Tanglou entered the ward and took a quick glance at the patient models and various equipment in the room.

Three or four medical staff were making preparations for first aid.

The head nurse was about to speak when she saw Tang Lou come in.

The old man from Tanglou stretched out a hand to signal for silence. He was like the old director of the emergency room:

"Head nurse, case, prepare the rest of the information."

The young nurse playing the role of head nurse glared at Tanglou with some dissatisfaction: "..."

I'm about to start, but you can't let me finish my lines, because you don't want to hear me imitate the head nurse's vivid tone!

"Come on, why are you in a daze? Young people are easily distracted. We may have to face a very dangerous first aid next, so please pay full attention and follow my arrangements."

The little nurse instinctively exclaimed, and obediently brought up the case. The aura of the head nurse that she had managed to accumulate was instantly broken!

"52-year-old man, fainted at work..."

Tanglou was looking at the cases, thinking, and then looked at the little nurse.

The little nurse quickly walked to the monitor and pulled up the picture.

"Black vomit?... Taking ibuprofen tablets all year round? Are there other symptoms?"

Tanglou continued to ask questions, and his tone really sounded a bit like a great doctor. With the blessing of emergency comprehensive (three stars, 9), various responses to first aid have become the body's instinct.

"Oh, the patient vomited blood, and the digital anal examination showed black stool."

The assistant doctor hurried over and reported to Tanglou the previous physical examination.

"Yes, well done. The patient presented with syncope, vomiting, and melena, which is a characteristic of upper gastrointestinal bleeding. Melena is caused by the decomposition of hemoglobin. The most important reason for upper gastrointestinal bleeding is peptic tract ulcer. Upper gastrointestinal bleeding

Tract malignant tumors, portal hypertension, variceal bleeding, and esophageal and cardia mucosal tear syndrome.”

"Thanks to your meticulous preliminary work, patients can basically be diagnosed with peptic tract ulcers if they take ibuprofen for a long time."

Several medical staff looked at the tenement building in a daze, wondering who the actors were and why it felt more real than what they had rehearsed.

I almost suspected that I was the one who entered the emergency room, slander\(??ω??)/:

“We really appreciate your compliments on your meticulous preparation!”

"You stole all the lines and scenes."

Especially the scorekeeper, who was supposed to be CUE, saw that Tang Lou had already given the answer to the first question and didn't know whether to add another question.

Look, is this all done by the players?

"Hey, I'm talking about you! Why are you dazed? Now that the diagnosis has been confirmed, we need to take first aid immediately."

Tanglou seriously reminded the question maker who was also an assistant doctor and scorer. "

"Yes yes yes."

I feel Tanglou's serious attitude towards emergency treatment, this serious aura, this is the actor's self-cultivation!

Instinctively, I started preparing for tracheal intubation.

Tanglou nodded happily and looked at the "head nurse" again, his eyes just arrived.

The little nurse was inspired by the strong aura of Tanglou and consciously said: "I understand, immediately cooperate with the assistant doctor to open the intravenous channel."

"Well, at least two channels of large aperture and crystalloids are prepared simultaneously."

Tang Lou nodded, added some control points, and saw several medical staff moving in an orderly manner. Tang Lou paid close attention to the examination instruments and the simulated vital signs on them.

"The patient has hypotension, tachycardia, and active bleeding is suspected. You, prepare a unit of red blood cells. You, monitor hemoglobin regularly."

"Okay, doctor."

Under Tanglou's control, these medical staff had already simulated the steps many times. For some reason, under Tanglou's calm instructions, they abandoned the fixed actions in their minds and instead followed Tanglou's instructions to adapt to changes.

Being organized gives me a sense of peace of mind.

"..The patient is hypovolemic and needs blood transfusion preparation..."

Tanglou is keenly aware of the subtle changes in the patient's vital signs. Since he has always been in the role of giving orders and coordinating the overall situation, Tanglou is more aware of the changes in the emergency room than the medical staff who have simulated it many times.

Moreover, due to changes in Tanglou's instructions to a certain extent, the previous simulation process has been disrupted. After all, plans made in advance are prone to deviations during drills. After Tanglou's on-site command, the confusion caused by these deviations will be eliminated.

Optimized to be more perfect and smooth.

"...Type O blood preparation..."

The medical staff are absolutely convinced by Tanglou's response, and the next step is to cooperate unconditionally.

In just five or six minutes, Tanglou established his absolute commanding position in the emergency room and had already twisted these people into a tightrope.

"The patient's hemoglobin is less than 7 grams per deciliter. Please note that after active bleeding, the hemoglobin will be falsely elevated due to blood concentration. It must be noted that PPI must not be used before endoscopy, especially if it is like

This patient, with such severe bleeding, must promptly prepare for an upper gastrointestinal bleeding endoscopic consultation with the gastroenterology department."

While Tanglou observed whether the medical staff's operations were standardized, he also put forward various precautions so that the medical staff would have peace of mind and avoid short-circuiting before emergencies.

Several simulators were still paying attention to the performance of the previous players when they were giving first aid, and were still scoring in their minds, but at this moment, they turned into junior doctors and assistant doctors under the watchful eye of Tanglou.

I began to worry about whether my actions were standard and in line with the requirements of the Tanglou doctor.

After all, this guy’s eyes are very poisonous!

...

"...You are doing a great job. It seems that you are not slacking off at all times, operating rigorously and responding quickly. With everyone's efforts, the patient's condition is now stable..."

Tanglou encouraged me a few more times and gave me a date with a stick. He was well versed in management and looked like he was anti-customer.

"Finally, I would like to add a few words about the urgency of endoscopy to deepen your understanding of risk stratification tools in terms of knowledge structure."

"In first aid, one of the tools we commonly use is the blatchford scoring tool, which relies on some parameters, such as urea, hemoglobin, systolic blood pressure, and whether syncope occurs..."

"The second one is called the Rockall scoring tool. Its basic parameters are similar to the Blatchford scoring tool, but its use is limited in emergency situations because it requires endoscopic results for scoring."

"Just like this patient now, endoscopy should be performed immediately after his condition stabilizes."

"Even if it is not severe bleeding, an endoscopy should generally be performed within 24 hours. Endoscopy can both diagnose and treat. Endoscopy can also help predict the risk of re-bleeding. The risk of re-bleeding is also affected by other factors, such as

Hemodynamic instability is manifested by hemoglobin less than 10 g/dl, large ulcer size and ulcer location.”

"For this patient, it is clear that several factors coexist. Through the scoring tool, we can determine that the patient needs to be admitted to the ICU."

After Tanglou finished speaking, he looked at the simulated medical staff who were listening attentively and felt embarrassed:

"Now that I have finished speaking, who is in favor and who is against?"

The few people who had just fallen into serious admiration suddenly woke up and looked at Tanglou's handsome and unruly face:

"..."

There was silence for three seconds.

"Doctor, this room has a score of 10, please leave the examination room quickly!"
Chapter completed!