"Shouldn''t it be?" Han Guangyun said unconvinced.


    "Guangyun, you haven''t had surgery. I don''t know. When the patient suddenly has high fever and stiff body on the operating table, the first thought must be over. Will the family members of the patient die on the table sue me?" Han Guangyun''s senior brother said with some emotion, "it''s rare to judge the patient''s condition and make a correct diagnosis in the shortest time."


    “……”


    The more Han Guangyun listens, the less he feels.


    "First, we need extremely strong psychological quality, and second, we need extremely profound medical knowledge and clinical experience."


    "..." Han Guangyun continued to be silent.


    "Let me give you two examples. I have encountered similar situations. They are rheumatic heart disease. Some have to do mitral valve replacement and some have to do aortic valve replacement. For the first time, a friend of mine encountered a patient with sudden high fever and systemic stiffness after establishing cardiopulmonary bypass. The whole person was stupid."


    "This is what he said when he drank too much at dinner. At that time, he judged it to be malignant high fever, but they didn''t have medicine locally. If they got it, they would die."


    "Later?" Han Guangyun asked subconsciously.


    "He was lucky enough to drop the temperature to 38.5 ℃ after cooling with an ice bag. At that time, he asked someone to consult on the stage, but he could not rule out the malignant high fever, but he still stubbornly finished the operation.


    Seven hours after operation, the patient was awake and removed the endotracheal tube. One hour after extubation, the patient developed irritability and tremor of both hands, and the HR increased to 145 times, t38.8 ℃


    "My friend didn''t dare to go. He kept looking at the patient in ICU. When he saw the abnormal changes, he immediately checked his body. There was a vascular murmur in the anterior cervical area. He was a little suspicious of the diagnosis at this time.


    If thyroid crisis is suspected, take 600 mg propylthiouracil and 10 mg propranolol orally immediately. The next day, take blood to measure the changes of thyroid function T3 and T4, and diagnosed as thyroid crisis. "


    "Wait..." Han Guangyun heard that there was a problem and said immediately.


    "What''s the matter?"


    "Elder martial brother, why can I have an examination the next day?"


    "At that time, the thyroid function test could not be done in the emergency department, and it could not be checked in the middle of the night. We had to wait until the next morning to send the test normally." Han Guangyun''s senior brother said, "it''s much better now. We all have routine preoperative screening here."


    "..." Han Guangyun heard the words "routine screening" and felt that countless flies were stuffed in his mouth. And some flies are still alive, flapping their wings in their mouths.


    "Er, not to mention the shortcomings, let''s talk about the cow''s place first." Han Guangyun''s senior brother said, "if you encounter abnormal conditions during the operation, you can judge them in the shortest time and check out the rare thyroid crisis. This person is a talent."


    "..." Han Guangyun choked silently.


    He felt that his stomach was full of flies. It was disgusting. But I can''t refute it. After all, I asked my senior brother for something.


    "The abnormality was found, the intraoperative treatment was also very timely, and the medication was very accurate." Han Guangyun''s senior brother continued, "the patient has taken the tube to the ICU now."


    "Yes."


    "It''s all right. Pull out the tube in two days and it''ll be over. Maybe it won''t take two days and you can come out in one day."


    "Senior brother, it''s just hyperthyroidism... It''s not a big problem," Han Guangyun said unconvinced.


    "Hahaha, Guangyun, how do you learn to be modest now?"


    "Er... I''m modest?" Han Guangyun sobbed. There were many flies in his mouth.


    "There are many people with hyperthyroidism. Generally speaking, they will ask before operation. This is a past history. However, some patients and their families do not know that they are ill. Once they get on the operating table, thyroid crisis is induced by surgical stimulation... What I told you just now is a successful case, and there are failures."


    "When I was flying a knife, I heard a doctor in a prefecture level city say about a similar case. It was a 22-year-old female patient who was hospitalized for rheumatic heart disease and was ready for surgery. There was no check-up of nail function before the operation, and the patient and the patient''s family members didn''t know there were problems in this regard, so there was an accident during the operation."


    "They were of average level. They thought it was normal during the operation and didn''t pay attention. They continued to have high temperature and convulsions after the operation. After reading for a day, they finally felt like a thyroid crisis or other problems.


    The next morning, I checked the nail work and found that there was an accident. The administration was already 48 hours after the operation. As a result, the patient''s condition became more and more serious, and IABP had no effect. Two days later, my family gave up rescue and died clinically. "


    Han Guangyun knew that his elder martial brother was only talking about cases like gossip, but every word was like an invisible slap in the face.


    "The problem in your hospital is also very big. I don''t know whether it is the boldness of the art expert or the carelessness of the bed doctor. The preoperative examination could have avoided the rescue and accidents on the operating table, but there are many screening items missing before the operation. Xiao Han, this... Let''s say, it''s called self righteous. I think the water level is high, and the preoperative examination is..."


    Han Guangyun was silent, and his senior brother kept nagging.


    "It''s not supposed to be. It can be seen at a glance that it''s a superior doctor with thyroid crisis... It''s estimated that they didn''t see it before the operation. Guangyun, you have to tell them not to be self righteous. They don''t see the patient or check before the operation. Although the level is high, they should pay attention."


    "Elder martial brother..." Han Guangyun wanted to say countless words in his heart, but he didn''t know what to say.


    "Hahaha, Guangyun, can''t you hold down such a powerful doctor?" Han Guangyun''s senior brother smiled. "I tell you, you can''t hold down. If you want to have a good relationship with them, you are the medical director. No matter how you say, they will give you some face."


    "Elder martial brother, I mean there are so many diseases to be screened before operation, and everything is checked. Isn''t that a burden for patients?"


    "Ah?" Han Guangyun''s senior brother was stunned. His tone was obviously confused. "Guangyun, are you okay?"


    "What''s the matter, elder martial brother? Am I wrong?"


    "Why did the patient come to the hospital?" Han Guangyun''s senior brother asked.


    "Cure."


    "Yes, if you don''t cure the disease, what expenses do you say? If you don''t come to the hospital, you will save 100 percent."


    "And people think it''s right that you save money for patients. Once something happens, it''s your responsibility." Han Guangyun''s senior brother said, "this is objective. Even if you want to save money for patients, you can''t rule out the contraindications of surgery."


    "But... Now the society says that random inspection..."


    "Listen to them, you don''t want to work in the hospital." Han Guangyun''s senior brother said, "there are some random examinations, but it has nothing to do with surgery and hospitalization. Do you think the doctors who can treat rheumatic heart disease need those three melons and two dates."


    Han Guangyun listened to his senior brother''s excited talk for half an hour. He was a little confused after hanging up the phone.