Chapter 6 Dilemma
"Director, the working team from the Medical Office is staying in our department, and I always feel uncomfortable."
Before the morning shift, an obstetrician and gynecologist and Director Sun Chatting and complaining.
Director Sun also felt very uncomfortable.
When doing clinical work, I hate having people from the government telling me what to do. Even though Luo Hao is sunny and amiable, he is from the Medical Department after all. Even if he always has a smile on his face, he still has evil intentions in the eyes of Director Sun.
"Director, when are they going to leave?"
"I can't tell you clearly. If you encounter any troublesome things at night, call them directly. After a few more attempts, they will leave on their own when they are tired." That's a good idea."
Director Sun had an idea, and after speaking in a low voice, he gave all the doctors a "you all understand" look.
Everyone understands.
The office door was pushed open and Luo Hao walked in.
It was like a ray of sunlight shining in. Director Sun's eyes were a little painful when he was stabbed, and he couldn't help but squint.
When Luo Hao arrived, the topic he just talked about stopped abruptly and he began to hand over shifts and make rounds to see patients.
A busy day begins.
……
Clinicians have complicated feelings about the medical office.
In the eyes of many doctors, the Medical Office is the "dog leg" of the hospital leadership, or to put it mildly, it is the Jin Yiwei.
Both doctor-patient disputes, complaints and medical record review are under the jurisdiction of the Medical Office. In the past year, even the most difficult medical insurance issues have been assigned to the Medical Office.
Clinicians do not want to offend the medical office, but they also find them annoying.
Just like when an obstetrician and gynecologist sees Luo Hao, he has a strong emotion of how a beautiful woman can be a thief.
That night.
Luo Hao did not leave immediately after get off work, but stayed to write the medical records of patients with ovarian cysts.
"Leader, there is a patient who I think has a problem. Please take a look." The doctor on duty in the obstetrics and gynecology department jokingly said to Luo Hao.
"Don't be a leader, I am also a donkey. By the way, what kind of patient?" Luo Hao asked.
"Premature birth."
"If you have a premature birth, the neonatologist will come over. Sorry, aren't you? I'll call him." Luo Hao took a look at the patient and knew what was going on. If you have any questions, call the neonatology department immediately.
"Hello, Luo Hao from the medical office. I'm in the obstetrics and gynecology department. I'm looking for an emergency consultation with the doctors on duty."
"I am, are you going to give birth prematurely? I'll be there soon."
The newborn's doctor agreed simply and hung up the phone.
The expression of the obstetrician and gynecologist was a little strange. Luo Hao looked at it and felt puzzled.
"Get ready to deliver the baby." The obstetrician-gynecologist called the midwife and went to the delivery room together.
Entering the delivery room, Luo Hao took a look at the medical records. He was not ready to change clothes. He stood in the corridor of the delivery room with his hands behind his back and a serious expression.
"Doctor Luo." The obstetrician-gynecologist had a strange expression and hesitated to speak.
"What's wrong?" Luo Hao asked.
"There is something wrong with the pregnant woman, don't you think?"
"I feel it." Luo Hao discussed the condition seriously, "35 weeks pregnant, color ultrasound showed that the baby is a bit big."< br>
"..." The obstetrician and gynecologist looked at Luo Hao with a half-smile.
“The fetus has a long head and thighs, because we cannot rely on the fetus’s biparietal diameter and femoral length to judge the gestational age and maturity in the later stages. I can’t say much, but don’t you think...”
"No matter how many, I know there may be problems with the pregnant woman, but we have to avoid some unexpected situations."
Luo Hao looked at the obstetrician and gynecologist with a serious expression, "Explain to the midwife and neonatologist "Don't say it's useless."
The obstetrician and gynecologist squinted, raised his eyebrows, turned around, changed clothes, and went into the delivery room to deliver the baby.
It is very common in clinical practice for patients to deliberately conceal their medical history and past history. It is not uncommon for obstetrics and gynecology to conceal the time of their last menstrual period.
The pregnant woman said she was 35 weeks, but the B-ultrasound showed it was full term.
But this has nothing to do with the hospital or the doctor, cough~
The obstetrician and gynecologist still wanted to see Luo Hao’s nervous and anxious look, but he didn’t expect that Luo Hao discovered the truth early on, and even He was more certain than himself that the child was not premature.
Luo Hao looked at the diagnostic assistant AI, but there was no entry indicating premature birth.
Compared with the B-ultrasound in the medical record, Luo Hao felt that nothing would happen.
He was worried that the obstetricians and gynecologists, midwives, and neonatologists would gossip, which would eventually lead to quarrels between the mother and her family members, so he simply stood in the corridor and whispered to each of them.
The pregnant woman was a multiparous woman. Half an hour later, Luo Hao heard the sound of crying.
The cry is loud and the child is healthy.
After a while, the midwife came out holding the baby.
Luo Hao glanced at it, full month.
He scratched his head and forgot about it as an episode.
The obstetrician and gynecologist came out after changing his clothes, took off his mask and smiled at Luo Hao.
"Little Luo, don't worry, we have seen this kind of thing too many times, and we will definitely not talk too much."
Luo Hao nodded and smiled.
"I didn't expect you to know so much at such a young age. I thought you would be worried." The obstetrician-gynecologist smiled.
“When I was in school, I was willing to go to the emergency room because the teacher chatted with me.”
“Oh? Is there anything else interesting.”
“The teacher said, The emergency room with the highest divorce rate...guess what it is." Luo Hao asked with a smile.
Divorce rate, emergency department, these two words are completely unrelated.
The obstetrician and gynecologist was stunned for a moment, thought for a few seconds and then tentatively asked, "Dermatology?" Divorce rates are highest among patients with lithiasis ”
! ! !
The obstetrician and gynecologist was stunned.
She looked at Luo Hao and couldn't figure out why this guy knew more than she did.
"I have seen it twice. The patient's face was as white as a piece of paper in pain, and he was sweating coldly all over his body. When the person who came with him heard that it was a stone, he sat on a chair and played games or something. He didn't care much anyway."
"The teacher said that as long as the stone is cured, there is a certain probability of divorce. The probability is very high, even higher than malignant tumors."
The obstetrician and gynecologist looked at Luo Hao's sunny face and said nothing. Thinking of this young man talking about clinical gossip, there is no trace of youthfulness.
"Don't worry." The obstetrician-gynecologist felt embarrassed and began to make up for it. "It will be fine. The main reason is that I always call newborns, and they don't look right at me. I can only trouble you. . Ronaldinho, please rest for a while, I’m going to write the medical record.”
The two walked out of the delivery room, and the man who had hit someone an hour ago covered his face with joy and cried happily.
Luo Hao felt extremely ridiculous.
But a doctor is a doctor and can only be a doctor. He shut his mouth and walked past the patient's family.
Back in the department, the doctor on duty in the obstetrics and gynecology department found a common topic and chatted with Luo Haoxian.
As for the little thoughts behind Director Sun’s words, the obstetrician and gynecologist did not pay attention to them.
No one wants to be a gunman.
Besides, Luo Hao is a nice person, so it’s okay to joke around. If he really wants to stumble, the obstetrician and gynecologist won’t be able to stop him.
While we were chatting, the sound of a flat car sounded. Along with the sound of the train, there was also the roar of the emergency department examiner.
"You go ahead and do your work first, I'll see the emergency patients."
"Ding dong~"
The system task prompt sounded in my ears.
Luo Hao perked up and looked at the system panel in the upper right corner of his field of vision.
[Emergency mission: Dilemma.
Task content: Treat a patient with scar pregnancy hemorrhage
Task time: 5 hours
Task reward: Experience value: 10,000 points, 3 hours of system surgery learning time . 】
Task!
Reward System Surgery Learning Time! !
Luo Hao suddenly became happy.
He is no longer satisfied with unlimited general teachers. He can learn and understand more during the systematic surgery learning time. Intuitively speaking, the experience value is at least 3-5 times that of studying alone.
Scar pregnancy…
After a brief period of excitement, Luo Hao's eyes fell on the task content on the system panel.
Scar pregnancy refers to women who have had a history of cesarean section. When they become pregnant again, the gestational sac implants in the original scar of the uterus, which often leads to heavy vaginal bleeding and late uterine rupture, which is difficult to deal with. Abnormal pregnancy.
This type of disease is extremely dangerous. In the field of obstetricians and gynecologists, the only thing that can compare is ectopic pregnancy.
As for treatment...
In the past, many patients needed hysterectomy after conservative treatment failed.
But now Luo Hao thought, and the interventional surgery skill tree was expanded. The simplest interventional catheter embolization surgery was a level four surgery, which was just within Luo Hao's ability.
Try it?
Try it!
Embolization of the communicating arteries of twins in utero cannot be done by oneself, but embolization of uterine arteries is not possible. This surgery is not difficult, and level 3 surgery can be completed successfully.
Luo Hao got up and walked out of the doctor's office.
The mine manager once had an interventional department and purchased expensive DSA machines, with more than a thousand surgeries performed every year.
Even at its peak, difficult techniques such as tips were carried out, and dozens of them were performed every year.
But that is all in the past.
With the changes in centralized mining policies, the reduction of group investment, and the increased efforts to poach people from the south, the intervention department established by the mine boss over more than ten years disappeared in less than five years.
Now the interventional department has shrunk and shrunk, and even the most basic surgical capabilities cannot be performed.
It was really an emergency mission, and Luo Hao was a little helpless.
A pungent smell of blood hit his face.
A middle-aged woman was lying on the flat car, her pants were soaked through, and dark red blood dripped down the flat car onto the marble floor.
The bright red blood has long frightened people into blindness. The patient’s family members seemed to have their mouths covered and could not say a word.
They followed the flat car stupidly, feeling helpless.
"Get ready for rescue!" The obstetrician-gynecologist shouted loudly as his adrenaline surged due to the smell of blood.
The young nurse was also a little nervous, but she still knew the basic rescue procedures - measure blood pressure and leave an intravenous channel first.
Luo Hao helped install an electrocardiogram monitor on the patient. The patient's blood pressure was extremely low, 65/32 mm Hg.
When diagnosing hemorrhagic shock, you must seize the time to stop bleeding.
The obstetrician and gynecologist took the time to call Director Sun, while Luo Hao went to the fire escape and called his uncle Lin Yuming.
"Uncle, it's me."
"Why are you calling me so late?"
Lin Yuming didn't wake up angry, and the phone call he received in the middle of the night became more meaningful. Every veteran clinician knows the dangers.
Luo Hao briefly stated the patient's condition.
"Uncle, I want to perform interventional DSA surgery on the patient."
Unexpectedly, Lin Yuming didn't want to deny it directly.
"No!"
"Uncle, the patient..."
"Call Director Lin!"
"..." Luo Hao choked Next, "Director Lin, the patient's condition requires it."
"What a bullshit condition. Without you performing interventional surgery, all those patients with scar pregnancy would have died? Let me tell you, after Director Qian of the Interventional Department went to the south, our mine has not had a single patient with scar pregnancy die. Do you think you are? Who!" Lin Yuming yelled.
"Uncle, calm down and listen to me first." "Listen to what you're talking about! Are you going to do a surgical operation and look at the X-rays? You have to take a thread, then it's radiation. ! ”
“Listen to me, uncle, your ideas are too old.” Luo Hao knew that he would not be able to persuade Lin Yuming with gentle words. The words were retorted back.
“The Interventional Department of Xiehe Union Medical College rarely performs traditional interventional surgeries, and mainly uses radiofrequency ablation under CT machines.”
"If you don't eat the thread, you won't eat it at all."
"And now many hospitals are carrying out seed implantation surgeries, so they won't eat the thread."
The other side of the phone was silent.
Luo Hao felt a glimmer of hope in his heart.
"Before you have a child, just stay away from sex for half a year. Uncle, I promise you that as soon as I have a girlfriend, I will not be exposed to these things. But the question at hand is whether the patient can keep his own organs. , of course you can just cut it off when you can’t do it, but now we know how to do it and can do it.”
"..."
There was deathly silence on the other side of the phone, and Lin Yuming didn't say a word.
"Uncle, can the machines in our DSA room still work?"
"Wait for me."
More than ten seconds later, Lin Yuming let out a sullen voice. After saying a word, he hung up the phone.
There are many types of interventional surgeries. Interventional surgeries are done under B-ultrasound machines, but traditional access surgeries refer to surgeries done under X-rays with DSA machines.
For example, coronary intervention surgery in the circulatory department.
Eating threads will affect the health of the operator, and the thyroid, eyes and immunity will be affected.
The most important thing is that eating thread may lead to congenital deformities in the child when the child is born.
The uncle's concerns are justified. Luo Hao does not think that the uncle's fierce reaction is making a mountain out of a molehill.
This is my family member. If someone else took the initiative to volunteer, I would probably fill the entire mine manager's cafeteria with the cakes painted by my uncle Lin Yuming.
What kind of director of interventional department, what kind of medical insurance tilt, what kind of key departments, what kind of key support in the hospital...
As long as you can think of it, I will give it to you.
But the problem is that no one really does it.
If you don’t do it, others will. This saying does not apply in interventional departments.
While Luo Hao was thinking about how to persuade Lin Yuming, he went back to help with the rescue.
The patient's condition was not good, he was in severe hemorrhagic shock, his expression was indifferent, and his whole body was clammy.
Ten minutes later, Lin Yuming hurried over.
He took a gloomy look at the patient's condition first, then grabbed Luo Hao's collar and led Luo Hao out of the emergency room under the surprised eyes of others.
“I’m giving you face, aren’t I!”
"The wings are hard, aren't they!"
"Xiehe and Xiehe, you talk about Xiehe every day, do you know Xiehe, does Xiehe know you! Who do you think you are! Why don't you stay in Xiehe if you have the ability!" ! ”
Although Lin Yuming tried to keep his voice down, his anger burst out.
He came to the hospital in the middle of the night not to discuss anything with Luo Hao, but to scold Luo Hao in person and keep an eye on the careless nephew to prevent him from going up to the interventional catheterization room for surgery.
"Uncle..."
"Who the hell is your uncle!" Lin Yuming stretched out his hand, pointed at Luo Hao's nose and cursed, "You can't intervene before you have a child. Why are you bullying me? I'm a professional doctor in animal husbandry imaging. , I know at least 30% of the people involved in the whole country!”
“Uncle, calm down,” Luo Hao kept bowing.
Lin Yuming raised his hand and slapped Luo Hao on the head, "Is there something wrong with your brain? Surgery under B-ultrasound is not enough for you to last a lifetime? Lao Liu said that your B-ultrasound level is at He is outstanding among his peers, and even he can’t be said to be much better than you.”
“Uncle, that’s a patient who needs to have his uterus removed without interventional embolization.”
"..." Lin Yuming was choked and couldn't say a word.
Luo Hao dared to stand on his moral prostate and suck himself!
Lin Yuming's eyes were as wide as bells, and Luo Hao even saw a hint of evil.
My mother is an uncle, and she knows how much she dotes on her. Luo Hao knows this in his heart. This is probably the first time Lin Yuming has hit him since he was a child.
"Uncle, listen to me, listen to me." Luo Hao explained with a pitiful look, "I promise, just this once!"
"One time, you What a liar! ”
Lin Yuming raised his hand again and slapped Luo Hao on the neck.
"Be careful of carotid artery intimal avulsion. You hit me on the back of the head just now, and I'm a little dizzy now."
Lin Yuming's eyes widened when Luo Hao said this, but he raised his head. The hand did not fall.
Luo Hao had a sneer on his face, "Uncle, really, it's just this once. I'm not sick. Surgery in a lead suit is disgusting. It's like a puppet. I don't want to. It's just too much, too much."
“It’s weird if it’s true.”
"Really, really. Uncle, let me tell you, I heard the teacher's judgment on future technologies, and one of them is puncture technology." Luo Hao said nonsense seriously.
"Huh?" Lin Yuming was startled, "Puncture is simple."
"It's not the kind of chest or abdominal puncture. In the future, if nanorobots are used to treat cancer, they will all need puncture. The robot was planted at the location of the lesion."
"Isn't it all taken orally?" Lin Yuming was dubious.
"It is a product that will be produced countless generations later. It is similar to science fiction, deceptive, and can also be said to be a vision. What can be seen now is puncture, where robots or drugs or radioactive substances used to treat diseases are left behind. In the lesion.”
When he heard the word "radiation", Lin Yuming's expression became ferocious.
"Uncle, let me find particle implantation technology for you." Luo Hao had already taken out his mobile phone and opened a website full of English to start looking for relevant literature on particle implantation.
This technology has appeared in the technology tree of interventional puncture. Luo Hao cannot do it now, but this does not affect Luo Hao's prior knowledge.
Luo Hao tried his best to divert Lin Yuming's train of thought, but who was Lin Yuming? Luo Hao's little tricks didn't work at all.
"I'm not looking, what are you going to say?" Lin Yuming asked with a cold face.
"Uncle..." Luo Hao swallowed, and seeing Lin Yuming's stern expression, he began to delete what he wanted to say.
He knew that if he couldn't get to the point in three sentences and get his uncle to agree, today's surgery would probably be in vain.
"I will say three things. First, we are doctors. This is not just a case of catching up with a patient, and I can still do it. If I do the operation, the patient's uterus can be saved; if I don't go, people will You can’t die, but you have to remove the uterus. After all, it’s still an organ.”
Luo Hao looked at Lin Yuming’s expression as he spoke.
"Second."
While Lin Yuming was silent, Luo Hao immediately came to the second point.
"Second, I guarantee that the operation time... the thread-taking time will be less than 20 minutes!"
"Huh?!" Lin Yuming was stunned.
Although he does not know how to perform interventional surgery, he is a graduate of the imaging major after all, and has seen surgeries performed by the mine's interventional surgeon before.
Scar pregnancy requires embolization of the uterine artery or internal iliac artery.
In the past, the director of the Interventional Department of the Mine General Hospital performed similar surgeries. As long as the patient's condition was stable, he would carefully embolize the uterine artery.
The diameter of the uterine artery is about 2mm, which is relatively thin and requires a lot of effort.
If the level is insufficient, the internal iliac artery can be embolized. The diameter of the internal iliac artery is 6-7mm, which is equivalent to eight rows of channels for interventionalists, which is very spacious.
Within less than 20 minutes of operation time, Luo Hao should embolize the internal iliac artery.
This bastard still has some tricks up his sleeve!
Lin Yuming snorted coldly.
Seeing that his uncle didn't say much, Luo Hao saw the turning point and immediately continued, "Third, this is my career plan, otherwise why would I need so many scopes of practice."
"Career plan? Tell me."
"Uncle, the patient is in hemorrhagic shock and is waiting for surgery." Luo Hao reminded.
Lin Yuming thought for a while and stretched out his finger.
"First, the actual operation time cannot exceed 20... no, 10 minutes. If it takes more than 10 minutes to seal the internal iliac artery, it proves that you don't have this talent."
"Okay, okay." Luo Hao Nodding like a chicken pecking at rice.
"Second, this is the last time. If you have to do it, find a wife and have a baby as soon as possible. Once you have a baby, you can do whatever you want. If I fart, it will be considered an old fool. It's okay. "More."
Luo Hao continued to nod obediently.
"Third, can you really do it?" Lin Yuming asked doubtfully.
Before, it was all about caring for the nephew as an uncle, but Lin Yuming asked the last sentence because of his position as the director of the medical department.
Luo Hao grinned, the sun was shining brightly.
The task is only one aspect. Interventional surgery can avoid removing organs. This is what Luo Hao wants to do most.
"Yes!" Luo Hao answered simply.
Lin Yuming looked Luo Hao up and down, his brows furrowed, as if a carving knife had carved the word "Chuan" between his eyebrows.
"I contacted the DSA department and found that the interventional department was no longer available, but the vascular department was still performing surgeries. Damn, I've been looking for an interventional doctor for three years, but I didn't expect..." Lin Yuming's voice became weaker and weaker.
"Uncle, tell me something else. Do you know that plus-size women undergo partial gastrectomy to lose weight?"
Lin Yuming was confused and nodded.
“Interventional surgery, embolization of the left gastric artery, can achieve the same effect without causing any damage.”
“Minimally invasive surgery is the direction of the future. As long as there are no unexpected factors such as war, By the time I reach forty, all existing techniques will be eliminated.”
"!!!" Lin Yuming held his cell phone, looked at his high-spirited nephew, and said scornfully, "You are the only one who can do it." How did the interventional surgery go?"
Lin Yuming is an experienced clinician, so of course he knows about this.
In the past, there were two general chests and one cardiothoracic department in the Department of Thoracic Surgery at the mine. But with the rise of interventional surgery, the mind has gone straight to zero.
It seems a little... wrong!
Lin Yuming immediately realized that his thinking had been deceived by Luo Hao. This boy was giving him psychological hints!
Md! Lin Yuming cursed.
"I don't care. Anyway, you will either do something else in the future, or you will get married and have a child."
"Okay, I promise to complete the task!" Luo Hao did not hesitate. Lin Yuming was perfunctory.
Seeing his uncle dial someone for emergency surgery, the smile on Luo Hao's face became brighter.
After a few minutes, Lin Yuming arranged everything, glared at Luo Hao and walked out of the fire escape.
When I arrived at the emergency room, the smell of blood hit my face.
Lin Yuming had long been accustomed to it. He strode into the emergency room and asked in a deep voice, "How is it?"
"Lin, the bleeding has been stopped temporarily. Over there in the blood transfusion department. The blood is being matched, and it is estimated that the transfusion will be available within thirty minutes," the obstetrician-gynecologist replied, "I have called Director Sun and will be able to come to the stage when the patient's condition is better."
"Inform Director Sun. , the patient underwent interventional embolization surgery.”
! ! !
The expression of the obstetrician and gynecologist is extremely wonderful.
She was stunned for a moment, a smile of relief appeared on her face, and her whole body relaxed, "Chu Lin, is Director Qian back from the south? Or did you find interventional talents somewhere? Awesome! You don't You know how much we hope that our mine will always have An interventional doctor who can perform embolization surgery."
Lin Yuming ignored the obstetrician and gynecologist and turned around and said to Luo Hao, "I will watch over all the pre-operative instructions for you." br>
"Okay." Luo Hao responded.
Luo Hao then called the patient's family members to the doctor's office.
The obstetrician and gynecologist watched helplessly what happened and was stunned. It took a few seconds to vaguely understand what happened.
Their department is connected with the interventional department, especially for patients with scar pregnancy, interventional hemostasis is the first treatment option.
Compared with surgery, interventional embolization causes almost negligible trauma to the patient.
But unfortunately, as Director Qian and others from the Interventional Department of the Mine General Administration went to the south one after another, this type of surgery had to be stopped.
When encountering similar patients, the only option is to stop the bleeding first. If the effect is not satisfactory, the only option is to cut the uterus.
Every time Director Sun performed a similar operation, he would curse in a low voice, Director Qian, the former director of the interventional department, for being jealous of money.
But patients in the south are also patients. Director Qian works to make money, which is not wrong at all.
The obstetrician and gynecologist was nervously guessing who Director Lin had hired to perform the interventional surgery. While taking care of the patient, he urged the blood transfusion department to quickly send blood.
Ten minutes later, rapid footsteps came from the corridor.
Bang~
The door of the rescue room was pushed open. The person who pushed the door was so hard that the door hit the wall directly with a loud bang.
(End of this chapter)