Chapter 5 Emergency Storm (4)
It's better to go to the doctor's office first and wait for Director Zhu and others to come and arrange, Tang Xiaofeng knew that before he had a medical license, no matter how excellent his work was, it was no different from being an intern or a resident, and now his identity was still an intern, and he had adapted to this identity. Pushing open the door and entering the office, there were only three people inside, Tang Xiaofeng recognized two of them, Zhao Yong and Jiang Tao, both were hospital residents, Jiang Tao was dozing off on the desk, Zhao Yong was writing something on a thick notebook on the desk, Tang Xiaofeng took one glance and knew that the notebook was the hospital's shift handover record.
Tang Xiaofeng pushed the door open with a small sound, but Zhao Yong still heard it and looked up to see Tang Xiaofeng. He gave a faint smile and then continued writing his handover report. Just as Tang Xiaofeng was about to greet the unfamiliar person, he heard the sound of an ambulance siren getting closer and closer. Zhao Yong put down the handover record he was writing and Jiang Tao suddenly got up and complained for a moment before rushing out of the office with Zhao Yong. Tang Xiaofeng, Zhang Wei, and others also hastily followed them.
"What's going on?" Zhao Yong asked.
"Preliminary diagnosis is an acute attack of chronic cor pulmonale." A pre-hospital doctor replied.
"Check blood work and cardiac monitoring."
"Check blood pressure and ECG." The nurse repeated "No breathing!" The nurse suddenly shouted.
"Prepare for endotracheal intubation."
"Intubation," said the nurse, handing over the instrument. Jiang Tao began the intubation procedure.
After 30 seconds
"Intubation successful, connected to ventilator."
"Connect ventilator."
"Dr. Zhao, Dr. Jiang, the blood test results are out." Dr. Zhao and Dr. Jiang took over the shift.
The nurse handed over the test results.
"Red blood cells and hemoglobin increased, combined with infection of white blood cell count increased, neutrophils"
"Multiple nuclei increased." Zhao and Jiang quickly scanned the lab results, exchanged a glance, and understood.
"Mr. Jiang, there's a fracture case coming in from outside," the nurse shouted as she came in.
"You go ahead, I'll be here." Zhao Yong said with a smile to Jiang Tao, Jiang Tao nodded and said
"Qian Liang followed me." He said and took Qian Liang away.
"Suction sputum, streptomycin 0.4mg intramuscular injection, perform penicillin skin test." Dr. Zhao Yong gave the order.
"Sputum aspiration, streptomycin 0.4mg intramuscular injection, penicillin skin test."
"Four Linked Needles." Tang Xiao Feng spoke up from beside him.
"What's a four-in-one needle?" The nurses were surprised, and Zhao Yong was also taken aback.
"It's a mixture of 1 milligram of adrenaline, 1 milligram of isoproterenol, and 1 milligram of norepinephrine injected together, plus 0.5 milligrams of atropine administered intramuscularly." Director Zhu and Deputy Director Sun walked into the rescue room, explaining while sizing up Tang Xiao Feng, and couldn't help but feel a shock in their hearts.
"The nurses here are not used to such terms." Sun Feng said with a smile to Tang Xiao Feng. Tang Xiao Feng was startled and thought to herself that it wasn't good, the term she had casually brought up was not something an intern could understand, so she hastily explained: "I usually read a lot of books, so just now I wasn't paying attention and accidentally brought it up, but I'll be more careful in the future." After finishing speaking, she gave Sun Feng an awkward smile.
"Administer 20mg of succinylcholine intramuscularly, and add 0.125mg of pancuronium to 30ml of 25% glucose solution for slow IV infusion. Has the penicillin skin test result come out?" Director Zhu took over from Zhao Yong and wrote the order.
"Administer 20mg of succinylcholine intramuscularly, and add 0.125mg of pancuronium to 30ml of 25% glucose solution for slow IV infusion." The nurse repeats.
"Penicillin is not allergic." Zhao Yong said.
"Add 280 units to 250ml of 5% glucose solution for intravenous drip." Director Zhu gave another order.
"Add 280 units to 250ml of 5% glucose solution for intravenous drip."
2 minutes later
"How are all the parameters now?" Director Zhu asked.
"It's normal." Zhao Yong felt relieved.
"Transfer him to ICU," said Director Zhu. The group of people then walked out of the emergency room.
Tang Xiaofeng and Zhang Wei followed Zhao Yong to observe the patient with a fracture, while Director Zhu and Deputy Director Sun walked towards the office.
The handover in the emergency department is the most troublesome. For critically ill patients, the handover doctor must complete the written handover record in a timely manner, making it clear who is responsible for each shift and keeping records. The doctor on duty needs to check the working status of various rescue equipment and communication tools in the department to avoid malfunctions that may affect the rescue efforts. After taking over the shift, the doctor on duty must conduct a comprehensive inspection of the ward, understand the patient's condition, especially for critically ill patients, and have a clear grasp of their situation. The doctor on duty should make timely written records of changes in the patient's condition and treatment process, and according to the needs of the patient's condition, can organize non-duty doctors from the same department or related departments to participate in the rescue through the medical department, general duty officer, and department head. For consultation requests from other departments, they must be consulted in a timely manner and have corresponding records.
Following the hospital's convention, after shift change was ward rounds, doctors had to prepare case files and leave first. The last one to leave was Director Zhu, who saw Tang Xiao Feng and Zhang Wei still sitting there motionless. Director Zhu walked over and told them to also go for ward rounds.
A line of sixteen people, majestically heading towards the ward, Director Zhu constantly asking questions, some attending physicians embarrassed to rush in front of junior doctors to answer, while Zhang Wei was like a model student, holding a pen and taking down notes on the diagnoses raised by Director Zhu, and Tang Xiaofeng, having just made a shocking remark with his "four consecutive needles", now pretending to be crazy and ignoring everyone unless called by name.
Won't go to answer. So every time a person answering questions is a real-life doctor named Li Zhen, and only when Li Zhen's answers are not comprehensive enough will other doctors supplement the answers.
Uh, if it wasn't for Director Zhu asking Tang Xiaofeng questions when checking the sixth bed, this round of ward checks would have almost become Li Zhen's one-man show. But unexpectedly, some insights proposed by Tang Xiaofeng during the check on the sixth bed made Director Zhu and Deputy Director Sun and others full of praise.
No matter what kind of start, the person who ends up performing well will be easily remembered. Just one case's insight made all the doctors in the emergency department witness Tang Xiao Feng's ability, at least for a moment, they had a feeling of surprise and finally understood why Director Zhu would personally bring an intern.
Just after finishing the ward round, before rushing back to the office, I heard the sound of an ambulance siren getting closer and closer. Head nurse Wang Hui was puzzled, as no emergency call had been received at the triage desk. Five ambulances and police cars stopped one after another in front of the emergency department door, and doctors and nurses who were holding patient records hastily put down what they were doing and rushed out.
Deputy Director Sun directed the emergency rescue scene, and 17 injured people were sent to the hospital by ambulance and police car. The cause was a conflict between the city textile factory and local residents due to land requisition. Although no one died at the scene, the serious injury of 12 workers was already a very serious incident. Tang Xiaofeng looked at Director Zhu pulling Zhang Wei into the emergency rescue team.
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