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【345】Lessons from death cases

There are projectors and screens installed in the conference room, but usually no one opens them. Doctors are very busy, and no one has time to prepare ppt presentations for this kind of routine meeting within the department. What is more important when discussing a case is that everyone clearly expresses their views on the case. idea.

Unless a leader comes to inspect, everyone must be carefully prepared.

"Let's get started." Shen Jinghui personally presided over the meeting. "Each group will bring out the cases that need to be discussed. The doctor in charge will tell you about the 16 and 31 beds that died last week."

Shen Jinghui is more comfortable working as the director of General Foreign Language II. He controls the meetings like a surgery to remove key parts and does not want to waste everyone's time.

Each group discussed quietly within themselves. The doctors in charge of the death cases in beds 16 and 31 spoke first.

"Bed 16 is a patient with advanced rectal cancer. They originally had radical rectal cancer surgery in our hospital. Due to the advanced stage, they underwent palliative surgery. This time they came in three years later and had a large amount of ascites after systemic metastasis."

There is always no way to save this kind of patient. The only way to relieve the patient's final suffering is to relieve the patient's pain.

"Bed 31 came in from the emergency department with acute suppurative appendicitis and diffuse peritonitis. Emergency surgery was performed immediately after coming in. However, after opening the cavity, it was found that it was too serious and the intestines were adhering to all directions. The patient in his thirties had to wait too long. The surgery was performed only after the surgery was over, and he died of septic shock after the operation."

This case triggered the thoughts of many doctors at the meeting.

"Originally, the mortality rate of appendicitis is very low. But such cases happen from time to time. There was also a case in the general surgery department recently. Their case was an older woman, a woman in her fifties, but she also came too late. After she came, The family members didn’t take it seriously and said that appendicitis doesn’t kill people now, so how could it happen?”

"Diffuse peritonitis is the most terrifying thing. If you want to treat the infection conservatively without surgery at this time, if you have intestinal obstruction like this, there is no time for the doctor to not operate."

"At the stage of intestinal obstruction, purulent infection, and then sepsis - speaking of which, Dr. Tan, did your team also admit an old lady with intestinal obstruction?"

Suddenly the topic turned to Tan Kelin. When the discussion first started, Groups 1 and 2 were very quiet, because people in Groups 1 and 2 have always been reluctant to express their opinions. Probably Deputy Director Liu wanted to liven up the atmosphere in the entire department. , moved the topic to groups one or two.

When others asked about this patient, Tan Kelin responded by the way: "There is no hospital bed, so we admitted him on Wednesday. All examinations need to be completed before the operation. It is expected to be performed next Tuesday, and I want to communicate with the anesthesiology department on the phone on Monday."

"Intestinal obstruction?"

"The tumor is relatively large and has almost blocked the entire intestinal tract, so at this stage, I am fasting, draining and enema, and relying on nutrient solution for support."

"I heard you are in your nineties?"

"Yes, I am old and my heart and lungs are not very good. The anesthesiology department is quite dissatisfied. But my student said it can be done."

Suddenly hearing Teacher Tan's last sentence, Xie Wanying was startled. Without thinking, the teacher immediately shook her out.

"Xiao Xie, please express your opinion." Sun Yubo turned to instruct her.

At the department meeting, all the doctors from the department, including the professor and director, were present, which was more complete than the shift meeting every morning. For example, Professor Li, who rarely comes to the department, is now retired and has gray hair. He is considered a highly respected senior figure in the general surgery department of the Chinese Association. Today, I came to participate in the academic discussion of the department. He is an academic master who is not seen at all on weekdays.

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