Chapter 9 Level 3 Skills, they are truly useful
Even if one has just been admitted to the hospital, it is essential to promptly administer certain medications
After clearing one's skill points
It is more convenient to stay at home, as it is not as noisy as the hospital ward. Don't you think so? We should be more considerate of the other patients behind us; they are still at a loss and are just waiting for treatment
Level 3 skills are truly useful
Fang Xian is responsible for three beds, specifically beds 13 to 15
As Fang Xian contemplated this, his thoughts suddenly became clearer while attending to patients, as if he had gained a much deeper understanding than before, becoming more organized in his approach
The foundational theory of trauma surgery has been elevated from level 2 to level 3. Fang Xian's idea is still to first establish the theory, striving to discover more diagnoses in clinical practice that others may overlook, thus increasing the potential to gain more skill points
Doctor Fang, we have been discharged, thank you very much
This is a gambler's type of investment, where the potential returns may not even match the initial investment in operational skills
... ...
Then? Haven't I already moved in?" the aunt said with a smile.
Fang Xian, upon hearing this, looked at him seriously for a moment, then set down both the pen and the notebook: "Postoperative infections occur from time to time, especially with open fractures where the risk of infection is even greater. We have also seen infections occur in similar patients here."
Deep vein thrombosis of the left lower limb, infection after open reduction and external fixation of bilateral lower limb fractures
Sister, as you know, our hospital has a very fast turnover rate, and the patients who have made appointments for hospitalization are also waiting. So I kindly ask for your understanding
These words have also been spoken by Associate Professor Song Yu, but the aunt's daughter seemed a bit displeased after hearing them: "Doctor Fang, can we stay a few more days? My mother is going back, and we don't know how to recover, which makes us uneasy!"
Bed 13 is for a patient who underwent bone grafting surgery due to femoral bone defect, and generally requires hospitalization for about one week Bed 14 is for a patient with a pelvic fracture, who also needs to be hospitalized for approximately eight to nine days
Medicine is a broad category, encompassing various sub-disciplines such as internal medicine, surgery, obstetrics and gynecology, pediatrics, psychiatry, dermatology, and others. Orthopedics is a subdivision of surgery, which includes categories such as orthopedic surgery, general surgery, and neurosurgery
Alright
After much persuasion, Fang Xian finally managed to convince the aunt from bed 15 to leave
As a resident in trauma surgery, I will likely continue to work solely in this field in the future. Consequently, I have focused my studies more on trauma surgery, gradually setting aside the foundational theories of medicine and the general principles of surgery, and dedicating more energy to the specialties of orthopedics and trauma surgery.
This girl looks very serious
This is supported by laboratory tests and must be continued. Please consult the pharmacy department.
Her current situation is quite complex, as she has sustained open fractures of both lower limbs due to a car accident, followed by postoperative infection and delayed healing of the fractures
Patient 15 has a comminuted fracture of the tibia and fibula and has undergone internal fixation surgery. She is the aunt who drank the fish soup with millet pepper. It is now only the fourth day post-surgery, and with her diagnosis, the average length of hospital stay after surgery at Xiangnan University Affiliated Hospital is about five days, ranging from three to seven days
When Fang Xian arrived at the entrance of the nurse station, the aunt from bed 15 was being pushed in a wheelchair by her daughter as they were heading out of the department. Upon seeing Fang Xian, she warmly greeted her.
At this moment, upon hearing Fang Xian's words, his emotions slightly calmed: "Doctor, your hospital must be different from Huai City Hospital; the professors here must have much better skills."
... ...
The diagnosis at Xiangnan University Affiliated Hospital www.hetushu.com.com should not be this complicated
Hi, don't say that, the technology at that hospital is inadequate
What is the rush? Even if one takes it slow and patiently waits for opportunities, even if one only gains an average of 1 skill point per day, after half a year, one can still increase three to four level 3 skills!
Trauma to both lower limbs: extensive contusions of the skin and soft tissues of both lower limbs, multiple muscle injuries in both lower limbs, rupture of the anterior tibial artery in the right lower limb, and multiple fractures with displacement of the tibia and fibula in both lower limbs
Therefore, this investment of 26 points is not significant at all; one must consider a longer-term perspective
If there weren't so many patients waiting in line, we certainly wouldn't speed up the turnover. Fang Xian explained this very skillfully
The 15 beds have been vacated, you may move in first
This is a routine diagnosis related to surgery. Based on the bacterial culture and drug sensitivity tests conducted at the First People's Hospital of Huai'an, Fang Xian preliminarily recommends administering anti-infection treatment. The sensitive antibiotics are piperacillin-tazobactam combined with ceftazidime
For instance, the most fundamental aspect is anti-infection treatment, followed by anti-swelling and anticoagulation, particularly anticoagulation, which requires special attention
After the ward round on Saturday, Associate Professor Song Yu directly instructed that Patient 15 is to be discharged today. Fang Xian should find a way on his own
The last two points raised a question for Fang Xian, as it had been 3 days since her transfer from the hospital, which does not necessarily mean that there is no thrombosis formation in her right lower limb
However, Fang Xian still believes that exploring methods to enhance skill points is the most crucial step
Even though choosing to focus on a broad category such as medical theory may be better, it is also necessary to consider the frequency and probability of the skills being applicable
After Fang Xian roughly inquired about the medical history of the new sister, he said: "So, you have already undergone surgery at the First Hospital of Huai City, and now you have an infection, and the fracture is not healing?"
Associate Professor Song Yu instructed, and Fang Xian could only comply
However, it is also good that after the 15 beds are collected, there will be no lingering thoughts, allowing for a more focused and undistracted practice of skills
The aunt at bed 15 noticed the woman in her thirties, whose lower limbs were bound with thick gauze and plaster, and the outer surface of the plaster was covered with a light green pus, causing her expression to change slightly
Fang Xian still needed to speak to Li Qiu, as he had heard the words of the duty nurse. He let out a slight sigh, having originally thought he could first go to the skills training room and only need to return in the afternoon.
This young man is wearing a short-sleeved shirt and shorts, along with sports shoes. He appears to be in his thirties and has a face full of complaints
The nurse station conducted a comparison and confirmed his identity as an appointment patient. They informed the on-duty doctor, Li Qiu, stating that he was to be arranged in bed 15. Upon seeing Fang Xian nearby, Li Qiu deemed it unnecessary to send a notification.
Why would one not acknowledge it? Perhaps you have read too many comments online?" Fang Xian chuckled casually
Fang Xian heard this and said: "Auntie, it is not right for you to speak like that. When you are in line, are you thinking that we are just trying to arrange for you to be admitted as quickly as possible, solely to make money off you?"
The nurse at bed 14 said, "Oh dear, Dr. Fang, your hospital already has so many patients, so please don't rush me. If you perform one less surgery, you can earn a little less money. Just let me stay a few more days."
It was initially thought that the newly admitted patient would arrive in the afternoon, but unexpectedly, the patient in bed 15 arrived even earlier than Fang Xian had anticipated. Fang Xian had just completed the discharge procedures, and only after the daughter of the patient in bed 15 finished the settlement, a cart was pushed over from the nurses' station, ready for admission.
Is it possible? She wore a beaming smile, and her eyes reflected a longing, showing no desire to be discharged from the hospital
This is the discharge diagnosis from the First People's Hospital of Huai City, but Fang Xian still needs to reorganize it.
The next day, in the morning, Fang Xian stared at his panel back and forth, finding the few skill points he had to be truly pitifully scarce
Fang Xian led the woman and her husband to bed 15, saying, "You have brought all the examination materials from the First Hospital in Huai City, right?"
As he walked, Fang Xian still felt a dull pain in his stomach, so he took a bottle of soda water from the lounge and brought it into the doctor's office
Post-operative debridement of bilateral lower limb trauma, post-operative external fixation of multiple open fractures of the bilateral lower limbs, post-operative multiple infections, thrombosis of the bilateral lower limbs, delayed fracture healing: nonunion of the bone
"How could an infection occur from a surgery?" said the woman's husband
The patient is experiencing pain and requires analgesic treatment. The selection of analgesic medication needs further consideration.
After they were sent to bed 15, Fang Xian put on a pair of gloves to assist in transferring the patient to the hospital bed. He then quietly explained to the patient in bed 1314 and their family that this was just a common infection and would not be contagious. After that, he took the medical records of the patient named Li Jiao and returned to the doctor's office
The patients behind you share the same mindset as you.
"The doctor I brought, will you accept these examination materials?" asked the middle-aged man
The reason for not choosing to add a foundation in medicine and surgery is that trauma surgery primarily consists of specialized cases and *illustrated* case studies. Selecting non-orthopedic diseases from specialized cases is somewhat misaligned with the intended direction
"Brother Xian, the new patient in bed 15 has arrived..." Li Qiu smiled and said this, then resumed his focus on writing the medical record
Fang Xian is inquiring about the basic situation of the older sister on the cart, so she merely nodded at her
Basic Theoretical Principles of Medicine Level 1 3 / 25
Fundamental Theories of Orthopedics Level 2 12 / 50
Basic Theories of Trauma Surgery Level 2 35 / 50
In this calculation, the cost of trial and error is quite low, and the options available are very high
There is only one vacant bed in the women's ward now, Dr. Fang, please explain the situation to the patients in the other two beds.
Aunt, your current condition is very good, and it is not that there is anything unclear about you. We will discharge you now. You just need to rest and exercise, and there is no need for injections anymore. Starting today, you can switch to oral medication.
Then, for venous thrombosis, it is necessary to first administer low molecular weight heparin sodium for anticoagulation treatment, and simultaneously request a consultation with the vascular surgery department
Yes, Mom, Dr. Fang is definitely right. Her condition is much more serious than yours. Just look at how anxious her husband is
Consider it from another perspective. Previously, I suggested that you go to Shashi First Hospital, but you were unwilling to go, correct?
16 skill points. The only area that can be improved is the theoretical foundation of trauma surgery
Looking closely at the relevant medical records of Huai City First People's Hospital, the lengthy diagnoses made Fang Xian particularly troubled
Basic Theories of Surgical Routine Level 1 14 / 25
After checking the room, I hurried to my bed: "Auntie, you are in quite good condition now. You can get out of bed and move around after the surgery. You will be discharged today to go home and rest, as well as to engage in functional exercises, okay?"