Li Min hurriedly put on a white coat in his hand clothes, and then wrapped himself in the public army coat worn on duty in the operating room outside, and hurriedly followed Jiang Ma back to the ward with the patient who had just undergone craniotomy.Out of the operating room, the two of them were startled by the family members who were densely gathered at the door of the operating room.Jiang Ma protected the infusion bottle in front of him, and stretched out his hand to stop the family members who were pushing and shoving."
Let it go, let it go.The injured person was Wang Zhiwei, and Wang Zhiwei's family came over.Everyone else dodges. ”Hearing that it wasn't his family, the crowd around them dodged away.But someone unwillingly grabbed Li Min's sleeve and asked, "Nurse, who in our family heard that it was a fracture, how is it?"
”Li Min pulled back the sleeves of his coat, tightened them in front of his chest and said, "I only know about this injured person."
Rest assured, the fracture is being treated. ”Jiang Ma dragged the flat car in front, Li Min pushed in the back, and several family members of the injured person entered the medical elevator.The female worker who drove the elevator saw the injured person who was being pushed in and had his head bandaged and immediately smiled and said, "Dr.
Li has done another craniotomy." ”"yes.How is your mom now?
”"My mom is fine.I still talk about you.She gave you two pairs of insoles for me to bring to you. ”The elevator worker said and took out a paper bag from the bag under his stool, stuffed it into the pocket of Li Min's coat, and said, "My mother's mind, don't dislike the soil." ”This is the second time that the fat old lady who has undergone rectal cancer surgery has given herself an insole after being discharged from the hospital.The insoles are hand-embroidered lifelike bright flowers, the colors are bright, and the needles are exquisite, so that Li Min, who is rough in embroidery, can't bear to step on the insole, which can be called a work of art.Li Min smiled and expressed his gratitude to the elevator worker: "Thank you for me, mother."
The embroidery is so beautiful. ”The kung fu elevator that spoke reached the eleventh floor, this time it was changed to Li Min dragging outside, Jiang Ma pushing behind, and the injured person's family members also helped, and the flat car entered the monitoring room smoothly."
Your family members helped to get through the bed.Three of them go to bed first, and two are left underground. ”Jiang Ma held the head of the injured person, Li Min looked at the family members who came around, asked the two nurses to each hold an infusion bottle, six or seven people got started, and lifted the injured person easily from the flat car, she immediately pulled out the flat car, and the injured person moved to the bed steadily."
Is it okay, Jiang Ma?""
It's okay, you go get busy, I'll watch here."
Jiang Ma went to this operation today, and before pushing the injured person out of the operating room, he heard Chen Wenqiang's instructions to Li Min.Li Min asked the head nurse who opened the door and came in: "Which ward is the other head injured in which ward?"
”"In the 17 ward.What did Dean Chen say?
”"I'll come back and get his CT scans and check the injured to see if they need immediate surgery
.
"*17 Ward, this guy is quite unlucky.He wasn't standing there waiting for the bus.He was passing by on his bicycle and when he found that when the crisis came, he accelerated his bicycle to escape the scene of the disaster.But he escaped being hit by a car and crushed by a bus shelter, but his bike slipped on the snow and his head hit the curb of the road.The man was in a coma.According to the time of the incident and his emergency department records, the coma lasted nearly half an hour.Li Min pushed open the door of ward 17, but saw that it was full of people.Wasn't the visitation a while ago very strictly managed, and how did this work?"
Leave one care for each bed, and the others please wait outside."
Li Min had no choice but to speak to maintain order in the ward.No one moved.Li Min had no choice but to raise his voice and added: "Too many people can easily induce infection.Please cooperate. ”"We've been living here for so long, and no doctor has come to take a look, saying that the infection is not infected, and calling your director to come.If you don't come again, we will complain about him. ”The head nurse came in behind Li Min, and said angrily when she saw this: "The director is all doing surgery in the operating room." ”"Then we don't have a doctor?"
Seeing the head nurse come in and speak, the people who visited were even more excited."
Isn't this Dr.
Li here?
You don't hear of Dr.
Li, who blocked the injured one by one, just looking at you.Leave a companion in one bed, and quickly make way for the place so that Dr.
Li can examine the injured person. ”The people in the room reluctantly began to walk out when the head nurse said this, but soon automatically and consciously fulfilled the request of only one companion per bed."
Head nurse, I still have to say something."
Li Min thanked the head nurse."
There are too many patients admitted today, and when I received them just now, I told them that they could only keep one escort per person.No, this ward is too messy today, you hurry up and look at the 2 beds, it's the one with a head injury.I'll have to tidy up the ward in a moment. ”Li Min walked to bed 2 and looked at the bed card, the injured person was only 23 years old, and the diagnosis was written as a basilar skull fracture and head trauma.The trauma on his forehead had been briefly debrided, but the slight blood stains oozing out of the gauze reminded Li Min that this was a simple, temporary measure."
Have you got the CT scans back?"
The escort looked at his watch and immediately exclaimed, "Oops, it's time."
There were so many people talking around him just now, and I forgot all about business.I'm going to get it. ”Li Min supported his forehead.The head nurse understood Li Min's thoughts and said for her: "Go quickly, wait for the CT film to decide whether to have surgery." ”"Okay, okay, I'll go."
*Li Min stepped forward to examine the injured.I saw that the patient's eye sockets were faintly black, and he kept blowing his nose with a tissue."
Got a cold before admission?"
The wounded man hesitated for a moment and said, "No."
Maybe I froze when I was unconscious in the snow.But how can there be blood in the nose?
Odd. ”The reaction was a little sluggish, but the thinking was still clear.Li Min took a look at the clear and shiny fluid left in his right nostril and concluded that the injured person had a cerebrospinal fluid leak.After a thorough and careful physical examination, it was found that the injured person's muscle strength was normal, and there was no pathological reflex.Li Min shook the head of his bed about 30 degrees.Tell him, "Lie on your right side."
Wipe your nose with paper, but don't blow it too hard.You're not a cold snot. ”Fu also said to the head nurse: "He is leaking cerebrospinal fluid, and he must control the visits and escorts in this ward, so as not to cause retrograde infection when he catches a cold."
Change him for cephalosporin in a moment. ”"Okay.""
Am I going to have a craniotomy?"
The young man asked tremblingly.Li Min replied to him soothingly: "Not for the time being." ”The injured man immediately relaxed, clutched his chest and exaggeratedly said, "I'm scared to death."
The one who was filming with me was dragged to the craniotomy.Oh my god, is that head so open?!
”"He's been sent back to the intensive care unit after the operation.I'm just saying that you don't need surgery for the time being, based on your current condition.You're lying like this, it's best not to move your head.When you come back with your escort, ask him to take the CT scan to the office. ”"Oops, what should I do when I go to the bathroom?""
Rent a toilet from the head nurse and defecate on the bed.Can't push it.If constipation tells me, I can give you a keesk to open the stool. ”"How's that going to work!
I'm a big man, with good arms and legs. ”"If you want to have a craniotomy, then you have to go down to the ground.But let me tell you first, you still have to lie in bed to defecate after the operation. ”The young man wailed, "But it's killing me."
Dr.
Li, there is no other way. ”"Not yet."
Li Min finished explaining what he had to do and walked out, and the escort of the bed at the door stopped Li Min and said, "Doctor Li, you can show us." ”The diagnosis card on the bedside reads: "Left patella fracture." ”The wounded man said in pain: "I planted and fell to my knees on the snow."
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The film said I had a broken bone.But I hurt now. ”Li Min read the card and asked, "Are there any other injuries besides the left knee?"
”"Hands, both hands are broken, and the fire hurts."
The injured man raised his hand to Li Min with a bitter face.Li Min nodded: "The injury is quite serious."
I'll talk to the nurse in a while to see if I can rinse your palms with hydrogen peroxide to avoid infection.However, there are many injured people today, and we need to save lives first according to the severity of the injury, and then deal with the injuries that are not life-threatening.You also heard what he just said, and he was dragged to a craniotomy for filming with him.Right?
”The wounded man and his escort nodded."
So, your injuries will have to wait until the critically ill ones have undergone surgery.If any of you feel that your injuries are getting worse or you have any bad feelings, ring the bell and call the nurse. ”The other two had fractures, and when they saw that they were heavier than them, they didn't do anything, so they simply didn't say anything.* Li Min wrapped up in her coat and walked out, the head nurse followed her to cover the door, and immediately said to the people gathered at the door: "You can't go in again, there is a cerebrospinal fluid leak inside, once the retrograde infection is suppurated in the head."
I tell you, it kills.Let's go, let's go. ”The head nurse stood still in the doorway, and behind her was the door of the hospital room, and these people in the corridor looked at each other, and no one wanted to harm anyone when it came to life and death.After a while, someone said, "Head nurse, I'll just say a word to the people in there and leave." ”"yes, we'll just leave."
The head nurse opened a crack in the door and shouted inside, "You three escorts come out for a while, they want to say a word to you and go back." ”", with this."
However, under the gentle insistence of the head nurse, by the time Li Min got the CT film, the trauma surgery department had restored the good order it had been in recent times.Li Min returned to the office and seized the time to revise the doctor's order of the injured person, and when she got the CT film, she took a look at it and went to the operating room.The parents of the injured person did not want to stop her in the elevator."
Doctor Li, where is my son's head hurt?"
The parents of the injured surrounded Li Min and asked questions carefully.Their faces and tones were full of worry and fear for their children."
This is the fracture line of the frontal bone, where his right forehead was broken, and here is the frontal sinus, and the bleeding in his nose is because of the ruptured frontal sinus.These are scattered bleeding spots, and this one is an epidural hematoma, so your son has broken the bones in his head, understand?
”Li Min pointed to the CT film and explained it to them."
Understood.Is it heavy, should I have surgery right away?
”"Because judging from this film, the amount of bleeding is relatively small, and there is no need for surgery for the time being.I took the film to the operating room and showed it to Dr.
Chen, who is an expert in neurosurgery.If there is any change in your condition, you should ring the call bell and tell the nurse in time. ”"Okay, thank you, Dr.
Li."
The parents of the injured insisted on following Li Min to the operating room, but Li Min's persuasion was unsuccessful and they had to let them go.* The rescue operation in each operating room has basically come to an end, Chen Wenqiang patrolled the operating room one by one, and found that all the injured were not in danger of life, and breathed a sigh of relief.He had seen Li Min's CT and talked to Director Li about God blessing."
God bless, don't you see if everyone is here today."
Director Li lowered his voice and said in Chen Wenqiang's ear: "Fortunately, Dr.
Yang is in the department today, otherwise I would be busy." ”Li Min saw Director Li and Chen Wenqiang whispering, so he went to Director Liang's side to watch the operation process, and several rupture and necrotic parts of the intestine had been removed, and the anastomosis was almost complete.However, because the victim has persistent blood in the urine, they must also have exploration of both kidneys, ureters, and bladder.Director Liang beckoned Dr.
Wang and Dr.
Yang to change their gloves, took a step back and said, "You two go on, I'll rest for a while." ”Dr.
Wang said to Dr.
Yang, "Come on." ”This part of urology is Dr.
Yang's specialty.If Director Liang doesn't retreat, he insists on exploring the past by himself.However, Director Liang stepped down and Dr.
Wang humbled down, which is to respect Dr.
Yang's professional skills."
Okay."
Dr.
Yang happily took the surgeon's position.Director Li leaned over uncomfortably and saw that Dr.
Yang had opened the posterior peritoneum.Fortunately, only the lower pole of the right kidney was partially bruised."
That's it.Now there are more and more people with uremia.This kidney was preserved for him as much as possible.Go back and give him some drugs that are less nephrotoxic. ”Chen Wenqiang looked at the injury and spoke, but neither Dr.
Yang nor Dr.
Wang sent it right.Director Liang sat on the round stool poured out by Director Li and said, "Then you two should shut up your stomachs." ”This requirement was a piece of cake for Dr.
Wang and Dr.
Yang.Li Min saw that there was nothing to do with him, so he said to Chen Wenqiang: "Dean Chen, then I will change my clothes and go back to the ward." ”"Okay, you can go back first."※※※※※※※※※※※※※※※※※※※※ disaster from the sky......
Popular science: The diagnosis of cerebrospinal fluid rhinorrhea is generally based on trauma history and physical examination.The glucose concentration of the transudate may also be checked laboratory.CT cisterns can directly show the shape and size of the leakage channel.Nowadays, MRI magnetic resonance imaging is more accurate to locate the leak.Treatment 1* When cerebrospinal fluid leakage occurs, the patient is biased to lie down, allowing the brain tissue to settle in the rupture, which helps to heal naturally.* Wipe off the exuate in time to keep the nasal cavity clean and unobstructed to avoid bacterial multiplication and cerebrospinal fluid reflux infection after blockage.
*Cerebrospinal fluid rhinorrhea for more than 24 hours may be complicated with meningitis.
*Intracranial infections caused by cerebrospinal fluid rhinorrhea are generally gram-negative bacteria, so cephalosporin antibiotics are often used.Treatment 2 * Continuous drainage of the lumbar cisterna * Craniotomy repair * Endoscopic intranasal approach repair - now the main surgical method * Microscopic extranasal approach repair () is a bit far away