Chapter 46 Grow up, but not grow up
“Where is Dr. Luo?” Lin Yuming asked the intern.
"Seeing patients in the emergency room, the blood pressure of elderly patients has dropped..." The intern was chattering, but Lin Yuming didn't want to listen and strode directly into the emergency room.
Luo Hao stood beside the rescue bed, staring at the values and graphics on the ECG monitor, thinking about something.
"Doctor Luo." Lin Yuming said solemnly.
"Director Lin? Why are you here?" Luo Hao turned around and saw Lin Yuming, "It's not safe to drive on such a slippery road. What are you doing here?"
Although it was a complaint, there was a lot of content between the lines. Full of concern.
Lin Yuming felt relieved.
The child has grown up and knows how to care for others, and is not as ignorant as before.
It is best to have someone to handle the chores, and to be able to direct things from the center, and to handle things that require a face recognition. In the past, Lin Yuming did not receive such treatment.
Although the medical office does not need to be perfect, and it is okay to just dawdle, Lin Yuming knows that he is facing a living life, and he must try his best if he can.
If you are more diligent, one person may be saved. You should only do good deeds to accumulate merit for yourself and gain some blessings for your son.
Although it is not materialistic to say this, doctors and nurses rely on a breath of immortal energy, which is not materialistic in itself, but very metaphysical.
Now that Luo Hao is here, the emergency department is in good order. Even if he rushes to take charge, he cannot achieve this effect. Lin Yuming is quite satisfied with this.
Not bad,
Very good!
Lin Yuming smiled.
He felt a little uneasy today, his heartbeat was racing, and he always felt like something was happening. That's why I came here.
Seeing Luo Hao handle the matter clearly, Lin Yuming felt that his worries were in vain.
"Director Lin, the orthopedics department is still busy, and then there is the intensive care unit. It would be great if there were doctors on call at any time." Luo Hao comforted him and began to make requests.
Lin Yuming nodded, "I'll make the arrangements. What's going on with this patient?"
The patient's family members were in the orthopedics department for a plaster cast and were not there. It was easier for Luo Hao to speak.
After briefly reporting the medical history, Luo Hao continued, "I think the patient has aortic dissection and needs an emergency 64-slice CT scan."
Lin Yuming looked at the energetic Luo Hao, his mood complex.
If he hadn't been his own nephew, if any of his department staff or even the department director dared to say that, Lin Yuming would have been fooled.
Then he carried him and asked him to look at the ground outside. In this situation, how could he find someone to work overtime?
What’s more, it’s still a preliminary diagnosis.
Lin Yuming frowned, "Is there any other way?"
Luo Hao also knew that it was dangerous to bring people from home to do a 64-slice CT in this weather. He scratched his head, " Director Lin, I can also operate the machine!" Lin Yuming was speechless.
Luo Hao's meaning is very simple. No one can do it. As long as he gives him permission, he can do it.
As for the qualifications, Luo Hao's intermediate certificate was obtained by Lin Yuming himself, and Lin Yuming felt like he was aware of it.
"Director Lin, the patient's condition is critical and difficult. Even if the diagnosis is clear, our mine manager cannot perform surgery."
"What should we do?" Lin Yuming asked .
"Shaking people." Luo Hao said naturally, "I'll ask my senior brother to fly over to do it. If the diagnosis is correct, the patient needs elephant trunk surgery, which I think our mine has never done."
grass!
Lin Yuming cursed directly.
Healing diseases and saving lives is all about curing diseases and saving lives, but not like Luo Hao.
Elephant trunk surgery is what doctors call it. Officially, it is simpler. It is called elephant trunk surgery, also called aortic arch replacement surgery.
This name comes from the fact that the aortic arch is shaped like an elephant's trunk.
This operation is one of the largest operations in cardiothoracic surgery. The industry considers it to be more difficult than almost all cardiac operations.
Not to mention the mine director, no one in the provincial capital dares to pat their chests and say that they can win 100% of the time.
Luo Hao wants to undergo elephant trunk surgery at the mining company?
What should I do if the patient dies? Nowadays, doctor-patient disputes are so serious that it is better to have one less problem than one more problem.
Lin Yuming had a lawsuit on his head and his head was buzzing.
"Director Lin."
Luo Hao continued while Lin Yuming was stunned, "The patient's condition is a little stable now. I want to take him to have a lung CT first to see how he is doing."< br>
Lin Yuming sighed.
Just after praising Luo Hao for growing up, he got a big thunder for himself.
This is nothing.
Lin Yuming nodded, and Luo Hao began to recruit people to move the patients.
I asked four male interns to follow me. They were strong and strong, and they didn’t look like the emergency department was short of staff at all. They rushed all the way to the CT room.
On the way, Luo Hao came close to Lin Yuming and whispered, "Uncle, I feel that the patient has aortic dissection. His condition is critical and there is no way to transport him. He can only ask an expert to perform surgery."
"Hmph!" Lin Yuming snorted coldly, expressing his dissatisfaction with Luo Hao's "noblesomeness".
“Uncle, my senior brother has a very high success rate in this kind of surgery.”
"Very high?" Lin Yuming caught Luo Hao's "speech problem", "Is it a 60% or 70% success rate?"
"Hey." Luo Hao recognized Lin Yu Ming was dissatisfied and did not continue.
No matter how high the success rate is, the mortality rate of this type of surgery is far higher than that of other surgeries.
In the 3.0 era of doctor-patient disputes, it is better to do less than to do more. Lin Yuming prefers referral.
If you are kind-hearted, contact the higher-level hospital and do not waste time. You are doing your duty. Why bother yourself?
This little guy Luo Hao, Bai Xiang himself just praised him for growing up and knowing how to care for people.
In the blink of an eye, this guy got himself into big trouble.
When he came to the CT room, Lin Yuming had a gloomy face.
Luo Hao directed the interns to lift the patient gently and put the patient on the machine for examination.
After scanning, Lin Yuming squinted at the image.
After all, he is one of the first batch of doctors to graduate from imaging majors in China and has rich clinical experience.
Lin Yuming smiled as soon as he glanced at him. Luo Hao, this bitch, actually made mistakes in diagnosis sometimes.
"Luo Hao, how did you diagnose aortic dissection?" Lin Yuming said easily, "Anyway, I didn't see any images of aortic dissection. Come on, come on, teach me."
The patient's CT scan was very clear, pericardial effusion, right pleural effusion, right obstructive pneumonia, and atelectasis.
Although lung CT cannot diagnose aortic dissection, experienced doctors can always find some clues in lung CT. (Note)
The lung CT scan of the patient who Luo Hao said would die if he did not undergo elephant trunk surgery was not serious. The main thing was to treat the patient first.
Lin Yuming did not think that the patient had aortic dissection.
"Uncle, the lung CT cannot confirm the diagnosis. How about you discuss it with the director of the CT room? Start the machine and do 64 rows? Aortic dissection can't be delayed. Besides, if it's an operation, we have to fly someone in. Early A few hours is a few hours," Luo Hao said with a smile.
At this time, Luo Hao was extremely humble, not at all like the sunny and upright young man he usually was.
He was like a veteran in society. Although he had a humble attitude and soft words, Lin Yuming was sure that as long as he didn't do what he said, Luo Hao might even lie on the ground and roll around, pretending to be dead.
I will not give up until I achieve my goal.
Who the hell did you learn this from? Lin Yuming felt helpless.
"Uncle, I have three, upper, middle and lower..." Seeing that Lin Yuming was silent, Luo Hao continued to encourage.
"Get out!" Lin Yuming couldn't control the anger in his heart and yelled, "There are three bullshit options, up, middle and down. Who do you think you are."
Only give one plan, If it fails in the end, it is the responsibility of the planner.
But given three plans and they failed in the end, it is the responsibility of the person who selected the plans.
The slick and secretive approach in the book actually appeared on Luo Hao, which Lin Yuming did not expect.
This child grew up so fast. Lin Yuming immediately found something to praise Luo Hao.
After all, he is his own child, so he deserves to be praised.
"Uncle, we still need to do a 64-slice aortic CT scan." Luo Hao said respectfully.
Although his expression was respectful, his tone was extremely firm and soft-spoken, even though the general CT scan had been finalized without any problems.
"Luo Hao, that's too much!" Lin Yuming said sternly.
"It is a trivial matter to do more examinations. I will tell the patient's family." Luo Hao said shamelessly, "But if you are negligent and the patient who could have been treated suddenly dies suddenly, am I not worried that you will be in trouble? .”
"Don't worry about me. As soon as you said you, I knew there was nothing good going on." Lin Yuming scolded, "The image is here, you tell me where there is aortic dissection?!"
Luo Hao remained silent in the face of Lin Yuming's questioning.
But he didn't give up, praying with his eyes.
I really can't stand it... Lin Yuming couldn't bear it when he looked at Luo Hao's resentful and pleading eyes.
For a moment, Lin Yuming thought of Luo Hao's father, his late friend.
You two have the same temper, what a shame! Lin Yuming cursed in his heart.
"Uncle, just this once, if there is no aortic dissection, what will you say in the future?" Luo Hao begged softly.
"If there was, I would have eaten the tablet."
"Don't worry, it's hard to digest." Luo Hao heard a glimmer of hope and said quickly, "Then I'd like to thank you on behalf of the patient. "
"Patient?"
"No, no, no, I thank you."
Lin Yuming was really helpless.
Maybe Luo Hao is still in the rebellious stage, forget it, just do what you want.
Lin Yuming calmly called the director of the CT room.
Although the Medical Office is the superior department, it still needs to be respected.
Besides, the person operating the machine this time is not a professional doctor in the CT room, so many troubles are no less complicated than doing an elephant trunk surgery.
When it comes to people, nothing is that simple.
After contacting him for half an hour, Lin Yuming "persuaded" the director of the CT room to open the door to the CT room in row 64.
The machine buzzed and started running. Luo Hao acted as both a doctor and a nurse, communicating with the patients' families, inserting needles for the patients, creating contrast agents, and conducting examinations.
Looking at Luo Hao, who shouldered all the work, Lin Yuming's emotions became more complicated.
Luo Hao is really capable, but he is a bit too capable and always looking for trouble.
Before the film was released, Lin Yuming said earnestly, "Xiao Luo, the county hospital in Libo County down below was smashed yesterday. Did you know?"
"Why?"
"A patient drank alcohol after taking antibiotics and developed an acute allergy. He was unable to be rescued at a small clinic and was sent to the county hospital. He had a tracheotomy and was rescued, but he still died in the end."< br>
Luo Hao concentrated on operating the machine and chatted with Lin Yuming "by the way".
"This is quite normal. The patient's family is not willing to give in? What's so fussy about this? Taking antibiotics and drinking alcohol, isn't this looking for death?" Luo Hao asked.
“The family filed a complaint with the Health Commission, claiming that they were sent to the hospital for a minor illness, but the doctor made a mistake and cut the trachea.” Lin Yuming warned Luo Hao with an example.
"!!!"
"I admit that the vast majority of people are good, and they also understand medical staff. But you imagine a scenario-as long as you are dissatisfied and complain, you can get benefits, and even the least is exempted. The cost of the hospital can be tens of thousands, hundreds of thousands, or hundreds of thousands in compensation."
"What would you think?" Lin Yuming asked.
“I’m not short of money.” Luo Hao looked at the machine screen intently and said casually. "Pa~"
Lin Yuming slapped Luo Hao on the back of the head.
"Uncle, it's easy to beat people silly here." Luo Hao complained, covering the back of his head.
"Be serious, you are likely to encounter this kind of situation in your future work."
"There is nothing we can do about it." Luo Hao said helplessly, taking a look at it Lucky value at a glance.
I really want to add all attributes, physical strength, mental energy, and luck.
The few attribute points given by the system are completely insufficient.
If possible, Luo Hao would fill up all the attribute points.
With such a high luck bonus escort, he should not encounter unreasonable family members of patients, Luo Hao thought in his mind.
“It’s better to do less than to do more. Even if you want to fulfill your responsibilities as a doctor, you have to consider the situation.”
“This patient’s family seems quite reasonable. Don’t worry, uncle. , I know it well.”
Lin Yuming's persuasion was once again rejected by Luo Hao.
Bullshit, let’s let the facts educate him. Reason with him yourself, say one sentence and Luo Hao has ten sentences waiting for you.
Lin Yuming decided to speak with facts.
The first fact is that Luo Hao made a mistake in diagnosis.
After seeing the ghost of aortic dissection, Lin Yuming made up his mind and looked at the ordinary CT images again.
Based on his analysis of many years of clinical experience, the patient did not have aortic dissection.
After watching the movie, Lin Yuming thought fiercely about what he said.
"Uncle, there is a problem!"
Luo Hao's voice interrupted Lin Yuming's thoughts.
"Is there a problem? Where?" Lin Yuming looked at the 64-row aortography screen.
"Here." Luo Hao pointed his hand on the screen, "There is an aortic dissection aneurysm just where the ascending aorta exits the heart! It cannot be seen with ordinary CT, it can only be seen with 64 rows."
Lin Yuming He stared at the position of Luo Hao's fingers.
Sure enough, there was a less typical image of an aortic dissecting aneurysm.
Really!
Lin Yuming was not ashamed of what he said before. In front of his own nephew, everything he said was fart. Luo Hao could still laugh at him.
When he saw the aortic hemangioma, Lin Yuming felt his hands were a little numb.
Troublesome patients.
There are several types of aortic dissection, and type 1 is the most difficult to treat. Unlike other types, there is a high probability that it can be solved with a big effort, and the vascular department can do it.
The patient in front of me is the most difficult type of type 1 aortic dissection.
Dissection occurs just after the blood vessel leaves the heart. Even if an operation is required, the difficulty of the operation will soar.
Luo Hao got himself into big trouble.
Lin Yuming even felt a little gloomy in his heart. It would be better not to detect this kind of patient than not.
It cannot be found out that the patient died suddenly, but there may be a medical dispute.
But what if we find out...?
Elephant trunk surgery?
Not to mention the current mine managers, even the mine managers in their heyday couldn't do it.
Not to mention the mine manager, what about the hospitals in the provincial capital? Elephant trunk surgery is not a routine surgery for them.
Explain the truth to your family members. It’s easy to talk to someone who is reasonable, but if you encounter someone who is pretentious, the probability of medical accidents and medical disputes will immediately increase to more than 80%.
Just when Lin Yuming was stunned, he suddenly heard Luo Hao's voice.
“It’s me, your adoptive father.”
"Seriously, who is the teacher with the highest success rate in performing elephant trunk surgery in your hospital?"
"Hai, I don't change my original intention. I used to be called teacher, and I am still called teacher now. Unlike you, who used to be called teacher." My adoptive father wants to change his tune now that he has become the deputy director. "
It's all about this, Lin Yuming was filled with tears.
“I have a patient with type 1. The imaging data will be sent to you as soon as possible. The patient is not in good condition and needs to seize the time for surgery. The sooner the better.”
“ Teacher Han, am I embarrassed to trouble him? I think it would be more polite to ask you, forget it, I will ask Teacher Han.”
"Hang up."
With that said, Luo Hao hung up the phone.
"Who did you contact?" Lin Yuming asked.
"Director Choi Ming-woo of Anzhen."
Fuck!
Directors Luo Hao and An Zhen have such communication as foster father and foster son? Thinking back to Luo Hao's words just now, Lin Yuming's hands became even more numb.
"Uncle."
Luo Hao approached Lin Yuming and asked softly.
"What's the harm in holding it back? If you have something to say, just say it." Lin Yuming had a bad feeling.
"The patient's condition is critical. For aortic arch replacement surgery, at least 20 units of red blood cells and 1500ml of plasma must be prepared. As for platelets, it is best to have them."
Knowing that Luo Hao didn't hold it in well, Lin Yuming glared at Luo Hao fiercely.
"I'll contact the experts and communicate with the patient's family. These are all minor problems. But some big problems can only be solved by you, uncle. You see..."
Lin Yuming As soon as he heard Luo Hao call himself "you", he got headaches one after another.
……
……
"Comrade, I am Wen Youren, Director of the General Surgery Department of the General Hospital of Mines. I report my real name to the Director of the Medical Department, Lin Yuming, and the Director of the Medical Department, Luo Hao."
Wen Youren arrived at his destination holding a heavy amount of information.
After entering the house, he couldn't wait to get warm and explained his purpose directly.
Wen Youren is familiar with this matter because he has done it before.
Many years ago, an old director who was as famous as Wang Guohua always looked down on Wen Youren, and Wen Youren held a grudge against him.
After retiring, the old director did not return to the mine. Instead, he went to a private hospital and used his technical skills and connections to attract many patients.
The anesthesiologist in the private hospital is served by his wife who does not have the scope of practice of an anesthesiologist.
This was Wen Youren's breakthrough. He patiently collected information on dozens of surgeries, and finally reported it with his real name, knocking the old director who offended him to the ground and stamping on him several times.
In Wen Youren's opinion, the old director at that time was so arrogant that he went to a private hospital and asked his wife to undergo anesthesia in order to earn a higher income, which violated medical principles.
I am on the side of justice.
This moment is like that moment.
For his own personal gain, Luo Hao used drugs beyond the scope of the drug and gave patients iodized oil that was not written in the instructions and could be absorbed into the blood.
This is a pest in the medical world! Worms! Must be cleaned up.
In the thick information, there are instructions for iodized oil, the operation records of Luo Hao's surgery, and medication records.
Wen Youren has been collecting this information for a long time, but it has never been revealed, just for today's thunderous strike.
Report with your real name, even if someone wants Paul Hao, you can't protect him!
Wen Youren held the materials with a smile on his face.
It’s just that his cheeks were frozen, and his imaginary smile was a little ferocious, like a hungry wolf in winter.
……
……
Luo Hao's cell phone rang.
Answer the call, it’s the emergency department nurse.
The patient reported a critical value, but the reason why it was delayed was that the laboratory department felt that the value was too outrageous, so they re-examined it, which delayed the time.
Hemoglobin 38g!
Before the operation, a blood transfusion was needed.
This time, not only Lin Yuming, but also Luo Hao felt a splitting headache.
The hemoglobin level must be at least 70 before surgery can be performed. Luo Hao scratched his head.
"I'll talk to the patient's family." Luo Hao sighed.
If you want to make trouble for yourself, you can’t blame others.
The patient's family members indeed suffered a fracture. He was hanging in front of him with a plaster cast and was sitting in the emergency room waiting worriedly.
Luo Hao called him out when he came back.
"Your mother's condition is like this." Luo Hao first briefly talked about the patient's condition, and then said, "Now the hemoglobin is too low and a blood transfusion is needed."
After hearing about the blood transfusion, the patient's family members His eyes lit up.
"Doctor, I have 12 blood transfusion certificates!" said the patient's family, "I can have free blood transfusion! This is not a problem."
Gan!
Luo Hao cursed in his heart.
Is it that simple? joke.
But the more this happens, the more difficult it is to explain to the patient’s family.
Luo Hao looked at the progress of the system tasks moving forward little by little. Wouldn’t it be better to win by lying down? Why treat such a difficult patient?
The thought flashed in Luo Hao's heart and then dissipated.
If the patient still has a glimmer of hope, it must lie with him.
The only person in the entire mine who can recruit such a difficult elephant trunk surgery in a short period of time is himself.
Forget it, Luo Hao sighed deeply.
"That's right." Luo Hao explained.
……
Note: At this point, I still have to wail.
On duty a few days ago, another patient vomited blood. For emergency treatment, the director was shaken from home to contact the center, and he communicated with the gastroenterology department to perform ligation to stop the bleeding at any time.
After the patient's condition stabilized, he smoked and chatted with the director. The director said that 80% of patients in the department who vomited blood rushed to my shift.
Shrugging shoulders, spreading hands, looking at the sky.
No way, this is metaphysics.
When I was in the Department of Thoracic Surgery, in 15 years, 8 patients with rib fractures complicated by aortic dissection were handled by my shift.
Misdiagnosis of this rare complication is almost equivalent to death. I have never seen other patients with rib fractures die suddenly, so it is basically certain.
However, I diagnosed all 8 patients with ordinary CT scans.
One of the cases was not obvious. I had my face scanned in the middle of the night, and I consulted with my most trusted CT doctor and looked at the film to get a confirmed diagnosis.
I really can’t help it. Maybe after I retire, the number of emergency rooms in our hospital will be less.
Sad.
(End of this chapter)