Chapter 293

「Jie Han, you're on the surgical team today! ~」

「Come to the Emergency Department for me. 」After searching around and finding no one suitable to help, Fang Ziye could only use his authority as Chief Resident to call Jie Han to the Emergency Department.

When the Chief Resident encounters emergency surgery, the surgical team arranged in the department must participate as assistants; such scheduling has a duty roster, and someone specific must be found every day.

Jie Han understood that Fang Ziye truly couldn't find anyone to help; although he was on the operating table, the operating table could still run normally without him.

No need to ask a superior for leave; the circulating nurse put the phone on speakerphone, and everything was clear.

Jie Han was immediately taken off the table, and Yan Zhiming, who had been fully suited and watching from the side, immediately squeezed into the assistant position Jie Han had originally occupied.

And after Jie Han left the operating room, only a few minutes had passed.

Yuan Weihong also lowered his voice to Professor Deng Yong: 「Professor Deng, why don't I take a temporary leave today? Xiao Fang is just starting his first day……」

……

After finishing the call, Fang Ziye hurried into the Emergency Surgery Resuscitation Room to read the images; after seeing the fracture situation, he breathed a slight sigh of relief!

Based on his own capability assessment, such a fracture met the indications for closed reduction and could be treated with closed reduction!

This patient also had an open wound, requiring a simple debridement, plus a subcutaneous tetanus antitoxin injection.

And the environment of his injury was poor, belonging to severe contamination, so he definitely needed several days of antibiotics for anti-inflammatory treatment……

Another more important factor was whether this patient's fracture counted as an open fracture; if it was an open fracture, the final treatment mode would completely change.

Another even more important matter was that he had chest and abdominal organ injuries, so the fracture treatment was actually elective surgery.

How could one not save a life first, and treat the fracture first?

The fracture had not caused major arterial and vascular damage; Fang Ziye was very sure of this, because with his current X-ray and CT image reading techniques, he could see the general course of the blood vessels.

He could also clearly distinguish whether there was an active hematoma.

So, his treatment opinion was……

While Fang Ziye was still carefully reading the images, Jie Han, who had hurried from the operating room, arrived.

The operating room was connected to the Orthopedics Inpatient Building, and the Orthopedics Inpatient Building was very close to the Emergency Department, so actually getting from the operating room to the Emergency Department didn't take long.

Many Chief Residents, even when in the operating room, could calmly reach the consultation location within fifteen minutes upon an emergency consultation.

「Senior Brother! ~」Jie Han spoke at the doorway.

Fang Ziye said: 「Jie Han, you go first and put a forearm sling on that dislocation patient, then talk and get a signature from the other fracture patient. 」

「By the time I finish the reduction, you take him up for a plaster cast for external fixation and minor debridement treatment. 」

「Can you handle it? 」

Encountering an emergency, everyone's operational opportunities could be maximized; Jie Han now had to step up. After fracture reduction, fixation was necessary, plaster cast external fixation was also fixation, and simple debridement—Jie Han definitely had no problem operating in the Training Room!

Then he also had to start learning and applying in reality.

Now the Chief Resident of Trauma Surgery was Fang Ziye, so the subordinates of Professor Deng Yong's group could fill up all the minor operations of emergency small surgeries.

Even Lan Tianluo, who didn't have a medical license, during emergencies, debridement, a Level 1 surgery, Lan Tianluo also had to do!

「Okay. 」Jie Han nodded, slightly nervous and excited.

If he seized today's opportunity well, then when he was on duty alone in the future, he would have more operational opportunities!

No need to report to Qin Geluo and others anymore, nor when encountering minor debridement and suturing, still have to report to teachers; his Senior Brother would complete a great feeding.

This was another closed loop, a small benefit exclusive to their Master's School.

Fang Ziye became Chief Resident, and his small Master's School would welcome a small surge of clinical minor operations……

Jie Han hurriedly left the consultation room, went to the doorway of the Emergency X-ray Room, and received the person who had previously undergone joint dislocation closed reduction into the operating room.

Fang Ziye looked at the consultation patients from other departments, then said to the Emergency Surgery doctor: 「Our Orthopedics Department currently has no absolute emergency surgery indications. I performed a physical examination and read the images, and found no active hematoma. 」

「Fracture is a surgery indication, but not an indication that needs to be treated now. The patient is currently in a coma with unstable blood pressure; I estimate there is active bleeding elsewhere. After the active bleeding is treated, my department will follow up on the fracture. 」

Fang Ziye was instructing not to keep calling Orthopedics. First save the patient's life—that was the business of Thoracic Surgery and General Surgery, big departments. Even if our Orthopedics did the fracture surgery perfectly well,

if active bleeding in the chest and abdomen wasn't properly handled, it would all be in vain.

The Emergency Department doctor and other consulting doctors glanced at Fang Ziye, then looked at each other, as if each saw in the other's eyes the expression of looking at a newcomer.

Fang Ziye didn't dwell on it so much; he seriously completed his procedures, and then wrote the consultation opinions clearly.

Only then did he leave the Emergency Resuscitation Room.

This patient's emergency—the real emergency wasn't in Trauma Surgery—so Fang Ziye had no pressure at all and could leave calmly!

At Zhongnan Hospital, no cross-department management, no cross-department handling.

This was called not overstepping boundaries.

Rules made it so.

「Doctor Fang, in my current situation, is it a fracture? Do I need surgery, hospitalization treatment……」After Fang Ziye left, he was questioned again.

The fracture youth who had talked and signed with Jie Han had already returned to the operating room. He had thick hair, a big nose, small ears; at this moment his nostrils kept flaring!

His face was tense, as if very afraid of being taken away by Jie Han, this child who looked even younger.

Relatively speaking, Fang Ziye looked slightly more mature than Jie Han by a little bit.

「Debridement will be performed in the operating room inside the Emergency Department. Now the operating rooms are empty; your wound is relatively simple. A minor debridement will do. As for this fracture, we choose closed reduction and plaster cast external fixation for external fixation. 」

「If reduction isn't done, then surgical reduction is needed. Of course, if you want to be safer, just go straight to surgical reduction! 」

「As long as you sign to agree, it's no problem. 」Fang Ziye didn't hear any more 120s coming from outside, so he patiently explained a few more sentences.

「Then let's reduce it first. 」This big-nosed youth also knew the cost difference between surgery and closed reduction; after hesitating, he decided this way.

「Your family isn't here; you have to sign yourself! I'll finish writing your medical record first, then we'll perform the reduction. 」Fang Ziye wrote the medical record while evaluating in his heart.

「Okay. 」

……

A few minutes later.

When Jie Han and that joint dislocation youth walked into the Emergency Clinic again, they found Fang Ziye performing reduction on the fracture patient.

The big-nosed fracture patient was there with his eyes closed, asking somewhat nervously, "Doctor Fang, have you started? ~"

"Almost done with the reduction, wait a moment!" Fang Ziye strained with both hands, muscles bulging, his voice strained.

"You said there'd be a little pain, but I don't feel any pain at all? I thought you hadn't started yet." The big-nosed man was flustered.

Hearing this, the youth with the joint dislocation asked Jie Han, muttering, "Why doesn't his reduction hurt?"

"Ah?" Jie Han turned to look at him, momentarily unresponsive.

"Nothing. Nothing." The youth glanced at Jie Han's graduate student name badge, as if it weren't his fault.

Fang Ziye's badge, at least, was that of a physician.

Jie Han felt looked down upon and wanted to explain, but thinking of Fang Ziye's procedure on the other side, he didn't dare interrupt, so he could only pretend not to have heard.

Seeing Jie Han speechless, the youth only confirmed his own thoughts.

Soon, Fang Ziye's side released the force, and the middle-aged man's lower limb deformity was roughly restored to normal.

And during the release after the fracture traction was completed, as the fracture ends realigned, the middle-aged man felt slight pain: "It hurts a little now, but it's fine!"

Fang Ziye's side only just released the force!

Looking at Jie Han, he asked with a smile, "Jie Han, do you know the answer to the question this patient friend asked?"

Jie Han knew his senior brother was giving him a chance to show off, so he quickly explained: "In the reduction process of a fracture, pain does not occur during traction; rather, traction separates the fracture ends, causing no contact or friction, and does not stimulate the nerve endings, so it feels relaxed and comfortable. Only at the end, when I release the force and the fracture ends are about to touch, will there be some pain."

"So, even if it's the same senior brother doing the reduction for you, one is a joint dislocation and the other is a fracture—the pain effect and the nature of its duration are completely different."

After explaining, Jie Han stood straight, enjoying the astonished gazes from the patient friend next door.

He thought to himself, Come on, I'm at least a master's graduate student at Zhongnan Hospital; in terms of knowledge reserve, I'm not someone you can bully at will.

Besides, closed reduction—we've been studying closed reduction techniques since last year; many people's understanding of closed reduction can't compare to our small group.

Especially theory.

Fang Ziye explained in detail this time: "The fracture should basically be aligned now; just need an X-ray for a follow-up. Then go to the surgical ward upstairs, let Little Duan do a debridement for you, and then handle hospitalization, okay?"

"Okay, okay. I'll listen to you, Doctor Fang." The big-nosed youth nodded quickly.

Now the ease and comfort after the fracture reduction, compared to the previous pain, was like entering a hot spring, his whole body warm and cozy, with an indescribable sense of relaxation.

After this, Jie Han quite excitedly took the middle-aged man to begin his own journey of debridement and plaster external fixation.

Of course, Fang Ziye still couldn't leave, but continued reading the films for that youth after reduction of his dislocation.

As the youth walked in, Fang Ziye showed him the post-reduction plain film: "Here, look, your dislocation has been treated."

"The humeral head is in place, you can move, and the pain has eased. No special treatment needed afterward. You feel much better yourself, right?"

"If you feel pain again later, you can go get an MRI; if there's no pain, you can temporarily skip it." Fang Ziye explained patiently again.

The youth looked around, saw that Jie Han had already left, and then asked: "Doctor Fang, why did it hurt like hell when I was just reduced, but not hurt after the reduction?"

"Didn't my fellow trainee just explain?"

"Originally, the pain mechanism of a fracture and joint dislocation are different. During traction of a joint dislocation, it further pulls on the tense, compressed muscles; before the joint is fully released, the pain gradually intensifies."

"After successful reduction, all muscles retract, and symptoms like compression are relieved, immediately different. But during traction, the muscles get tighter and tighter, and the pain intensifies—the principle is different."

"Your forearm sling stays on; after a month, go to any hospital for a plain film follow-up, and then remove the forearm sling depending on the situation. During this period, there are some taboos, you must remember..."

"Okay, thank you, Doctor Fang!" The youth was convinced.

To know how to do it, and also know why to do it, why it hurts.

That's quite professional!

Who was that?

Seems not unprofessional either.

Huang Yan pushed that middle-aged man out of the CT consultation room; the middle-aged man still spoke with a Sichuan Province accent: "I can pay by scanning the code."

"No rush, we'll talk about the fees later." Huang Yan replied, then walked into the consultation room again.

"Doctor Fang, this patient's head and chest/abdomen show no obvious damage for now; you can do a follow-up consultation from a surgical perspective!"

"The patient inside has unstable vital signs and an abnormal heart rate; I'll go take a look." Huang Yan hurried toward the emergency resuscitation room.

"Okay, Senior Sister Huang." Fang Ziye replied, but the other party seemed not to hear.

Treating illness is simple—Fang Ziye alone could cure quite a few—but saving lives, even a group might not be enough!

After Huang Yan left, Fang Ziye began interacting with this somewhat humorous Sichuan Province middle-aged man; the other's humorous cells were rich, always joking and having fun with Fang Ziye.

"Doctor Fang, how did you train your muscles? I've always envied you being so muscular; I think men should have muscles." The other was like a chatterbox.

Sitting in a wheelchair, not a bit quiet.

"Does it hurt?" Fang Ziye asked.

"What's this bit of pain? Let me tell you, Doctor Fang, when I was young, fighting was popular; after fighting, punches and kicks—what's this bit of pain..." The middle-aged man boasted proudly, as if showing off that he used to be a big shot.

But now, the seas have turned to mulberry fields; everything has changed.

"Uncle, you still fight?" After finishing his dislocation reduction and fracture reduction, Fang Ziye was stunned to find that although this middle-aged man was a clown, he could really endure pain.

He curiously asked.

"Hey, speaking of fighting, rather say I was unilaterally beaten by my wife, the tigress."

"Very fierce, let me tell you." The middle-aged man said.

Marry a Sichuan Province-Chongqing woman, enjoy a life of being bossed around.

Fang Ziye secretly gave a thumbs-up; worthy of being a Sichuan Province man!

"Do you have a girlfriend? Where's your girlfriend from? Let me tell you, never find one from Chongqing or Sichuan Province..." The middle-aged man turned his head to advise Fang Ziye.

Fang Ziye was stunned upon hearing this.

Good fellow, isn't Luo Tingzhu from Chongqing?

Of course, Fang Ziye didn't directly reply to him, but first had him scan the code to pay, then spent another ten minutes or so finishing his forearm sling and plaster external fixation.

Only then did he take a serious look and say: "Uncle, you're all set. Your fracture can only be temporarily fixed like this for now; surgery will be needed later, using intramedullary nail internal fixation!"

"Plaster external fixation is only temporary fixation and doesn't provide particularly strong fixation."

Fang Ziye explained again.

Actually, he had already explained all this; the middle-aged man had surgical indications, and the current treatment was only temporary treatment for pain relief.

Even for fractures where plaster external fixation cannot achieve fixation, temporary fixation must still be done after entering the hospital to avoid displacement worsening the pain!

This makes it more convenient for family members to take care of him.

"Is it all done?" The middle-aged man felt he hadn't had enough fun yet and sighed.

Fang Ziye joked: "Uncle, we can dislocate it again and then reduce it again; anyway, there aren't many patients coming now."

"Or maybe I reduced it wrong?"

The middle-aged man's face changed immediately, and he hurriedly protected his arm: "Don't talk nonsense~"

"Just joking, Uncle. You need to call home; someone needs to take care of you afterward. I'll take you to the ward first." Fang Ziye was naturally just joking.

Mainly because the other person started the joke.

Then Fang Ziye issued an admission certificate for him, telling him to process admission procedures at Trauma Surgery; as for how he got to Trauma Surgery, that was beyond help, and he could only figure it out himself.

……

Finally, Yuan Weihong couldn't hold back.

Hiding in the shadows of the Emergency Department, he had no choice but to show himself.

Around ten ten, sitting at the doorway of the consultation room, Yuan Weihong saw five or six people inside; three were queuing, and the other three were moving their joints.

They all seemed to be joint dislocations!

Even Yuan Weihong, who had seen Fang Ziye take on a batch of patients all at once before, was startled.

In front of them, Fang Ziye sat at the operation station, and with a crack, he sent away a patient with wrist joint dislocation whose disobedient joint had slipped out of the joint surface.

Saying: "Your reduction is done. Rest here for a bit; later I'll put a plaster cast on you. You can slightly move your wrist's internal and external rotation, like this."

Fang Ziye demonstrated for him, rotating his forearm left and right.

He also slowly learned.

The two people queuing behind looked at him enviously as he was free from pain again, laughing and saying: "Doctor Fang, it's my turn now, right?"

Yuan Weihong walked in, Fang Ziye saw Yuan Weihong, smiled at him, and then continued to calmly see the next patient with shoulder joint dislocation.

Fang Ziye explained: "Yours is a rare posterior shoulder joint dislocation. For this kind of dislocation, the probability of accompanying soft tissue injury is very high. The current diagnosis is Type II, considered relatively minor, and can undergo closed reduction, but after reduction you need to……"

"Okay okay okay, I'll definitely listen to you, Doctor. You're so professional?" He looked at some others who had been reduced; they were all relaxed now, only urging Fang Ziye to hurry up.

But Yuan Weihong standing beside was confused.

Actually, just now when Fang Ziye was doing closed reduction on the wrist joint dislocation, he felt it was inappropriate. After all, although the wrist joint is small, small joint dislocation doesn't mean it's easy to handle.

Fang Ziye reduced it for him.

Now this posterior shoulder joint dislocation, such an atypical reduction, Fang Ziye still wanted to try it himself?

But since Fang Ziye had already said it, he couldn't stop him midway; he could only watch patiently.

……

Four minutes.

Just four minutes, Yuan Weihong's heartbeat accelerated four times.

Every time Fang Ziye performed a reduction, Yuan Weihong's heartbeat would suddenly flutter once; first, he thought the type of joint dislocation Fang Ziye was handling was a bit weird, and second, it was the speed of Fang Ziye's closed reduction.

Is there anyone who reduces people this fast?

Finally, after everyone's reductions were finished, Yuan Weihong directly 'picked up' Fang Ziye in front of everyone!

Of course not literally picking him up; Yuan Weihong first knocked on the table.

"Come out with me!" Yuan Weihong's tone was serious.

The man who came from dark to light seemed a bit angry.

(Chapter End)