Chapter 141 Damn it, he got it again! (Please subscribe!)

"Will you come back later?" Luo Yun said more, mainly because he felt that the patients he just saw were too unpleasant.

Although he has returned to his profession.

But all the opportunities to show off were taken by Zhou Cheng, leaving him only with words.

While Luo Yun was reluctant to leave Zhou Cheng and left after pretending to be cool, Zhou Cheng actually didn't want to leave either.

Following Luo Yun, Zhou Cheng felt the long-lost feeling of being able to learn knowledge and skills from real people.

And this feeling is not found in other people.

It's not that Cai Dongfan and others are not qualified to teach Zhou Cheng anything, or that Zhou Cheng can learn nothing from them, but they simply don't have the awareness to teach.

He just asked Zhou Cheng to do things and did not take the initiative or consciously teach him.

But Luo Yun did it.

Moreover, Luo Yun allowed Zhou Cheng to see another side of medicine——

Medicine is not simply about diagnosis, prescribing medicine, and surgery, which is about curing diseases and saving lives.

"Teacher Luo, I came over immediately to help after I finished the emergency room. Zhang Zhengquan happens to be here to help." Zhou Cheng hurried back, thinking that Luo Yun was bringing someone to help him write medical records.

The person on duty today is not Du Yanjun, but Xu Yanlin from Yan Haihan's group.

This month's shift schedule is strictly as follows: Min Chaoshuo, Lin Lin, Du Yanjun, Xu Yanlin, Du Ruiqi, Zhang Zhengquan, Huang Yu, and Wang Yongxiang are on duty at Xianghaibin in turn.

There are three groups of three-day shifts. Whether it is a weekend or a weekday depends entirely on luck. This is also the fairest method of duty.

Du Yanjun was on duty on the third day, that is, he was on duty yesterday, but he called Zhou Cheng to prove that Du Yanjun had not finished the work in the department and had not returned yet, and happened to encounter another emergency patient.

The reason why Zhou Cheng thinks about this is mainly because he feels that he came to the clinic not long ago.

Very reluctant to leave.

Then Zhou Cheng walked towards the ward, his feet speeding up several points.

As a veteran who has entered the third year of training, Zhou Cheng knows very well that there are not many learning opportunities during the training period.

If he hadn't obtained the simulator system by chance, he would only be slightly stronger than Zhang Zhengquan now.

After getting a simulator, you can only improve your skills through simulated copies.

It will not improve other abilities, just like the very strong communication skills and control demonstrated by Luo Yun just now.

Yes, Luo Yun showed this strong control over the medical process, which made Zhou Cheng's heart beat.

Want to learn.

He almost ran to the department at a trot.

Then I hope to finish it as soon as possible and go back to the outpatient clinic as soon as possible to continue to figure out Luo Yun's thoughts.

When he came to the ward office, Zhou Cheng first saw Du Yanjun who was busy in front of the computer. However, Zhou Cheng was not prepared to look for him. Instead, he asked: "Yan Jun, where is Xu Yanlin on duty? Didn't he say there was an emergency call?"

?”

Du Yanjun stood up immediately when he saw Zhou Cheng and quickly replied:

"Brother Zhou Cheng, Yan Lin went to the emergency department for emergency consultation."

"When I was leaving, another child came into the department for emergency treatment. Brother Yan Lin took a casual look and found no fractures."

"So Brother Yan Lin asked me to help with it, so I called you!"

Zhou Cheng nodded. It was very normal for residents to help each other. Even if they were not in a group, they would not divide their respective tasks into such details.

Du Yanjun pointed to the computer and said: "I just finished asking about the medical history and am now watching the movie."

"I still don't quite understand it."

"Brother Zhou Cheng, why don't you come over and take a look first?"

The patient's plain radiographs were printed and placed in an imaging data bag, but in front of the patient, Du Yanjun knew that it would be inconvenient for Zhou Cheng to take him to see the films.

Although Zhou Cheng was anxious, he also felt that he had to watch the movie first to have a little bit of confidence in his mind.

only?

At least seven or eight minutes have passed since Du Yanjun called him. Du Yanjun still hasn't understood?

Could it be that this patient is still difficult to deal with? It will take a lot of time?

Thinking this, he frowned slightly.

Then Du Yanjun took the initiative to pull out the stool and let Zhou Cheng sit down. He pointed at the film and said, "The patient is a little girl about three years old. She has a history of trauma, but the history of trauma is not clear."

"Her mother said she took a picture in the emergency department and was brought to our department."

Speaking of this, Du Yanjun touched his head a little embarrassed and said: "Brother Zhou Cheng, because the epiphysis of a child is not fully developed, I am not sure whether the patient has a fracture or not."

"It's still dislocation."

"The sign of physical examination is pain when pressing, and other physical examination signs are uncooperative."

Zhou Cheng nodded and looked at Ping Pian.

It is very difficult to read orthopedic radiographs in children because the epiphysis is not completely closed and there may be hidden fractures that are difficult to detect.

And because the epiphysis is discontinuous, it is difficult to evaluate even slight dislocations.

If you encounter the radiograph of the wrist joint, it is even more complicated, because the bones of the wrist joint only appear together every few years.

It's even harder to judge.

If orthopedics must be separated into a separate department, pediatric orthopedics can definitely be listed separately...

However, when Zhou Cheng looked at the flat film, he also frowned slightly.

Because according to Du Yanjun's guidance, he also looked at the child's elbow joint. Although the epiphysis was separated from the backbone, the edges were basically flat and aligned.

Under such circumstances, obvious fractures can basically be ruled out initially.

The reason why only obvious fractures can be excluded is because occult fractures may require CT and MR to be further displayed, and plain radiographs cannot show fracture information.

However, the child was in pain during the physical examination and was unable to cooperate.

Therefore, the possibility of hidden fracture cannot be completely ruled out——

Continue to look at the joints, the joints are in place...

"Are there any lateral plain films?" Zhou Cheng asked again after seeing no problem in the front view.

"Yes, it's on the next page." Du Yanjun hurriedly replied.

Zhou Cheng clicked the mouse. After reading, he put his hands on his chest and frowned even more.

Not dislocated?

No fracture?

What's the reason for the child's pain? Could it be that the ligament is broken?

He touched his head and turned around and asked: "Have you done a physical examination? How is the triangle relationship behind the elbow joint?"

Zhou Cheng asked quickly.

When plain radiographs can’t tell you anything, you have to look for clues through physical examination!

The patient is a three-year-old girl who was brought here by her parents. No fracture or dislocation was seen on the plain radiograph. This is very similar to the subluxation of the radial head that cannot be diagnosed by imaging examination and needs to be confirmed by medical history!

However, one of the diagnostic differences between radial head subluxation and other dislocations of the elbow joint is whether the posterior triangular relationship of the elbow joint is normal.

If it is abnormal, it is definitely not radial head subluxation, but if it is normal, it may not be certain that it is radial head subluxation.

To understand this situation, you may have to ask the family members carefully.

The diagnosis can only be made by looking for clues from the medical history, physical examination results, and imaging examinations.

"I've touched it and found that the triangular relationship behind the elbow is normal and not a posterior dislocation of the elbow joint." Du Yanjun nodded quickly and even eliminated one of Zhou Cheng's inner doubts.

If the elbow triangle position is normal, elbow joint dislocation can basically be ruled out.

Then this patient is probably that thing.

Zhou Cheng breathed a sigh of relief and said, "Let's go check on the patient's condition together. I really haven't figured it out yet."

But Zhou Cheng didn't say it clearly. This was just his empirical judgment. In many cases, experience cannot be simply used as dogma, nor can experience be ignored.

We absolutely cannot rely on empiricism to automatically determine the diagnosis!

Will suffer a loss.

Soon, Zhou Chengcheng and Du Yanjun came to the operation room.

After walking in, Zhou Chengcheng saw that the patient was a very cute little girl with two pigtails and a pink and fleshy face. She should be a very cute little girl in normal times.

But at this moment, her eyes were red, her mouth was depressed, as if she had suffered endless grievances, and her nose was stuck to her nostrils, making her look a little dirty. Her mother was going to wipe her nose.

But the little girl always let her mother's hand hold her little fleshy forearm and refused to let her go, as if she would be in great pain if she let go.

Seeing the white coat coming in, the little girl seemed to remember the pain of having a needle tap her butt again, and she shivered dominantly.
To be continued...