MTL - Doctor’s Life Simulator-Chapter 7 Incurable diseases, do you want Qin Lang to talk about it?

On the 13th hospital bed, there is a man in his forties, Wang Qiang.

"The patient Qin Lang will be handed over to you to manage the bed. If you have any situation, you can contact me directly."

Qian Liang instructed that due to the special situation of this patient, this time he would personally come to inquire about the patient's situation.

"Wang Qiang, how are you feeling now?"

The patient lay sickly on the bed, his entire face was a little dull, and the lips were even more chapped and rough.

Seeing Qian Liang come to ask, he opened his eyes slightly, but the whole person exuded a sense of resistance.

"It's still the same as before, the whole person is very uncomfortable, and the calf seems to be bitten by countless ants. Doctor, can you figure out the problem?"

Seeing Wang Qiang's pain, the family members on the side also questioned:

"The doctor at the town hospital said at first that it's okay, it's okay, debridement and disinfection, and antibiotics can reduce the infection, but look, it's been a long time. After finally changing to the city hospital, how come one day has passed, and the more It's getting more serious."

Hearing the doubts of the patient and family members, Qian Liang also said that he was suffering. It is true that this patient is very abnormal.

Common sense, such debridement, intravenous antibiotics should have relieved symptoms long ago.

Qian Liang could only bear the interest and continue to check.

When Qian Liang was doing a further physical examination, Peng Yun, who was on the side, also came over.

Peng Yun is 30 years old this year. He is a very talented young doctor in the city's first hospital. He graduated from the Imperial College Union Medical College and is very hopeful to be promoted to attending physician at the end of this year.

Peng Yun motioned to the two little doctors under his command to stand aside and came to Qian Liang's side.

"Is it the patient who was transferred from the county hospital yesterday?"

Seeing Peng Yun coming, Qian Liang nodded, and naturally handed Peng Yun the various auxiliary inspection materials in his hand.

After the latter took over, he looked at it: "According to the current situation, the patient has a fever, and the general condition is slightly worse. It has reached at least level 2 of skin and soft tissue infection. If complications are further checked, it will reach level 3. "

Peng Yun stepped forward and looked at the patient's wound: "Local redness, swelling, heat and pain, this is a typical manifestation of inflammation."

"There are local sinus tracts and secretions, and it seems that the situation is worse than I thought."

Hearing Dr. Peng's analysis, Qian Liang also gave a wry smile. He had already used conventional debridement and intravenous antibiotics yesterday, but the situation did not improve at all.

When the two resident physicians were talking, Cheng Yunfeng and the other two little doctors showed puzzled expressions on their faces.

So, Cheng Yunfeng habitually turned his head to look at Qin Lang, a habit he has developed these days:

"This is the 2014 U.S. guideline for the diagnosis and treatment of skin and soft tissue infections, which divides the degree of infection into 4 grades."

"Grade 1, no fever, generally good. Grade 2, fever, generally poor, but no unstable complications. As for grade 3, there are symptoms of severe poisoning or at least one complication."

Qin Lang naturally would not disappoint Cheng Yunfeng, and added a lot of his own analysis:

"Originally, the patient was just an open fracture with a lesser degree of soft tissue damage to Gustilo type I. The treatment was very simple, but by accident, he was an employee of a chemical plant and was soaked in toxic liquid, so it may develop into grade 3. Even if it is not cured for a long time, it is more likely Caused sepsis, a life-threatening grade 4 infection."

"I see."

Also while listening, Qin Lang was able to analyze so much, but he was at a loss.

Peng Yun's two little doctors suddenly felt a sense of shock, followed by a burst of frustration.

It was Cheng Yunfeng who secretly smiled, it seemed that he could not be beaten alone.

In front of Qin Lang, all the Gian Peisheng present here are rubbish!

Cheng Yunfeng's face also thickened, and he continued to ask:

"Hey, Qin Lang, can you explain what the Gustilo Type I is?"

The two little doctors on the side also pricked up their ears.

"Type I: The wound length is less than 1cm, generally a relatively clean puncture wound, the bone tip penetrates from the skin, the soft tissue damage is slight, there is no crushing and contusion, the fracture is relatively simple, it is transverse or short oblique, and there is no comminution."

"Type II: The soft tissue damage of the wound more than 1cm is extensive, but there is no avulsion injury, and no tissue flap is formed. The soft tissue has mild or moderate crushing and contusion, and the wound is moderately contaminated."

"Type III soft tissue extensive damage, mostly high-energy damage, serious pollution, fracture comminuted, unstable."

Qin Lang didn't care, they were all colleagues, and of course they were happy to share.

The three of Cheng Yunfeng couldn't stop nodding, and they rose again!

While several little doctors were struggling to digest, the two residents also began their own analysis and discussions.

"It now appears that routine debridement can only be continued first, while bacterial culture of sinus secretions and deep tissue extracts looks for pathogenic bacteria."

Peng Yun thought about it for a while, but he couldn't find a solution for a while. He could only check further:

"In this way, Wang Qiang, we need to do a B-ultrasound, an X-ray, and an MRI to see if there is any abnormality before confirming the next treatment plan."

Qian Liang and Peng Yun exchanged glances. In this case, only experienced doctors would dare to make a direct judgment. Based on their current clinical experience, they can only analyze after waiting for the examination.

Although it can be fully judged, the disadvantage is that it will take a lot of time and the patient may have further infection.

"Another inspection, and let us wait? Can you guys do it?"

The patient's family and Wang Qiang got angry when they heard that the two doctors had been discussing for a long time, but there was still no good treatment plan.

Qian Liang and Peng Yun could only persuade the patient with a wry smile:

"The causative bacteria are unknown now, and after all, the fracture is accompanied by venom soaking. We can only determine the cause through further examination..."

The two of them have already thought about the patient's condition and will show the patient's condition to the superior doctor to discuss the treatment plan. Now they can only treat it in a conventional way.

Just as the two were about to leave, an untimely voice sounded.

"I think it's time to adjust the patient's treatment plan. If the routine debridement is continued, it is very likely that the infection will worsen and the patient may have the possibility of amputation."

Qin Langshi's earth-shattering voice sounded.

Qian Liang was not too surprised, and looked at the doctor who had repeatedly surprised him. UU Reading www.uukanshu.com

Another resident physician, Peng Yun, did not have such a good temper. He glanced at Qin Lang. Their superior doctor was discussing issues. Where should he be to intervene, especially in front of the patient, so rashly It would be very irresponsible to say that the treatment regimen was changed.

Moreover, it is also hitting them in the face.

Peng Yun sneered: "This is your doctor for further education, so you don't understand the rules?"

Among the same generation in the city's first hospital, Peng Yun has always been talented and far ahead, so he speaks very strongly, even if Qian Liang does not behave well, he will be angry, let alone this little doctor.

Seeing her superior doctor get angry, her two little doctors shrank their necks, like quails, and they were very well-behaved.

Although Peng Yun has a hot temper, she can't stand her high level.

For Peng Yun's rebuke, Qin Lang was neither humble nor arrogant. After all, in the simulator world, he knew the situation of this patient.

Moreover, the patient's debridement will also fall into their own hands. According to their judgment, after the debridement is done, the patient will be seriously infected and eventually lead to amputation.

At this time, whether it was for the mission, the safety of the patient, or his own future, Qin Lang did his part.

When Peng Yun scolded Qin Lang, Qian Liang on the side also had a headache, but he still liked Qin Lang very much, so he still said good things for him:

"Qin Lang is a training doctor from a community hospital after all. In the community hospital, he and a superior doctor have to deal with various patients, so he has developed the habit of inquiring, and he is quite accomplished in debridement. To be honest, last time, it was Qin Lang's suggestion to let the 18-bed uncle heal ahead of time."

"Would you like him to talk?"