"Tell me about it." Zheng Ren placed his left hand under his armpit and rested his right elbow on his left arm. He rested his chin on his hand and narrowed his eyes at the radiographic films on the radiographic film viewer.
"Here are the typical radiographic findings of traumatic pulmonary edema." Su Yun tapped the radiographic films with his right index finger. "However, such a severe fracture would result in a few hundred milliliters of bleeding and a small amount of pneumothorax."
"You think it's strange that the patient doesn't have a hemothorax?"
"Yes." Su Yun did not shy away from the topic. If he wanted to be polite, he would at least want the patient's condition to be as mild as possible.
However …
He did not.
Bluntly …
Bluntly.
"There's indeed a problem." Zheng Ren pondered and followed Su Yun's train of thought. "The patient's blood pressure isn't high. At his age, his blood pressure should fluctuate between 120 and 130. Multiple rib fractures, severe pain, and a blood pressure of 150 to 160 should be expected. However, the patient's blood pressure is between 90 and 100, which is worth considering. "
Lower blood pressure meant bleeding.
However, bleeding in the chest, be it from a ruptured lung or an intercostal artery, would result in pleural effusion.
However, this did not appear on the patient's lung CT scan.
Even the System, that big pig trotter, didn't mention how serious the trauma complications were. Ruptured lung was a diagnosis that could be severe or self-healing.
Under normal circumstances, the patient could be admitted to the cardiothoracic surgery ward for observation. They would take it one step at a time and deal with any problems at any time.
However, Zheng Ren and Su Yun were worried that if there was a problem, it would be a big problem. This was the best time to solve it!
"Su Yun, you're asking me for a consultation for this disease?" A voice came from the other side of the room.
They turned to look and saw the cardiothoracic surgery chief resident, Cao Guozhen.
He was tall and sturdy like a black bear, and he walked with great vigor.
Speaking of which …
It was just as vigorous as usual.
His words were laced with sarcasm, probably because Su Yun and Zheng Ren had embarrassed the cardiothoracic surgery department during Yang Lili's rescue. Even now, he was still upset.
He glanced at the radiographic films with a disdainful smile on his face.
"The most typical traumatic pulmonary edema. Did the two leaders of the emergency department have to study it together?"
Zheng Ren thought of countless possibilities in his mind. Su Yun ignored Cao Guozhen's provocative words and frowned in deep thought.
"You want to keep the patient in the emergency ward, don't you?" Cao Guozhen sneered. "Let's keep him, no problem. Let me tell you, use hormones first, then 10 mg of dexamethasone daily, plus anti-inflammatory, aerosol, and phlegm-reducing treatment. Don't give Mucosolvan according to the instructions. 100 vials a day. Pump it into the vein. There's no problem at all. "
Zheng Ren and Su Yun were still pondering.
"Give Mu Shu Tan according to the instructions. Serious hypostatic pneumonia will definitely appear in three days. Don't say I didn't remind you." Cao Guozhen chattered.
What he said made sense. It was advice from the bottom of his heart.
Su Yun knew that imported drugs like Mu Shu Tan were cheap and had almost zero side effects. When he was in the Imperial Capital, the largest amount he used was 300 tubes a day, and the intravenous pump was pumped continuously for 24 hours.
After that, pay attention to turn over, knock on the back, and cough up phlegm to prevent hypostatic pneumonia. The patient can be discharged in a week.
However, the problem was that they did not consider the patient's simple right rib fracture and traumatic pulmonary edema.
Whether it was in the emergency ward or the cardiothoracic department, if they missed this opportunity, the patient …
There was a possibility of danger.
However, it was just a possibility.
Medicine was an empirical science and also a science of inquiry.
Without evidence, you f * cking told me to do an exploratory thoracotomy. Are you afraid that the patient will sue you to death after the surgery?!
After a few minutes of judgment, Zheng Ren suddenly thought of the f * cking reason Su Yun had called him back.
He wanted to do an exploratory thoracotomy, but he did not have the authority to do so.
Just like how he always asked Old Chief Physician Pan to bear the brunt of the thunder, this f * cker was asking him to bear the brunt of the thunder!
"The patient can't be treated like this." Zheng Ren put his hand down and turned to look at Cao Guozhen. "At the very least, we need to do an emergency fracture internal fixation surgery."
Su Yun was stunned.
Zheng Ren's words were too f * cking shameless.
The patient's fracture alignment was good, so there was no need for refixation.
However … this was a very good reason and excuse, was it not?
"Yes, look here. The dislocation is obvious. The bone stubble may have pierced the pleura and lungs when the patient turned over and hit his back, causing a secondary hemopneumothorax," Su Yun said confidently as he pointed at a small fracture point on the radiographic films.
Under normal circumstances, a lung CT scan was a tomography scan, not used to look for fractures.
To look at the fracture, a chest X-ray and a 64-slice CT scan with 3D-image reconstruction were needed.
However, a lung CT scan could see a little bit of the situation. Su Yun grabbed one of the positions and said that the fracture was very serious.
Cao Guozhen was stunned …
The emergency ward was so shameless in order to snatch the surgery?!
F * ck, no wonder the general surgery department could not beat them.
According to them, this surgery had to be done in the emergency department. If they did not do it, they would have something to say if the patient made any movements in the future.
Cao Guozhen's mind worked quickly. Then, he said, "Then put it away. I'll do it."
"You?" The corner of Su Yun's mouth revealed a mocking smile. "You know how to do surgery? Have you cut a lung before? Have you done a sleeve resection? You don't know anything but a fracture. How dare you say you know how to do surgery? "
"You …" Cao Guozhen really wanted to go up and kill Su Yun.
He had always spoken politely. Although his tone was a little sarcastic, he did not use any vulgarities at all.
Su Yun actually dared to insult him. Was he a wild dog?
"Send ten rib clamps over," Su Yun said calmly as he blew the black hair on his forehead.
"Why?!"
"Are you looking for the medical administration division? Or Old Chief Physician Pan? We don't have time for thoracic surgery. If we find Old Chief Physician Pan, he will definitely keep the thoracic emergency department. Su Yun said with a smile, "It's just a chest bottle. Even the nurses know how to do it. How dare you say it's surgery?"
These words … were really f * cking embarrassing.
Cao Guozhen realized that Su Yun was speaking the truth. If they took the opportunity to keep the thoracic emergency department, the chief would definitely kill him if he found out.
Holding his breath, Cao Guozhen turned around and left.
"Admit him to the hospital. I'll inform Yiren and the others to prepare for emergency surgery," Zheng Ren said.
"Okay." Su Yun nodded. As he turned to leave, he suddenly said, "Boss, thank you."
"It's okay." Zheng Ren waved his hand. "I trust you."
…
…
Note 1: This usage of Mu Shu Tan was taught by Professor Chen Houkun from Medical University fifteen years ago. Professor Chen was a very kind person. He used this method that exceeded the instructions to treat several patients with severe trauma, traumatic pulmonary edema, and hypostatic pneumonia. One of the patients gave up and threw him on my hospital bed. He was discharged on the 26th day and returned home. After that, the patient came to visit me once while on crutches.
Note 2: This surgery was performed on a patient I received in 2009. Looking at the radiographic films, there was no indication of surgery. I looked at the radiographic films for an hour, called the chief three times, and finally brought him from home in the middle of the night for surgery. Fortunately, the surgery was done early. It was also thanks to Dali who was in the ICU at the time.
Note 3: Thank you, Red Dust Alliance. Please wait for more updates.
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