In fact, there are not many complicated cases in the emergency observation room.
Most of the complicated cases have been sent to specialists the moment they enter the emergency department. Those who can stay here are either patients that the emergency department wants to intercept, or they are too complicated and have diseases from multiple specialist systems. Each specialist is shirking their responsibilities and cannot send them out. They need to be treated after a multidisciplinary consultation.
Then there are some troublesome cases, such as patients injured in car accidents. Because the compensation is not clear, in order to protect their own interests, they can only stay in the hospital and wait for the compensation to be clear before leaving. For this kind of patients, the specialist beds are tight and they are generally not admitted. They can only be observed in the emergency department first. These are also included in the case at this time.
However, this is not the focus of Vishnu's attention. He just needs to go through the case and remember the general idea.
The focus is on the first two.
Especially for those patients that the emergency department wants to intercept, the First Affiliated Hospital of Dhalora Medical University has its own emergency operating room, and there are three surgical teams to perform operations. Some operations that the emergency department can perform, as long as they encounter, will not be sent to the specialist department, but directly performed in the emergency operating room. Operations represent income. When the department's income increases, doctors can achieve greater performance. There are
also many operations that the emergency department can perform. The most typical ones are appendix and gallbladder operations in general surgery. As long as it is acute appendicitis or acute cholecystitis and gallstones that have been in the emergency department, general surgery will not be considered, and the emergency department will do it. Because there is an observation room, you can stay for one or two days after the operation and then be discharged directly.
Because of this, almost every hospital is in trouble with the emergency department. After all, these two are also the main surgical income of general surgery. If they are snatched by the emergency department, the income of general surgery will go down. There are
also some acute operations in the cardiology department. The emergency interventional surgery of the First Affiliated Hospital is well carried out.
There are also some acute operations in the gastroenterology department, such as acute abdomen and gastrointestinal bleeding, which can also be performed by the emergency department.
There are some others, but the surgeries in these three departments account for the majority. In the observation room, the cases before and after the surgery account for the majority.
Vishnu naturally wanted to perform surgery. He would definitely work in surgery in the future. Surgeons are trained through surgery. Now that he has come to the emergency department, how could Vishnu not seize the opportunity? Opportunities cannot be waited for. First, familiarize yourself with the cases. When the opportunity comes, go directly. The
doctor system in the observation room also uses the inpatient system. The page is still different from yesterday's outpatient clinic, but it is not difficult to get familiar with it.
"Doctor Savitri, a patient who needs emergency surgery has come. Director Neel has admitted him. Please do the preoperative preparations quickly."
A nurse rushed into the medical office. The voice came before the person. This is also a major feature of the emergency department. Almost all doctors and nurses who leave the emergency department are in a hurry because they are used to racing against time.
After entering the medical office, the nurse saw that Savitri Devi was not there. She looked at Vishnu and Pooja, "Where is Doctor Savitri?"
Pooja was still a little at a loss, Vishnu had already stood up, "Doctor Savitri is out, let's contact her, tell me what the patient is."
The nurse looked at Vishnu's name tag. She had never seen Vishnu before, and there was not much information on the name tag. Doctor Vishnu, if she didn't introduce him carefully, who would know that they were interns.
Seeing Vishnu's imposing appearance, the nurse did not delay any longer, "Gallbladder perforation, emergency surgery is required."
Vishnu immediately understood that this was an opportunity. He asked the nurse's name, quickly printed out the patient's outpatient medical record, and turned to look at Pooja, "Pooja, let's go see the patient."
Ah!
Is it so exciting? Pooja hurried to catch up.
Following the nurse, Vishnu quickly browsed the emergency medical record. Although it was an emergency medical record, Director Neel had already written it in great detail.
Suny xx, male, 57 years old, chief complaint: pain and discomfort in the right upper abdomen for 10 days, aggravated for one day.
Emergency abdominal ultrasound showed gallstones; gallbladder perforation?
Savitri Devi's phone was quickly connected.
"Teacher Savitri, a patient with gallbladder perforation is here. Director Neel is seeing him. He requires preoperative preparation as soon as possible."
"Please ask the patient about his medical history first. I'll be back soon."
Vishnu agreed, walked past the nurse's station, and said to the head shift, "Sister, I need an operating room for a patient with gallbladder perforation."
The head shift glanced at Vishnu's name tag and nodded, guessing that it was Savitri Devi who asked.
Bed 6, the patient on the bed was already curled up in pain, his face was pale, and he was sweating profusely. There were
quite a few family members, as many as five or six, and they were all very anxious at this time.
"Make way, the doctor is coming."
The nurse yelled, and the family members surrounding the patient immediately made way. When they saw Vishnu coming, they hurried over again.
"Doctor, how is our old Suny?"
"Director Neel said he needs surgery. When can it be done?"
"Doctor, is it dangerous? Can we not have surgery? Old Suny is usually fine, there is no problem."
"Doctor..."
...
Five or six family members, one after another, have already begun to output to Vishnu. Vishnu quickly screened their requests, picked out the useful ones, and finally fixed his eyes on a middle-aged woman, "Who can sign?"
Five or six family members also instantly fixed their eyes on the middle-aged woman.
"Doctor, I am the patient's wife."
Vishnu nodded, came to the patient, and began to check the patient's physical signs. There was tenderness, rebound pain, and muscle tension in the right upper abdomen. Murphy's sign was positive. The physical signs were very typical. The patient was in so much pain that it was difficult to speak. Vishnu looked directly at the patient's wife, "When did the pain start?"
"Are there any other symptoms? Are there nausea and vomiting?"
"Nurse, take your temperature."
"Have you had any examinations before?"
"Have you had any other diseases? Have you had surgery?"
...
Quickly sort out the medical history. When asking about the medical history, if the patient cannot cooperate, the patient's wife can be said to be the doctor's favorite to see. After all, this is a relative that the patient lives with day and night, and is much more reliable than sons and daughters. "
Doctor, is the surgery necessary?"
The patient's wife was obviously still hesitant about the surgery, but since Director Neel had already admitted the patient, he must have discussed this matter. At this time, asking was just to get a positive answer.
"The patient's gallbladder has been perforated. It is very dangerous if no surgery is performed. We recommend surgical treatment."
"Director Neel said the same thing. Well, let's do it."
"Then when can it be done? Look at how much pain my husband is in. You should take care of him instead of just asking questions."
"Yes, my husband is in so much pain. Stop the pain first and use the medicine first."
...
Vishnu was besieged again, but he didn't care. He looked at the patient's wife and said, "Let them take care of the patient first. Come with me to sign the preoperative documents and we will perform the surgery as soon as possible."
After that, Vishnu went straight to the medical office.
The patient's wife hurried to catch up. Seeing that Vishnu ignored them and said that the surgery should be performed as soon as possible, the other family members of the patient could only continue to surround the patient and worry.
(End of this chapter)