"There was a patient who was injured by a fall from a height, and he jumped from the fourth floor, and his family did not want to be hospitalized. Yuan Li explained vaguely.

Zheng Ren's heart moved, jumping off the building, not wanting to be hospitalized, these two keywords were connected, and he thought of several possibilities.

"Is it because of insurance?" asked Zheng Ren in a low voice.

Mr. Wang was very emotional and admired.

Medical technology is medical technology, and what Dr. Yuan just said is a matter of another plane.

He was in the imperial capital and rarely touched the matter of insurance. Admitted to 912 Hospital, the deposit paid in advance is 50,000 yuan. In other words, if you don't pay 50,000 yuan, you won't even be able to live in the hospital.

As for whether the patient can be reimbursed, it is not within the scope of Mr. Wang's consideration.

But the situation in Haicheng is completely different.

Whether or not you can be reimbursed for seeing a doctor here is definitely a major consideration for the patient's family to choose where to be hospitalized and what kind of treatment method to choose.

But Boss Zheng knew at a glance that it was because of insurance, what the hell was this? Mr. Wang also realized the problem.

Yuan Lileng paused and nodded.

Zheng Ren smiled, "You can continue to talk." ”

After speaking, he and Mr. Wang continued to walk forward.

"Boss Zheng, what's wrong?" Mr. Wang asked.

"Jumping off a building is a suicide, and the insurance will not reimburse you. Zheng Ren said, "Without insurance, many steel plates in orthopedics cannot be used." If you use domestic cheap steel plates, most of the injured are in the lower limbs, and the steel plates may break if they have to bear weight in the future. ”

“……”

"In the future, it's all a medical risk. Therefore, if the emergency department admits such a patient, it is not very urgent, and it cannot be reimbursed, the orthopedic surgeon will be very unhappy. If you're in a hurry, you won't.

But didn't Dr. Yuan say that the injury of the person who jumped from the fourth floor was not very serious, and he had a lower leg fracture, or an intertrochanteric fracture or a femoral shaft fracture. ”

"These, as long as they are not open, are not a big deal. So I changed to a hospital and told the doctor that I accidentally fell, and I was fooled. ”

"Uh...... Is this really good?" Mr. Wang has been working as a doctor in the country's top large-scale tertiary hospital, and he has been in Haicheng for a few months, and he has done a lot of surgery, but he has not mastered this very obscure careful thinking.

"I don't know if it's good or not, and even if it's serious, it's a scam. Zheng Ren said very blandly: "But after all, it is to treat people, and it is better than those small community hospitals, which hedge cash out every day." Haicheng Community Small Hospital, hospitalization does not cost money, and money is paid every day. ”

"Money, so powerful?"

"Hmm. Zheng Ren nodded as he walked, "I've heard people say that it's about a hundred a day, which is about this price." Hanging on the bed to prescribe medicine, the hospital takes it and sells it, which is a kind of hedging. There are many other ways to do it. The large deficit of medical insurance does not lie in tertiary hospitals, but in the community. ”

"This is not ......," Mr. Wang was indignant.

"Calm down, grassroots, it's all like this. The stricter the management, the more convergent. If the tube is loose, I will seize the time to prescribe medicine. Zheng Ren smiled, "Everyone has good things, and no one will go to many things." Actually, it's said that everyone is good, but in the end, everyone is not good. But how, who knows. ”

Zheng Ren put on an attitude that he was just a doctor and was only responsible for seeing patients and surgeries, which was not in his hands, and he couldn't control it.

Mr. Wang was a little embarrassed, there were so many loopholes below, and he didn't know it before.

Walking to the door of the rescue room, Zheng Ren glanced around.

His body stiffened slightly, and he immediately walked quickly into the rescue room.

There are nurses busy in the emergency room, the patient is lying on the emergency bed, and the number displayed by the ECG monitoring is still very stable.

Jung In walked in briskly, attracting the nurse's attention.

She turned her head and said in surprise: "Mr. Zheng, you are back." ”

However, the surprise was only for a moment, and when the little nurse looked behind Zheng Ren, she immediately fell into boundless disappointment.

Zheng Ren knew that the person who could really surprise the little nurse was Su Yun. That goods, now I don't know if I drank it with Chang Yue or not.

Nodding, Zheng Ren came to the patient's side, stretched out his hand, and said, "Stethoscope." ”

Mr. Wang was a little puzzled, took out the Yuyue stethoscope from his white pocket and handed it to Zheng Ren. The patient's blood pressure was 150/100 mmHg, heart rate was 102 beats per minute, breaths were 28 breaths per minute, and oxygen saturation was 98%.

The ECG oscilloscope is sinus rhythm, which is an emergency patient, but not a critical patient.

The patient's injury was the same as Zheng Ren's judgment, and in the lower leg, Mr. Wang estimated that it was a tibia and fibula fracture. It's just that the fracture is a little severe, the left calf is congested and edematous, and the skin is a little shiny.

Compartment syndrome, obviously, is easily recognizable.

If this patient were dealt with by Mr. Wang, he would neither talk to the patient's family about medical insurance like Yuan Li, nor listen to the abdominal cavity with a stethoscope like Zheng Ren......

Isn't this?

The vital signs are stable, and it is estimated that the abdominal organs are fine, otherwise Yuan Li would not have leisurely talked to the patient's family about medical insurance.

Take 10,000 steps back, even if there is something, you shouldn't auscultate.

"Bedside B ultrasound, call, immediately!" Zheng Ren said in a deep voice, and in an instant, he had returned to the role of the inpatient director of the emergency department of Haicheng First Hospital, "Nitroprusside, blood pressure lowering, high blood pressure is kept below 120." ”

The little nurse was stunned for a moment, although Zheng Ren had been gone for half a year, Ji Wei was still there, and his body instinct was to obey, not to question.

She hurriedly called someone to call, and she hurried to add the medicine herself.

"Boss Zheng?"

"Tears in the thoracic aorta and abdominal aorta are suspected. Zheng Ren directly gave a diagnosis, "Go and call Yuan Li in." ”

Zheng Ren had just glanced at the rescue room, and the bright red background color of the system panel attracted him in. The system diagnosis seriously made Zheng Ren dare not delay time.

Auscultation, just one way, is rarely used. Because the patient is relatively thin, the stethoscope is pressed hard, and the sound of blood flow in the aorta can be heard. But there is a lot of noise, and that's not how the real diagnosis works.

This is just a way of Zheng Ren's retrograde inference, and others can't learn it.

"......" Mr. Wang looked at Zheng Ren in surprise, and then at the patient, very speechless. Where is this?

However, the diagnosis and treatment experience of patients with P-J syndrome told Mr. Wang that he must obey.

He hurriedly walked to the door and called Yuan Li in.

Yuan Li was a little unhappy, he had just finished talking to the patient's family vaguely, and he didn't say it himself, but he let the patient's family know what to do.

The next step is to sign a letter that you will be responsible for all the consequences, and then be sent by 120 ambulance to another hospital in the city for diagnosis and treatment.

In Yuan Li's view, it's just a fracture, which hospital doesn't treat it?

Zheng Ren, did he come back to make trouble for himself?! He was a little angry.

……

……

Note: This is a patient who was received at 10 years. My level is not high, I looked at the chest CT and did not find a dissection. To explain, dissected aneurysms at the beginning are also difficult to distinguish. I just had doubts in my heart, and I had to leave at home, so I waited until dawn the next day to contact the emergency vascular CT for reconstruction.

Finally, I was diagnosed with dissection and went directly to the ICU. The next thing is also true, people lived, but a lot of money was spent, and the family was a mess. When I was discharged from the hospital, his lover didn't look at me right, the vicious kind.

But so be it, smile.

To be aside, my constitution is more attractive to dissecting aneurysms. There have been 8 patients with rib fracture and aortic dissection in the department for more than ten years, and I am on duty.

This is very speechless.