wavenovel Chapter 10: Reviewing Medical Records!
Chapter 10: Reviewing Medical Records!
After Chen Zhuoan went into the doctor's office and asked for Professor Dong's account and password, he started doing his own thing!
He is an eight-year doctoral student, a doctoral candidate under Professor Dong, and also the attending physician in the department.
After entering clinical practice, students in the eight-year program will also need to perform bed care tasks such as taking patient histories, writing medical records, writing prescriptions, and changing dressings for patients.
Otherwise, after graduating with an eight-year doctorate, they won't even know how to change dressings or remove stitches, which would only bring shame to the eight-year university education system.
Fortunately, Chen Zhuoan only has two assigned beds, both of which are post-operative.
Today's tasks are to change the dressing for patient 19 and discharge him/her, and to stop intravenous analgesia for patient 20 and switch to oral celecoxib.
Checking medical records isn't something that can be done in a few minutes or hours.
Tomorrow's surgery is not scheduled for a bed under Chen Zhuoan's supervision. Even if Chen Zhuoan wanted to do something, his fellow apprentices wouldn't give him the chance.
Medical students have very few opportunities, and having your own assigned bed is a valuable 'learning resource'!
……
After doing all this, Chen Zhuoan reported to Qin Huai.
The general inpatient office was cramped, with a small, 50-centimeter-square window that let in plenty of ventilation. Qin Huaimao was lighting a "little happiness" candle on the window.
After Chen Zhuoan gave Qin Huai a brief report, Qin Huai asked with some skepticism, "Professor Dong entrusted that patient in the ICU to Wu Ruiqi's care, but now he's assigned him to you?"
Wu Ruiqi is Dong Anhua's doctoral student and is currently in her second year of doctoral studies.
Chen Zhuoan completed his doctoral studies in eight years, but this is his sixth year of medical school.
Wu Ruiqi has been studying medicine for ten years.
Chen Zhuoan's tone was neither humble nor arrogant: "Teacher Qin, the teacher instructed me and Senior Brother Wu to manage this together. I guess he also wants to give me some experience."
The main thing is to keep it down and not be arrogant.
Thinking back to what happened that morning, Qin Huai nodded: "Alright... I can take you downstairs."
"But let me make this clear from the start: when you're managing this patient, you can't say anything carelessly, and you can't meet with the family members alone."
"This is absolutely not something you can control!"
"Okay," Chen Zhuoan agreed.
Respect the gods and their positions.
Chen Zhuoan certainly didn't want to reveal his rebirth, so he could only act according to his eight-year doctoral degree and ten-year medical regulations.
"Wait until I finish this one."
"Bed 19... well done. Professor Zeng also praised you," Qin Huai said.
Chen Zhuoan didn't react much to these words.
Qin Huai took a couple of deep breaths, his eyes becoming unreadable.
Does Chen Zhuoan think that just because he's an eight-year PhD student, he can disregard Associate Professor Zeng Tianfang?
……
Medical records classified as medical malpractice are indeed not accessible to the average person.
If Qin Huai hadn't personally taken Chen Zhuoan down to the ICU, Chen Zhuoan probably wouldn't have even been able to get into the ICU.
The intensive care unit is a special area in every hospital.
No one dares to trespass here!
With Qin Huai leading the team, Chen Zhuoan naturally obtained copies of the patients' medical records.
However, since it is just a copy of the medical record without a stamp or signature, it has no legal effect.
Currently, only Professor Dong's account has the authority to edit new ward round medical records for this patient. Professor Dong has no authority to change the medical records in the ICU!
Even for something as simple as making copies of medical records, Qin Huai still had to ask a friend in the ICU: "Teacher Qi, thank you so much."
Professor Qi is an associate professor in the ICU. He is short and stocky, with strong, muscular neck muscles: "It's nothing."
"When I was doing my rotations in orthopedics, I was working under Professor Dong."
"So Professor Dong is also my teacher in a way."
"However, Xiao Qin... the situation in the medical industry is quite severe right now... we are trying our best to find a solution."
Medical malpractice is also classified into different levels.
Whether the patient is dead or disabled will affect the final judgment.
The main task for this patient in the ICU right now is to keep him alive.
Qin Huai said, "Thank you, Teacher Qi. You've gone to so much trouble."
Professor Qi smiled wryly: "The trouble is nothing, but it's really troublesome if I can't get the signature."
"Now we can only take it one step at a time."
"I have to see other patients, you can do as you please." The ICU is a place for saving lives, and Professor Qi was the team leader on duty, so he didn't have much time to argue with Qin Huai.
He picked up his mask and left the office, heading towards the ward.
……
After obtaining the patient's medical records and examination data, Chen Zhuoan carefully took a rubber band from the ICU doctor's office and tied it up.
In fact, relying on Chen Zhuoan's current memory, although he only watched for more than ten minutes, he also remembered most of the examination results.
Special indicators should be memorized in their entirety, while normal indicators may be omitted or missed.
Dr. Wu Ruiqi came down with Qin Huai, and he was discussing with Qin Huai how to write today's routine medical record.
The patient has orthopedic issues. Although the patient said that Professor Dong's surgery was not good, the trauma surgeon still needs to make rounds and give medical orders on a daily basis.
Neither of them took Chen Zhuoan seriously.
Unable to get a computer in the ICU, Chen Zhuoan told Qin Huai and then left the ICU to return to the doctor's office in the trauma surgery ward.
About two hours later, Chen Zhuoan was certain that he had reviewed almost all of the patient's test results.
This includes laboratory tests, temporary blood gas analysis, and all imaging examinations performed since admission.
Imaging examinations involve looking at films.
The patient's initial diagnosis upon admission was rather simple and fatal: active hematoma in the lower abdomen and pelvic region.
Without immediate surgery, the mortality rate is 100%, it's guaranteed to kill you.
After the surgery, the patient is still alive, but after being transferred to the ICU, he developed severe infections in the abdominal cavity and pelvic region.
In May, the patient's infection developed into sepsis, but the sepsis was reversed through joint treatment by the infectious disease department, respiratory department, gastroenterology department, and general surgery department.
However, the infection in the patient's lower abdomen and pelvic area has not been completely eliminated.
Furthermore, due to local bacterial mutations and new bacterial infections, another outbreak of bacteremia occurred in early June.
Through the combined efforts of multiple departments, the patient was once again brought back from the brink of death.
The patient is currently in a "stable period"!
However, the infection still exists.
The antibiotics used have been upgraded to the highest level currently available at Xiangya Hospital!
This patient could potentially cause a medical accident, and it also affects Professor Dong Anhua's future in trauma surgery.
The chief physicians of multiple departments, including the ICU, infectious disease department, and laboratory department, held consultations multiple times.
In such a situation, the patient's infection still could not be completely cured, which shows how difficult it is to treat.
The patient's infection area and diagnosis were very clear: osteomyelitis in the sacral region was the "source" of infection.
However, the problem is that the sacral region has a rich blood supply, and routine surgeries need to avoid damaging this area.
It has become infected, so you cannot have it cleaned yet.
What are the principles of surgical treatment for infections?
Thorough wound cleaning and full-course administration of sensitive antibiotics.
Debridement and drainage are fundamental and basic.
Currently, because of the unusual location of his infection, the most important tool, debridement, is rendered useless.
The sacrum has multiple blood supply systems.
Chen Zhuoan recalls that in the early 2000s, someone published a paper stating that the short-term mortality rate of sacral osteomyelitis complicated with ascending spinal canal infection was significantly increased, reaching as high as about 30%!
Although long-term mortality rates have not been statistically analyzed, the estimates are not optimistic.
Because no clinical team would proactively emphasize reporting clinical group deaths...
This is very troublesome.
This is 10 years, not 30 or 40 years.
Some of the technologies used in later generations cannot be brought back in the short term.
Improving equipment also requires a process.
What should we do?