surgeries can be performed in the emergency department, as long as they encounter , so they are not sent to specialists, but are performed directly in the emergency operating room. Surgery represents income. Only when the department's income increases can doctors achieve greater performance.
There are many surgeries that can be performed in the emergency department. The most typical ones are appendiceal and gallbladder surgeries in the general surgery department. As long as it is acute appendicitis or acute cholecystitis and gallstones that have been treated in the emergency department, the general surgery department can perform the surgery. Don't think about it, just go to the emergency room. Because there is an observation room, you can stay for a day or two after the operation and then be discharged directly.
Because of this, almost every hospital is having trouble with the emergency department. After all, these two are also the main operating income of the general surgery department. If the emergency department robs them, the income of the general surgery department will drop.
There are also some acute surgeries in the Department of Cardiology and emergency interventional surgeries in the First Affiliated Hospital, which are performed well.
There are also some acute surgeries in the gastroenterology department, such as acute abdomen and gastrointestinal bleeding, which can also be performed in the emergency department.
There are others, but the surgeries in these three departments mainly account for the majority, and the observation rooms account for the majority of the cases before and after these surgeries.
Wu Xiaofu naturally wants to have surgery. He will definitely do surgery in the future. Surgeons, who are fed by surgery, are all in the emergency department. How can Wu Xiaofu not seize the opportunity? The opportunity is not waiting for him. Yes, familiarize yourself with the cases first. When the opportunity comes, go directly.
The doctor system in the observation room is also the inpatient system. The page is still different from the outpatient clinic yesterday, but it is not difficult to get familiar with it.
"Doctor Liu, there is a patient who needs emergency surgery. Director Zhang took it in and told him to make preoperative preparations quickly."
A nurse rushed into the medical office in a hurry, arriving before anyone else. This is also a major feature of the emergency department. Almost all the doctors and nurses who leave the emergency department are in a hurry because they are used to racing against time. .
After entering the medical office, the nurse saw that Liu Wenyin was not here, and looked at Wu Xiaofu and Qu Ying, "Where is Dr. Liu?"
Qu Ying was still a little at a loss, and Wu Xiaofu was already Standing up, "Doctor Liu is out. Let's contact her. Tell me first what kind of patient it is."
The nurse looked at Wu Xiaofu's nameplate. She had never seen Wu Xiaofu. The information on the nameplate Not many, doctor Wu Xiaofu, if they didn’t introduce them carefully, who would know they were interns.
Looking at Wu Xiaofu’s imposing appearance, the nurse no longer delayed, “The gallbladder is perforated and requires emergency surgery.”
Wu Xiaofu immediately understood that this was an opportunity. He asked the nurse's name, quickly typed out the patient's outpatient medical record, and turned to look at Qu Ying, "Qu Ying, let's go see the patient."
Ah!
Is it so exciting? Qu Ying hurriedly followed.
Following the nurse, Wu Xiaofu quickly browsed the emergency medical records. Although it was an emergency medical record, Director Zhang had already written it in great detail.
Sun xx, male, 57 years old, mainly complained of pain and discomfort in the right upper abdomen for 10 days, which worsened by one day.
Emergency abdominal color ultrasound showed gallbladder stones; gallbladder perforation?
Liu Wenyin’s call was quickly answered.
"Teacher Liu, there is a patient with gallbladder perforation who was treated by Director Zhang. He requires preoperative preparation as soon as possible."
"You ask the patient's medical history first, and I'll do it right away. Come back."
Wu Xiaofu agreed, passed by the nurse's desk and said to the main staff, "Sister, I want an operating room for patients with gallbladder perforation."
The head teacher glanced at Wu Xiaofu's badge and nodded, guessing that it was Liu Wenyin who told him.
Bed 6, the patient on the bed at this time was huddled together in pain, his face was pale, and he was sweating profusely.
There are many family members, five or six in total, and they are all very anxious at this time. "Make way, the doctor is here."
The nurse shouted, and the family members surrounding the patient made way for a while. When they saw Wu Xiaofu coming, they hurriedly gathered around Come up.
"Doctor, how is our old grandson?"
"Director Zhang said he needs surgery, when can he do it?"
"Doctor, is there any danger? Can you not? It’s an operation, Lao Sun is usually fine, there’s nothing wrong with it.”
“Doctor...”
……
Five or six family members, who spoke to each other, had already begun to convey their opinions to Wu Xiaofu. Wu Xiaofu quickly screened their appeals, picked out the useful ones, and finally set his sights on a middle-aged woman, "Who can sign? "
Five or six family members immediately focused on the middle-aged woman.
"Doctor, I, I am the patient's wife."
Wu Xiaofu nodded, came to the patient's side, and began to check the patient's physical signs, including right upper quadrant tenderness, rebound tenderness, muscle He was nervous, Murphy's sign was positive, and the physical signs were very typical. The patient was in so much pain that it was difficult to speak. Wu Xiaofu looked directly at the patient's wife, "When did the pain start?"
"There are other symptoms. Any nausea or vomiting? ”
"Nurse, take your temperature."
"Have you had any examinations before?"
"Have you had any other illnesses? Have you had any surgery?"
……< br>
Quickly sort out the medical history. When asking about the medical history, if the patient cannot cooperate, the patient’s wife can be said to be the doctor’s favorite person to see. After all, this is the relative that the patient gets along with day and night, and is more reliable than his son or daughter. .
"Doctor, do we have to do surgery?"
The patient's wife was obviously still hesitant about the surgery, but since Director Zhang had already admitted him, he must have communicated about this matter. At this time, he asked , it just wants a affirmative answer.
"The patient's gallbladder has been perforated. Without surgery, it will be very dangerous. We recommend surgery."
"Director Zhang also said the same, well, let's do it."
"When can we do it? Look at how much pain my brother is in. You should take care of it. Don't just ask questions."
"Yes, brother, it's so painful. Let's stop the pain first and use the medicine first."
......
Wu Xiaofu was besieged again, and he didn't care and looked towards The patient's wife said, "Let them take care of the patient first. You and I will sign the pre-operative procedures and we will operate as soon as possible."
After saying that, Wu Xiaofu went straight to the medical office.
The patient's wife hurriedly followed. The other patient's family members saw that Wu Xiaofu ignored them and said they needed to operate as soon as possible. In addition, the patient had already left, so they could only continue to work around the patient angrily. in a hurry.
(End of this chapter)