top student at medical school

Chapter 142 Joining the Plaster Team (Please Subscribe)
However, just as Fang Ziye was about to leave, Li Yuanhong jogged over, looked at Fang Ziye pushing his suitcase out, and hesitated to speak.

He changed his question to, "Dr. Fang, are you planning to go back?"

Fang Ziye said, "Brother Hong, a brother just came and said he's too busy here, so I thought I shouldn't get in the way. Do you need my help?"

"How about you come a little later? To be honest, we're a bit short-handed when it comes to putting on casts here."

"The number of patients this time is really too much. Several buses, a total of several hundred people, all of whom have some kind of injury. At least three hundred people have needed minor wound cleaning and suturing. If you divide them among the hospitals, the number of patients pouring in is just too much." Li Yuanhong said somewhat embarrassedly.

Upon hearing this, Fang Ziye immediately and decisively shoved his suitcase into the doctors' lounge, then grabbed a white coat and said, "It's okay, Brother Hong, where can I get a mask and a hat?"

"There's one at the nurses' station, thank you for your hard work." Li Yuanhong said apologetically.

After Fang Ziye went out, he saw that the number of patients had suddenly increased. Although the patients who came to the ward were not major trauma patients, since major trauma patients were usually taken directly from the emergency department to the operating room or emergency operating room.

There were seven or eight patients who needed to go into the operating room for minor wound cleaning. Everyone was wearing bandages, and the surface of the bandages was more or less stained with blood.

In the office, a doctor on duty and another doctor who came to help were surrounded by eight or nine patients who needed to complete the admission procedures and more than ten family members. There were also some bloodstains on the arms and calves of the family members.

There was no fracture, but the skin was scraped and broken.

It's a very complicated situation.

Li Yuanhong was sorting out other people at the nurses' station. Those with simple fractures were given casts, while those with slightly more complex fractures were left to wait. He would take them to another operating room later for manual reduction, and they would also need casts.

Inside the control room, one of the team members was already busy at work.

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

Meanwhile, at the nurses' station, several nurses started operating simultaneously: scanning codes, writing medical orders, and explaining to patients. Some people complained that getting a cast was expensive, while others asked if they could pay extra to get it done first.

A mess.

Fang Ziye grabbed two face masks, two hats, and two pockets of inspection gloves, then tore open the outer packaging of the masks and hats and put them on.

Although you are in a hurry, you must also take care to protect yourself. Wearing a hat and a mask is essential.

Applying plaster casts was something Fang Ziye often did when he was on duty in the orthopedics department of Zhongnan Hospital. He only gained a fraction of a point of knowledge from each case, but it was simple and better than going into the practice room.

Fang Ziye told Li Yuanhong, who was explaining to a patient, that he was going to get his cast put on. Li Yuanhong nodded and continued to reassure him, "Everyone, don't rush. We must standardize and follow procedures so that we can speed things up."

“I know you are all in pain, but in our eyes, we are all here to solve your problems, so we won’t call or ask acquaintances or anything. We won’t answer any calls now.”

"This is a critical period. Not only will the hospital leaders not call, but the city leaders won't either. Everyone should be treated equally, go and line up, and come one by one."

“None of us are playing around. Even our chief and former chief are still seeing patients in the emergency department or performing surgeries in the operating room. I’m sure you all know better than I do what’s going on.”

"Although there's something unpleasant to say, it's fortunate that you were able to come here, whether you left or were pushed, and that you weren't kept in the emergency department. Let's all try to understand and be considerate of each other. Our hospital is a very reputable hospital and will not abandon anyone, but we will also handle each case according to the severity and urgency of the illness."

Li Yuanhong remains very composed.

After Fang Ziye arrived at the control room, he immediately began to help.

The person applying the cast inside was an attending physician named Wang Zhongxing, who worked under Chief Physician Wu Guonan's team. Fang Ziye briefly explained his purpose and identity, and Wang Zhongxing nodded.

“Perfect timing, brother. Could you help me with my leg? This patient’s family doesn’t know how to support a leg, and this young nurse is an intern. You should know how to use traction to support the leg, right?” Wang Zhongxing asked, seeing that Fang Ziye was quite young.

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

The woman, who was lying on the operating table, said in her local accent, "Doctor, it hurts! Please be gentle."

This person should be from Enshi, but not necessarily from within Enshi city, as they have a local dialect accent.

Fang Ziye, speaking in the local dialect, said, "Don't be afraid, I'll be gentle, it won't hurt."

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

Fang Ziye didn't reply. It was enough to calm him down. The next step was to see how things went.

The traction-supporting leg method mentioned by Dr. Wang Zhongxing actually uses traction force to separate the fractured bone ends to a certain extent, so as not to produce friction.

In this way, even when helping patients transfer to a bed, onto a trolley, or move around, there will be no sharp pain. If it is not a professional who does not know the appropriate traction technique, then transferring a fracture patient to a bed will be a painful experience.

This woman has a type A fracture of the midshaft of her fibula. The fracture ends are well-aligned, and she only needs temporary fixation with a plaster cast.

Wang Zhongxing has already started laying the plaster made of polymer material, which is about 120 centimeters long.

For fractures of the middle fibula, the cast must be long enough. For fractures of the lower fibula, the cast only needs to reach the knee joint. Wang Zhongxing is very professional in this regard.

After a fracture, the leg must be raised so that the fracture line is perfectly parallel; otherwise, pain will occur due to gravity or muscle traction.

However, this is not difficult for Fang Ziye.

While applying traction towards the soles of her feet, Fang Ziye carefully supported the patient's popliteal fossa, saying, "It doesn't hurt, Auntie. You have to bear with even the slightest pain!"

To say it's absolutely painless and as comfortable as a normal person's, don't even think about it. There will definitely be slight pain points, but the aunt didn't groan anymore.

"Oh dear!" she sighed.

"This is much better. Before, when I was on this trolley and in the ambulance, I felt like my legs were broken..." she sighed.

Fang Ziye did not reply, but waited for Wang Zhongxing to come over and perform the plaster cast fixation.

Plaster external fixation involves soaking a plaster made of polymer material in water, shaping it, and finally wrapping it with a bandage to form a good external fixation.

Soon, Wang Zhongxing came over and applied the plaster to the back of Fang Ziye's hand. Fang Ziye then gently wrapped the plaster around his hand and held it close to the bottom of the patient's woolen pants.

At the same time, Fang Ziye also helped to curl the two ends of the plaster to prevent it from causing pressure on the patient's skin after it solidified.

Wang Zhongxing nodded slightly as he watched Fang Ziye's skillful cooperation.

He thought to himself that this PhD was fairly decent, not the kind that was all academics and knew nothing about clinical practice.

After quickly wrapping the plaster cast around the patient and securing it, Fang Ziye placed a small piece of material in the popliteal fossa. Then, watching Wang Zhongxing move elsewhere, he instructed, "Don't straighten your leg. If you don't maintain the natural curve here, you'll be in a lot of pain while the cast is in place."

"Leave a slight curve here so it'll be easier for you to sit down later."

Unless there is a fracture at the knee joint, a cast should be applied to the popliteal fossa to create some curvature. Otherwise, the entire lower limb will be stiff, making it difficult not only to use the toilet but also to sit down normally.

Watching Wang Zhongxing skillfully review the X-rays of another patient who was about to have a cast applied, Fang Ziye continued, "Also, when you get back, sit on a higher stool. Give me your medical record book, and I'll write it down for you."

Although there are two operating beds, they cannot be operated on both sides simultaneously.

Because preparing the plaster takes time, and the plaster also takes time to solidify, it's only possible to say that both sides can be completed in rotation. We can't start applying plaster at the same time, otherwise we'd still have to wait.

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

"Hey; remember to pay me back." Wang Zhongxing blurted out subconsciously, as if it were an instinct.

“Okay, Dr. Wang.” Fang Ziye nodded.

Then it began to write: "After you go back, you still need to pay more attention. Avoid physical activity and strenuous exercise. You also need to have a follow-up examination to determine when to remove your cast."

"Don't sit for too long. You can walk with a cane without bearing weight. As for a cane, just go out and buy one."

"Doctor, where can I find it?" the aunt asked.

"Most pharmacies have them. They're not in Enshi, but they're available in pharmacies in your hometown. If all else fails, you can have a carpenter make one. I don't know where to find one."

“The department originally had some, but they’re probably too busy right now, and these crutches are cheap too. Okay.” Fang Ziye read the previous medical orders while taking notes.

The area was immobilized with a plaster cast. Rest was advised, and the patient was advised to avoid weight-bearing activities, heavy physical labor, and strenuous exercise. Sitting on a high stool was recommended to prevent excessive pressure on the skin and the risk of pressure sores.

After writing it down, Fang Ziye reviewed the film again and, finding no problems, handed the emergency room medical record to her.

Her family members, on the other hand, had to wait a while before they could come in.

There's no other way; the control room is only so big. We need to put casts on both sides. If the family members all rush in, then we can forget about putting casts on them and just squeeze everyone together.

"Doctor, can you hurry up? I can't stand up anymore," someone outside urged.

"One by one, her cast needs to be immobilized, otherwise it's a waste of time." Fang Ziye replied to the outside and then hurried to Wang Zhongxing's direction to assist in applying the special cast for the next ulna fracture.

Meanwhile, Fang Ziye was overjoyed to see 0.3 knowledge points added to his account. Less than ten minutes in the control room was equivalent to three hours in the training room. He was very pleased with himself.

Of course, Fang Ziye quickly accepted this offer and obediently became his assistant.

Patients left the operating room one by one. Fang Ziye collected the few but numerous pieces of knowledge he had learned little by little. Although the assistants who applied the casts earned even fewer knowledge points than the operators, there was no need to compete for them.

Solving patients' problems and getting them out of the hospital as soon as possible, thus alleviating the current congestion caused by the large number of patients, is the top priority.

However, when they were working on the seventh patient, Fang Ziye finished reviewing the patient's X-ray and frowned slightly.

"Dr. Wang, is it really appropriate to just put a cast on this patient? His fracture is an unstable fracture, and surgery might be necessary to avoid leaving a large scar at the fracture site later." After some consideration, Fang Ziye still made this suggestion.

"Huh?" Wang Zhongxing was already planning to prepare the plaster cast.

The fact that this patient needed a plaster cast was at the behest of his superiors, and that Fang Ziye had pointed it out, made him feel a little uncomfortable.

"I think we should ask Dr. Li again. It might be better to admit this patient to the hospital," Fang Ziye continued to suggest.

"Huh? I need to be hospitalized?" The person who came in was a middle-aged man who was nearly fifty years old. He had a kind face, but when he heard Fang Ziye's suggestion, he couldn't help but become nervous.

"Hospitalization would be better. If you just get a cast, your leg will be under stress, which will cause problems when you walk or work, and the scar will be bigger."

"There is even a chance that it could lead to fracture displacement and nonunion," Fang Ziye said.

His fracture was indeed a midshaft tibial fracture, but it was classified as B2.3. At present, fractures of this type are generally not treated with manual reduction and direct plaster fixation, even though the fracture line appears to be well aligned.

Fang Ziye has read many articles, but he can't make definitive statements, since they are just statistical data.

"What about that Dr. Li from before?" The crew-cut man's forehead furrowed.

“Uncle, there are too many patients now. A quick glance may not be accurate. Only slow and careful work can produce good results. Our advice will definitely be adapted to your specific situation.”

“Being a doctor isn’t like working on an assembly line, where you just put a cast on a patient and send them on their way.” Fang Ziye still looked at Wang Zhongxing.

Wang Zhongxing had already grabbed his film and hurriedly ran out.

About two minutes later, Wang Zhongxing came back in. He handed the X-ray to the middle-aged man and said, "Uncle, you need to be hospitalized. Director Xue from our department has reviewed it and determined that hospitalization is the best treatment option for you."

"Plaster cast immobilization is not sufficient to achieve the required fixation. Please understand that, given the large number of patients we've had this time."

“But we still have to be responsible for you.” Wang Zhongxing was very honest.

"Oh dear, I thought I could just get a cast and go home. How come I have to stay in the hospital after coming out for a trip?" he said with a hint of complaint. He looked quite honest and simple, as if he came from a fairly well-off family.

"Uncle, we can only respect the facts, right? Please go to the doctor's office first and complete the admission procedures. We are really overwhelmed. There are only six doctors in our department, and we still can't handle all the patients. Please understand if there are any oversights."

"Family member, come here and help this uncle to the doctor's office to complete the admission procedures..." Wang Zhongxing called out as he went, not daring to waste any time.

"Next, Auntie..."

However, when Wang Zhongxing shouted this, his expression towards Fang Ziye changed slightly.

To be honest, he had never even considered this possibility, but Fang Ziye, who was not in his position, was able to offer his own ideas. From a thinking perspective, Wang Zhongxing felt that he was a level below Fang Ziye.

He was only thinking about doing things, like applying plaster, while Fang Ziye was thinking about treating illnesses, and he was quite skilled at it.

Perhaps because the number of patients piled up all at once, neither the man nor his family made a fuss.

However, if he's the only one there and you make a wrong diagnosis, you could be in trouble.

Having seen it many times, one will develop a certain degree of empathy.

When the next patient came in, he quickly asked, "Doctor, will this condition be cured with a cast?"

Even the patient lying in the next bed asked, "Doctor, am I sure I'm not mistaken?"

Upon hearing this, Fang Ziye quickly explained, "No, no, big brother, auntie, there are no mistakes. Your fractures are both simple. It's just that the stress was relatively low when you were injured. A cast would have been enough."

"We're not admitting anyone just for the sake of admitting them; we're definitely giving you the best possible treatment."

This time, Wang Zhongxing was more cautious. He felt that if a young student like Fang Ziye could think for himself and not take the superior's decision as the only standard, then he should also learn to think for himself.

Time is like water!

Fang Ziye and Wang Zhongxing completed nearly twenty plaster cast fixation procedures in three hours, clearing out the number of patients with simple fractures at the entrance of the operating room.

Midway through, Fang Ziye and Wang Zhongxing switched positions slightly, since no one could maintain that level of endurance if Fang Ziye was always the one performing the repositioning traction.

Over time, Fang Ziye and Wang Zhongxing became relatively familiar with each other.

After tying the last patient's plaster cast into a bow, Wang Zhongxing stretched out halfway, and when he didn't see any patients, he simply plopped down on the ground.

Even though it's just a cast, why don't you try having a cast applied for more than three hours straight?
It would be a lie to say I'm not tired.

Fang Ziye, however, was not so casual because the white coat was not his own and needed to be washed by someone else. But he still stood against the wall, writing medical records while saying with a dry mouth, "You can sit on a low stool when you go back, because you fractured your toe bone."

"So there aren't that many rules, but you have to be very careful not to kick anything. The toe bone is already brittle, and now it's fractured. If you kick something else, it could easily fracture again."

"Okay, okay, thank you, doctor." The patient and family members quickly nodded their thanks, and then the family members helped the patient hop out on one foot.

Upon reaching the door, they turned back and said, "Thank you, doctors. You've worked so hard." They were the last in line, and it was clear that the two doctors in white coats hadn't even had a chance to drink water, working tirelessly without a break.

After the patient left, Wang Zhongxing looked at Fang Ziye and gave him a thumbs up: "As expected of a PhD, your theory is really strong. You said two patients were not suitable for a cast, so you didn't put one in."

Fang Ziye is very approachable, and his address has changed from "Dr. Wang" to "Brother Wang," and now to "Brother Xing."

Wang Zhongxing naturally couldn't put on airs anymore.

He wouldn't refuse a down-to-earth PhD friend.

"Brother Xing, just laugh at me, I don't care. You can just call me Ziye." Fang Ziye rubbed his wrist.

Rubbing his thumb.

His thumb, in particular, was aching from writing. He stretched and looked outside. "Brother Xing," he said, "I'm going to get some water. Want to come?"

Wang Zhongxing then took out a cigarette: "Want some Little Happiness?"

Fang Ziye declined.

Wang Zhongxing said, "Then I'll go to the break room for some water. You go to your office..."

The two broke up.

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(End of this chapter)