When Li Min arrived at the department, she looked through the handover book, but Zhang Zhengjie stopped her and said: "Xiao Li, I explained to the outpatient department, if there is no major traffic accident tonight, if the orthopedic department can admit it, I will not admit orthopedic patients to our department."
If there is a general surgery patient who needs emergency surgery, you should go to see the patient before admitting the patient, and if you need to go to the intensive care unit after surgery, you will be handed over to the general surgery department for admission. ”Li Min was surprised.Zhang Zhengjie opened the window and said brightly: "Several of our guardianship rooms are in use.One of the three burn wards was also appropriated.If there is a serious illness coming in, we will have no place to settle it.Wait until Monday to remove yesterday's and today's surgeries before you can consider taking in another serious patient. ”"Well, I see."
Even if they are removed, it is unlikely that they will be admitted to the emergency department again, and elective surgery is scheduled for both treatment groups.Two days of elective major surgery and emergency surgery quickly filled up the limited number of ICU beds.As a result, patients who used to stay in the intensive care unit for three to five days can now stay only for two days, and once their vital signs are stable and there are no postoperative complications, they are transferred to a small ward.As for the patients who want to stay in the small ward until they are discharged, unless they are seriously ill, such as yesterday's thyroid adenoma surgery, they will be transferred to the eight-person room by the morning after tomorrow at the latest.* Li Min first went to see the patients in the intensive care unit and burn ward after major surgery, and then went to the pediatric department to see the child after intussusception.But after a day's work, I quickly became haggard when I was a mother.Six adults nursing a child, how is this all right?"
No way.When a child is sick, he only recognizes his mother. ”Dr.
Neikomi explained to the surprised Li Min.The child grabbed his mother's fingers and refused to let go.Fortunately, the child was still able to listen to persuasion and was willing to let his mother eat and go to the toilet. ”"You're not crying, are you?""
I didn't cry much hard.""
Coax him, don't let him cry.Why did this week go by?
”"yes.""
Aunt Li, how many days do I need to be fine?"
The child is articulate.The expression of blinking his eyes and not crying made Li Min feel pity for him from the bottom of his heart."
You have to be as obedient as today, tomorrow morning Auntie will come over to change your dressing, and let your father help you see if your belly has grown, okay?""
Good.I want to play on the ground. ”"Not today.I have to wait for my belly to grow. ”The little boy immediately pouted and wanted to cry, but the mother quickly bowed down to comfort her son."
The child recovered quickly, Sister Wang, you have to take care of yourself."
Nurse Wang smiled bitterly, "I didn't dare to leave when he fell asleep, and he woke up as soon as I moved."
When you go to the toilet, you have to consult him first. ”"I can only coax more in the past few days, otherwise the abdominal pressure will increase when the child cries, and the rupture of the incision on the outside is easy to deal with, but I don't know if the inside will bloom."
The six adults all had sad faces."
Sister Wang, I'll come over if I call at night, I'm going to see the other two children, and then I'll go back.""
Okay, you go back and get busy, I heard that your department has done a lot of surgeries in the past two days.""
yes, I'll go back first.Something to call. ”After seeing the child with intussusception, Li Min went to see the child who had ependymoma surgery.The little girl had a little flesh on her face, and she looked a lot more energetic, and she followed word by word under her mother's teaching: "Hello Auntie." ”"This kid is so smart.""
Not really.Just because this child is too smart, he can teach something and learn it, and he vomited like that at home before, and the old lady of the neighbor said that our family is not blessed enough, and the child who is too good cannot be kept. ”The child's mother wiped the tears from the corners of her eyes, "It's getting better."
Otherwise, I don't want to live. ”Li Min smiled and gave the child a comprehensive physiological reflex and muscle strength test."
You see, she's recovering every day now.""
Yes, yes, the little hands are getting stronger and stronger."
Finally, there was the child who was still in the neonatal unit."
How is she today?""
At five o'clock, I ate almost 30ml of milk in one go.Looks like the recovery is fast. ”This kid Li Min didn't dare to touch it, she only looked outside the isolation cover, Dean Chen would come to check the room at night, wait for Dean Chen to come.But when she left the custody room, she was stopped by a tightly wrapped woman."
Doctor, how is my daughter?""
Your daughter?"
Li Min followed her line of sight and saw that her daughter was the newborn with a brain contusion and laceration lying in the isolation cover."
The child is recovering well.It took 5 o'clock to finish 30ml of milk in one go. ”Li Min hurriedly relayed the nurse's words to her.The woman thanked Li Min warmly, and then took out a small bottle from her arms."
This is what I just squeezed out in the pediatric disposal room, please help me send it in, Dr.
Li, okay?""
You didn't deliver it in the afternoon?"
There is a rule in the neonatal ward that milk can be delivered twice a day.Tears immediately welled up in the woman's eyes, and she choked up and begged, "I didn't protect her, and she was born with such a sin."
I can't even hug her, and I can make her drink a few more sips of milk.Doctor Li, can you help me?
”Li Min subconsciously took the bottle.Half a bottle of warm milk."
Where do you live?
You've got to have a good confinement.Your daughter will be discharged from the hospital in a while, and she will have to count on you. ”"Thank you, Dr.
Li."
The woman raised her still puffy face and said with a smile: "I rented the house of your provincial hospital staff to live in."
I asked if it was your ward round today, so I came here at this point.I'll go back.Thank you. ”Li Min nodded at her, turned around and went to the neonatal ward again.This time she didn't go in again, only gesturing to the nurses inside through the glass window of the isolation."
What's the matter with Dr.
Li?"
The nurse inside opened the intercom."
The child's breast milk is bruised by a brain contusion, you can help take it in.""
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Good.Wait, I'll bring you the bottle she's finished. ”Two small bottles were handed out in a plastic bag."
You tell her to do a good job of confinement.I come here several times a day, and my heel hurts later. ”The nurse also took pity on the woman.Li Min smiled and agreed, turned around and went out to hand over the empty bottle to the woman who had been staring at him.I couldn't help but persuade her: "You go back and lie down."
You heard what the nurse said. ”"Hmm.Thank you, Dr.
Li. ”The woman thanked her repeatedly, tightened her headscarf over her hat, put on her mask and hat and left.* Li Min returned to the trauma surgery department, and when he saw that Mu Jie had not yet arrived, he went to check all the patients in the ward, and changed the dressings.By the time she got back to the office, it was almost seven o'clock.She picks out the medical records of the patients she manages and carries them into the office.Muljay sat in her place reading a book."
Been here for a long time?""
It's been a while, and I see you're changing the patient's dressing."
Mu Jie raised the book in his hand, "It's the same when I read here. ”So one of them continued to read, and the other began to write a record of the course of the illness.Time flies, and it was more than eight o'clock after Li Min finished writing the record of the course of the illness.She took the medical record clip back to the nurse's office and plugged it in, feeling a little uncomfortable with the silence of the night.It's been a long time since I've had a night like this!"
Try the dressing room again?"
Li Min asked Mu Jie."
Okay."
In the past few days, when Mujay has been alone, he has been thinking about the final battle repeatedly.In that battle, the entire battalion commanders and fighters led by himself had done their best.The remaining thing to be solved is how to make sufficiently advanced early warning equipment as soon as possible.Mujay sat calmly on the treatment bed, silently recalling the battle.It may be that he has watched it too many times in the past few days, and he actually feels that he is too calm—less excited, palpitations, and the strong desire to take revenge when he thinks about this battle for the first time."
Mujay?"
Li Min watched outside the door for ten minutes, and when she saw that Mu Jie was calm, she extended the time.It wasn't until the sound of a flat cart in the hallway woke her from her preoccupied observation.- It must have been a new patient hospitalized.Wake up Mujay.Mu Jie opened his eyes at Li Min's call.There was peace in his eyes.The calmness made Li Min mistakenly think that he was just taking a nap or meditating."
Are you alright?"
Li Min reached out to feel Mu Jie's pulse.Mu Jie reached over peacefully, smiling as Li Min counted his pulse.The heart rate is 56 beats per minute."
Are you alright?"
Li Min was surprised, and her voice trembled with excitement in her ecstasy."
It's all right."
Mu Jie held Li Min's hand with his backhand, and rubbed a few handfuls on Li Min's head with the other hand."
My good girl!
Thanks to you.I've been thinking about that battle a lot in the past few days, and I might have had some reactions at first.Once I realized it, I started thinking about you, and then I was able to get out of the PTSD state.I've probably been repeating too much in the past few days, and now I'm so numb that I can't react. ”Mu Jie said it with ease, and Li Min remembers his reaction in the first few treatments.What a daring man!
Tears wet her eyelashes."
When you're alone......
Mu Jie smiled proudly, "If I really get caught by this PTSD, I don't deserve to be a major of the Chinese People's Liberation Army."
Okay, you see, I'm not good. ”Li Min looked up at the ceiling, forcing back the tears in his eyes, and then looked into Mu Jie's eyes and said, "You have read so many psychology books, when you know that it is very dangerous to do the experiment alone, and the possibility of aggravating the symptoms is very high." ”Li Min reminded Mu Jie fearfully."
Don't worry, I have a sense of proportion.I've been bothered by this for a while, and I always have to get rid of the effects of the last game before I return to the team, so that I can travel light. ”Mu Jie's voice was soft, but there was unwavering persistence in his tone.Li Min looked at Mu Jie like this, and wanted to blame him more, but he couldn't say anything.A thousand words turned into a coquettish sentence: "You reckless stupid and bold." ”* Li Min didn't sleep much this night.In contrast to the calm of the succession: after two successive cases of acute appendicitis, another patient with acute cholecystitis came.The patient's symptoms were severe and did not look like a conservative treatment.Appendicitis Li Min called the night doctor of the general surgery department and Wang Yang, who happened to be in his same lineage, to do it together, but when it came to this acute cholecystitis, which was suspected to be perforated soon, they were not qualified or brave to do it.Although cholecystectomy and appendectomy are both first-level surgeries, due to the special anatomical location of the gallbladder, the main reason is that once irreversible common bile duct damage occurs during the operation, the operation will be escalated every minute.Therefore, this first-level operation must be watched and approved by senior doctors before they can do it."
Let's find Director Xie."
Li Min yawned, "It's 12 o'clock, and it's not good to call Director Liang of our department." ”"Okay.If you receive a patient from your department and ask Director Xie for surgery, you are not afraid that your director will say it, and you are not afraid that Director Xie will be unhappy, so you can call him. ”Li Min rolled his eyes and called Xie Xun himself.Zhang Zhengjie wished that nothing would bother him before the exam.When anyone can't understand the list of surgeries next week, all of them have surgeries, but he is not on stage.But calling Xie Xun instead of calling Director Liang to come, Ming'er saw Director Liang and said that he called Xie Xun, which was only good for Xie Xun.At this time, she didn't know that Chen Wenqiang was brewing a new duty arrangement for the unified surgery.Li Min decided to have surgery, and Wang Yang had to cooperate with her to make preoperative preparations.The two of them gave a doctor's order and a test sheet, and they cooperated very well."
I'll write the first trip in the ward, and when Director Xie comes over, you can take the patient to do an emergency B-ultrasound.Let's see if it's safe to have another operation.I did an electrocardiogram as well. ”"It's okay for me to take him to do B ultrasound, so what about Shen Min?"
Wang Yang glanced at the temporary doctor's order list and grabbed the ECG list to write.Lu Qing was impatient with Wang Yang's verbosity: "When the time comes, you will take a look."
If you can't tell if it's allergy, you draw a circle on his arm to test the allergy result.You hurry up and push the patient over, if I have time here, I'll go over and see it myself. ”"Sister Lu, don't be so fierce."
Wang Yang stood up with two checksheets with a smile and reached out to help the patient's family turn the direction of the flat car.He didn't care about Lu Qing's attitude.The old nurse looks at the new doctor with this virtue."
Hurry up.I'll be back soon, I'll have to prepare the skin and the urinary tube. ”When Wang Yang disappeared, Lu Qing said, "The old nurse of the general surgery department is annoying him." ”Li Min added the operation notice in his hand to the surgeon and assistant, and then looked up and asked, "Why?"
”"He asked the old people about the situation at the home of the department heads."
Li Min raised his eyebrows and looked at Lu Qing."
You don't understand the Tao here, he's choosing an old man."
Li Min smiled and pushed the operation notice to Lu Qing."
I have to write down the first journey and the preoperative explanation, and you can help me notify the operating room.""
Good.You go get busy. ”When Xie Xun arrived, Li Min was busy preparing for the text, and Wang Yang took the patient to do B ultrasound and had not yet returned.Xie Xun yawned and listened to Li Min's report on his medical history and physical examination, and at the same time looked through the test sheets and temporary medical orders."
Director Xie, all the existing inspections are here.There are also blood clotting tests, etc., and the results will be available in the laboratory later. ”"Okay, it's all quite complete.I'll go to the ultrasound room. ”Without waiting for Director Xie to go out, the sound of a flat car sounded.Lu Qing's voice followed: "Push it to the side of the dressing room."
I need to prepare the skin, the lower stomach tube, and the urinary tube. ”Li Min hurriedly went out to greet the patient's family: "You can sign alone, parents, spouse, and eldest son." ”The patient is in his fifties, and although the pain is unbearable, he is still in the mood to joke with everyone: "My parents went to the door, and they couldn't come back, and they couldn't come back because they couldn't come to sign for you."
Don't look at her old, this is my daughter-in-law. ”The woman twisted his arm lightly, and he cried out, "It hurts to death, are you going to murder your husband?"
”"Playing poor again, it hurts you to death.Boss, come and sign with me. ”Wang Yang handed the B-ultrasound list to Xie Xun: "Director Xie, Dr.
Fang of the B-ultrasound room suspects that it is a roundworm." ”"Doctor Fang's night shift?"
Li Min asked, holding his chest and secretly glad that he didn't take the patient to do B ultrasound.Xie Xun smiled and said, "No wonder you've been gone for so long."
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This could really be a roundworm.My sister came over to take a look. ”B-ultrasound showed that the size of the gallbladder was 85x47mm, the tension increased significantly, the gallbladder wall was smooth and slightly thicker than 3mm, and the flexion and circling movable cord shadow could be seen in the gallbladder, with a uniform thickness of about 4-5mm."
Do you like to eat raw?"
Xie Xun asked the patient's daughter-in-law."
yes.said that he has not changed his life for decades.In summer, raw cucumbers are stuffed into the mouth without washing, and the melons are always stuffed in the mouth when they are rubbed, and they always say that the washed melons have no taste.What is he?
”"At present, it is suspected that roundworms have burrowed into their gallbladders.Specifically, it is not necessary to have surgery.You and Dr.
Li signed the consent to the operation, and we pushed him to the operating room. ”The patient's eldest son said happily, "Where to sign?"
I got it. ”Li Min wanted to talk to him about the possible accidents during the operation, but he shook his head and said, "When my daughter-in-law had a caesarean section, your doctor said a lot of things that were not available, and I quickly signed for you to have surgery for my father."
The old man is dying of pain. ”I signed it without looking at what Li Min wrote!
There are also such people?
Jiang Ma was on the night shift, and he laughed and teased Xie Xun for being called for surgery in the middle of the night and not being able to sleep with his daughter-in-law.Xie Xun smiled and teased him: "It's that you can't sleep with your daughter-in-law, right?"
I slept at home before I came. ”"Are your legs weak?
Can you still stand?
”Jiang Ma escalated the topic."
Shut up.My sister is here.Go back and complain to Su Ying, I will be cleaned up.Senior sister, I won't let you in the middle of the night, hurry up and finish it and go home to sleep. ”Through the eyes of the mask, Li Min smiled and expressed that he understood what he meant.Then Xie Xun stood in the position of the surgeon and set off.The procedure was very fast, and she needed to concentrate to keep up with Xie Xun's movements.Xie Xun's movements were too fast, which made Li Min suspect that he was familiar with the anatomy of the liver and gallbladder part, probably like his own palm prints.…… The gallbladder was soon exposed by Xie Xun.The wall of the gallbladder is swollen, like an elongated gourd without a waist.The swollen wall of the sac is visible to the naked eye, fluctuating as the contents of the sac squirm."
Give two clips.I first clamped the common hepatic duct and common bile duct.Prepare the aspirator. ”"Lao Xie, what are you going to do?"
Jiang Ma asked from the side of the headframe."
Catch turtles in the urn.Plug the ends and suck it out.This gallbladder is useful, and he can keep it without picking it up.Wang Yang, try the attractor. ”Wang Yang grabbed the suction head in the palm of his hand, "It's okay." ”Li Min reminded him softly: "Unscrew the suction device head." ”"That's it, my sister still understands my heart.You help me lift the gallbladder wall, be light, don't leak it.Wang Yang, step on.Suction device for me.Gauze pads, sharp knives. ”Xie Xun padded gauze, used a sharp knife with one hand to cut an opening at the bottom of the gallbladder that could accommodate the suction head, and then stuffed the suction head into it with the other hand.The patrol nurse immediately shouted, "Come out, Director Xie."
Wang Yang, don't step on it. ”She held the suction jar up for everyone to see, and sure enough, a roundworm was wriggling in the little bile."
You said that this roundworm is also powerful, I am numb to such a big person, and it is fine in the gallbladder.""
Your anesthetic went into the patient's body, but it didn't get into the roundworm's body.A small round needle with a 0 line, and then prepare a 7-gauge urinary catheter for me. ”Xie Xun made two layers of purse sutures at the incision of the gallbladder, and tightly clamped the urinary catheter for draining bile in the middle.After a simple irrigation of the abdominal cavity, the drainage strip is released and the abdomen is closed."
Alright, we're ready to call it a day.My sister remembered to deworm him in two days and check his stool a few more times. ”"Yes."
Li Min hurriedly agreed."
Actually, we don't put this urinary catheter, and we can directly suture the bottom of the gallbladder.But it's safer to do so.Aren't you two disappointed?
”I thought I would have a gallbladder removed, but in the end I only had a cholecystostomy.It's a bit thundery and rainy, and it's a lie to say that I'm not disappointed."
God makes the human body grow gallbladder, and it has its own intentions.Keeping this gallbladder for him is only good for him. ”"That is, if you don't keep your gallbladder, next time the roundworm may go directly into the liver."
began to sew the skin, and Director Xie let Li Min and Wang Yang operate.I was chatting with Jiang Ma with the thread scissors, and the two of them sang and sang as if there was no door on their mouths, saying half-truths and half-truths to scare patients.But this unconscious patient with epidural anesthesia can't stand it.He immediately exclaimed, "I don't eat raw anymore." ”"It's okay, your daughter-in-law called you and you didn't change it for decades, and you changed it after an operation, isn't it obvious that your old man is timid and afraid of surgery?"
Jiang Ma coaxed."
That's right, let's eat, eat, at most, we won't sleep, and we'll give you another bowel massage.You have such a big roundworm in your gallbladder, and you must have it in your gut.Maybe one day you're drunk and vomiting so badly that you can vomit a few roundworms. ”Hey, it's going to be disgusting to death.The patrol nurse poured out the roundworms and brought them to the patient's family with a dirt basin.There were three strong men carrying the patient over the bed, and Li Min could finally lift the infusion bottle alone.* Fortunately, in the second half of the night shift, there were no emergency patients, but Li Min only slept until five o'clock and got up.She has to finish writing the two post-appendicitis post-operative and post-acute cholecystitis hospitalization records, and she doesn't write them herself, the day shift is Director Liang, and it will be boring to let Director Liang write the big medical records.After writing the medical records, she rounded the ward, came back and wrote the shift, and Director Liang came to take over.She hurriedly told Xie Xun about the operation she had done in the middle of the night last night.Director Liang smiled and nodded, pleasing Li Min and Xie Xun for their sensibility and knowledge, and then the two of them went to the pediatric department to see the little patient.By the time Li Min left the hospital, it was almost half past eight.※※※※※※※※※※※※※※※※※※※※ life is full of states, here + one * There are still risks in eating unwashed fruits and vegetables raw.Especially nowadays, organic vegetables are sought after to a very high level, and cleaning is a very important level before entering the entrance () is a bit far away