Chapter 164: Prepare for a rainy day and explore the cause of the 7-bed patient

Author: Jiangbian Yuweng

Chapter 164: Prepare for a rainy day and explore the cause of the 7-bed patient

The origin of ICU construction abroad is unclear. The earliest ICU construction in China was led by anesthesiologists.

Speaking of this, I have to introduce the emergency department first.

In the past, domestic hospitals did not have emergency departments. They were a department that came into being to rescue emergency patients. Later, a series of standards and discipline definitions were carried out, and finally consistent with its name, all emergency patients can call the emergency department.

.

And the emergency department cannot refuse treatment.

Also, specialist clinics do not treat patients at night.

There are doctors on duty in the emergency department 24 hours a day. Any time you go to the hospital for an emergency call, you are required to have a doctor on duty.

With these two gold standards in place, the emergency department later added some privileges.

For example, after a car accident patient was brought here, he had no family members. It was impossible to contact his family members or the patient's immediate relatives for a while. The patient was in critical condition, and according to the hospital's rules, the family members had to sign and pay the fee before treatment could be given.

In this case, the emergency department has an additional privilege. During working hours, if there is no family member to sign, you can go directly to the medical department, and then the director of the emergency department will sign on your behalf.

No one pays, but if surgery or rescue is not arranged immediately, the patient will die immediately.

Easy to handle!

When dealing with arrears, deal with them first.

Even today, the emergency department still ranks first among the departments with the most bad debts in hospitals.

In addition to these privileges, emergency examinations are generally marked as expedited.

There are a lot of things you can do without queuing up and do them first.

If a specialist wants to be hospitalized, you have to wait until beds become available before they can admit you.

Emergency medicine doesn't have to be so particular. If it really doesn't work, you can lie down in the observation room.

Anyway, you doctors can't watch your patients die in the hospital, right?

With many conveniences and privileges, patients really like the emergency department services.

As a result, the emergency department has become the busiest department in the entire hospital.

When the department heads, experts, doctors and nurses from various major departments saw all the patients going to the emergency department, they naturally refused to agree.

As a result, the emergency department, which was inherently deficient, became a transfer station for diagnosis.

Only emergency and critically ill patients will be treated, and only preliminary treatment will be provided. After the patient's condition is stable, he will be directed to the corresponding specialist to continue treatment.

As a result, the specialist department felt at ease.

It is equivalent to having an extra handyman who can perform initial screening and treatment of patients.

When you are sent to a specialist for treatment, the specialist doctors and nurses will just take your time and step by step.

The specialist found that life was much more comfortable than when there was no emergency department.

Key revenue has not decreased.

Because the emergency department only provides initial treatment to the patient, medication, surgery, and hospitalization account for the bulk of the medical expenses, and the emergency department can hardly collect 10% of the medical expenses.

But the emergency department does more work than any other specialty.

I have to endure all kinds of abuse and even beatings from patients and family members.

The work in the emergency department is tiring and dangerous, and the pay is low.

Therefore, there is a saying in the medical community that advises people to go to the emergency department to be careful of lightning strikes.

As time goes by, few doctors are willing to really stay and work in the emergency department for a long time. Especially those capable doctors, after gaining experience, move to high-level departments, where they become popular and have a high status.

Failure to retain elite doctors will inevitably lead to poor emergency department care.

What to do?

Later, the Department of Critical Care Medicine appeared.

For some critically ill patients admitted to the emergency department, when treatment was uncertain, the medical staff of the critical care medicine department took action to save the patient's life.

When it comes to life support and life monitoring, doctors in the anesthesiology department are undoubtedly the top leaders.

This is also the early critical care medicine department in China, and the key doctors are basically anesthesiologists.

Later, the nutritional support of the internal medicine department was integrated into the critical care medicine department, and the life support of the anesthesiologist was combined. This was quite perfect.

Gradually, some critically ill patients were admitted to the ICU, and they were no longer admitted alive and carried out dead.

The number of patients transferred alive to general wards is gradually increasing.

Up to now, the Department of Critical Care Medicine has absorbed examinations from the Medical Technology Department, nutritional support from the Internal Medicine Department, life monitoring and life support from the Anesthesiology Department, and surgical support from the Surgery Department. Such as invasive ventilators, tracheostomy intubations, and urine bags.

etc.

It can be said that the current Department of Critical Care Medicine represents the comprehensive strength of a hospital.

Elite medical care is drawn from various departments to provide patients with the best medical resources, life support, and various treatments.

However, no matter how it develops, doctors in the anesthesiology department have the first-mover advantage and currently still play a decisive role in the department of critical care medicine.

"It turns out that Dr. Shi used to be an anesthesiologist, so it is understandable that he is reticent. Do you think the development of the critical care medicine department is better compared with the anesthesiology department?"

Zhou Can is very curious, which department is better?

The Department of Anesthesiology and the Department of Critical Care Medicine are relatively mysterious to most doctors.

Little is known about income and development prospects.

"Everyone has his or her own merit! Dr. Shi's transition to the Department of Critical Care Medicine should be considered a very successful one. Although he was promoted to the attending level in the Department of Anesthesiology before, after switching to the Department of Critical Care Medicine, his professional title remains unchanged. But he is likely to be

If you are still engaged in anesthesia work, you may not be able to get a deputy senior professional title."

Evaluating for a deputy senior professional title is a hurdle for many attending doctors.

At least one topic at the provincial level or above and three papers at the core journal level are enough to stop many people.

As for the written examination for the deputy senior professional title, it is only the first and easiest level.

Dr. Shi's age should be around 39 to 40 years old.

Some doctors with good talent, good foundation, and good luck may be awarded deputy senior professional titles at the age of 38. But after all, there are only a handful of them.

Many people are grateful to God if they can be awarded a deputy senior professional title before the age of 45.

Why add a good luck factor?

Because when choosing a topic for research, if you can hug a big boss's thick legs and participate in a good topic, or assign him a more common topic for you to host.

All these good things require luck and character.

Dr. Shi was able to reach the rank of associate senior at the age of 40, and in a large hospital with extremely fierce competition like Tuya, which is definitely a very successful transformation.

Zhou Can tried his best to inquire about this matter in order to prepare for his future professional title evaluation.

My family knows their own affairs.

His low academic level is a flaw. The higher he climbs, the more obvious this flaw becomes.

Although with his current development momentum, there is a high probability that he will be able to solve the academic problem in the workplace, he still has to prepare for the worst in everything.

Now it’s time to inquire more and be prepared for a rainy day.

"Xiao Zhou, I will hand over to the ICU at eight o'clock tomorrow morning. Remember to arrive about half an hour early."

Before Dr. Hu said goodbye to Zhou Can, he warned him.

Today is only the first day at work. Zhou Can mainly learns the operation of various equipment and gets familiar with the environment.

Tomorrow, we should slowly add some tasks to him.

After get off work, even though Zhou Can had dinner in the hospital cafeteria, he was still thinking about the patient in bed 7. What is the cause of lower gastrointestinal bleeding?

The patient's various examination reports were constantly replayed in his mind.

Intestinal bleeding, if not treated in time, is very prone to perforation. But the patient persisted for half a year without treatment, and there was no perforation of the intestines.

This shouldn't be a miracle.

There must be some unknown reason.

The patient has already undergone endoscopic hemostasis treatment. If there are obvious abnormalities in the intestine, the doctor will definitely be able to detect it in time.

The patient underwent routine stool and occult blood tests.

There was no obvious cause found on the inspection report.

An anatomical diagram of the human digestive tract appeared in Zhou Can's mind.

The human intestine is composed of the small intestine and the large intestine.

The small intestine starts from the pylorus of the stomach and connects to the cecum of the large intestine at the lower end.

The length of the entire large intestine is only about 1.5m for an adult. It is not too long because the end can be probed through the intestinal portal, so it is easier to detect lesions in the large intestine.

Zhou Can secretly thought to himself that intestinal tumors, polyps, intestinal ulcers, and various types of enteritis can now basically be ruled out.

Vascular malformations and varicose veins can also be ruled out.

This disease is really difficult to treat.

I really don’t blame the gastroenterology doctors for not being able to detect it.

This patient's disease is too complex.
To be continued...