medical simulator

"It's impossible for the child to have multiple traumas, and I checked his healthy and affected sides, and I don't support ligament laxity."

"If it wasn't caused by epilepsy, it could only be due to abuse, but I don't think this is the reason for the family's love for their children."

"It may be difficult for the family to accept."

Du Yanjun nodded upon hearing this.

Zhou Cheng's explanation is relatively clear, but what Du Yanjun still doesn't understand is: "Brother Zhou Cheng, why didn't you explain this just now?"

Zhou Cheng sighed and said, "Actually, it's useless to explain so much. The best way to treat habitual dislocations is through arthroscopic surgery in sports medicine. Our hospital doesn't even have arthroscopic equipment, so we can't do it at all. "

"And if the primary disease is epilepsy, the child will eventually be transferred to the Second Affiliated Hospital of Shonan University or the affiliated hospital. We can't see it here, so don't waste their time."

"Otherwise, I don't need to say so much."

"Give them a nerve electromyography directly, and let them get the result before going to other hospitals to see it."

It's hard for a smart woman to cook without rice. The No. [-] Hospital has no sports medicine equipment, and there is no neurologist who is extremely professional to treat epilepsy. Naturally, it is better not to waste their time.

It's hard to accept to say more, but at least it can give them a preliminary impression. In the end, as long as one person cares, or mentions more, the experts and professors at the Affiliated Hospital of Shonan University or the Second Hospital will definitely understand. Take it to heart.

There was only so much Zhou Cheng could do.

……

After sending the patient away, Zhou Cheng called Luo Yun again and talked about it.

The reason why I want to report to Luo Yun in advance is to explain the situation and my own diagnosis ideas, and the second is that it is hard to say whether the patient and family members will go to the medical department to complain first or go to other hospitals first after they leave the department door.

Give Luo Yun a vaccination first. If there is a complaint, Luo Yun should have a plan to deal with it, so there won't be so many troubles.

After Zhou Cheng finished explaining, Luo Yun said: "Zhou Cheng, you are right, but there is one thing that you still have to work hard on."

"You call the outpatient department and ask them to check the phone number bound to the child's outpatient card, record it, and then call and follow up in one to two hours. Ask where they are. Is it the child's family!"

"At the same time, if you borrow a second mobile phone to record, you must confirm the identity of the other party, and explain carefully that the family members of the patient are required to take the child to another hospital for follow-up visits."

After Zhou Cheng listened, he nodded instantly——

Jiang is still old and hot, this call is not wrong.

As a doctor, you must be cautious. Although patients can choose not to trust doctors, doctors are still obliged to follow the patient's whereabouts, and to do all their suggestions.

This is for the patient's consideration, and it is also for self-protection, leaving an objective evidence, so that even if something goes wrong.

Then the family members of the patient have the right to choose freely as a Chinese citizen and to refuse the doctor's advice.

However, doctors have fulfilled their obligations, and it is impossible to infringe on citizens' right to freedom of choice.

The responsibility is not on oneself.

"Okay, Mr. Luo, you are more careful and thoughtful." Zhou Cheng quickly replied.

"It's not careful and thoughtful, it's all a lesson of blood and tears."

"In the past, when I was a graduate student, I was in the emergency department. There was also a college student who was brought to the emergency department by his parents. At that time, the teacher said that it might be an ectopic pregnancy. The patient's family members didn't believe it, and they made a big fuss in the hospital. Cracked and died."

"The teacher didn't leave any objective evidence, and the patient's family members directly accused him of misdiagnosis."

"Besides, the patient's family members were emotionally unstable at that time, and they didn't even have time to write the medical records, and they didn't dare to write them." Luo Yun gave Zhou Cheng an example.

"Okay, Mr. Luo, I understand." Zhou Cheng shuddered and remembered this matter in his heart.

"I'll call the Security Office again, and I must be fully prepared." Luo Yun also sighed with emotion, and then replied.

……

After Zhou Cheng had done everything according to Luo Yun's instructions, he finally felt relieved.

He borrowed Du Yanjun's phone to call the patient's family, and the phone that recorded it was his own, because if he used his phone to record, the other party might be found.

I just hope that this recording is not used.

Fortunately, Zhou Cheng was on the phone and got a reply that the other party had brought the child to the Affiliated Hospital of Shonan University.

Zhou Cheng called to worry about the child's situation, so although the other party's attitude was still lukewarm, he didn't get angry with Zhou Cheng again.

After all, none of them thought that Zhou Cheng would call to ask such an extra question.

……

at the same time.

Right at the entrance of the Emergency Department of the Affiliated Hospital of Shonan University.

Liu Suolong then said to his mother: "Mom, don't even think about reporting on that Doctor Zhou from the Eighth Hospital, he is also kind."

"Otherwise, there's no need to call us again and tell us what we must go to the hospital for."

Li Mengxiang, who is also Liu Suolong's mother, scolded in a low voice: "He is a guilty conscience, did my Qiqi provoke him?"

"The mouth is not clean."

"Epileptic epilepsy, his whole family is epileptic, so he talks like that."

"Go and see quickly, have your dad and the others registered? Your dad is also frizzy in his work. I'm really worried."

But before Li Mengxiang finished speaking, Liu Dashan and his in-law Zhu Yongzhi walked over, and then hurriedly said: "It's registered, the nurse told us to go to the emergency department."

A group of people hurried to the emergency department.

When the emergency surgery doctor saw it, he immediately frowned, feeling that something was wrong, took a look at the X-rays and reports from No. [-] Hospital, and immediately called the chief inpatient of the Orthopedics Department.

It took more than ten minutes for the general hospitalization of the orthopedics department, and he rushed to the emergency department wearing a green hand sanitizer, probably just off the operating table.

After seeing the results of the child's examination at the emergency department, he gave the child another physical examination.

Immediately, he frowned fiercely and asked, "Such a situation like yours must have happened before, right?"

The child’s mother, Zhu Qingqing, said the same thing as the little doctor in the No. [-] Hospital, “Yes, it happened a few times before, but it returned to normal after a while, neither crying nor fussing, I thought there was nothing wrong. "

"I took a nap today, and it's like this. I saw something wrong, so I hurried to the hospital for a look. I went to the No. [-] Hospital first, but I didn't see it, so I came here."

The chief hospital officer in green clothes nodded and said, "It's not too late, this is a recurrent shoulder dislocation, and it's also a habitual shoulder dislocation."

"Let's take an MRI first. For recurrent shoulder dislocation, there must be lax ligaments or structural insufficiency, which cannot be shown on this film."

After speaking, he immediately said to the doctor on duty in the emergency department: "Mr. Du, thank you for prescribing an emergency MRI for the child. After the scan, I reset him and fixed him early."

"Children's habitual shoulder dislocation should be done early, and the plasticity is quite strong."

Du Daixiong is the attending doctor of the emergency department, one level higher than Li Yong, the general resident of the orthopedics department, so Li Yong is called Teacher Du Daixiong.

However, Du Daixiong is only a doctor of emergency surgery, and he is definitely not as professional as Li Yong in orthopedics, so he said: "Okay, then I will mark it on the checklist to see if the radiology department can do it in advance."

"Li Yong, arrange for someone from your department to come over and talk. I'll send you to the operating room of the emergency department from here."

"Okay." With this in mind, Li Yong decided on the diagnosis and treatment.

……

Two hours later, Liu Suolong's family finally took Liu Qiqi out of the MRI room of the emergency department, and hurried back to the emergency surgery clinic.

Then I found that the general inpatient of the orthopedics department was still here for another patient's consultation. I was overjoyed and hurried forward and said, "Dr. Li, we have finished the MRI, but it takes two hours to get the report. It won't be printed until tomorrow."

"Look, are we going to be hospitalized now?" Liu Suolong looked at Li Yong helplessly, hoping that Li Yong could help him think of a way.

"I don't need to wait for the report, I just need to watch the film!"

"The film will be in the film reading system after you have taken the MRI. Wait a moment, I will issue a hospital certificate for this patient." Li Yong was writing the emergency medical records at this time, but he still politely replied to Liu Suolong .

"Okay, okay." Liu Suolong immediately became overjoyed.

If I hadn't met Li Yong, I guess I'd have to wait a long time.

Five minutes later, Li Yong issued a certificate of hospitalization, and asked the fracture patient in the emergency surgery department to be hospitalized in the first ward of the orthopedics department under the guidance of his family members.

Then I found a computer, turned on the film reading system, and watched it for 2 minutes.

Liu Suolong's family waited quietly, Liu Suolong and Zhu Qingqing both approached them curiously, but unfortunately they knew them from the black and white NMR, but they couldn't understand those things.

Seeing that Li Yong had almost finished watching the movie, he asked eagerly, "How is it, Doctor Li?"

Li Yong glanced at the child and guessed that there was no need to avoid the patient, so he said directly: "Sure enough, the biceps tendon, the subscapularis and the supraspinatus of the rotator cuff all showed relaxation."

"The structure formed by these tendons is the rotator cuff, which is equivalent to a fixation device for the shoulder joint."

"It's like the door in our house."

"The rotator cuff is the hinge that holds the door."

"When the hinge is stable, the opening and closing of the door is just right, and the door will not fall, but when the hinge is loose, the door will directly fall to the ground and cannot be closed tightly. It is your child who is out of position."

"You can lift the door once in a while, and it can close again, but because it is not stable, it will fall down again when you open it. This is the habitual dislocation of your child."

"If he's older, then the only option is to fix the hinge and have an operation."

"But now that he is young, he can fix his shoulder joint after manual reduction, and his tendons can grow again. There is no need for surgery yet."

"This kind of reset, we don't even need to go to the operating room to do it, just go to the department or the emergency department."

After Li Yong explained this, he still said: "You guys should go to the department. After you go to the department, it will be easier to deal with the follow-up. After all, it has to be fixed."

Li Yong's explanation was easy to understand, and Liu Suolong and the others understood it, and immediately breathed a long sigh of relief.

Liu Suolong immediately bowed to thank him: "Doctor Li, thank you, thank you."

"Thank you so much, I will work hard for you."

Li Yong said: "It's not hard work, it's what we should do. You are lucky, I happen to be on duty today. If the other general hospitalists are on duty, you may have to go to trouble, they will call again Call me to see."

"I'm a joint surgeon."

"By the way, after the treatment is over, you must remember, don't let the child get injured again? After the reset, if you get injured again, if the ligaments and rotator cuff tendons haven't grown up, it's easy to dislocate again."

"You go to the department first, I'll be here in a while."

"Okay, okay!" Liu Suolong and Zhu Qingqing immediately lost their hearts.

Smiling, remembering what Du Yanjun said when he was talking to them in the No. [-] Hospital, he shook his head.

It's really ignorant people who make things happen, but it didn't scare me to death.

……

It was almost time to get off work, and Li Yongcai returned to the department, and then printed a template for the conversation and signature of joint dislocation manual reset. After issuing a doctor's order, he asked one of the family members to pay the fee.

Then they talked and signed with other family members.

For 15 minutes, the family members were very cooperative, and Li Yong also talked about the points and risks that should be discussed.

Just say: "Okay, that's about it."

"Precautions, you must pay attention. Don't get hurt again."

"You take the child to the dressing room first, and I'll prepare something, and then I'll come over and reset."

After speaking, Li Yong also looked at the time.

"It's twenty past five!"

"I don't have much time. I still have a lot of consultations to do later. I try to finish them as soon as possible, and you all go home early."

"Okay, thank you for your hard work, Doctor Li. Can't you get off work on time later?" Liu Suolong asked politely.

Li Yong smiled: "Damn!"

"Where do we have a normal off-duty point? We are always hospitalized and never off-duty."

After speaking, Li Yong planned to stand up and prepare some other things.

But after hearing Li Yong's words, Li Mengxiang's heart finally fell to the ground, and she said to her son, "What am I talking about? The doctors in the Eighth Hospital just don't know how to read it, and they are not good enough. You still don't believe me."

"What did they say at the time? They said that surgery was necessary, and the risk of manual reset was high."

"Have you read what Dr. Li said?"

After Li Yong heard this, he was actually very pleased, but he also explained: "Auntie, you can't say that, there are specialties in surgery, and it's not easy to be a doctor. It's a good thing to be cautious."

"Such a dislocation requires a special professional joint surgeon to deal with."

"If the child is older, you will have to do arthroscopic surgery. Many hospitals in our province have not yet set up special joint surgery and sports medicine."

"What they said is also correct. Based on their perspective, it is a choice made by respecting you when they say that surgery is required."

"If they come up and tell you that this can be done by resetting it casually, then you have to be careful."

"There are some irreducible joint dislocations, and even the professor dare not say that they can be restored." Li Yong explained a few words for his colleagues in the No. [-] Hospital.