If you want to assess vision, you need the cooperation of an ophthalmologist, but non-neurosurgeons can do it. This is called specialization.
If you are really worried about skull fracture, you can take an X-ray to confirm the general situation, and then do a CT scan if necessary. So, if Dr. Guan had considered the neurological damage in this regard at the first time, he should have ordered an X-ray instead of arguing with Dr. Wang on the phone about the CT queue.
CT is not like MRI. The time it takes for each patient to be scanned is relatively fast, but the time it takes for the doctor to read the film is slow. The imaging doctors on duty at the tertiary hospitals at night are actually very experienced. If there are a lot of patients crowded together, they will scan all of them first and then read the film, so as to avoid complaints from patients and their families waiting in line.
To sum up, what exactly does Dr. Guan want?
Dr. Guan is considering whether to call an ophthalmologist to come down and deal with the situation.
Eye injuries are very special. Let’s not talk about diagnosis. If there is an eye injury, eye injury suturing is an independent specialist skill in ophthalmology and requires in-depth study. If the suturing is not done correctly, it will directly affect the patient’s vision and cause complete visual impairment.
When Dr. Guan told the nurse that any surgeon could sew up the wound, he was just talking nonsense. Now Dr. Guan thinks about it and realizes that his words were ill-considered.
There is no obvious wound on the patient's eyes. His vision must be impaired, after all, there is a bruise. Let the ophthalmologist come down to test the patient's vision. Other more detailed examinations probably cannot be done at night. It is better to let the patient be observed in the hospital for one night. If there is nothing wrong, he can go to see the ophthalmologist in the daytime. The level of the doctors on duty at night is not very good.
In the final analysis, the injured person will have to stay in the emergency room and cannot be admitted to the inpatient department.
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Does the ophthalmology department accept patients? This is because the ophthalmology department of the National Association is not well-known. It is a very small department with very few beds.
Do you think that's just the way it is?
Xie Wanying said, "Teacher, this patient needs an electrocardiogram as soon as possible."
"What?" Doctor Guan asked in surprise.
The cardiothoracic surgeon said that they had just checked and determined that the victim's heart was fine.
Mi Wenlin and Mi Siran, the junior and senior brothers and sisters, looked at Xie Wanying who was speaking in unison, with dissatisfaction in their eyes. They suspected that Senior Xie was just looking for trouble with them.
"Does your chest hurt?" Xie Wanying lowered her head and asked the injured person again.
"Yes - it hurts -" the injured person's weak voice came out of his mouth.
Doctor Guan sensed something was wrong this time, and approached the injured man and asked, "Where does it hurt? Isn't it your head?"
"It hurts here." The patient tried to raise his hand.
Everyone could see clearly that the injured person's hand was trying to point to his chest.
"Impossible." Mi Wenlin and Mi Siran said flatly, lifting the injured man's shirt and pointing, "There are no wounds, no pneumothorax, and no bleeding. The heart sounds clear and the heart rate is within the normal range. He may have some rib damage and some pain. Otherwise, take a chest X-ray."
If the ribs are really damaged, generally speaking, there will be some bruises on the skin. This patient said that his chest hurt so much that he could hardly speak. If it is a chest injury, it is impossible to say that there is no skin bruise at all.
As for whether these junior brothers and sisters can really hear the heart murmur, the senior brothers Zhang Desheng and others at the scene have to question it. If the heart murmur is very obvious, it is easy to hear.
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