bookpower Chapter 164
Chapter 164
Lin Feng didn't want to pay attention to the things on the Internet, because a lawyer would help him handle it.
Lin Feng is preparing to find Wu Zhengye, director of hepatobiliary surgery, to report,
"Hey, it's lunch..."
"Forget it, let's go have lunch first..."
Then I turned around and went to the dining hall to eat.
Wu Zhengye: "........................"
Flip table(╯‵□)╯(┻━┻!
After lunch at noon, in the afternoon, Lin Feng will give lessons to interns and regular training doctors.
......
Class.
Teacher: Lin Feng
Students: Interns and doctors (more than 300 in total)
Venue: Training Base (Conference Room No. 10 of the First Municipal Hospital)
In addition to the ordinary trainees, more than a dozen attending physicians who did not come to work also came to listen to the class.
This is already Lin Feng's eleventh class.
(There are points for classes, and points are required for promotion in the medical system)
With Lin Feng's lectures again and again, many people found that Lin Feng's lectures were easier to listen to, easier to understand, and more rewarding, so Lin Feng's lectures began to have attending physicians to listen to the lectures one after another, and even some chief physicians.
This time, it was the first time that Lin Feng taught a new batch of interns.
Look around,
Without exception, their faces were filled with a bit of green aura.
Moe new breath ~~~
Lin Feng sighed that time was not worth much, and in a flash, Lin Feng had been in the first courtyard of the city for almost 2 years, and back then, he was the same as them.
"Today, let's talk about shock..."
"Shock is a more dangerous clinical syndrome that is more likely to appear in many surgical and emergency scenes. (It's not a disease)"
"The concept of shock: it is a systemic pathological process in which the effective circulating blood volume is reduced due to various reasons, and the microcirculatory perfusion flow of tissues is seriously insufficient, resulting in cell damage and serious disorders of the function and metabolism of important organs. "
"By etiology: blood loss, trauma, burns, infection, sepsis, endotoxin, cardiogenic, allergy, neurogenic... (suffix "sexual shock")
After talking for more than ten minutes...
Getting to the core:
"Shock, the treatment method is naturally - "rehydration"!"
"The principles are: salt before sugar, crystal before gum..."
"First, saline supplementation... That is, the sodium supplement formula, the specific formula is: (140-blood sodium) x body weight x 60%..."
"But!"
"Students should remember that the formula for female rehydration is the last one to change to 50%!"
Lin Feng was about to continue...
"Why?"
Suddenly, another female intern raised her hand sharply and looked at Lin Feng with a little anger.
Lin Feng was stunned for a moment: "???"
Female intern: "Why?
Lin Feng said with a smile: "That's because women's muscles have a lot of water..."
Female intern: "No, I'm asking, why do you stipulate that women supplement sodium less than men!"
This female intern, speaking in a tone full of doubts!
And with anger!
Glaring at Lin Feng like an angry bull!
Lin Feng: "????"
What do you mean?
Lin Feng didn't understand what this female intern meant.
The students were also at a loss.
They didn't understand either.
At this time, the female intern continued to say angrily: "We women, why do you want to discriminate? Why do you want 10% less? Why are men and women equal?"
Burst~~~
Then a mouthful of old blood spurted out of the audience!
Now everyone understands!
Nima!
This is a female boxing master, my grass?!
Lin Feng was also stunned!
What brains!
Is this sexism when I step on a horse?
Can this also rise to women's boxing?
Wouldn't it be legal to kill someone after treating someone in the future?
"What's your name?" Lin Feng's face quickly turned cold.
"My name is Zhang Mengzhen..."
"Well..."
I picked up the phone and called the medical and education office, and told the medical and education department about this side.
It didn't take 10 minutes...
Director Zhang of the Medical and Education Department quickly ran to the classroom, his face black.
"Zhang Mengzhen, give it to me!"
Zhang Mengzhen also walked out with a "unconvinced" look.
"In the future, you won't use the city first courtyard, I have already called your school..."
"I'm not convinced, I'm not done with my internship!"
Zhang Mengzhen shouted angrily...
Then you go to the school... Our city and one court can't tolerate this big Buddha of yours..."
"Hmph, is the first city hospital amazing?
"Huh~~~"
Director Zhang of the Medical Education Department looked at Zhang Mengzhen with a sneer.
As far as your brain, it is estimated that no hospital dares to ask for you, it is good to graduate!
......
It was just a small episode.
Lin Feng continued the class,
Finally, he talked about his own experience:
Regarding the various states of shock, how to rehydrate correctly?
Under normal circumstances, CVP (central venous pressure) and BP (blood pressure) are low, so it is necessary to quickly rehydrate.
If CVP is low and BP is normal, slow down appropriate rehydration,
If CVP is high and BP is low, it may be overly fluid, and diuretics should be used to quickly export fluid. There may also be cardiac insufficiency, and heart boosters are required.
If CVP is high and BP is normal, vasoconstriction indicates vasoconstriction, and vasodilators should be used.
Explain the profound in simple terms!
Whip in!
The students are attentive, the experience is +10+10+10+10+10...
......
Time seems to pass very quickly,
In a flash, 2 hours passed,
End of class!
The audience was in an uproar~~~~
There was applause.
"Dr. Lin is amazing!"
"I don't know why, Dr. Lin's class is so easy to listen to!"
"I feel like I have mastered the points of shock at once. "
"Me too!"
Lin Feng said goodbye to many students and returned to the hepatobiliary department.
......
The next day,
Lin Feng continued to go to work.
Just arrived at the hepatobiliary department, a small nurse stopped me.
"Doctor Lin..." (secretly looking at Lin Feng's handsome face, joyful)
"What's wrong?" Lin Feng asked in his head.
Little nurse: "Dr. Lin, I am Li Lizhen from the Department of Urology... The thing is like this, originally Director Shen Qingyan had a unilateral nephrectomy today, due to physical reasons, he could not perform the operation, and the director wanted to ask you to help with this operation... Is that okay?"
Wu Zhengye, the director of the hepatobiliary department who just walked in: ".................."
Lin Feng: ".................."
Lin Feng was a little speechless, how big and small things came to him, I don't believe that the first hospital in this city can't find a second chief physician who can perform unilateral nephrectomy.
Lin Feng: "Are there no other doctors?"
The little nurse explained: "That's right, this operation is actually a demonstration of learning surgery, for interns, and regular training doctors to learn, but also negotiated conditions with patients, signed agreements... The director said that other doctors are not yet competent, so they can only look for you. "
The little nurse stuck out her tongue, indicating that she was also acting on orders, and Lin Feng couldn't blame herself.
Lin Feng: "............ Well, are the operations all ready?"
Little nurse: "All ready." "
Lin Feng spread his hand to Director Wu Zhengye, meaning: Director, it's not that I don't want to stay in the hepatobiliary department, it's really that I'm too busy...
Wu Zhengye waved helplessly: "Let's go..."
Lin Feng nodded: "Thank you, Director!"
......
It took more than half an hour, and Lin Feng read all the patient's information...
The basic information of the patient is as follows:
Patient male, 47 years old.
·183cm，220kg，
Acquired obesity.
A week ago, 10 days of right back pain without obvious cause, the outpatient was admitted to the hospital with "right kidney mass lesion". During the course of the disease, the spirit, physical strength, appetite, and sleep were normal, and there was no significant change in weight.
Accompanied by gross hematuria.
Urological CT examination showed a tumor of the right kidney
Surgical protocol: after evaluation, kidney-sparing surgery is not available and radical resection (total right kidney resection) is required.
Surgical evaluation: laparoscopic surgery is not possible and open (open) surgery is required.
Lin Feng was surprised!
More than 400 pounds!
Only 170cm!
This is already super scary obesity, right?
This patient is really special enough!
......