As the cold wave continues to settle and another wave of snow rages, the rooftops of the provincial capital are covered with snow.The main motorway in the provincial capital has long been assigned to the adjacent enterprises and institutions to be responsible for snow clearing.The so-called snow removal is to push the snow on both sides of the road to the road teeth as soon as the snow stops, while the snow on the road has not been compacted by the passing vehicles, so as to ensure that the passing vehicles will not slip while driving, so as to reduce the occurrence of traffic accidents.Therefore, on the roads in the provincial capital in winter, there are snowdrifts piled up to clear the road after a snowfall from the left and the right.Passers-by can easily tell by color the order in which the snowdrifts are formed: the grey and dirtiest-looking ones are the ones that snowed at least two weeks ago, and the cleanest ones are the latest results of today.As for the sidewalks, because they are not required to be cleaned, the snow has been trampled into a solid gray-black color in the crowded places.Not only does it look dirty, but you have to be careful when you walk on it, or you might get a slippery step at some point.The little one fell and got his coat or pants dirty.If you don't have a good color, it may be a tail vertebra fracture.In addition to caudal vertebra fractures, there are also a variety of fractures in various patterns, such as carpal fractures: the wrist hits the ground first when falling; Patella fracture: it is a kneeling fall, and the knee hits the ground first; These two are common.The femoral shaft, femoral neck, and pelvic fractures generally occur in older and osteoporotic elderly, and are common in postmenopausal women.
As for those who hit the ground hard and fell out of the cerebral hematoma to have a craniotomy, it was by no means one and a half, and the nurses in the trauma surgery were accustomed to it.Lu Qing also joked with Li Min: You can clear the cerebral hematoma with your eyes closed, right?
The reason for the pedestrian fall is simple, distraction - the mental head is not concentrated under the soles of the feet.They are often distracted by "attacks" from overhead and wrestle.Because in the northern winter, the northwest wind is indispensable to howl every day.The poplar tree, which has no leaves, is covered with snow on its bare branches.Although the snow was blown by the cheerful northwest wind, it did not interfere with the pedestrians who were armed and sheltered under hats, scarves, masks and armor.But at some point, a large piece of frozen snow will fall from the tree and hit the pedestrian's head, and the person who is so frightened that he forgets his feet will easily fall down.It was another Monday, and the morning meeting of the day was not held, and the staff of the hospital collectively went out to clear the snow, and it took more than half an hour to finish work.Zhang Zhengjie and the head nurse climbed the stairs side by side, he held gold-rimmed glasses in one hand and a snowboard in the other, and said to the head nurse with a tired snort: "This year's snow comes early and urgently, each one is bigger than the other, and we have to add more beds in our eight-person ward." ”The head nurse was originally a person with an excellent temperament, but at this time she also frowned and worried: "It's already bed to bed, and if you add it, you have to stack it."
Let's see how to discharge those who are hospitalized after fractures. ”"That one is willing to be discharged?
If you ask, I'll do it for him right away. ”"Director, you can't talk like that.Let me tell you, if you don't let the doctor mobilize those who have broken bones to be discharged from the hospital, and then the outpatient clinic will admit you for surgery, I can leave without a bed. ”The work pressure was high, and the head nurse saw that the director was cheating, so she immediately forced herself back.Zhang Zhengjie didn't have a move, so he had to call all the doctors together for a meeting."
I'm telling you, our department is full of beds, and there is no room for extra beds.If the condition is almost stable, it is necessary to be discharged, especially if the fracture is broken.If they are raised in Cory for three months, we big guys won't have to eat meat for the New Year.The head nurse can say that if the outpatient clinic is operated on, she will be sent away without a bed. ”Director Liang smiled, this one is indispensable every winter."
What's the standard, Director?"
Dr.
Liu asked.He had the most fractures."
Hospitalized for a week, no, more than five days, re-examination of fracture and broken end alignment.""
How do you get back?
Shall we Corey still help call an ambulance?
”Dr.
Yang's questioning is also well-founded, and this was done last year."
Call it.The cost of the ambulance is added to the hospitalization fee.Half for self-paying patients. ”So for the rest of the day, the two groups were busy mobilizing eligible patients to be discharged.But after being busy like this for a long time, I didn't see a few beds poured out of the ward.In the hallway, there are still patients with extra beds waiting for surgery.* At present, the provincial hospital is not only short of beds in trauma surgery, but also in the pace of severe cold, the provincial capital has been encircled as a forbidden place, and the cold wave has made cold patients everywhere in the outpatient clinic, overcrowded the respiratory department, and filled the pediatric wards and corridors with the cries of small pediatric patients.Leng Xiaofeng sat in the pediatrician's office, she tried her best to maintain a calm and natural smile amid the crying of young children, and calmly prescribed prescriptions and wrote medical records.She even began to practice listening to breath sounds and identifying heart sounds amid the crying of the child.What can be done, some children enter the hospital and start crying, seeing the white coat, whether it is a doctor or a nurse, can instantly raise a few octaves, even if the crying hoarse voice, no child can spare her ears.This result "benefited" many first-time parents, and their usual trick at scaring their children was: "If you are disobedient, I will take you to the hospital for injections." ”It was under such circumstances that Li Min followed Chen Wenqiang to the pediatrics.As soon as they got out of the elevator, the crying from the shop made both of them a little uncomfortable.The two of them went to the doctor's office first, and Director Wu, who was explaining to the parents of the child, saw them coming over and immediately handed over the matter to Leng Xiaofeng."
Dean Chen, follow me to the office here, I have all the materials ready."
Closing the door of the director's office could not completely isolate the crying of the children, but also made this place a paradise.This relatively quiet small space made Chen Wenqiang and Li Min breathe a sigh of relief."
I'm going to be blown up by you kids."
Chen Wenqiang sat down at the desk, rubbing his temples and complaining.Director Wu took out the patient's outpatient medical records and prepared auxiliary examination materials from the filing cabinet.He should complain to Chen Wenqiang: "I have been crying by the patient in the past few days, and my brain has exploded I don't know how many times." ”"You've been in pediatrics for more than 30 years, haven't you gotten used to it every year?""
Alas, the past few years have been different.In the past, the children saw our pediatrician with a tense face, not to mention that the child would lower his crying if he was afraid, and the adults would also coax the child to stop crying.It's good now, a baby egg in a family, who is afraid of our face.There are so many sick children that they don't have to leave work if they don't hurry up.But when I get up quickly, my movements are not gentle enough, and my parents have to come to me to say a few words.Annoying. ”It's annoying.Li Min stood beside Chen Wenqiang and followed the outpatient cases, then the auxiliary examination in the outer hospital, and finally the examination in the hospital after hospitalization.Director Wu introduced the condition to them: "This child is just 5 and a half years old.When I was able to express myself at the age of 3, I once told my parents that my ears were ringing, and I didn't find anything in the district hospital, so I lived like a normal child.After catching a cold last month, I suddenly lost my hearing in both ears and lost my hearing completely.I was afraid that the CT scan of the small hospital outside would not be accurate, so I rechecked a brain CT here.Yesterday's CT scan showed a right acoustic neuroma, and I admitted my child to the hospital.Dean Chen, can you see if this can be operated?
”Director Wu stared at Chen Wenqiang, his face full of expectation.Chen Wenqiang took two CT scans and compared them.Li Min followed the side and looked at it carefully, and finally asked suspiciously, "Are you sure that both ears are completely deaf?"
On the CT scan, I only saw an enlargement of the right internal auditory canal. ”"yes, I think it's weird, too.The first CT scan is similar to what we shot.I tested my child to be deaf in both ears and suspected that there was something wrong with the CT scan.I thought about it for half a night last night, and I didn't understand how the child could react like this.Can it be surgical?
”"Just looking at what is shown on this film, it should be possible."
Chen Wenqiang first gave Director Wu a reassuring pill, and then said to him: "My thoughts are the same as Xiao Li's.Let's go see the child first, and let the ENT department do a hearing test.Otherwise, this acoustic neuroma craniotomy surgery, the tumor is removed, but the child's right ear and the left side have the same reaction. ”*Director Wu led the way to the ward in front, and Chen Wenqiang pondered all the way about the child's deafness in his left ear.Director Wu saw that Chen Wenqiang ignored him, so he turned back to Li Min and said, "Xiaofeng said that you are on night duty every Saturday, and you will go to my house to eat dumplings together this Sunday."
The sauerkraut that your Aunt Fan drew is famous in the provincial hospital. ”"Okay, I'll go over when I have time."
Chen Wenqiang stopped her and said, "Lao Wu, the exam won't be long before you go, do you still have the heart to make dumplings?"
How prepared are you for the pediatric exams?
”"Well, I think they can pass if they are qualified.But I can help with the "Pediatrics" part, and I can't do anything about pathology and patients, it's all up to them.How is Xiao Li preparing?
”"I've been so busy lately that I don't have much time to read."
Li Min first laid a foreshadowing sentence for himself, "But fortunately, the "Surgery" and "Local Anatomy" we took the exam are used every day, and the pressure is still a little smaller." ”"Lao Chen, do you really want to post the results of this exam?"
Director Wu is planning for the doctor in his department, "If the score is too low, won't it affect the mood of work?"
There are so many children in Corry, and if any one is neglected, it is a big problem. ”"I don't know.You ask Lao Shu. ”Director Wu didn't believe it, and Chen Wenqiang didn't know.But if he borrowed his three guts, he wouldn't go to Dean Shu to say a word more about this.
*The children are placed next to the neonatal ward, and although it is a small ward with a four-person room, it is packed with six children with extra beds, and there is no place to turn around.Chen Wenqiang frowned: "Old Wu, you are so nervous here, where is the child going to be put after surgery?"
”"Let's talk about it."
Director Wu led the way to the ward, pointed to a boy playing with his fingers and said, "This is the child."
This is Dean Chen, an expert in the Department of Neurosurgery of our provincial hospital, and this is Dr.
Li. ”Director Wu introduced to the parents.The little boy played with his fingers, as if he hadn't heard their conversation, and paid no attention to the white coat who came over.The rest of the children who were on the infusion were already sobbing timidly.It's just that the white coats didn't give them a look, and the cry didn't get louder.Chen Wenqiang looked at the little boy carefully for a while, then reached out and pinched the child's cheeks, "Does it hurt?"
”The little boy didn't react.Chen Wenqiang gradually increased his strength, and the little boy finally reached out to save the left side of his face.Chen Wenqiang let go of his right hand but his left hand continued to exert force, and after a while, the little boy cried and shouted, "It hurts." ”The pain evoked the cry of the entire ward.Li Min took out a notebook to record, and couldn't help but reach out to cover his ears.But I heard Chen Wenqiang calling her: "Look, the uvula is on the left." ”Li Min hurriedly squeezed over, bent down and lowered his head and stretched his neck forward, looking at the uvula exposed by the boy who opened his mouth and howled.Sure enough, it deviated to the left.This is consistent with a CT scan.However, more neurological professional physical examinations cannot be detected because the child's crying and kicking are not cooperative."
Dean Chen, Director Wu, what is the problem with our children.My life is worse than death every day. ”The child's mother was about to cry."
Xiao Li, you come and talk to her.""
We just looked at all his examination data, and based on the images on the CT film, it was judged to be a space-occupying lesion in the right pontine cerebellar angle area.Right acoustic neuroma is currently considered.But if you say that the child can't hear in both ears, then we need to do some more tests to drain out the underlying lesion on the left side. ”"What kind of checks are you going to do?""
Hearing related examinations, go to the medical university for MRI.""
Can you find out?"
Dean Chen nodded: "We need to find out the potential lesion on the left side as soon as possible and find out the cause of his deafness in both ears at the same time before we can do the operation."
Otherwise, as I just said to Director Wu, the right tumor has been removed, but it is troublesome if the hearing is not restored at all. ”This is powerful, and the couple had heard about it when they were holding their children to seek medical treatment.I found the provincial doctor here because the postoperative results of several cases of pediatric intracranial tumors were very good.Now that Dean Chen said so, they had no choice but to follow the arrangement.After leaving the ward, Dean Chen said, "Pure tone audiometry should be done again, and the brainstem evoked potentials and magnetic resonance scans and enhancements should also be arranged."
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But I wonder if this kid is a little autistic?
You have a good communication with the parents of the child.I'll go back and ask Xiao Li to send you the relevant checklist.Where are you going to plan for this child after the operation?
You can't mix it up with the flu kids.You'd better isolate him today.Don't test the results are suitable for surgery, but your child has a cold and has to postpone surgery.Okay, we'll have to recheck again, you know what I mean, right?
”"Yes, yes.I'll do what you ask.Thank you, Dean Chen, and thank you for your hard work, Dr.
Li, I asked the parents of the children to pick up the checklist in half an hour?
”Li Min immediately gave him an affirmative answer, and then followed Chen Wenqiang into the elevator.() The distance is a bit far