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"Don't I just have a common cold?" the patient wondered.

Lu Chen shook his head.

"There is a big difference between pneumonia and colds. Most colds are also caused by viruses, but the infection site is usually limited to the nose and throat. You may experience discomfort such as runny nose, sneezing, sore throat, etc."

"Once the infection enters the trachea, it's bronchitis. If it goes deeper and invades the alveoli and lung parenchyma, it's pneumonia."

"In this respect, pneumonia is definitely much more serious than a cold."

"What's more, if it was just a common cold, you would definitely not be admitted to the hospital, and you would be admitted to our cardiology department."

The patient nodded to show informed understanding.

Lu Chen asked a few more questions, which were all about routine medical history, and the patient answered them truthfully.

For example, they are not married, have no children, have no history of unclean sex, etc., and are free of infectious diseases such as hepatitis B and tuberculosis.

Although it should be recorded in the medical records, Lu Chen still asked again.

Back to the doctor's office.

Yin Xinhua immediately looked at Lu Chen and Fan Zhiping.

"How is the patient?"

Lu Chen paused and said, "Initially, it is thought that it is delayed pneumonia. In addition, the patient's electrocardiogram has ST-T changes, which does not rule out the possibility of myocarditis."

Such a young patient is generally unlikely to have myocardial infarction, but myocarditis cannot be ruled out.

Myocarditis is also easy to miss. It is like a cold, but much more serious than a cold. Blood tests for cardiac enzymes and troponin are necessary to confirm the diagnosis.

Patients with pneumonia and suspected myocarditis usually go to the cardiology department rather than the respiratory department in the emergency department.

Cardiology will definitely treat pneumonia, but respiratory medicine may not necessarily treat myocarditis.

So this patient was admitted to the cardiology department in an emergency.

Yin Xinhua nodded slightly and said: "I just looked at the medical records and the diagnosis was pulmonary infection, excluding the possibility of myocarditis. The patient's myocardial enzymes are normal, and it is considered that the main disease is lung disease. We attach great importance to the diagnosis and treatment of pneumonia and cannot rely on it. Big, maybe someone will be killed.”

Pneumonia cannot be cured without antibiotics.

You know, in the era without antibiotics, pneumonia would kill people.

We don’t feel scared when we hear about pneumonia now, that’s because we are used to the era when we had antibiotics.

"The patient's examination has not been done yet." Lu Chen checked the patient's medical order.

When the patient was admitted, his body temperature was only a low fever, not as high as it is now, so the treating doctor did not complete the chest CT examination.

"Let's do a chest CT in the emergency department, and then do an abdominal CT as well." Yin Xinhua said, "Then we'll check the blood culture and review the inflammation indicators."

Some patients who appear to have pneumonia may also have cholecystitis, appendicitis, or pancreatitis.

This situation cannot be explained clearly, it is very clear.

Inspection is the most reliable.

Your hands and eyes may not be reliable, so don’t rely too much on your eyes unless you really have a sharp eye.

Lu Chen returned to the ward again and explained the necessity of these examinations to the patient.

The patient was very cooperative and went out for examination.

The results of the CT scan of the chest and abdomen came out, indicating that there was some inflammation in both lungs.

Among the indicators for subsequent blood reexamination, except for the high white blood cell count, other indicators were basically normal. Myocardial enzymes were reexamined again, and myocardial enzymes were also basically normal.

"Look, the problem should still be in the lungs, and the possibility of myocarditis is very small." Yin Xinhua pointed to the lesions on the chest CT, "The patient probably had pneumonia more than ten days ago, but never paid attention to it. Treated it as a cold. That’s not possible without antibiotics.”

Lu Chen nodded, "I'll explain the condition to the patient."

…

Lu Chen came to the ward.

"Then if I take anti-inflammatory injections for a few days, can I be discharged from the hospital?" the patient asked doubtfully.

Lu Chen paused and said: "It depends on the specific condition. If a pneumonia patient has chest tightness, he must be vigilant that it may progress to severe pneumonia, so don't be anxious and take good care of yourself. In addition, we still have to be vigilant about the heart. If you are sick, it is also good to run less. "

"good."

The patient was obedient. He had no family members to accompany him, so he borrowed a power bank from the patient in the bed next to him, and then he could safely infuse.

After handling the patient, Lu Chen and Fan Zhiping returned to the doctor's office.

…

Today's night shift seems to be particularly quiet.

Except for the patient in bed 37 who has a fever, the other patients in the ward are in stable condition.

Ten p.m.

The lights in many wards were out.

Yin Xinhua breathed a sigh of relief.

She turned to look at Lu Chen and Fan Zhiping standing aside.

The two were discussing the knowledge of electrophysiology enthusiastically.

"It seems that these two people are not popular tonight?"

As soon as this thought flashed through his mind, Yin Xinhua heard the shouting of the nurse on duty from the nursing station.

"Doctor Yin! Bed 37 is sick! It's no longer possible!"

The nurse shouted several times in succession.

"You really can't think about this!" Yin Xinhua's heartstrings immediately tightened after he relaxed slightly.

Picking up the stethoscope next to her hand, she immediately ran out of the office.

Lu Chen and Fan Zhiping saw this and followed closely behind.

…

Run out of the doctor's office.

As Lu Chen ran, a big question mark arose in his heart.

"The patient in bed 37 is dying? But wasn't his health value just now 68?"

"Even if it was severe pneumonia, how could he suddenly become ill?"

With this question in mind, Lu Chen quickly ran into the ward.

In the ward.

The patient was breathing heavily and sweating profusely.

My eyes are almost blurry!

"The patient suddenly became breathless and his whole face turned blue."

The nurse on duty quickly reported the situation.

After all, Yin Xinhua is a battle-tested attending physician.

Although the situation in front of her happened quickly, she responded very quickly. She immediately asked several nurses to help give the patient oxygen, and at the same time ordered Lu Chen to prepare endotracheal intubation, ventilator and other equipment.

The first aid box was also pushed over.

Yin Xinhua put the stethoscope close to the patient's chest.

But at this time, the patient's breath sounds were too chaotic, and there was a loud gasping sound, so no special changes could be heard at all.

But one thing is clear to Yin Xinhua: the breath sounds of the patient's two lungs are basically symmetrical.

This means that the patient should not have pneumothorax or atelectasis, which is very critical.

If the patient has a tension pneumothorax, the patient will definitely be doomed if he cannot take a breath.

Seeing the patient's lips becoming more and more purple. UU read www.uukansｈhu.net

"What was the patient doing just now? Why did his condition become so fast?" Yin Xinhua asked the two nurses on duty again.

The two nurses on duty shook their heads, "It's nothing special. I've always been here and done nothing else."

It came so suddenly that no one could figure out the situation.

On the side, Lu Chen prepared the tracheal intubation in a few seconds.

There was no other way. At this time, the patient was severely hypoxic.

Although the reasons are not yet fully understood, pulmonary embolism, pneumothorax, atelectasis, pericardial effusion, etc. should still be considered.

Auscultation does not look like pneumothorax or atelectasis.

It is impossible to hear pericardial effusion, and the breath sounds are too loud, which especially affects the auscultation of the heart. The only way is to rely on cardiac color ultrasound, but now it is obvious that color ultrasound cannot be done, and we must save lives first!

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