top student at medical school

Chapter 292 The Man Who Came from the Shadows to the Light (Please Subscribe)
"Jie Han, you're on the operating room shift today!"

"Get me to the emergency room." After searching around and not finding anyone suitable to help, Fang Ziye could only use his chief resident authority to call Jie Han to come to the emergency department.

When a resident encounters an emergency surgery, the department's scheduled surgical team will require the resident to participate in the emergency surgery as an assistant. Such a schedule has a duty roster, and the appropriate person must be found every day.

Upon hearing this, Jie Han realized that Fang Ziye had genuinely failed to find anyone to help. Although he was on the operating table, the system could still function normally without him.

There was no need to ask for leave from her superiors; the circulating nurse simply turned on her phone's speakerphone, and everything became clear.

Jie Han was immediately forced to step down, and Yan Zhiming, who had been fully armed and watching from the sidelines, immediately moved to the assistant position where Jie Han had been standing.

Only a few minutes had passed since Jie Han left the operating room.

Yuan Weihong also lowered his voice and said to Professor Deng Yong, "Professor Deng, how about I ask for leave today? It's only Xiao Fang's first day..."

……

After making the call, Fang Ziye rushed into the emergency surgery room to review the X-rays. He breathed a slight sigh of relief after seeing the fracture.

Based on my own assessment of my abilities, this type of fracture meets the indications for closed reduction and can be treated with closed reduction!

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

Moreover, the environment in which he was injured was quite poor, heavily polluted, so he will definitely need several days of antibiotic treatment to reduce inflammation...

Another important factor is whether the patient's fracture is an open fracture. If it is an open fracture, the final treatment approach will be completely reversed.

Another important point is that he had damage to his chest and abdominal organs, so the treatment of the fracture was actually an elective surgery.

How could we not prioritize saving lives and treating fractures?

Fang Ziye was very certain that the fracture did not cause major arterial or vascular damage, because his current X-ray and CT scans showed the general course of the blood vessels.

It can also clearly identify whether there is an active hematoma.

Therefore, his proposed solution was...

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

The operating room is connected to the orthopedic ward building, which is very close to the emergency department. So, it doesn't take long to get from the operating room to the emergency department.

Many chief resident physicians, even when in the operating room, can calmly arrive at the consultation location within fifteen minutes if an urgent consultation is needed.

"Senior brother!" Jie Han had just spoken at the door.

Fang Ziye said, "Jiehan, go and put a forearm sling on the dislocated patient first, and then talk to the other fracture patient and get the signatures."

"After I finish the repositioning, you can take him upstairs to get a cast for external fixation and minor debridement."

"Can it be done?"

When an emergency occurs, everyone has the opportunity to perform their skills to the fullest. Jie Han also needs to step up now. After the fracture is reduced, it must be immobilized. Plaster cast immobilization is also a form of immobilization. In addition, Jie Han can definitely perform simple debridement in the training room without any problems!

Then he also needs to start applying what he has learned in real life.

Fang Ziye is now the chief resident of trauma surgery, so Professor Deng Yong's team can take on all the minor emergency surgeries and procedures.

Even though Lan Tianluo doesn't have a medical license, he still has to perform level one surgeries like debridement in the emergency room!

"Okay." Jie Han nodded, a little nervous and excited.

If I seize the opportunity today, I will have more chances to operate when I am on duty alone in the future!
No longer needing to report to Qin Geluo and others, nor needing to report to the teachers after encountering minor wound cleaning and suturing, their senior brother would complete the large-scale feeding.

This is another closed loop, a small perk unique to the sect.

With Fang Ziye becoming the chief resident, his small research group will experience a surge in clinical procedures...

Jie Han quickly left the consultation room and went to the entrance of the emergency X-ray room, where he took the patient who had previously undergone manual reduction of joint dislocation to the operating room.

Fang Ziye looked at the people consulting from other departments and said to the emergency surgeon, "Our orthopedics department does not have any absolute indications for emergency surgery at the moment. After I performed a physical examination and reviewed the X-rays, I did not find any active hematoma."

"A fracture is an indication for surgery, but it is not an indication that needs to be treated at this time. The patient is currently in a coma and has unstable blood pressure, which suggests active bleeding in other areas. We will follow up and treat the fracture after the active bleeding is treated."

Fang Ziye was telling them not to call the orthopedics department anymore. Saving the patient's life first was the priority; that was the responsibility of the thoracic and general surgery departments. Even if our orthopedics department performed the best fracture surgery, that was still their responsibility.

If active bleeding in the chest and abdomen is not treated properly, all efforts will be in vain.

The emergency room doctor and the other consulting doctors all glanced at Fang Ziye, then looked at each other, as if they could see the expressions of looking at the newcomer in each other's eyes.

Fang Ziye didn't dwell on it too much. He carefully completed his procedures and wrote down all the consultation opinions clearly.

Only then did they leave the emergency room.

This patient's emergency room visit was not actually an emergency in the trauma surgery department, so Fang Ziye felt no pressure at all and could leave calmly!

At Zhongnan Hospital, management and treatment are conducted within the same department.

This is called not crossing the line.

It's the rule.

"Dr. Fang, given my current condition, do I have a fracture? Do I need surgery and hospitalization?" Fang Ziye was pressed for answers as soon as he left the house.

The young man with the broken bone who spoke with Jie Han and signed the papers has returned to the control room. He has thick hair, a big nose, and small ears; his nostrils are twitching incessantly!
His face was tense, as if he was very afraid of being taken away by Jie Han, who looked even younger.

Comparatively speaking, Fang Ziye appears to be a little more mature than Jie Han.

"Let's do the debridement in the emergency department's operating room. There aren't any operating rooms available right now. Your wound is relatively simple. We'll do a small debridement. As for the fracture, we'll choose manual reduction and external fixation with a plaster cast."

"Surgery is only necessary if the bone cannot be repositioned. Of course, if you want to be on the safe side, you can opt for surgical repositioning directly!"

"As long as you sign your agreement, there won't be any problems." Fang Ziye didn't hear another ambulance arrive outside, so he patiently explained a few more words.

"Then let's reposition it first." The big-nosed young man knew the difference in cost between surgery and manual repositioning, and after hesitating for a moment, he made this decision.

“Your family member isn’t here, so you’ll have to sign it yourself! I’ll finish writing your medical record first, and then we’ll proceed with the repositioning.” Fang Ziye wrote the medical record while mentally assessing the situation.

"it is good."

……

After a few minutes.

When Jie Han and the young man with the dislocated joint walked back into the emergency room, they found that Fang Ziye was performing a reduction on a patient with a fracture.

The patient with the fractured nose, eyes closed, asked nervously, "Dr. Fang, have you started?"

"Almost finished repositioning, just wait a moment!" Fang Ziye strained with both hands, his muscles bulging, his voice choked with emotion.

"You said it would hurt a little, but I don't feel any pain. I thought you hadn't started yet." The big-nosed man was a little flustered.

Upon hearing this, the young man with the dislocated joint asked Jie Han, muttering, "Why doesn't his reduction hurt?"

"Huh?" Jie Han turned to look at him, not reacting for a moment.

"It's nothing. It's nothing." The young man glanced at Jie Han's graduate student badge, as if he didn't blame him at all.

Fang Ziye's name tag at least indicated that he was a doctor.

Jie Han felt slighted and wanted to explain, but considering Fang Ziye's actions, he didn't want to interrupt, so he pretended not to hear for the time being.

Seeing that Jie Han was speechless, the young man became even more convinced of his own inner thoughts.

Soon, Fang Ziye's strength subsided, and it could be seen that the middle-aged man's lower limb deformity had largely returned to normal.

During the process of unloading the fracture fragments and realigning them after the traction was completed, the middle-aged man felt a slight pain: "It hurts a little now, but it's okay!"

Fang Ziye finally relaxed his grip!
Looking at Jie Han, he asked with a smile, "Jie Han, do you know the answer to the question this patient asked?"

Knowing that his senior brother was giving him a chance to demonstrate, Jie Han quickly explained, "The process of reducing a fracture does not involve pain during traction. On the contrary, traction separates the fracture ends, preventing them from touching or rubbing against each other and thus avoiding nerve ending stimulation. This makes it feel easy and comfortable. Only when I release the force at the end, just as the fracture ends are about to come into contact, will there be some pain."

"So even if my senior brother performs the reduction for you, one is a joint dislocation and the other is a fracture. The pain and duration of the reduction process are completely different."

After explaining, Jie Han stood up straight, enjoying the astonished looks from the patient next to him.

I thought to myself, "Are you kidding me? I'm a master's student at Zhongnan Hospital, after all. You can't just bully me when it comes to knowledge."

Besides, we've been studying manual reduction techniques since last year, and many people don't understand them as well as our group.

Especially the theory.

Fang Ziye explained in detail this time: "The fracture should be mostly aligned now. You just need to take an X-ray for a check-up. Then go to the surgical ward upstairs and have Dr. Jie do some debridement. After that, you can be admitted to the hospital, okay?"

"Okay, okay. I'll do whatever you say, Dr. Fang." The young man with the big nose nodded hurriedly. The ease and comfort he felt after the fracture was reduced was like being in a hot spring, compared to the pain he experienced before. His whole body felt warm and comfortable, and he had an indescribable sense of ease.

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

Of course, Fang Ziye still couldn't leave; instead, he continued watching the film of the young man who had been repositioned after his dislocation.

When the young man came in again, Fang Ziye was showing him the X-ray after the dislocation was corrected: "Look, the dislocation here has been fixed now."

"The humeral head is in place, you can move around, and the pain has been relieved, so there's no need for any special treatment afterward. You also feel much better now."

“If you experience pain again later, you can get an MRI. If you don’t experience pain, you don’t need to do it for now,” Fang Ziye explained patiently again.

The young man looked around and, finding that Jie Han had already left, asked again, "Dr. Fang, why did it hurt so much when I was having the repositioning done, but it didn't hurt anymore afterward?"

"Didn't my junior brother just say that?"

"The pain mechanisms of fractures and joint dislocations are different. During the traction process of joint dislocation, the tense and trapped muscles will be further pulled, and the pain will gradually intensify before the joint is completely released."

"After a successful repositioning, all symptoms such as muscle retraction and compression are relieved immediately. However, during the traction process, the muscles become increasingly tense, which will aggravate the pain. The underlying principle is different."

"Keep your forearm in a sling. In a month, go to any hospital for a follow-up X-ray, and then we can remove the sling as needed. During this time, there are some precautions you should take..."

"Okay, thank you, Dr. Fang!" The young man was convinced.

They not only know how to do it, but also why they do it and why it hurts.

That's incredibly professional!
that whoever?
It doesn't seem like they're unprofessional.

……

When Huang Yan pushed the middle-aged man out of the CT scan room, the man still spoke with a Sichuan accent: "I can pay by scanning a code."

"No rush, we can discuss the fees later," Huang Yan replied, then went back into the consultation room.

"Dr. Fang, there are no obvious injuries to the patient's head, chest, or abdomen at the moment. You can conduct a follow-up examination from a surgical perspective!"

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

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

Treating illnesses is simple; Fang Ziye alone can cure many. But when it comes to saving lives, even a group of people might not be enough!
After Huang Yan left, Fang Ziye began to talk to the somewhat humorous middle-aged man from Sichuan Province. The man had a great sense of humor and kept joking with Fang Ziye to make him laugh.

"Dr. Fang, how did you build those muscles? I've always envied you for having muscles like that. I think men should have muscles." The other person was quite talkative.

Even while sitting in a wheelchair, he doesn't stop moving at all.

"Does it hurt?" Fang Ziye asked.

"What's this little pain? Let me tell you, Dr. Fang, back when I was young, fighting was all the rage. When we fought, we were punching and kicking each other. What's this little pain?" The middle-aged man boasted arrogantly, as if showing off that he used to be a tough guy.

But now, times have changed, and everything has come to a head.

"Uncle, you still fight?" After Fang Ziye finished reducing his dislocation and fracture, he was surprised to find that although this middle-aged man was a joker, he could actually endure pain.

Then he asked out of curiosity.

"Hey, speaking of fighting, it's more like I got beaten up by my tigress all by myself."

“He’s very fierce, let me tell you,” the middle-aged man said.

Marrying a woman from Sichuan or Chongqing means living a life of misfortune.

Fang Ziye secretly gave a thumbs up. As expected of a man from Sichuan Province!

"Do you have a girlfriend? Where is she from? Let me tell you, whatever you do, don't date someone from Chongqing or Sichuan..." The middle-aged man tilted his head and warned Fang Ziye.

Fang Ziye was taken aback upon hearing this.

Good heavens, isn't Luo Tingzhu from Chongqing?

Of course, Fang Ziye did not give him a direct answer. Instead, he had him scan the code to pay first, and then spent another ten minutes to finish the forearm sling and plaster cast fixation.

Then he took a closer look and said, "Uncle, it's all taken care of. With your fracture, we can only temporarily immobilize it like this for now. We'll still need to have surgery later to fix it with an intramedullary nail!"

"Plaster fixation is only a temporary fixation and does not provide a particularly strong fixation effect."

Fang Ziye explained again.

In fact, he has already explained all of this. There are surgical indications for middle-aged people, and the current treatment is a temporary measure to relieve pain.

Even for fractures where plaster cast immobilization is ineffective, temporary immobilization is necessary after admission to the hospital to prevent displacement and increased pain!
This makes it easier for family members to take care of the child.

"Is that all?" The middle-aged man sighed, feeling that he hadn't had enough.

Fang Ziye joked, "Uncle, we can reposition it after it's dislocated, since there aren't many patients coming in right now."

"Perhaps I might have reset it incorrectly?"

The middle-aged man's expression immediately changed, and he quickly protected his arm, saying, "Don't talk nonsense!"

"Just kidding, Uncle. You should call home. You'll need someone to look after you. I'll take you to your ward first." Fang Ziye was genuinely just joking.

It was mainly because the other party made the joke first.

Then, Fang Ziye issued a hospitalization certificate to the other party and told him to go to the trauma surgery department to complete the hospitalization procedures. As for how the other party got to the trauma surgery department, there was nothing that could be done; the other party would have to figure it out himself.

……

Finally, Yuan Weihong couldn't hold back any longer.

He was hiding in the shadows of the emergency room, but he had no choice but to show himself.

Around 10:10, Yuan Weihong sat down at the door of the clinic and saw five or six people standing inside. Three people were queuing up, and the other three were moving their joints.

It seems that they are all joint dislocations!

Even Yuan Weihong, who had seen Fang Ziye suddenly take on a large number of patients, was taken aback.

In front of them, Fang Ziye sat at the operating table, snapping away from another patient with a dislocated wrist joint, the dislocated joint that had been stubbornly detaching from the joint surface.

He said, "Your wrist has been reset. Rest for a bit, and I'll put on a cast to immobilize it. You can gently move your wrist in and out, like this."

Fang Ziye demonstrated for him, moving his forearm from side to side.

He gradually learned as well.

The two people in the queue behind him looked at him with some envy as he was free from pain again, and said with a smile, "Dr. Fang, is it my turn now?"

Yuan Weihong walked in, and Fang Ziye saw him too. He smiled at Yuan Weihong and then calmly continued to see the next patient with a dislocated shoulder.

Fang Ziye explained, "This is a rare posterior shoulder dislocation. The chances of this type of dislocation being accompanied by soft tissue injury are very high. The current diagnosis is type II, which is considered a relatively mild case. Manual reduction can be performed, but after reduction, you need to..."

"Okay, okay, I'll definitely listen to you, doctor. You're such a professional!" He looked at the other people who had their joints repositioned, and they all looked relaxed. He just urged Fang Ziye to hurry up and finish.

But Yuan Weihong, who was listening nearby, was completely dumbfounded.

Actually, when Fang Ziye was performing manual reduction of the wrist dislocation, he felt that it was not quite appropriate. After all, although the wrist joint is small, small joint dislocation does not mean it is easy to handle.

Fang Ziye reset it.

Now, with such an atypical reduction of a posterior dislocation of the shoulder joint, Fang Ziye still wants to perform the procedure?
But since Fang Ziye had already said everything, he couldn't very well stop him halfway through, so he just watched patiently.

……

Four minutes.

In just four minutes, Yuan Weihong's heart rate increased four times.

Every time Fang Ziye performed a reduction, Yuan Weihong's heart would skip a beat. Firstly, he felt that the type of joint dislocation Fang Ziye was treating was rather unusual, and secondly, he was impressed by the speed at which Fang Ziye's technique reduced the dislocation.

Are you some kind of person who can reset their body so quickly?

Finally, after everyone had finished resetting, Yuan Weihong lifted Fang Ziye up in front of everyone!
Of course, he wasn't really going to bring it up; Yuan Weihong first tapped the table.

"Come out with me for a moment!" Yuan Weihong said sternly.

The man, who had turned from darkness to light, seemed about to erupt in anger.

(End of this chapter)