Chapter 141

However, just as Fang Ziye was about to head out, Li Yuanhong came jogging over; seeing Fang Ziye pushing his suitcase out, he hesitated, wanting to speak but stopping short.

He changed his question: "Doctor Fang, are you planning to go back?"

Fang Ziye said, "Hong Brother, a colleague just said things are too busy over here, so I thought I shouldn't get in the way. Do you need me to help?"

"How about you wait a bit? To tell the truth, we're a bit short-handed for plaster casting here."

"This patient volume is really too much — several large buses, hundreds of people more or less injured, minor debridement and suturing cases alone add up to at least three hundred-plus; divided among hospitals, the influx is simply overwhelming." Li Yuanhong was a little embarrassed.

Hearing this, Fang Ziye immediately and decisively shoved his suitcase into the doctor's rest room, then pulled on a white coat, saying, "No problem, Hong Brother. Where do I get a mask and cap?"

"The nurse station has them. Thanks for the trouble." Li Yuanhong looked embarrassed.

After Fang Ziye went out, he saw that the patient volume had truly concentrated all at once; although the patients coming to the wards were not major trauma — major trauma goes straight from the Emergency Department to the operating room or emergency operating room.

Just the patients needing to enter the operating room for minor debridement numbered seven or eight. Each was wrapped in bandages, the outer layers more or less stained with blood.

In the office, a duty doctor and another doctor who had come to help were surrounded by eight or nine patients needing admission procedures and over a dozen family members, and the family members' arms and lower legs also had slight bloodstains.

Just no fractures, but scrapes and abrasions that broke the skin.

It was also an inextricable mess.

Li Yuanhong was triaging at the nurse station: simple fractures get plaster casts, slightly complex ones wait to the side for him to take them to another operating room for closed reduction later, also needing plaster casts.

In the operating room, a young colleague had already started busying himself.

On the cart to his right, at least twenty or thirty plaster casts of various models were piled up.

Meanwhile, at the nurse station, several nurses operated simultaneously — scanning QR codes, issuing medical orders, explaining to patients; some complained the plaster cast was expensive, some asked if they could pay extra to go first.

A chaotic mess.

After Fang Ziye grabbed two masks, two caps, and two pockets' worth of examination gloves, he tore open the mask and cap packaging and put them on first.

Although it was very urgent, he still had to protect himself; wearing a cap and mask was absolutely necessary.

Plaster casting — Fang Ziye did it often during orthopedics duty at Zhongnan Hospital; a case yields only a fraction of a knowledge point, but it wins on simplicity, better than going into the training room.

Fang Ziye told Li Yuanhong, who was explaining to a patient, that he was going to do plaster casting first; the other nodded, still soothing: "Everyone don't panic, we must be standardized and procedural — only then can speed improve."

"I know you're all in pain, but in our eyes we must solve your problems, so don't call connections or anything; we're not taking any calls right now."

"Right now is a critical period — not to mention hospital leadership calls, even city leadership won't be calling. Everyone is treated equally; line up and come one by one."

"None of us are playing around — including our Director and Old Director, they're still seeing patients in the Emergency Department or doing surgery in the operating room; the specific situation, you all probably know better than I do."

"Although there's an unpleasant thing to say: the fact that you could get here, whether walking or pushed, and weren't kept in the Emergency Department — that's a kind of luck. Please understand and bear with each other. Our hospital is a very proper hospital; we won't abandon anyone, but we must handle them one by one according to the severity and urgency of the condition."

Li Yuanhong was still very steady.

After Fang Ziye reached the operating room, he started helping first.

The person doing plaster casting inside was an attending physician under Director Wu Guonan's group, named Wang Zhongxing. Fang Ziye briefly explained his purpose and identity; he nodded.

"Perfect, brother, help me hold the leg — this patient's family won't hold the leg, and this little nurse is an intern. You should know the traction leg-holding method, right?" Wang Zhongxing asked, seeing Fang Ziye's young age.

"No problem, Doctor Wang." Fang Ziye replied to Wang Zhongxing.

The aunt lying on the operating table spoke in a local accent: "Doctor, it hurts, be a little gentler."

She should be an Enshi person, not necessarily from the city proper, carrying a dialect accent.

Fang Ziye also spoke in the local dialect: "Don't be afraid, I'll be gentle, it won't hurt much."

Hearing Fang Ziye's accent, the aunt said, "You should be from Ba County, right? Your accent sounds like my brother-in-law."

Fang Ziye didn't reply; soothing her emotions was enough; what followed still depended on the operation.

The traction leg-holding method Doctor Wang Zhongxing mentioned actually uses traction force to create separation at the fracture ends without generating friction.

Under this method, whether helping the patient transfer beds, getting on a stretcher, or moving, no sharp pain is produced; if it's not a professional who knows the proper traction technique, a fracture patient's bed transfer is a torture.

This aunt had a mid-shaft fibula type A fracture; the ends aligned well, only needing direct plaster casting for temporary fixation.

Wang Zhongxing had already started laying out the polymer-material plaster cast, about 120 centimeters long.

For a mid-shaft fibula fracture, the plaster cast must be long enough; if it were a distal fibula fracture, it would only need to reach the knee joint — this point, Wang Zhongxing was still very professional about.

After a fracture the leg must be elevated, and the patient's fracture force line must be kept very parallel; otherwise gravity or muscle pull and other forces will cause pain.

However, this point was not difficult for Fang Ziye.

Fang Ziye applied traction force toward the sole while carefully supporting the patient's popliteal fossa, saying: "Doesn't hurt, Nai Nai (Auntie), just bear with it if there's a little pain!"

To say absolutely no pain, as comfortable as a normal person — don't even think about it; there would definitely be slight pain points, only the aunt didn't groan anymore.

"Ai! ~ Yo." She sighed.

"This is much better; earlier when I got on this stretcher and the ambulance, I felt like my leg was broken..." she sighed.

Fang Ziye didn't reply, just waited for Wang Zhongxing to hurry over and perform the plaster external fixation.

Plaster external fixation requires soaking the polymer-material plaster cast in water, then molding it, finally wrapping with bandages to form a good external fixation.

Soon Wang Zhongxing came over, placed the plaster cast on the back of Fang Ziye's hand; Fang Ziye gave it a slight turn and gripped the plaster cast into his palm, pressing it tight against the bottom of the patient's wool pants.

At the same time, Fang Ziye also helped curl the two ends of the plaster cast, to avoid pressure sores on the patient's skin after it solidified later.

Watching Fang Ziye's skilled coordination, Wang Zhongxing also nodded slightly.

Inwardly he thought this Doctor was still pretty standard — not the purely academic type who knows zero clinical practice.

After quickly wrapping and fixing this patient's plaster cast, Fang Ziye placed a small pad at her popliteal fossa, then seeing Wang Zhongxing go elsewhere, he instructed: "Don't straighten your leg — if you don't keep this curve here, during the continued plaster fixation period you'll be in great pain."

"Keep a slight curve here, so it's convenient for you to sit down later."

Unless it's a knee joint fracture, the popliteal fossa must have a slight curve when casting; otherwise the whole lower limb stiffens — not only is using the toilet inconvenient, even sitting down normally is very hard.

Seeing Wang Zhongxing already very skillfully reviewing films for another patient about to get a cast, Fang Ziye continued instructing: "Also, after you go back sit on a higher stool; give me your medical record book, I'll help you write in it."

Although there are two operating tables, they cannot operate on both sides simultaneously.

Because preparing plaster takes time, and plaster solidification also takes time; you can only say the two sides complete a perfect rotation — they cannot start casting simultaneously, otherwise the rest still have to wait.

Fang Ziye habitually reached into his pocket for a pen, but there was none, so he directly turned and took one from Wang Zhongxing's pocket.

"Hey; remember to give it back." Wang Zhongxing subconsciously blurted out, as if by instinct.

"Okay, Doctor Wang." Fang Ziye nodded.

Then he started writing: "After you go back, you still need to pay more attention, don't do physical labor or strenuous exercise, and you also need a follow-up to decide the time for removing the plaster cast."

"Also don't sit for long periods, you can walk with crutches without weight-bearing, as for crutches, you can just buy one outside."

"Doctor, where can we get them?" the aunt asked.

"General pharmacies all have them, Enshi City doesn't have them inside, your hometown pharmacies will also have them, if it really doesn't work just have a carpenter make one, I don't know where to get them either."

"Originally the department had them, but now it's estimated they're too busy to keep up, this crutch is also cheap. Okay." Fang Ziye looked at the previous medical orders while recording.

Treated with plaster external fixation, recommend rest, avoid weight-bearing and heavy physical labor, avoid strenuous exercise.

Recommend sitting on a high stool, avoid excessive skin pressure causing bedsores.

After writing like this, Fang Ziye reviewed the films again, found no problems, then handed the emergency medical record book to her.

As for her family members, they had to wait a while before they could come in.

No way, the operating room is only this big, both sides need plaster casting, if family members all rush in, then forget plaster casting, it'll just be people squeezing people.

"Doctor, can you be faster, I can't stand anymore." Someone urged from outside.

"One by one, her plaster cast also needs fixation, without fixation it's wasted effort." After replying to the outside, Fang Ziye hurried to Wang Zhongxing's direction to help as assistant for the next ulnar fracture's special plaster casting.

At the same time, watching 0.3 knowledge points credited, Fang Ziye was extremely delighted, operating room less than ten minutes, catches up to training room 3 hours, smug.

Of course, such thoughts, Fang Ziye quickly put away, honestly and dutifully acted as assistant.

Patients left the operating room one by one continuously, few but many knowledge points, bit by bit collected by Fang Ziye, although plaster casting assistant gets fewer knowledge points than operating position, but no need to snatch.

Solving problems for patients, letting them leave the hospital early, unclogging the current patient pile-up congestion, is the first priority.

However, just when proceeding to the seventh patient, Fang Ziye finished reading this patient's flat films, brows slightly furrowed.

"Doctor Wang, this patient, directly plaster casting, isn't it a bit unsuitable? His fracture belongs to unstable fracture, might need surgical treatment to be better, otherwise later the fracture end residual scar will be a bit large." Fang Ziye considered a moment, still suggested so.

"Ah?" Wang Zhongxing was already preparing to get plaster.

Because this patient was to be treated with plaster casting, it was the superior's intention, now Fang Ziye pointed it out, making him a bit unaccustomed.

"I think we can ask Doctor Li's opinion again, this patient admitted for hospitalization might be better." Fang Ziye continued suggesting.

"Ah? I need to be hospitalized?" The person who came in was an uncle nearly fifty years old, appearance honest, but at this moment hearing Fang Ziye's suggestion, also couldn't help becoming nervous.

"Hospitalization treatment would be better, if directly plaster casting, then your leg later, stress won't be good, walking, working, will all leave quite a few problems, and scar will also be large."

"Even has probability of causing fracture malunion, leading to nonunion." Fang Ziye said.

His fracture, indeed is tibial midshaft fracture, but belongs to b2.3 classification, this classification of fracture, at current level, generally doesn't undergo closed reduction and direct plaster external fixation treatment, although the fracture lines look relatively well aligned.

Fang Ziye has read many articles, also can't speak absolutely, after all that's just statistical data.

"Then that previous Doctor Li?" The bald-headed man's forehead wrinkles tightened.

"Uncle, right now too many patients, rough glance might not be that precise, only slow work produces fine work, our advice to you is definitely based on your actual situation adapting."

"Being a doctor isn't an assembly line, patient comes just directly plaster cast and leave." Fang Ziye still looked at Wang Zhongxing.

Wang Zhongxing at this moment was already holding his films hurriedly running out.

Roughly two minutes later, Wang Zhongxing re-entered, he gave the films to the middle-aged uncle, then said: "Uncle, you need hospitalization, our department's Director Xue has seen it, confirmed yours is best treated with hospitalization."

"Plaster casting's plaster external fixation, cannot meet fixation requirements. This you also understand, after all this time too many patients came."

"But we still must be responsible for you." Wang Zhongxing was very sincere.

"Ai yo, I thought just plaster casting would let me go home. This trip out to play, how did it turn into hospitalization." He complained a bit, looking quite honest and simple, as if family circumstances quite well-off.

"Uncle, this we can only respect facts, right. You go to doctor's office first, then handle hospitalization procedures, we really are too busy, our department currently only six doctors total, still can't keep up with consultations, slight oversight, please understand."

"Family member come over, help this uncle to doctor's office handle hospitalization procedures..." Wang Zhongxing called out while shouting for next patient to come in, not daring to delay time at all.

"Next, Nai Nai (Aunt)..."

Just, when shouting like this, Wang Zhongxing's expression looking at Fang Ziye slightly changed.

Truthfully, he never even thought to consider this aspect, but Fang Ziye not in his position, yet could raise his own ideas, from thinking level, Wang Zhongxing felt himself weaker than Fang Ziye by a layer.

He only thought about doing things, completing plaster casting this kind of operation, Fang Ziye thought about treating illness, and level still a bit high.

Maybe patient volume suddenly piled up, so this uncle and family didn't make trouble.

But if only him alone, you diagnosed wrong, then you might be in trouble.

Seen many, also exists certain degree of empathy.

After next patient came in, hurriedly asked: "Doctor, my plaster casting can cure it?"

Including patient lying on next bed also pressed: "Doctor mine nothing wrong right?"

Fang Ziye hearing this hurriedly explained: "No no, Big Brother, Nai Nai (Aunt), where so many errors oh, you two's fractures both simple, should be when injured stress relatively simple, plaster casting can handle."

"We're not making anyone hospitalized for the sake of hospitalization, definitely all giving you the best treatment method suggestions."

Wang Zhongxing this time, grew an extra mind-eye, he felt, Fang Ziye this young student, would think, not treating superior's decision as only standard, then he also must learn to think a bit.

Time flows like water!

Fang Ziye and Wang Zhongxing two people, in three hours time, completed nearly twenty plaster external fixation operations, only then cleared the simple fracture patient volume at operating room doorway.

Midway, Fang Ziye and Wang Zhongxing slightly swapped positions, after all always letting Fang Ziye do reduction traction, nobody has that long endurance either.

Back and forth, Fang Ziye and Wang Zhongxing became relatively familiar.

After tying the last patient's plaster bandage into a butterfly knot, Wang Zhongxing stuck half his body out, saw no patients, then directly plopped down on the ground.

Although just plaster casting, but continuous plaster casting three plus hours, you try?

Not tired is fake.

Fang Ziye instead considered white coat not his, needs others to wash white coat, so not so casual, but also leaned against wall, while writing medical record, while dry-mouthed said: "Yours ah, after going back can sit low stool, because your fracture is toe bone."

"So not that many particulars, but must pay close attention, don't kick things ah, this toe bone originally brittle, now still fractured, if kick something again very easy to re-fracture."

"Okay okay, thank you Doctor." Patient and family hurriedly nodded thanks, then family supported, patient hopped on one foot out.

At doorway, still didn't forget to turn back and say: "Thank you ah, two doctors, you also worked hard." They queued last, really saw two white coats, not even space to drink water, just continuously rotating shifts here.

After the patient left, Wang Zhongxing looked at Fang Ziye and gave a thumbs-up: "Live up to being a Doctor, this theory is really strong. You say two people are unsuitable for plaster casting, and they don't get plaster casting."

Fang Ziye had no airs, and his form of address went from Doctor Wang, to Brother Wang, to now Brother Xing.

Wang Zhongxing naturally wouldn't put on any airs himself.

A down-to-earth Doctor friend, he wouldn't refuse.

"Brother Xing, go ahead and laugh at me, I don't mind. Actually, just calling me Ziye is fine." Fang Ziye rubbed his wrist.

Rubbing his thumb.

Especially his writing thumb hurt, then he stretched a lazy stretch, and looked outside. He said: "Brother Xing, I'm going to drink some water first, are you going?"

Wang Zhongxing took out a cigarette: "Xiao Kuai Le, want one?"

Fang Ziye politely refused.

Wang Zhongxing then said: "Then I'll go drink water inside the rest room, you go to the office..."

The two separated.

Seeking the last day of monthly tickets ah, add update at six thousand. All reader big shots who think it's okay, vote ah.

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(Chapter End)