Practicing Medical Skills in a Small Clinic novel Chapter 618

Chapter 618: Chapter 284: Irrelevant Answers, Competing for Surgical Qualification (Part 2)

According to experience, examiners seem to prefer giving exceptional contestants some advantages in scoring in the early stages, allowing them to seize surgical qualifications later.

This is also to screen out some doctors who are less skilled or careless.

Thereby improving the safety of the practical competition segment.

Li Jingsheng first wrote out the treatment plan but did not rush to submit it.

The patient is undergoing a local fracture surgery on the right lower limb, so why bother measuring bilirubin and ALT levels?

It’s important to know that these are not part of routine blood tests.

From these data, it can be seen that the patient’s liver function has issues.

There might be serious cirrhosis.

The patient’s red blood cell count is only 3.2, which is very low. It falls below the normal range of 4.8-5.8 for adult males.

This further suggests the patient has liver function problems.

There’s also bleeding and clotting test, which isn’t usually done for small surgeries.

Now it can basically be concluded there are issues with the patient’s liver, what surgical risks should be noted?

People with liver problems are most afraid of persistent bleeding.

But this patient doesn’t have this risk.

So where is the risk?

Li Jingsheng usually performs skin tests before administering local anesthetics during surgeries at the clinic.

For fear of patient allergic reactions to the medication, leading to an incident.

The anesthesia method for this patient’s surgery is local anesthesia.

Besides testing for allergy before administering local anesthesia, what else should be noted?

He feels his pharmacodynamics and pharmacokinetics are somewhat lagging behind current standards.

Rack his brains to identify risks, he seems to have some findings but can’t grasp the key point.

"No, I must enhance pharmacodynamics and pharmacokinetics, it’s been a long time since they were upgraded."

Having enough life value, he isn’t stingy.

Immediately elevated these two medical skills from Minor Achievement to Major Achievement.

Instantly, his understanding of drug effect dynamics and metabolic dynamics, along with medication experience and analytical ability, have qualitatively improved.

Analyzing the anesthesia risks in this case now, he feels much more at ease.

He is already capable of identifying some potential dangers within.

After careful deliberation, he believes the greatest risk should come from the patient’s impaired liver function.

The patient’s impaired liver function presents with hypoalbuminemia and an inversion of the globulin ratio.

This means once medication enters the patient’s body, its metabolism rate will become extremely slow.

Definitely slower than normal people.

Under such circumstances, when the blood concentration of the medication rises high, a toxic reaction from local anesthetics becomes very easy.

Since local anesthetics usually prefer procaine, applied through local infiltration anesthesia for injection.

After medication use, the patient may not immediately exhibit toxic reactions.

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