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in the morning.
Director Huo Congjun came to the emergency department to make a cup of strong tea, directly pour off the first bubble, then sit down and slowly drink the second tea.
After that, he walked out of the director's office with his hands and began to inspect from the observation room.
Behind Huo Congjun, there are three deputy chief physicians and six serving physicians.
Everyone, forming a sharp arrow, like a lion on the prairie, hunting with the lions.
The resident doctors on duty quietly waited in front of their own bed, like a hyena on the prairie, waiting for the debris left in the lion's teeth.
The interns are seemingly free vultures. They have no fixed position and are not valued by the sick. They can only wait quietly to clean up the remains of the lion and the hyena.
The territory of a department is not large. In the observation room of the emergency department, there are usually only a few dozen beds. However, the order is still maintained by the lions and hyenas.
In addition to Huo Congjun, there are two other chief physicians in the emergency department of Yunhua Hospital. They do not need to follow him to check the house.
Although they are all called directors, the director of Huo Congjun is the owner of the territory because of his administrative powers. The other two chief physicians only got senior titles, just like the wandering lions, they need to pay more. In order to maintain their freedom.
Every day at 7 am, it is the time for the hospital to show order.
Ling Ran wears a white coat, puts 30 pieces of Hetian jade Buddha into the bag, and then comes to the rescue room, silently observing everything around him.
He already has some hunting techniques to kill specific ailments, but in the territory, that is not enough.
"Xiaoling..." Huo Congjun suddenly screamed and waved Lingran.
"This is your patient, let me introduce it." Huo from the military station to the 12-bed patient, looked at the medical record, and handed it to the rapid step forward.
According to the value bed system, the patient should actually belong to the doctor of the attending Zhou. Even if all the people in the field know that they have done more than 50 cases of sutures before the day before, they should first ask the inscription.
However, the director of the department is the king in the territory. What he can do, he can do anything. Even if the director is going to remove a kidney from a seemingly healthy patient, the other doctors can only verbally disagree and cannot obstruct.
Of course, the patient and the patient's family can refuse to operate, but in the hospital environment, the authority of the department director is still very high.
While reminiscing about the patient's condition, Ling Ran opened the medical record and said: "Patient female, 19 years old, has always been physically fit. This time, the elbow is torn due to falling from the stairs, and debridement is carried out..."
He said half a word and finished his first bed check.
Without waiting for a breath, Huo Cong suddenly asked: "Why did you choose line 0?"
The No. 0 suture is much smaller than the commonly used No. 4 line in the emergency room. Line 4 is expressed in the United States Pharmacopoeia standard as 2-0, with a diameter of 0.3 mm. Line 0 uses a USP standard of 4-0 and a diameter of only 0.15 mm, which is exactly half of the 4th line.The diameter of the two wires is doubled, and the cross-sectional area is four times worse, similar to the gap between the little finger and the thumb.
Correspondingly, the tensile strength is also the strength against stretching, and it is much weaker.
In other words, the suture wound on line 0 is more likely to crack than the larger line 2, line 4, or even line 7.
Ling Ran was asked a bit, and the girls and family members on the bed were not aware of it and looked at the young doctor.
"I think Line 0 can meet the needs of the stitching." Ling Ran quickly answered, but some answered questions, too succinct.
Interns, disciplined students, and resident doctors were asked questions during the rounds. It was the daily routine of the hospital, but in general, everyone would say at least two more words.
Even if it is martyrdom, it is very difficult to get.
Huo Congjun shook his head and continued to ask: "Why don't you choose the regular line? What should I do with the 0 line and the wound is cracked?"
"If it cracks... re-sewn up?" Ling Ran feels that this problem is still rather stupid, but he is not a reasonable person, let the superior doctor not come to Taiwan on the spot... Although he has done it, but not every time do all.
Ling Ran gives a kind and caring smile, very handsome in the sun.
Huo Congjun did not keep up with the idea of Ling Ran. He checked the house every day and checked it for decades. Such a clever little doctor has never seen it.
The chief physician, deputy chief physician, attending and resident doctors who accompanied the ward round also fell into silence for a long time.
Dr. Zhou, a good old man, secretly sighed and coughed. "I was not very serious when I saw the wound. It is estimated that Line 0 can guarantee the effect and it will be used."
"You don't want to defend him, you are also wrong." Huo Jun was in front of the patient's family and said: "It is unreasonable to choose Line 0. You must point it out."
The family members of the patient who could not understand it were suddenly anxious. The mother standing on the side of the bed was busy asking: "Doctor, is there a problem with my daughter's arm?"
"There is no problem now, but it requires more careful care and avoidance of activities. We mainly consider the tensile strength of the suture, that is, it is not afraid of it. If it is cracked, it will not heal." Huo Junjun is cheerful to the patient, and There is no seriousness in the meeting, and it is not changed because of the mild symptoms of the patient.
The family members of the patients looked at each other and showed some anxiety.
At this time, Ling Ran understands the key points of Huo Congjun’s question, and immediately said: “The tension strength of Line 0 is sufficient. Avoiding activities and careful care is appropriate, but I don’t think I have to worry too much.”
Huo from the military education subordinate doctor's tone said: "You do not need to worry about using the 4th line?"
"The patient is only 19 years old. The area of the wound tear is too large, but not deep. If the thick line is used, the scar left is too big, which will affect the future life."
They just said on Line 4 of Line 0 that the patient didn't understand it very well. Ling Ran said that the thickness was small, and several people knew it in seconds.
The slightly fat girl on the bed, looking at the gaze, is no longer a suspicion, but a proper thank you.Huo Congjun, a military doctor, was unmoved. He said: "Consider scars. But you have to understand that there are many causes of scars. It is related to the patient's constitution and is related to the condition of the wound. From this perspective, choose 0. Line is not desirable."
The girl on the bed was really nervous at this time, and hurriedly looked at Ling Ran.
"Besides the suture, the tissues on both sides of the wound should be tightly aligned and the skin should be flat." Ling Ran lifted his eyelids and said: "This can be achieved."
Pause for two seconds, and then again: "The distribution of suture tension should be concentrated in the subcutaneous tissue and the deep layer of the dermis. There is no tension in the superficial layer of the dermis and the epidermis. This is also achieved. I think the proliferation of scar tissue will not be too much. It is necessary to consider the thickness of the suture."
When Ling Ran just opened his mouth, Huo Congjun and the doctors behind him were somewhat contemptuous.
From their point of view, Ling Ran obviously considers a small problem and forgets the bigger problem. This kind of unclear doctor has never seen much in their careers. .
However, Ling and then continued to talk about the two problems, but it was a real shock to everyone.
It’s not that the complexity of the problem, but what he can take care of, is really amazing.
"Is it time to change the medicine? Just now." Huo Congjun found a reason for the nurse to give the gauze on the patient's arm.
A doctor who was present at the scene, bent over and observed the wound on the girl's arm.
Huo Congjun is more serious about watching.
For a long time, Huo Congjun looked up, but he recruited other residents and interns. He said: "Let's talk about the idea of sewing."
Lingran has never been in the market. He mastered the master's intermittent suture technique, and he was more familiar with the road: "General debridement sutures are intermittent sutures. This time is no exception. In suturing, the main point is to pay attention to the angle and depth of the needle. It is bulged after suturing, which can act as a buffer before scar formation."
Nearly 10 residents and more than 10 interns, around a bed, the location is not enough, so someone simply stood on the chair to see the patient inside.
The patient's family now understands that the doctor's operation is excellent, so they are happy to give up the place.
Ling Ran’s voice is not big, but it’s clear and clear: “The basic principle is that the needle is thick and the position is shallow, and the edge of the wound is thin. The needle is deep. In addition, because the patient has a skin defect, hit The knot should not be too tight, so as to avoid the blood circulation around the wound becoming worse, the healing is delayed... After that, pay attention to the stitching, which should minimize the appearance of scar tissue..."
"It’s very good." Huo Jun took the lead in applauding.
Looking at the room, suddenly applause.
"Everyone has learned it." Huo Jun looked at the young doctor.
"learnt."
"learned."
"understood."
The resident doctor and the intern quickly nodded.
"It’s good to learn." Huo Jun slowly nodded, and then the voice became harsh: "But no one can learn!"
Everyone is ashamed.Huo Congjun said: "There are many ways to cover up scars. For example, you can wear long-sleeved clothes afterwards, or use a tattoo to cover up. As a doctor, the first thing you need to consider is treatment."
"I don't want to wear long sleeves or tattoos." The girl shook her head.
Huo Congjun ignored him and said to himself: "It’s reasonable to think about it, but you can be bold in art. If you don’t have enough other levels, don’t think so much. Let’s sew the wound and say it. do you understand?"
"Understood." This time, the morale of young doctors is not so high.
No one wants to admit that he is weaker than others, let alone weaker than a small intern.
Huo Congjun was the temper of the army. Ang’s scorpion: "I didn't hear it, didn't I eat?"
"Understood." The little doctors raised their voices and the answers were mixed.
After all, the hospital is not an army. Huo Congjun does not insist on it. He turned to Ling Ran: "This time, you pass the customs. Help the patient change medicine."
"Yes." Ling Ran was stunned by Dr. Zhou and replied quickly.
"Then I will not stay." The girl looked at the inspection team and asked, and quickly asked.
"The scar will be shallower, it is impossible to leave it completely." Huo went out of the army for several meters, and also specifically answered it.
The girl’s sensible “oh” sounded, and then smiled sweetly: “Thank you Dr. Ling.”
"You're welcome." Ling Ran nodded and was about to change the medicine, but there was a white treasure chest in front of him.
New achievements: patient heartfelt thanks
Achievements: The patient’s heartfelt thanks is the biggest compliment to the doctor.
Reward: Junior Treasure Chest
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