Chinese medicine: When you do things to the extreme

Chapter 231 Is this how you serve as a hospital resident?
Two o'clock in the morning, in the main inpatient office.

There was tin foil on the wooden dining table, which still had wrinkles even when flattened. Inside the foil, the chili sauce made of chili peppers, chopped green onions, and mashed garlic exuded a rich aroma.

There are also hot stews such as cabbage, duck feet, and beef tripe mixed in.

Two pairs of chopsticks kept rising and falling, and the smacking sounds made an alluring sound.

Lin Yuxuan took a long sip of Oriental Leaf's jasmine tea, and then heaved a long sigh: "Yanqing, this day is so great!"

"It would be even more refreshing if we could have some beer." Lin Yuxuan did not reply, but followed Zhou Yanqing all the way.

If there is an emergency, he will go to the hospital; if there is no emergency, he will wait. Occasionally, he will go to the training room to practice his skills, and occasionally ask Zhou Yanqing for some tendon sutures within his ability.

A few days passed and it remained the same.

"Brother Xuan, please buy a few bottles. I can't drink on duty, so it's okay for you to drink some!" Zhou Yanqing particularly liked the spicy ginger chicken feet in another box today.

The soft and glutinous chicken feet, fried with ginger, are really cooling.

Zhou Yanqing didn't care about the folk saying that eating ginger late at night is like arsenic. During the hospitalization period, he had time to eat, replenish energy, and supplement protein, so he should be content!
Today is October 12th, Zhou Yanqing's fifth day as chief resident, and he has not eaten on time for two meals!
After not being with Ban Ning for a long time, Zhou Yanqing forgot the general rules of hospitalization.

Eat as much as you can, sleep as much as you can.

Not picky about the environment or food, just supplement protein when you have time!
"No, Brother Lin, I know better than you how I was hospitalized."

"Yanqing, it's hard to ask for help."

"Medicine is not an industry where you can get by easily once you enter the industry. Once you enter the industry, it will be even more difficult to ask for help from others!" Lin Yuxuan's voice was full of emotion, as if he had experienced the ups and downs of human nature.

In other industries, you can be lazy and do whatever you want if you have connections, and if your connections are strong enough, your separation from your boss will worry more than someone else being shot three times.

But medicine is not like that.

No one will be willing to accompany you on the verge of life and death for a patient. Do it if you can, and get out if you can’t.

No matter how strong your background is, you can't play with a few lives "openly"!

Zhou Yanqing spat out a mouthful of bones, then pinched the leaves of the Dongfang tree and stuffed them into his mouth, not caring about hygiene.

His biological clock had been disrupted by several emergency surgeries two days ago, so he went to bed immediately after eating.

"Brother Lin, it's even harder not to ask for help!" Zhou Yanqing replied soberly.

Lin Yuxuan was stunned when he heard the words, and instantly looked at Zhou Yanqing in surprise, as if he had been enlightened.

Yes, it is difficult to ask for help from others, but at least you know who you can ask for help.

There are only two reasons why you don't need to ask for help from others. There is no one to ask for help from, and it is more difficult to not need to ask for help from others than to ask for help from others!

Many people can only understand the first point and ignore the second point of the second point.

If you want to not rely on others, you must have more accumulation and more output than others. Only then is it possible!
After Zhou Yanqing finished speaking, he picked up another portion of fried and braised beef tripe and stuffed it into his mouth.

The old-fashioned resident's cell phone on the table behind him started to ring!

Zhou Yanqing continued to feed with his right hand, and quickly pressed the answer button with his left hand along his upper body.

The other party was even more anxious than Zhou Yanqing. Before Zhou Yanqing could even say hello, Brother Liao Fan from the emergency surgery clinic came over with a hurried voice: "Yanqing, here comes a person with a severed finger. Come here quickly."

Thanks to sister Huang Yaqin's strong recommendation and Zhou Yanqing's considerate treatment of him for coffee a few times, Zhou Yanqing became quite familiar with several big brothers in the surgical clinic.

Zhang Liaolong, chief of gastrointestinal surgery, Chen Xiao, chief of thoracic surgery, Huang Yaqin, chief of hepatobiliary surgery, and Liao Fan, chief of geriatric surgery, are the four major doctors on duty in the emergency surgery clinic.

Zhou Yanqing put down his chopsticks and chewed the tripe vigorously. He stood up and reached for a tissue: "Brother Lin, do you want to continue?"

"If you don't follow me, I'll call someone."

Lin Yuxuan lowered his head and started eating: "Yanqing, you go first, I'll eat two more slices of cabbage and come down, it's very quick."

"Very hungry!"

Zhou Yanqing is the chief resident and he is his follower, so they have relatively more time for meals.

"Okay!" Zhou Yanqing didn't say anything more. Before he even swallowed the tripe in his mouth, he picked up his white coat and ran out to the resident office.

He put on his white coat while running, and buttoned it up when he reached the elevator door.

After arriving at the emergency surgery clinic, the doctor who severed his finger was a middle-aged man in his forties, who was also a night shift worker.

The middle finger and ring finger are severed. The nurse in the emergency department is drawing blood in the emergency room for routine preoperative preparation.

When Zhou Yanqing arrived, Liao Fan was talking to another old lady who had abdominal pain. The other party spoke in Shaoxing dialect, which Liao Fan could not understand, and the other party did not understand Mandarin very well. The old lady's daughter was still on the way...

Zhou Yanqing himself could not understand the dialects of many places in Hunan Province.

He did not act as an interpreter, but asked, "Uncle, have you ever had underlying diseases such as high blood pressure and diabetes? How is your health? Have you ever had a physical examination?"

Routine simple medical consultations are a must, especially for heart disease and lung disease, as they are the key to deciding who will perform the anesthesia during the operation.

If there are contraindications to surgery, even replantation of severed fingers will have to be shelved!
Compared to losing your life, losing your hands is insignificant!
"No, I don't have those diseases. I'm in good health usually. It's just that my right arm hurts a little occasionally. It's an old problem." The uncle should have woken up from the numbness after the partial finger amputation and started to feel pain, so he gasped when he spoke.

"You definitely need emergency surgery. Have you notified your family?"

"Even if your family members are not here, you have to sign yourself. If you don't sign, you have to put your fingerprints on it! The sooner the better." Zhou Yanqing said when he saw that the patient was injured in his right hand.

"okay!"

"The supervisor of our factory said that I will advance part of the medical expenses and the insurance company will come to pay when the time comes."

"I don't have much money in my card now." said the middle-aged man.

"It doesn't matter. Just pay as much as you can first. You must pay some in advance!" Zhou Yanqing quickly recorded.

"You!~" Zhou Yanqing had just asked this question when a very hurried sound of a cart being pushed was suddenly heard outside the door.

Moreover, loud shouting was heard outside the emergency department.

"Massive bleeding from the femoral artery!~"

"The patient is in shock!"

"The emergency room is over here!" From afar, there were responses from people in white coats and nurses.

The loud shout startled Lin Yuxuan who had come running behind him, and he quickly turned around.

Zhou Yanqing paused, stood up and said bluntly: "Brother Lin, come over here and talk to the patient and get his signature!"

Lin Yuxuan quickly walked over and said, "Yan Huanyu is still on the stage. This is a massive hemorrhage in the femoral artery. If the bleeding is not stopped in time, he may die."

“It’s an emergency hedge.”

Lin Yuxuan was afraid that Zhou Yanqing would continue to sit back and relax, so he said this in advance.

He has followed Zhou Yanqing for a long time. Zhou Yanqing would only take action under very coincidental circumstances. Before the other party's specialists arrived, Zhou Yanqing would mostly want to drag someone into the water.

For example, Professor Tong Nan from the Department of Emergency Surgery, or Professor Li Gang.

Zhou Yanqing didn't reply, but walked straight out. He quickly took out the examination gloves from his right pocket, put them on, and started to run diagonally to the side of the cart, quickly taking a look at the patient's basic condition.

The patient had a metal body injury in the lower abdomen, with a small amount of metal fragments remaining.

On the front of the right thigh, near the groin, there was a blade-like steel piece embedded in the skin, covered with a large amount of clothes, a sterile cotton pad soaked in blood, and a gauze pressure bandage.

Emergency compression was used to stop bleeding.

But at this moment, after the blood had soaked through the pressurized layer that was more than ten centimeters thick, it was still slowly seeping out...

Zhou Yanqing had the gloves on his hands just right, and because he moved so quickly, the backs of his hands were hit by the rubber gloves and hurt.

Moreover, Zhou Yanqing reached out to the bottom layer of the gauze without much hesitation, and seeing the look in the eyes of the 120 doctor pushing the cart, he explained in a low voice: "I am the chief resident of the orthopedics department!"

Zhou Yanqing is the chief resident of hand surgery and also one of the chief residents of orthopedics. He can work on behalf of the orthopedics department. As long as Dean Lei of the orthopedics department does not sell him out, he can take all emergencies within the scope of orthopedics' business!

This is what Tan Zhongyu told Zhou Yanqing.

Because, in the scope of surgical practice, there is no distinction between hand surgery and trauma surgery. The Health Commission only has the scope of practice for internal medicine and surgery. In the hospital, there is only the scope of practice for orthopedics and non-orthopedics.

"The femoral artery is ruptured, but I don't know about the femoral vein. I don't know anything else."

"Left anterior tibial artery ruptured!"

"Injured in a car accident." One of the people in green clothes did not reach out to stop it, but quickly reported the situation to Zhou Yanqing.

In Xiangya Hospital, no one dares to act as the chief resident of other departments!
No one dared to wear a white coat and pretend to be a doctor here, or to make a joke of pretending to participate in the emergency.

Once such a joke occurs, it is a serious violation of the law, written in the criminal law...

Zhou Yanqing lowered his head and lifted the innermost layer of gauze, and a small amount of blood spurted out.

In just a moment, his white coat was "temporarily destroyed" again!
Zhou Yanqing ignored him and reached in with his right hand.

……

Hemostasis is a general hemostasis technique. In addition to compression hemostasis, there are many other hemostasis techniques, such as electrocoagulation hemostasis, drug hemostasis, and manual hemostasis.

If we have to break down the nature of hemostasis, gauze pressure bandage, manual hemostasis by clamping, and instrumental hemostasis by hemostatic forceps are all mechanical hemostasis and have the same nature.

Hemostasis is not the most basic skill in hand surgery. Zhou Yanqing did not practice it deliberately, but only passively improved to a very high level.

When one reaches the expert level in hemostasis, one can stop bleeding with bare hands. Even if one is not the best in the whole hospital, at least one can do something useful, at least one level higher than the general resident level!
"No more bleeding?" After Zhou Yanqing finished the operation, the blood stopped immediately, and the other party in green clothes was stunned. He was originally pushing the cart, but he was dragged away by the cart for two steps before he regained his strength.

"Professional!" Zhou Yanqing took a deep breath and felt a very tough tube-like object between his thumb and index finger being pushed constantly, trying to escape from his grip.

At the distal end of the thumb and index fingertips, blood pushed by the beating heart sprayed on the blood vessel walls in waves, while also squeezing Zhou Yanqing's fingertips!

Zhou Yanqing didn't move at all.

……

The emergency department's emergency room is managed by two very senior life support experts, Professor Li Xiangming and Professor Li Gang.

Professor Li Xiangming is in charge of rescue area one, and Professor Li Gang is in charge of rescue area two. Today it is the turn of rescue area two to take over the intensive care unit.

Therefore, when the 120 ambulance doctor shouted, Dr. Zhang Mu, the deputy chief physician who followed Professor Li Gang, ran out of the emergency room.

He walked quickly in that direction and turned back to shout, "Vascular Surgery, Trauma Surgery Consultation!"

“No need for that.”

"Debridement pack, hemostatic forceps!"

"Present gauze. I need a lot of gauze and saline solution!" Zhou Yanqing instructed Deputy Chief Physician Zhang Mu very calmly after seeing him.

Zhou Yanqing knew Zhang Mu, but Zhang Mu didn't know him.

But this did not prevent Zhang Mu from being a very professional emergency doctor. He stopped, turned sideways, grabbed a cart violently, and rushed over here.

There was no aseptic principle, no other concerns, and he just used his bare hands to violently apply the debridement pack!
The hemostatic forceps and stainless steel basins inside were running around.

"The gauze is on the way. Has the bleeding been stopped temporarily?" Zhang Mu asked.

"It's stopped." Zhou Yanqing replied. He didn't care about the principle of sterility. He directly picked up a large hemostatic forceps and inserted it with his left hand.

Zhou Yanqing chose to clamp the hemostat only after the outer curve of the hemostat was in contact with the tip of his finger.

The reason for this is that the professor of trauma surgery told him after a previous hemostasis was completed that if the outer curved side was not close, Zhou Yanqing's subcutaneous cells and tissues might have been pinched to death!

Zhou Yanqing has a deep memory of these details.

After a click, Zhou Yanqing slowly loosened his right hand, and then used the back of his hand to slowly push away the many layers of gauze and clothes on the back of his hand.

A small amount of blood was still oozing out of the wound, but this was definitely not a ruptured artery!

"Just put some gauze back in and continue to apply pressure."

"I'll go check the anterior tibial artery of the other leg!" Zhou Yanqing didn't care about his identity and directly ordered Zhang Mu.

Zhang Mu nodded quickly, not caring about Zhou Yanqing's age: "Okay!"

Hemostasis at the anterior tibial artery is much simpler than hemostasis at the femoral artery.

Because it is relatively superficial and easy to find, just clip it closed!
If it doesn't work, you can use a rope to directly tie the upper part of the calf to stop the bleeding.

Half a minute later, Zhou Yanqing retreated.

He tilted his head and whispered in Zhang Mu's ear, "Director Zhang, please call the chief resident of the trauma surgery department and ask him to handle the follow-up."

"I'm a hand surgeon. There's another severed finger over there."

"In our orthopedics department, emergency consultations may be conducted in shifts in the future, so the order we have received is to treat it whenever it occurs," Zhou Yanqing explained.

"What's your name?" Zhang Mu was still flushing the patient's wound, trying to find small blood vessels to temporarily stop the bleeding, while looking back.

"Hand Surgery, Zhou Yanqing." Zhou Yanqing was already taking off his gloves and white coat.

There was still blood on my clothes, so I guess I would have to change them again later.

Zhou Yanqing sighed. This was something that Brother Ning Zhu had not mentioned before.

Being in the hospital always costs money on your clothes and wallet.

If I have to be hospitalized like this all the time, I won’t be able to make ends meet even if I lose a month’s salary!

"Okay, I remember."

"Awesome!" Zhang Mu tried hard to squint his eyes and praised with two words, not daring to say any more.

Zhou Yanqing turned around and went back.

(End of this chapter)