Among them, the first-diagnosis responsibility is to avoid pushing the patient to run here and there.

The essence of the consultation system is actually to collaboratively diagnose and treat illnesses, and to hand over specialist issues to specialist doctors.

It is absolutely correct that this patient must require emergency surgery. However, if Lu Cheng and Chu Lin did not write consultation records, there would be no consultation records and opinions except for any related department issues.

No matter how perfect you are on the operating table, no matter how painful and tiring it is, if you make a mistake in the first step, it is all fake and you are completely responsible for it!

It will not count if you ask for a consultation.

Basically, people who often go to consultations will not make mistakes, but it does not rule out that they encounter some newbies, or people who are not familiar with the core system, and they are often taken over in this way.

This can range from fines and interviews to serious consequences of license revocation.

This is the biggest difference between being a doctor and being a student.

If you practice alone and are solely responsible, you need to take full responsibility for what you do, unlike when you are a follow-up physician or a bedside physician, where the superior physician is generally responsible.

These are all aspects of growth on the road to becoming a doctor.

So even if their condition is extremely urgent, Lu Cheng and Chu Lin can only finish writing the medical records first, and then call someone to arrange surgery and other matters. Lu Cheng quickly finished writing, and then started to call the doctor on duty in his department, asking him to call the emergency doctor.

The consent form for the surgery was ready and he would go up to get it later.

Lu Cheng only needs to be responsible for conversations related to the orthopedics department. He does not need to take care of other departments at all and cannot control them. However, if there are no family members now, he can only call the general manager on duty for authorization first, step down or the family members arrive, and sign as soon as possible!

Lu Cheng quickly finished writing the consultation record and handed it to the elder brother in charge of the bed. He said, "Teacher, please send the patient to the emergency operating room. I will prepare the materials. If the family members come later,

, please also ask him to be at the door of the operating room, and we will talk to him then."

"Thanks for your hard work."

After Lu Cheng said this, he was going to the operating room to prepare for emergency surgery.

But at this moment, another voice about him came from the outpatient clinic outside the emergency care unit.

"Another patient with trauma from a car accident came in. He seems to have a dislocated hip joint."

"Call an orthopedic emergency consultation." This seemed to be what a doctor outside said to a subordinate or a nurse. Because he also needed to perform other operations, the emergency consultation call could only be left to other people.

However, someone outside said: "Dr. Liu, it seems that the chief resident of the Department of Orthopedics is seeing patients in the intensive care unit of our emergency department."

"That's the patient in bed 3 with multiple injuries all over his body."

"It's quite serious. This?"

Doctor Liu said: "Then you go and pull out the film and ask him to take a look. This patient has no skin trauma for the time being. I will explain it to him first and then listen to what treatment needs to be done. I will then take a look at his chest, abdomen and

Is there any head injury?"

Two overarching principles of emergency medicine.

Save your life first.

The bottom line is to save your life!

"Okay!" The nurse walked in quickly.

After hearing this, Chu Lin smiled and said: "Your orthopedics department is quite popular, here comes another one."

"Brother Lu, I'm leaving first. I'm going to the operating room early."

Lu Cheng nodded, but before he could say anything more, a nurse from outside the door walked in.

"Are you the chief resident of the Department of Orthopedics? Dr. Liu from the outpatient clinic asked you to take a look at this film. It just came out. The patient's feet are very swollen and he can't move. Do you have time to take a look?" The nurse in green clothes walked up to Lu Cheng.

, after speaking quickly, he pointed at the computer at the nurse's station.

But his expression was quite polite.

There is a certain time limit for the development and printing of plain films, CT, MRI and other examinations, so each hospital will have an independent reading system. As soon as the examination is completed, the pictures can be read by computer.

However, this kind of film reading is mostly used for emergency patients, so that the doctor can understand the condition at the first time.

The nurse just called Mr. Lu Cheng in the hospital. Firstly, he was not very familiar with the orthopedic doctor system, and secondly, he wanted to avoid being polite.

She has to take charge of at least a dozen emergency patients a day, and each patient is even visited by three or four doctors for consultation. If every doctor is polite, she will be exhausted. Over time, the chief resident, teachers and doctors will all come to visit.

Replacement.

It's not that I disrespect Lu Cheng.

"Okay, I'll go take a look first. I don't know when I can go on stage yet." Lu Cheng followed immediately.

When I came to the computer and took a look, a plain film was read out.

Posterior hip dislocation, looking at age, 54 years old, male.

This kind of medical record is very suitable for emergency manual reduction, but Lu Cheng does not make empirical or operational errors.

One of the charms of orthopedics is manual reduction. There are many patients who are in great pain when entering the hospital. Their pain may be immediately relieved through manual surgery. Some even enter the hospital lying down and walk out after ten minutes.

However, empirical mistakes must not be made.

Lu Cheng continued to look through all the layers of the CT, but found no signs of fracture. After reading it, he asked: "How is the patient's consciousness now?"

"Do you have a headache, chest pain, or abdominal pain?"

"If not, I will directly print a template for hip dislocation reduction surgery and send it to the operating room."

The nurse shook her head and said: "I don't have any headaches, chest pains, but Dr. Liu and the others are still watching relevant films. I think you can prepare a consent form for the conversation first. If there are no problems with Dr. Liu, I will send him to emergency surgery first."

room."

"Then I'll call you after the anesthesia is completed. This patient can just be sent to the emergency operating room, right?"

"Well! I also have a person who does incision and exploration to stop the bleeding. It may take a while. Just send it to the operating room and do spinal anesthesia. Then remember to ask Teacher Liu to tell the anesthesiologist and add some muscle relaxants. Wait a moment.

Call me and tell me which operating room to go to, and I will take the time to go and do the reset." Lu Cheng explained.

After posterior hip dislocation, muscle relaxants must be added because the pain will cause muscle tension behind the hip.

"Okay!" The nurse in charge didn't ask specifically why. She just felt that Lu Cheng was a little pitiful. The last emergency patient hadn't been dealt with yet, and a new one came. And it was very late to get to this point, unless he called his superiors.

Help, otherwise no one will help you.

She was in the emergency room, and if she had to ask about every medical order given by the doctor, many patients might die.

Unless she can find a particularly serious mistake.

Of course, this chance is very small.

After this, Lu Chengcheng was really busy. He quickly found a computer and printed out two consent forms for the surgery.

The surgery consent form only states the name of the surgery, complications and risks, and the patient's basic information has to be filled in by hand. Because the patient is not hospitalized, it cannot be uploaded to the medical record system.

One part was debridement and exploration, and the other part was manual reduction.

I thought I could go to the operating room after having a talk with the family members of the hip joint reduction surgery. What I didn’t expect was that just when Lu Cheng finished talking and was about to enter the operating room, another middle-aged couple ran in from outside and hugged each other.

Holding a child who cries incessantly.

The child was at most three or four years old. One of his hands was drooped, and his mother was holding his hand. The child's face was crying, his eyes were red, and he was crying and feeling aggrieved.

The nurse immediately asked the man to register first and his wife to take the child to the clinic first.

The woman ran and shouted: "Doctor, doctor, show my baby quickly!"

"He suddenly couldn't lift his hand. What's going on?" It could be seen that she was very anxious and wanted help impatiently.

There were three doctors in the outpatient clinic, and the one who received him was Dr. Liu.

When he saw the person coming, he glanced at Lu Cheng helplessly and said, "You want to take pictures first! How did you get hurt?"

"I took my baby shopping, and I pulled him, and he suddenly started crying and fussing."

"No matter how hard I hug or coax, I won't listen. I just say my right hand hurts. Is this serious?" she immediately replied.

It was a very unprofessional reply, but it was indeed a bit embarrassing for the patient's family to tell the story in professional terms in a very rigorous manner.

Dr. Liu had almost made a decision in his mind, but Lu Cheng was here, so he had no choice but to say to Lu Cheng: "General Hospital of Orthopedics, you'd better come and take a look and see if you need photos and processing?"

"I write medical records!"

It's not that he is lazy or shirking responsibility, it's just that since Lu Cheng is here, naturally he has to ask Lu Cheng's opinion.

After listening to the medical history, Lu Cheng basically had his own diagnosis in mind.

Radial dislocation, photos may not be helpful, diagnosis is based on history and physical examination.

Lu Chengcheng immediately put the conversation list on the table, then went up and touched the child's elbow.

The child was crying and hiding, and while retracting his right hand, his fingers wanted to grab Lu Cheng, crying: "I don't want it, I don't want it. It hurts, I don't want it."

In fact, Lu Cheng's hand had already touched his elbow, and his eyes had confirmed through his finger movements that there was no temporary nerve damage, and his hand could still be retracted, proving that the possibility of a fracture was unlikely.

Just confirm the tenderness at the radius again.

And at the same time, as long as you hold the wrist with one hand and the elbow with the other, hold the radial head with your thumb, and rotate the forearm from extension to flexion of the elbow joint, you can reset the dislocated radial head.

He said: "Kid, let me check again, just for a check, okay?"

The child looked at Lu Cheng without wearing a white coat, as if he had found someone of the same kind, and nodded while crying: "I'm afraid of pain."

But just as he finished speaking, Lu Cheng heard a slight click.
To be continued...