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骨外科医生的一天

Day in the Life - Orthopedic Surgeon

My name is Randall McKnight.
我叫麦克耐特
I am an Orthopedic Surgery Residency.
是一名骨外科住院医师
This is a day in my life.
这是我生活中的一天
《医学院内线》
浮生一日 第6集
It’s a Saturday morning.
现在是星期六早上
it is a on-call day.
我要去值班
So we’re just driving to the hospital
所以我们现在正开车去医院
and the goal is to see all my patients,
为了给我的患者看诊
have all my notes written before 7:00 AM,
还要在早上7点前写完我的全部病历
at which point, I will meet up with the call team
7点我会和值班团队见面
and we’ll kind of run the lists
接着一起写门诊记录
see what patients came in overnight
看看夜里来了哪些病人
what surgeries have to be done,
有哪些手术要做
and then I’ll head off to the operating room and pick up our pager.
然后我将带着传呼机前往手术室
So I’ll operate throughout the day
也就是说 我要做一整天手术
and also see any consults that come in to the emergency department.
还要给急诊科的患者看诊
And then once the day is over, I stay overnight.
今天工作结束后 我还要值夜班
And I will finish my shifts tomorrow morning at 7:00 AM.
直到明早7点再下班
It’s about 7:30, just got done with rounding on all my patients,
现在大概七点半 我刚巡视完我的病人
writing all my notes for the day.
同时写完了今天的病历
Now, we’re getting ready for our cases.
现在 我们要准备手术了
We’ve got a patient that had broke his femur,
我们刚接到一个股骨骨折的患者
so the thigh bone.
也就是大腿骨折
What we’re gonna do is go in,
而我们所要做的就是
put a long metal rod down the inside of the bone,
将一根长的金属棒放入骨头里
to just bring the bone pieces back together
接着只需将碎骨复位
and keep the bone stable
并固定它们
so they can start to walk on it.
患者就能靠它行走了
But first, we need to scrub in.
但首先 我们需要擦洗消毒
So to scrub, first you’re gonna take your scrub brush,
你得先拿起刷子
you’re gonna get your hands,
你要打湿你的手
the brush,
打湿刷子
wet all the way up to your elbows.
一直到把你的手肘都打湿
I typically turn the water off afterwards, just to save it.
为了节约用水 我通常会随手关掉水龙头
Then you just start scrubbing.
接着开始擦洗
So you want to make sure you get every part of your hand at least 10 times,
你要确保把手的每处都至少擦洗十次
that includes both sides of your fingers.
包括每根手指的两侧
Then you’re gonna flip it over and use the brush to actually
然后把刷子翻个面
get your finger nails.
用刷子刷洗指甲
You know you’re doing it long enough,
如果同台手术的人都洗好了
if everybody else that’s scrubbing into the case is already done.
就说明你洗得够久了
So then once I got my hands done,
洗完手后
I want to get my forearms,
我还要洗前臂
again going a couple inches above the elbow.
肘部上方几英寸以内都要洗
So again, we’re only sterile up to our elbows.
就是要保证手肘也是无菌的
I am going to rinse off my hands,
我要冲洗双手
keeping my fingers above my elbow.
保持手指在手臂上方
This way any germs will rip down my arm
这样 病菌都会移向我的手臂
and not towards my hands,
而非手掌
which I want to keep sterile.
毕竟要保证手掌无菌
Again at this point, I’m trying hard not to touch anything,
在这期间 我尽量不碰任何东西
and I’m ready for my case.
这样就做好手术的准备了
So we finished our cases for the day.
我今天的手术已经完成了
Typically, that happens around 3, 4 o’clock on a weekend.
周末的话 我一般在三四点完成手术
Just an example of the type of things that we do.
这只是我们工作中的一个例子
You can see that this person had broken their femur
你可以看到这人的股骨在这里折了
right here and a little bit of a fracture up there as well.
上面这里也有点骨折了
So we take a long metal rod
对此 我们会
and we actually push it in from the hip
从臀部放入一根金属棒
and go down the bone after aligning
将骨折的断处对齐后
the two different ends of the bone.
再下移骨头
And then we put these screws in, going up into the femoral neck
接着将这些螺丝钉插入股骨颈
to keep the bones from rotating
以防止骨头
around the rod that we put in.
绕着钉棒旋转
And typically, when patients come in with an injury like this,
通常 这类患者来的时候还不能走路
they go from not being able to walk to being able to walk on this, the next day.
第二天就可以下地走路了
For the rest of my shift, typically,
在快下班时
I’ll be holding the pager.
我一般会一直拿着传呼机
So any consults that come in to the emergency departments,
这样 如果有任何发生了四肢感染
there’s people that have infections of their extremities,
骨折或者脱臼的患者来到急诊室
have broken things, dislocated things I’ll go and see.
我就可以过去看看
Just an example, if we had a patient– they called me…
比如说 来了病人 他们就呼叫我…
the ankle fracture dislocation like you can see here.
如你所见 该患者踝关节骨折脱位
This is something that’s going to need surgery at some point.
这种情况在之后需要做手术
But right now we can’t just leave them like that,because…
但不能让他以这种情况等待手术 因为…
all their cartilage will die,
一旦脱位骨头相互挤压
if it’s just pressing on the bone.
周围的软骨都会坏死
So I’ll go down to the emergency department and see the patient.
因此我会先去急诊室看一下这个病人
Reduce the fracture which means
减轻他的骨折症状 也就是
take that ugly image and make it look
去处理这张令人难受的片子中的骨头
something a little bit more normal.
让它看起来正常些
Here’s just an example,
就比如这个
so you can see there’s still a fracture here and a fracture here.
你能看到这两处仍有骨折
But for the most part, the bones are well aligned
但大部分骨头是正常连接的
and it looks more like a normal joint.
看起来比较像正常关节
So this patient would either be sent home
所以这位病人要么被送回家
to follow up for surgery in the future,
等候随访 安排手术
or we’d admit them to the hospital
要么会在一到两天内
to do surgery in the next 24 to 48 hours.
来医院做手术
And we’ll typically get one consult
我们在值班时一般每小时
like this per hour when we’re on call.
就会接到一例这样的患者
Why orthopedics?
为什么会选择骨科呢?
And I think for me the big thing is that in Ortho,
我想对我来说 主要是因为
you actually get to make patients better…
骨科治疗会切实改善病情
as opposed to other specialties where you temporize things and–
相比之下 其他科系只能延缓病情
Actually, hang on one second,
而且实际上……稍等
we are going to have to call this page back.
我得先回个电话
That was the ED.
是急诊科
They’re calling.
是他们打来的
We have what we call a native hip dislocation.
来了个先天性髋关节脱位的病人
So we need to go down, see the patient.
我们需要下楼去查看这个病人
Get some X-rays, get him sedated
给他拍X光片 注射镇静剂
and then we’ll put the hip back in place.
然后再给他复位髋关节
[音乐]
麦克耐特医生整晚忙的不可开交
一边值班接诊 一边回电话
我们第二天早晨才能和他说上话
This is the end of the call night or day at this point.
值班夜 现在应该叫值班日了 终于结束了
It was a pretty busy night.
这一晚上可真忙
Had a few distal radius fractures.
接诊了几例桡骨末端骨折
A few ankle fracture dislocations.
几例脚踝骨折错位
Bunch of long bone fractures.
一大批长骨骨折
A couple hip fractures.
还有几例髋骨骨折的患者
So it was pretty busy.
所以真的很忙
Now I just need to finish up some notes
现在我只需要再写完一些病历
then I’m going to get out of here and go home and go to sleep.
然后我就能下班回家睡觉了
That’s it, it’s the end of a call day.
值班日就这样到了尾声了
So that was a day in the life of
那么这就是
an Orthopedic resident on call.
骨科住院医师值班的一天
Hope you enjoyed it.
希望你能喜欢
If you have any questions,
如果有任何问题
you hit me up on MedSchoolInsiders.com
可以通过MedSchoolInsiders.com.联系我
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视频概述

想知道医生的一天是怎么度过的吗?我们跟拍采访了一位骨外科住院医师的值班日常,来看看他的故事吧!

听录译者

收集自网络

翻译译者

Norah

审核员

审核员DJS

视频来源

https://www.youtube.com/watch?v=Sb64DcYyaug

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