medical simulator

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10 beds, refractory postoperative infection.

The 11th bed is for postoperative patients left over from the previous days. The batch of patients who just started work in the new year have been discharged one after another. He is still in the hospital and is still in a state of post-anesthesia delirium. Please quickly ask the anesthesiologist and neurologist Medical and psychiatric consultations assist in diagnosis and treatment.

The patient's family members are very noisy.

The last patient has 12 beds. The situation of 12 beds is a bit more special than the previous 11 beds...

At present, the diagnosis is not clear, but there are fractures and no trauma. A tumor test was done in a lower-level hospital, and no bone tumor was found in the biopsy.

While Zhou Cheng was taking notes like this, he suddenly discovered a more detailed problem, and it was also a very real problem.

The orthopedics department of Shanghai No. [-] Hospital cannot provide extra beds like Shashi No. [-] Hospital. Moreover, the bed settings in each ward are different.

There are a total of 55 beds in the three orthopedic wards, four groups, Professor Xue Xiude, a total of only twelve beds.

However, the staffing of Professor Xue Xiude's group includes: Professor Xue Xiude, Associate Professor Gu Zhongliang, Shen De's attending physician and Mao Yuxuan's chief resident physician.

At present, all domestic hospitals and all departments in the hospital are self-financed. The twelve beds are all trauma and postoperative infection patients. The average length of stay for such patients is as little as one week and more There are more than 20 days.

In other words, every month, the turnover rate is the highest, which is four rounds.

According to the highest calculation, there are 48 patients in each group per month, and each patient is mostly undergoing debridement and suture surgery, then, even if the hospitalization cost is relatively high, it is about 1 to 2 w.

The profit margin of clinical departments is after deducting the rents paid to drug suppliers, pharmacy departments, hospitals, departments and operating rooms.

(Note: I won’t write this in depth. Readers, you should know that it is actually very realistic now. The operation of a department is actually looking for a place rented by the hospital, and the same is true for surgery in the operating room. Specifically why, don’t do it for a knife, Xiaodao doesn't know.)

(If you are interested, you can go to the channel to find out.)

That is to say, the bonus coefficient, the most that can be allocated is 20.00%, which is considered as high as the sky.Broken ceiling.

That is to say, within a month, within a group, the bonuses that can be given out are as high as 13-14w, and part of it will be distributed to the nurses in the department.

Then, there is a professor, an associate professor, an attending doctor, and a general resident.

Four Ph.D.

Still in the magic capital.

Isn't the pyramid echelon coming out? If the young doctor's family is not good.

I want to buy a house, I just want to eat farts...

This income is really not necessarily comparable to that of doctors in teaching hospitals in provincial capital cities, because there are more high-quality patients there, operations are simple, and high-end consumables can be used.

Of course, these problems, because Zhou Cheng was far away, Zhou Cheng quickly just made extra calculations casually.

Of course, it is also possible that the reality is not as dire as I imagined. After all, in many other industries, a doctoral degree is quite popular.

Read professional books.

Zhou Cheng looked through the surgery textbooks and professional books. Basically all the information, the definition of the treatment of infection is just such a few tricks.

Thorough debridement, the use of sensitive antibiotics, and the use of sufficient and sufficient antibiotics.

Then, it's basically gone.

Because no one can provide textbook-style guidance on the infections you encounter in reality. The infections that each person encounters may be infected with different germs, and the strength and consultation capabilities of the pharmacy department are also different in each place, and even There is also a gap in the strength of the laboratory.

This is the horror of infection once it occurs in surgery.

Regardless of other things, as far as the 5 beds and 8 beds undergoing surgery today, must the surgery performed today be the most correct?

This is not conclusive, because there is no standard answer for the diagnosis of such a disease.

However, for the 2-bed and 3-bed patients who will be operated on tomorrow, the operations that can be performed are debridement and suture + implantation of sensitive antibiotic copper sulfate carrier + continuous irrigation and drainage.

Then curettage and bone grafting will be performed in the second stage. The purpose of the first stage operation is to control infection.

Then Zhou Cheng looked at his skill list, and found that the best thing to deal with such a diagnosis was debridement and suture.In theory, debridement and suture are only part of the treatment.

More important things are the choice of key antibiotics and an experience in the treatment of infections.

Not all diseases in reality will be ill according to the textbook.

Zhou Cheng looked at his skill list again, and finally found it in the proficient skill.

Proficiency-level skills: experience in shoulder joint injury treatment, knee joint injury treatment experience, tendon injury treatment experience, post-fracture infection treatment experience.

Zhou Cheng vaguely remembered that these mastery-level skills came from Luo Yun's academic bag, or that Zhou Cheng had licked Luo Yun to death in the simulated world at that time.

At that time, Zhou Cheng still thought that Luo Yun was quite powerful.But later, as Zhou Cheng's skills at the perfect level gradually increased, he felt that Luo Yun was actually quite good.

Looking back now, Luo Yun is of course very good compared to himself, but he is actually not good.

Not everyone is the same as yourself, the growth curve is a skill from 0→perfect.

More people still come from entry, proficiency, proficiency, and perfection.

Moreover, in the process of learning, others must not only learn one thing and choose one, but comprehensively improve it like they simulated surgical skills themselves.

For example, the treatment of infected patients is a comprehensive module, and it is a relatively large section, which is no less than a discipline such as complex joint revision.

Infection is what all surgeons fear the most, and it is also the nightmare that all surgeons are afraid of encountering.

With Zhou Cheng's current strength, he must be able to treat such patients, but he needs to dismantle them slowly in the clinic, and take a step-by-step approach to targeted treatment.

And this is called being adaptable. Zhou Chengcheng felt that it was still necessary for him. In terms of basic medicine, the infection after fracture surgery should be simulated. It would be best to be able to simulate a skill package.

After setting the initial goal, Zhou Cheng selected several related perfect level skills, and then started the simulation.

The difficulty of this simulation goal is not small.

【The simulation starts! 】

【You have extremely solid theoretical foundation and clinical skills!You become interested in infected patients, so you start studying.But you still have other clinical research tasks, so you don't have much thought about infection. 】

[One year later, your clinical project was successfully completed, and your scientific research team has entered a new field! 】

[You gradually faded out of the original research group and returned to the clinic.Because your topic has a great impact, you will soon be awarded a master's degree and academic qualifications as an exception, and the educational institution in your country promises that as long as you can complete enough academic accumulation. 】

[An exception can still be made to grant you a doctorate degree and a doctorate degree, and the reason why you are not granted at the same time is to allow the public to have a process of acceptance and avoid shocking the world. 】

[Another year later, you launched a new clinical project, you were awarded a doctorate degree and a doctoral degree in advance, you were awarded an intermediate professional title in advance, and you were awarded an associate senior research title in advance. 】

[Three years later, your country opened a new chapter in the orthopedic clinical department, and the minimally invasive surgery was officially established. In the same year, you published your first personal monograph, which was included in one of the hundred basic books that orthopedic doctors must read . 】

[Ten years later, the discipline of minimally invasive surgery was booming. During this period, you took the time to complete the research statistics on the treatment of infected patients, and you completed the treatment research statistics on some special infected patients, and gained experience in the treatment of infection after fracture surgery ( Perfect)……】

【You have reached the simulation target. 】

[The simulation ends. 】

[Acquired skill: experience in treating infection after fracture surgery (perfect).Additional skills: special infection treatment experience (perfect), including special germs, viruses, microorganisms, etc. 】

[Simulation evaluation: The first half of life was dull, without any challenges. 】

After reading it, Zhou Cheng has already gotten used to it.

Today's aptitude is much better than before, almost half of Yang Yifeng's, and more than ten times that of Dong Yuhai and Du Yanjun. If it takes several lifetimes to solve such aptitude, then this Infection is basically not something that the current superiors and teachers can solve.

After acquiring the skills, Zhou Cheng was stunned for a while, and then, he discovered that, in fact, although the bacteria infected after fracture surgery are different, they still have their own classification and order, as long as they are handled properly.

There are still certain rules to follow, and through this experience and clues, Zhou Cheng seems to have faintly touched another level of infection. Perhaps, the progress and treatment of infection can be controlled through techniques and certain skills. Reduce the incidence and recurrence of infection.

However, thinking about it, Zhou Chengcheng naturally moved in this direction to continue the simulation.

This time the simulation was considered an unexpected situation, so Zhou Cheng pushed back the direction of the previous simulation.

【The simulation starts! 】

[You become interested in infection, and you think there are still unsolved mysteries about infected patients, basic anatomy, and trauma surgery.After you talked about your great cause with your companion, you handed over the clinical task to your companion. 】

[Because you have completed the preliminary basic and theoretical research of the clinical project, and your friends are quite capable, so even though you have lost your backbone, it still took five years of ups and downs to successfully complete the problem. 】

【Five years later, your research team has entered a new field! 】

[You who have returned to the clinic for five years, because of the perfect level of skills, have now obtained a professional doctorate and are taking on the role of the general inpatient. 】

[Because your subject has a great impact, you have been exceptionally promoted to associate professor.You became the fifth youngest associate professor ever in your unit. 】

[The research group you are in has started market-oriented operations, but one of your friends lost interest in market-oriented operations. He began to change careers, became a clinical lecturer, and opened training courses. 】

[And, still persist in writing his own novel.You invited him to your research group, and he felt that your research was too vague and without theoretical basis. 】

[But he didn't persuade you, he just said that you still have the capital to be proud, and you can do whatever you want very willfully.Because even if you waste another lifetime of time, the technologies and skills you have already mastered can already make you worry about food and clothing. 】

[Skills are not overwhelming, because the economic rewards brought to you by high abilities can make you more calm when faced with various choices. 】

[You are married. 】

【Three years later, you were promoted to a professor, and a new chapter in the clinical department of orthopedics was opened in your country, and minimally invasive surgery was officially established.The medical association in your country invited you to be the editor-in-chief of minimally invasive surgery, but you declined and just became an ordinary editor. 】

【Ten years later, you became tired of the monotonous repetition of clinical tasks, so you discussed with your wife that you wanted to resign and concentrate on doing research, and your wife supported your decision.And she very boldly built an animal laboratory just for you. 】

[The funds are from the dividends of the patent shares of your previous clinical projects. 】

[After learning that you resigned, you were invited to countless offers and headhunting companies, but you rejected them one by one, and devoted yourself to basic research. You started with the most basic knowledge of anatomy. 】

[When you were 65 years old, you dissected a total of [-] mice, [-] pigs and [-] cows. At the same time, you conducted more than [-] open classes on human anatomy, making the best use of everything. . 】

[But you still haven't arrived where you expected to be.You go on to begin the study of basic anatomical theory. 】

[When you were 75 years old, you made a very firm decision because of the excessive energy you spent these years. You hoped that after anesthesia on your lower body, you would complete your own dissection...]

【Your ideas are too shocking. No one dares to assist you in completing this 'great conjecture'. Others respect you as a teacher and a professor. They only respect you, so they understand your madness very well. 】

[After this idea was exposed, you were exceptionally promoted to an academician of orthopedics, because someone interpreted that you had this idea because you didn't get enough fame and fortune. 】

【But your wife made you perfect. 】

[You died from self-dissection. Before you died, you finally realized something. You believe that there is definitely a set of cavities between the muscle layers, and this set of cavities forms a network and interweaves with each other, which will cause the recurrence of infection and the main cause of fluctuations. 】

[You acquire basic anatomical theory (pioneering - indefinable). 】

[The simulation ends. 】

[Acquired skills: basic anatomy theory (creation—undefinable). 】

[Simulation evaluation: Pioneers of basic scientific research, scientific research lunatics, people who even sacrificed themselves, thinking outside the box...]

Eh, all right.

Zhou Cheng felt that breaking through the basic theory of a subject was still somewhat difficult. With his current aptitude, he spent a lifetime of in-depth research before he came up with a basic anatomical theory.

It seems that only people like Yang Yifeng, who have studied deeply for a lifetime, can uncover the basic theory of a subject.

But there is no rush, I still have plenty of time, with basic anatomical theory, what am I afraid of?

However, at the end of this simulation process——

But your wife fulfilled you.

Doesn't this sentence mean that my wife will be anesthetized? To be more straightforward, that is to say, there will be an anesthetist by my side, and I will eventually become my wife?

Seeing this sentence, Zhou Cheng felt that he was rather scary, because he didn't feel any special feeling, just that kind of shyness, impulsiveness and embarrassment.

It seems that this is the way it should be, like an old husband and wife.

Will this make my relationship history less than something?Zhou Cheng began to worry.

However, when he really recalled the process of getting along with An Ruo today, Zhou Cheng still thought it was quite interesting.I have taken most of the initiative, but there are still accidents that I can't imagine.

So after thinking about it for a while, Zhou Chengcheng started the third simulation.

Zhou Cheng planned to waste and give up this simulation opportunity.Zhou Cheng's planned simulation direction is An Ruo. He will try to see what kind of story will happen under his deliberate guidance.

It was supposed to be the second time to simulate this direction.

However, because a little accident happened in the first simulation, Zhou Cheng made one more simulation.

Finally, after waiting patiently for half an hour.

Zhou Chengcheng started his own simulation.

[Simulate the target and find a girlfriend. 】

[Initial carrying skills: none. 】

[The simulation begins. 】

【You confessed to a girl you don't know if you like it or not, and she agreed. 】

[One year later, you got married. 】

[The simulation ends. 】

[Simulation evaluation: A life of nonsense, completely inconsistent with the theme.The simulation orientation conflicts with the intended orientation of the mock copy.Rewards get cut. 】