Chapter 1108 Careful Thoughts of Primary Hospitals

"There is a patient injured by a fall from a height who jumped from the fourth floor. The family does not want to be hospitalized." Yuan Li explained vaguely.

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

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

Mr. Wang was very moved and admired.

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

In the imperial capital, he rarely touches insurance. To live in the 912 hospital, the advance deposit is 50,000. In other words, if you don't pay 50,000 yuan, you can't even live in the hospital.

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

But the situation in Haicheng is completely different.

Whether the patient's family members choose to be hospitalized and whether they can be reimbursed for medical treatment here is a major consideration for the patient's family members.

But Boss Zheng knew at a glance that it was because of insurance. What the hell is this? President Wang also realized the problem.

Yuan Li was stunned for a moment, then nodded.

Zheng Ren smiled, "Continue talking."

After speaking, Mr. Wang continued to walk forward.

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

"Jumping off the building is suicide, which is not reimbursed by insurance." Zheng Rendao said, "Without insurance, many orthopedic steel plates cannot be used. If domestic cheap steel plates are used, most of the injured will be in the lower limbs and will bear weight in the future, and the steel plates may be damaged. fold."

"..."

"This is a medical risk in the future. So if the emergency department admits such a patient, it is not very urgent, and it cannot be reimbursed, and the orthopaedic doctor will be very unhappy. If it is particularly urgent, it will not.

But didn't Dr. Yuan say that he jumped down from the fourth floor. It is estimated that the injury was not serious. There might be a calf fracture, or an intertrochanteric fracture, or a fracture of the femoral shaft. "

"As long as it's not open, it's not a big deal. So I changed the hospital and told the doctor that I accidentally fell, and I was fooled."

"Uh...Is it really good to do this?" President Wang has been working as a doctor in the country's top large-scale tertiary hospital. He has been in Haicheng for a few months, and he has done a lot of surgery, but he has not grasped this very subtle thought. .

"I don't know if it's good or not, or even more serious, this is insurance fraud." Zheng Ren said plainly: "But after all, it's to treat people, it's better than those small community hospitals, where the insurance can be realized every day. The small hospital in the Haicheng community does not cost money for hospitalization, and it also pays money every day.”

"Making money? So powerful?"

"Yeah." Zheng Ren nodded as he walked, "I've heard people say that it's about a hundred a day, which is probably the price. Hanging up the bed to prescribe the medicine, the hospital takes it and sells it. This is part of the hedging. There are many ways to do it. The large deficit in medical insurance is not in the top three hospitals, but in the community.”

"This is not..." President Wang was filled with indignation.

"Calm down, the grassroots, it's all like this. If you are stricter, you should be more restrained. If you are loose, you should seize the time to prescribe medicine." Zheng Ren smiled, "Everyone has good things, and no one will go to them too much. In fact, it is said that everyone is good, and in the end, everyone is not good. But how to do it, who knows."

Zheng Ren put on an attitude that he was just a doctor who was only in charge of seeing a doctor and performing operations. This kind of thing was not up to him, and he couldn't control it either.

Mr. Wang was a little sighed, there are so many loopholes below, I didn't know it before.

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

His body froze slightly, and he quickly walked into the emergency room.

Nurses are busy in the emergency room, the patient is lying on the emergency bed, and the numbers displayed by the ECG monitor are still stable.

Zheng Ren walked in quickly, attracting the attention of the nurse.

She turned her head and said in surprise, "Mr. Zheng, you're back."

But the surprise was only a moment, 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 guy, I don't know if He Chang Yue has finished drinking.

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

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

The ECG oscilloscope is in sinus rhythm, which is an emergency patient, but not a critically ill patient.

The patient's injury is the same as Zheng Ren's judgment. In the calf, President Wang estimated that it was a fracture of the tibia and fibula. It's just that the fracture is a little serious, the left calf is congested and edema, and the skin is a little shiny.

Compartment syndrome, obvious and easy to identify.

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

Boss Zheng listens to the abdominal cavity dry wool? Isn't this nonsense?

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

Step back 10,000 steps, even if there is something wrong, it should not be auscultated.

"Bedside ultrasound, call, immediately!" Zheng Ren said in a deep voice, and in an instant, he had returned to his role as the inpatient general of the emergency department of Haicheng First Hospital, "Sodium nitroprusside, blood pressure, high pressure maintained at 120 or less."

The little nurse was stunned for a moment. Although Zheng Ren had been gone for half a year, the prestige was still there, and her body's instinct was to obey, not question.

She hurriedly called someone to call, and she took the time to add medicine.

"Boss Zheng?"

"It is suspected that the thoracic and abdominal aorta are torn." Zheng Ren gave the diagnosis directly, "Go and call Yuan Li to come in."

Zheng Ren just glanced at the emergency room, and the bright red background color of the system panel attracted him. The system diagnosis seriously prevented Zheng Ren from wasting time.

Auscultation is just a method that few people use. Because the patient is relatively thin, the sound of blood flow in the aorta can be heard by pressing hard on the stethoscope. But there are so many murmurs that the real diagnosis doesn't do that.

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

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

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

He quickly 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 in a veiled manner, and his words were vague, but he let the patient's family understand what to do. This requires a lot of skill, and he is a little proud of himself.

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

In Yuan Li's view, it's just a broken bone. Which hospital doesn't treat it?

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

...

...

Note: This is a patient received in 10 years. My level is not high, I looked at the chest CT, but no dissection was found. To explain, the dissecting aneurysm at the beginning is also more 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 and contacted the emergency vascular CT reconstruction.

Finally, I was diagnosed with dissection and went directly to the ICU. The latter thing is also a real thing. People live, but they spend a lot of money, and the family is in a mess. When he was discharged from the hospital, his lover looked at me in the wrong way, the kind that was vicious.

But, so be it, smile.

To say a little more gossip, my physique belongs to the physique that is more attractive to dissecting aneurysms. For patients with rib fractures and aortic dissection, 8 departments have been in the department for more than ten years, and all of them came from me on duty.

This is very speechless.