Chapter 979: Rescue of severe cases! An operation that no one in the international community can per
As everyone waited, the time finally came to 10 o'clock in the morning.
As the bell rang, everyone was stunned. Everyone looked away from Shi Lian and looked at the head of the invigilator on the podium.
"In yesterday's assessment, a dark horse emerged in the famous knife competition again. When we compare the medical talents of the younger generation, we often exclude Dr. Xu Qiu, but his student won the crown of a single assessment again. The Union Hospital, West China Hospital and other hospitals should reflect on the fact that they have so much national funding, but they are not as good as a clinical doctor who only relies on provincial financial support..."
Before the assessment began, today's head of the invigilator gave a lecture.
Everyone looked at each other but was speechless... Facing Xu Qiu, they really couldn't think of competing.
That young doctor was too amazing and shouldn't be in the same evaluation system as them.
Otherwise, anyone would look mediocre, even a little stupid...
But no one expected that only Xu Qiu's students came forward and got a result that shocked everyone again.
Although it is not as eye-catching as Xu Qiu's full score back then, it is also a jaw-dropping achievement.
…
After the lecture, the head of the invigilation team announced the content of the assessment.
"In the past few days, after screening and review by our judging panel and expert group, we have extracted 20 severe and difficult cases from the domestic case database.
"After that, one of them was randomly selected as a simulated patient.
"The content of this assessment is that the participating teams from each hospital will make the next step of speculation based on the existing patient history, and finally rescue the patient!"
Then, the head of the invigilation team briefly introduced the specific content of the assessment.
After listening, everyone fell into deep thought, thinking about the purpose of this assessment.
"The examiner said to rescue the patient, not diagnose... In other words, the difficulty of this competition lies in saving people?"
"It is very likely! These are critically ill patients, and it is estimated that it is very difficult to deal with them... But is this really fair?"
"What do you mean?"
"For example, for a certain rescue method, other doctors cannot save the patient, but I can save him. But the assessment must be based on a fixed formula. What if the rescue method is judged to be wrong?"
"Do you think you are Dr. Xu..."
As soon as these words came out, everyone immediately became quiet.
Indeed...
Think about it carefully, in the history of the famous sword competition, Xu Qiu is the only one who has proposed a problem with the standard answer and the examiner's judgment is wrong.
He is the only one who has trained clinical thinking to an almost impeccable level.
If Xu Qiu is on the stage, some of the methods he proposed are not in the standard answer, and perhaps the examiner will doubt whether he has not considered it enough.
Who else has this qualification except Xu Qiu?
The head of the invigilation team seemed to see the doubts of the crowd and explained: "Don't worry about this. There is no fixed formula for medical rescue. Our expert group has developed a detailed scoring method based on clinical practice. As long as your method can really save people, it is impossible to misjudge!"
After hearing this, everyone was relieved.
The professionalism of the famous knife competition is beyond doubt. The expert group and judges are all very capable to host the top medical competition in the country.
Of course, it is not for them, a group of so-called geniuses who are still in the rising period, to touch porcelain.
Seeing that the contestants had no doubts, the head of the invigilation team ordered: "In this case, without further delay, all groups are ready to start!"
Clang!
The field suddenly became noisy.
Many contestants came to their respective venues.
The venues were separated by partitions.
In addition, different venues were even equipped with sound-absorbing cotton. Unless the people inside shouted loudly, if it was just a normal conversation, it would be impossible to hear the discussions in other venues.
Shi Lian also brought the team of clinical doctors to his own venue.
To be honest, when Shi Lian heard the assessment requirements, she breathed a sigh of relief.
It was actually rescue!
She followed her teacher and did all kinds of rescue the most... Even if this patient was complicated, she, who came from the emergency department, could do better than him!
While thinking, Shi Lian came to the assessment site.
Looking around, there was a simple conference table with twelve stools placed around it and a 48-inch screen in the middle.
The basic information of the patient was played on it.
"Patient A, 45 years old, had a body temperature of 38.5 degrees Celsius, a pulse of 140 beats per minute, a small amount of moist rales on lung auscultation, an oxygen concentration of 80% on the ventilator, and a central venous catheter pumping norepinephrine (0.4ug/kg/min) rapidly...
"Family members complained: The patient had diarrhea for more than half a month, more than ten times a day, and dark green stools...
"Five years ago, the patient underwent liver transplantation in a top three hospital in the south due to hepatocellular carcinoma and liver cirrhosis. After the operation, tacrolimus, mycophenolate mofetil, sirolimus and other drugs were used to control the rejection reaction. He has been reviewed on time for five years and his condition has been stable..."
The information on the first page is what the doctor can get in the first three minutes of the consultation.
It is important to say that it is important, which can help determine the basic principle of diagnosis.
However, after a closer look, there are not many substantial characteristics.
The only one is probably diarrhea for half a month, dark green stools, more than ten times a day.
"Where's the next page?" Jiang Mai saw that there was no remote control on the table, so he bent down and looked under the table. After searching for a long time, he still didn't see any remote control device.
Shi Lian was also a little confused... Could it be that the rescue and treatment can be carried out based on the information on this PPT?
How could this be done!
Even if the teacher came, it would not work!
…
…
At the same time, clinical medicine.
A multidisciplinary consultation was also held in the conference room of the emergency department.
Led by Xu Qiu, the directors of the ENT, general surgery, pediatrics, critical care pediatrics and other departments were all present.
The patient's medical history was also displayed on the screen in front.
"Jia Jia, female, three years old..."
In terms of the severity of the disease, Jia Jia's cholesterol granuloma is far from the point of being called to the critical care pediatrics department.
But if surgical treatment is to be carried out, it is necessary to operate on the skull base. A slight deviation of the scalpel may mean the difference between life and death, so the critical care pediatrics department must be checked.
No matter how confident Xu Qiu is, he will not be so arrogant as not to invite even a doctor with a critical illness.
Otherwise, he will treat the patient's life as a joke.
At this moment, everyone was quietly flipping through the case in their hands.
"Jia Jia, female, 3 years old, was admitted to the hospital due to repeated swelling and pain in the left ear accompanied by hearing loss for seven months... The child began to have repeated yellow purulent discharge from the left ear seven months ago with a foul odor and no blood...
"... After examination at the local hospital, local medication in the external auditory canal was used for treatment, but the effect was not good.
"Past history: The patient failed the hearing screening in both ears at birth, had poor response to sounds such as knocking on the door, and had delayed language development. She was diagnosed with: extremely severe sensorineural hearing loss in both ears..."
The above information has been read privately many times.
Including the patient's temporal bone mastoid CT examination report, the ENT and pediatric doctors also discussed it.
However, after trying every possible way, they still found it difficult to figure out a safe approach.
The patient's cholesterol granuloma was too large. In this case, it might be a bit exaggerated to say that it was as difficult as climbing to the sky to peel it without damaging other parts, but it was underestimated that no one in the province dared to do it.
Even the international community may not be able to pick out a few people who can break into such a complex ear canal and remove the tumor safely!
"Even if we don't talk about the difficulty of the operation, the most difficult point is how to prevent recurrence!"
"The child's condition did not develop in a day or two, which means that cholesterol crystals will continue to accumulate in her ear canal... Even if it is removed, it may grow again in a few years."
To put it bluntly, surgery is useless!
Everyone shook their heads, feeling helpless.
In the crowd, Xu Qiu, who was sitting in the main seat, seemed to have been prepared.
After a crazy and explosive liver, he really found a solution...
