Chapter 618: Chapter 284: Irrelevant Answers, Competing for Surgical Qualification (Part 2)
According to experience, examiners seem to prefer giving exceptional contestants some advantages in scoring in the early stages, allowing them to seize surgical qualifications later.
This is also to screen out some doctors who are less skilled or careless.
Thereby improving the safety of the practical competition segment.
Li Jingsheng first wrote out the treatment plan but did not rush to submit it.
The patient is undergoing a local fracture surgery on the right lower limb, so why bother measuring bilirubin and ALT levels?
It’s important to know that these are not part of routine blood tests.
From these data, it can be seen that the patient’s liver function has issues.
There might be serious cirrhosis.
The patient’s red blood cell count is only 3.2, which is very low. It falls below the normal range of 4.8-5.8 for adult males.
This further suggests the patient has liver function problems.
There’s also bleeding and clotting test, which isn’t usually done for small surgeries.
Now it can basically be concluded there are issues with the patient’s liver, what surgical risks should be noted?
People with liver problems are most afraid of persistent bleeding.
But this patient doesn’t have this risk.
So where is the risk?
Li Jingsheng usually performs skin tests before administering local anesthetics during surgeries at the clinic.
For fear of patient allergic reactions to the medication, leading to an incident.
The anesthesia method for this patient’s surgery is local anesthesia.
Besides testing for allergy before administering local anesthesia, what else should be noted?
He feels his pharmacodynamics and pharmacokinetics are somewhat lagging behind current standards.
Rack his brains to identify risks, he seems to have some findings but can’t grasp the key point.
"No, I must enhance pharmacodynamics and pharmacokinetics, it’s been a long time since they were upgraded."
Having enough life value, he isn’t stingy.
Immediately elevated these two medical skills from Minor Achievement to Major Achievement.
Instantly, his understanding of drug effect dynamics and metabolic dynamics, along with medication experience and analytical ability, have qualitatively improved.
Analyzing the anesthesia risks in this case now, he feels much more at ease.
He is already capable of identifying some potential dangers within.
After careful deliberation, he believes the greatest risk should come from the patient’s impaired liver function.
The patient’s impaired liver function presents with hypoalbuminemia and an inversion of the globulin ratio.
This means once medication enters the patient’s body, its metabolism rate will become extremely slow.
Definitely slower than normal people.
Under such circumstances, when the blood concentration of the medication rises high, a toxic reaction from local anesthetics becomes very easy.
Since local anesthetics usually prefer procaine, applied through local infiltration anesthesia for injection.
After medication use, the patient may not immediately exhibit toxic reactions.
After some time, when local anesthetic transfers from peripheral microcirculation into the bloodstream, a formidable toxic reaction can occur. Rescue becomes too late by then.
The patient’s advanced age, impaired liver function, combined with the injury.
Such a convergence of issues forms a fragile body.
By the time medical staff notice something amiss, they are already operating on the patient.
It’s likely that half the operation is completed, or even at the closing stage.
This adds another contingency to the disadvantages, surgical trauma.
When four adverse factors combine and a toxic reaction occurs, a cat with nine lives would still be insufficient.
Thinking this through, Li Jingsheng broke into a cold sweat.
Quickly wrote down the surgical risk elements, recommending either a general anesthesia plan or tight monitoring of the patient’s blood drug concentration.
The latter poses extremely high difficulty.
It’s nearly impossible to monitor the patient’s blood drug concentration at all times.
After submission, he sighed in relief.
Just waiting for the results to come out.
The big screen showed the rankings of the second hospital’s orthopedic surgery department, mentioning seventh place.
Chen Anchen and Hu Jia scored zero, while Li Jingsheng displayed "+1" beside his name.
The display on the big screen is as follows.
Second hospital orthopedic surgery department Chen Anchen’s team, Captain Professor Chen Anchen, members Associate Professor Hu Jia, Attending Physician Li Jingsheng +1 point. Team total score 1 point.
There are far more experts than expected.
Because the number of teams receiving bonus points is still increasing.
All teams answering correctly earn 1 point.
Some teams have four or five people answering correctly, which feels impressive.
Basically, they come from the top-tier hospitals, the People’s Hospital and Qiaobang.
Additionally, Jiangli City Medical University Affiliated Hospital’s performance this year is eye-catching.
Especially in Internal Medicine and Pharmacology, it appears formidable.
Slightly weak in surgical capabilities.
Nevertheless, it won two bronze awards in the General Surgery competition.
This is quite commendable.
No wonder industry insiders rumored the Medical University Affiliated Hospital wants to compete against People’s Hospital, Qiaobang Hospital for supremacy.
It seems not groundless.
The competition between these major hospitals is growing increasingly intense, gradually becoming fierce.
Jiangli City is just a microcosm of the nationwide situation.
The competition among major hospitals across the country is equally escalating, and the annual global famous hospital ranking is beyond words—more heated than the Forbes billionaire list.
The domestic annual comprehensive hospital ranking, individual department ranking, is similarly of great interest.
Which hospital has strong departments, ratings include research projects, medical quality, patient ratings as three major items.
Some departments are strong, but have low patient ratings and poor reputation.
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