Practicing Medical Skills in a Small Clinic-Chapter 104 - 101: Unlimited Bone Palpation Opportunities, Teaching by Example_3

Chapter 104: Chapter 101: Unlimited Bone Palpation Opportunities, Teaching by Example_3

Don’t be fooled by the anesthesiologists’ silence and excessive low profile; during surgery, they are referred to as patients’ guardians of life.

Since ancient times, there has been a saying that the surgeon treats the disease, while the anesthesiologist ensures survival.

In pre-operative risk assessment, anesthesiologists have the right to veto.

If the surgeon believes the operation can proceed, but the anesthesiologist considers the risk too high, then it must be abandoned. Consequently, arguments between the surgeon and anesthesiologist are often heard in the consultation room.

In truth, they are a pair of close comrades.

"Old Yu, is it about done?"

Dr. Xu asked the anesthesiologist.

"Yes, it’s ready."

The anesthesiologist named Old Yu is around forty years old, with a full beard on his face, standing about 1.8 meters tall, quite tall but not particularly robust.

Since arriving, he has spoken only four sentences in total.

"Is he the one to receive epidural anesthesia?"

He then assessed and examined the patient, while the nurse inquired about any history of drug allergies and underlying conditions.

"If there’s no issue, please have the family sign a consent form."

"During anesthesia, it’s crucial not to move."

These are the four sentences the anesthesiologist spoke upon entering.

Li Jingsheng always felt that many taciturn anesthesiologists developed mental and psychological disorders due to prolonged high stress during work, resulting in cold facial expressions and reluctance to speak.

Of course, he would never say this in front of the anesthesiologists.

Dr. Xu approached the left side of the hospital bed and said to Li Jingsheng and Dr. Chen, "For this hip joint Type I dislocation reduction, you need to relax the muscles first, then perform anesthesia before manual reduction."

"During reduction, the patient can lie on the hospital bed or on the ground. Dr. Chen, you hold the patient with both hands to stabilize their body."

"Alright!"

Dr. Chen finally felt a bit noticeable, even showing a happy smile.

When it comes to hip joint reduction, it’s not just him; even the attending doctors in the department rarely master the procedure.

While the basic method is understood by most, actual practice is another matter entirely. 𝙛𝒓𝒆𝙚𝒘𝒆𝓫𝙣𝓸𝙫𝓮𝒍.𝒄𝒐𝓶

If you haven’t learned the Bone Touching Skill, succeeding in slightly more complicated bone-setting reductions is challenging.

"Xiaoli, watch closely."

Dr. Xu’s next words caused the smile on Dr. Chen’s face to instantly stiffen.

Biological ties remain biological ties.

Wild ties remain wild ties.

Besides envy, he wanted to understand Li Jingsheng’s relationship with Dr. Xu.

Even the dean doesn’t get such treatment, yet Dr. Xu meticulously guides Li Jingsheng everywhere—it’s too envy-inducing.

"During bone-setting reduction, you must face the patient, get their joint bent, then grip the back of their knee and apply continuous traction. This is when you need to sense the relaxation level of the patient’s muscles. Once conditions are met, rotate slightly outward..."

Crunch!

A sound of bone snapping echoed, and the patient’s right leg appeared much more natural.

Dr. Xu turned to Li Jingsheng, "Do you understand?"

"Yes, I roughly understand."

Li Jingsheng nodded.

"Check the patient to see if the hip joint has been successfully repositioned."

This was another opportunity for experiencing Bone Touching Skill!

With the teacher’s approval, the treatment was different.

Li Jingsheng recalled his previous job at another large hospital, where senior doctors wouldn’t even let him handle the retractor, compared to now where opportunities abound—it’s a stark contrast.

He bent over to touch the patient’s bones.

Clearly felt the patient’s leg muscles in a relaxed state, and the positioning of bones changed too.

Felt more natural to the touch.

From far to near, he carefully sensed the positioning of the joint bones when touching the hip joint, along with the joint’s shape. He wasn’t satisfied with just that, but also touched the patient’s left hip joint for comparison.

This time, the family said nothing; instead, they watched nervously, hoping for good results.

As for the accident-causing driver, nothing more was said.

If hip surgery were needed, he heard the treatment could cost several tens of thousands at the higher end, while the lower end could still cost over thirty thousand.

Even treatment for infants younger than 18 months could exceed six thousand.

In addition, there’s the patient’s loss of earnings, nutrition costs, caregiver fees, and miscellaneous costs combined, which could surely make the driver break down.

If manual reduction succeeded, many of the costs would be significantly reduced.

Everyone looked at Li Jingsheng expectantly, waiting for him to give a result.

Dr. Chen stood on the side, enviously overwhelmed.

"Both hip joint positions are essentially symmetrical; the right side’s bone position is natural, with no dislocation at the joint, indicating successful manual reduction. However, for more accuracy, an X-ray would be better."

Li Jingsheng added a final note.

An X-ray isn’t expensive and can reduce disputes.

If reduction wasn’t successful and wasn’t detected, eventual femoral head necrosis could lead to significant liability.

The driver and family’s faces showed smiles, as did the patient, who expressed a joy of survival.

"Dr. Chen, please take the patient and their family for an X-ray. If reduction is successful, admit the patient to the hospital for bed rest, perform skin traction, and wear anti-rotation shoes."

Dr. Xu’s words renewed the frustration for Dr. Chen.

Why not have the new guy, Li Jingsheng, do it?

He shot Li Jingsheng a resentful glance before obediently taking the patient for an X-ray.

Old Yu, the anesthesiologist, packed his toolkit and prepared to leave with the anesthesia nurse.

He stared at Li Jingsheng for a moment, then asked Dr. Xu, "A new apprentice?"

"No."

Dr. Xu firmly denied.

"Hmm, such treatment seems only available for apprentices. I’m out."

Old Yu took a meaningful look at Li Jingsheng again and left with his treasure chest.

The most mysterious figures in a hospital must be the anesthesiologists.

They’re often seen in operating rooms, wards, and emergency rooms. When they appear, they always carry a green leather, yellow lid toolbox, in and out quickly.

Dr. Xu pretended not to hear, didn’t rush to call in the next patient, but rather asked Li Jingsheng, "What did you learn from bone touching just now?"

"I could feel the position and shape of the bones, along with the surrounding muscle and fat layers."

"Not enough; these perceptions are rather superficial. You must delve deeper to discover some nuances."

Upon hearing his words, a flash of satisfaction discreetly appeared in Dr. Xu’s eyes.

Yet his face remained expressionless.

His words lacked praise, comprising only of admonishment.

"After returning, thoroughly comprehend the entire hip joint reduction process and its details; this type of reduction is rather rare." After speaking to Li Jingsheng, he turned to nurse Li Li. "Call the next patient in!"