When I was trying to answer the question, I was in deep thought, such an answer may be read by someone, but not up to the impressive effect, how to make people feel impressed? Brain not only surfaced a sunny day ......
言寺光是一个不苟笑的医生，新进医院急诊科不久，他总想干出一些成绩让人看看，可惜值班这几天，运气出奇的好，连一个危急病人都没有，大多都是感冒发热拉肚子的普通病例， Let the temple light a little too big to use the feeling, in a complaint inadvertently was heard by the director, was also criticized. The first thing you need to do is to get your hands dirty.
In the speech temple light boredom, the emergency room door came a burst of rapid footsteps, and heard someone shouting urgently: "Doctor! Doctor~ Come save my child!"
Teramitsu grabbed his white coat and walked out while wearing it
"What is it?"
"My child was hit by a car and both his legs were run over by a car ......" the child's father choked up and briefly told the doctor what happened.
Terakwang, while examining the child's wounds, asked the child's father "How old is the child? How long has it been since the injury?"
"About 7 or 8 hours, it was hit by the warehouse roadside, there is a camera ......"
Terakwang looked at the child in a trance, did not cry, the limbs are weak and sagging, there is an ominous feeling in the heart,
"Take blood pressure, do a bedside ECG ......"
While giving instructions to the nurse, he asked the father to carry the child to the bed in the emergency room, the child's father put the child down and turned to the doctor and said." Doctor, can my child's legs be saved?" "Please you must save his legs ah, he loves to play soccer ~"
The father's pleading voice with a sobbing voice made Terakwang inexplicably annoyed in his heart, and told him to wait outside.
"Blood pressure 50/70, here's the EKG ......" the nurse showed Teramitsu the EKG,
"Heart rate 120, T-wave hyperacute . ... "Looking at the electrocardiogram, Terakwang immediately told the nurse, "Put on cardiac monitoring, establish intravenous access, and infuse isotonic solution; and draw blood to send to the Laboratory Department to check electrolytes, blood routine and ......" Terakwang while talking to the nurse, while cleaning the child's legs, some necrotic tissue clean up at the same time, check whether there is still blood flow, if there is blood flow can save the legs, if there is no can only be amputated ......
Terakwang not only ringing in his mind the child's father's voice again "please! You must save his legs ah, he loves to play soccer ~"
At this time the director came in, as soon as he entered the door, he chided "How can you speak to the family like this, his child is like this you should have empathy ...... "Did you take X-rays? Check blood there is no cardiac enzymes, liver function, kidney function are checking" in the face of the director of the inquiry, temple light while complementing the report card, while the cold sweat, remembered the previous director of the teaching, this time to go back to really have to reflect on it!
Unfortunately, this idea has not disappeared, this side of the sudden situation, the child's blood pressure continues to fall, "speed up the amount of infusion ......" "ready to transfuse blood, call the laboratory as soon as possible to produce a report! ......"
Two hours later ......
Terakwang and the director dragged his tired body out of the emergency room, the director walked to the child's father, said regretfully: "I'm sorry, we did everything we could, we still couldn't resuscitate him, your child is gone ......"
"Doctor, what are you talking about? How did my child die, he was only crushed with his feet, at best his feet are gone, how could he even be gone? You return my child"
Terakwang then realized that there were already more than 20 family members waiting outside, and they were all very agitated, and I don't know who shouted, "You killed the child!" Then they punched and kicked the director and Terako. What's more, not only even the nurses also hit, even the hospital things are smashed ......
Terakwang escorted the director, back to the duty room, blocked the door, the body does not dare to leave the door of the room, for fear of being kicked open. The director also immediately called the medical section, calling for security and others to be sent over.
Things through the regulation, things of the storm is considered to be over, but the temple light heart a little twisted, in the present status of the doctor is too low, right, to save people do not achieve to be beaten?
The beautiful dean - Dean Lee went to Terakwang, meaningfully said these words (answer):
1. What are the other comorbidities of the current trauma, explain the reasons, and how to deal with the next step. Reference points
The patient in addition to trauma there are serious comorbidities, hyperkalemia, reasons: ① car crushed lower limbs can make intracellular potassium migration ② there is a blurred mentality, limb weakness clinical manifestations ③ electrocardiogram T-wave hyperacute;
Then for the patient's next step in the treatment: ① prohibit all potassium-containing drugs ② reduce serum potassium concentration: after intravenous infusion of sodium bicarbonate 5% 60 100ml 100 200ml; intravenous GI solution (25% glucose 100-200ml, adding insulin 1U per 5g of sugar); the use of potassium-excreting diuretics; oral cation-exchange resins; dialysis therapy if necessary.
③ Counteracting cardiac arrhythmias; intravenous infusion of 20 ml of 10% calcium gluconate, which can be repeated.
2. You are very dedicated to your work in therapy, but the leader is always telling you what to do and picking on you everywhere, what would you do? Reference points
Attitude: work to learn to live in harmony with the leadership and coworkers and everyone, to find the right way to get along, to build harmonious interpersonal relationships.
Reason: ① may be that although I do a lot of things in the work, but the way there is a lack of leadership to me to put forward some optimized approach, conducive to solving the problem, improve work efficiency. ② may be the leadership of my higher work requirements, pointing out my work in the problem, I am a kind of encouragement and encouragement, I should correctly and objectively look at this matter.
To resolve: ① before doing more thinking, more questions, seek the views of the leadership and views, and strive to optimize the solution to improve efficiency, to achieve leadership satisfaction. ② The suggestions and corrections made by the leadership should be seriously considered in the actual work of the application, and constantly improve themselves.
Avoid: everyone has a different way of communication at work, should be differentiated, choose the most suitable way to get along with everyone, to be tolerant and tolerant, in order to establish harmonious interpersonal relationships.
3. In recent years, patients or their families shocked and smashed hospitals, beating and killing medical staff of the vicious incidents occurring around the world, and is on the rise, some places a few doctor-patient conflicts have escalated dramatically, there is a tendency to evolve into violent incidents. For the tense doctor-patient relationship, please talk about your views? Reference points
Deduction: In recent years, the doctor-patient relationship is becoming increasingly tense, the media reported that the injury to the doctor killed doctor smashed the hospital events are also endless, as a medical worker, we inevitably have feelings. The occurrence of such vicious events seriously disrupt the order of the hospital, affecting the patients, and let the medical staff worried about the safety of the working environment, affecting the normal working conditions, we should think y about the truth behind the incident.
Analysis: the occurrence of doctor-patient conflict is caused by multiple factors. First, some medical staff due to the weak legal concept, do not respect the patient should enjoy the right to choose, the right to know and so on. Secondly, patients lack of general medical knowledge and have too high expectations of health. Third, the law is not yet perfect for the regulation of the responsibilities and obligations of physicians and patients, and the punishment for illegal behavior is weak.
Countermeasures: In order to reduce the number of injuries and killings of doctors, we must collaborate *** with the governance. On the one hand, from the laws and regulations of the rules and regulations of the clear medical personnel and patients' responsibilities and obligations, the medical process of medical order and medical issues to make clear provisions. On the other hand, from the action to do to understand the law and abide by the law, the hospital security work should pay attention to, once the disruption of the medical order to stop the behavior in a timely manner; Finally, to popularize the medical knowledge in the whole society to improve the legal knowledge of the masses.
Sublimation: In today's rapid economic and social development, medical disputes have become one of the factors affecting social stability, should cause a high degree of social concern, and we ourselves should also build a harmonious doctor-patient relationship, to maintain social stability to make due contributions.
Question by: Mr. Lee