Since 1981 Health School

Yi Zewen was very happy sitting in the front seat of the emergency van.

Originally, he was a little nervous before leaving the car. How serious is the patient who needs to be picked up by emergency. Maybe his heartbeat and breathing have stopped, so he has to press all the way back to the hospital.

In the end, nothing happened, just a fall, at most a concussion or something, these are minor problems.

So Section Chief Yi, who was in a happy mood, was still in the mood to joke with the driver, but his joy turned into sadness.

The car was still driving halfway, and Bai Xue fainted and lost consciousness again.

At the beginning, the nurse with the car noticed that Bai Xue was not in the right state. She felt that she was in a daze, and thought she was motion sick, so she didn't care.

In the end, who knew that Bai Xue started to twitch again without saying a word, and Manager Xie was so frightened that she yelled, and the little nurse had no response to calling Bai Xue at this time.

Yi Zewen lost all his soul when he saw this posture, and after parking the car, he rolled and crawled into the carriage. He felt his body temperature was still there, his breathing was still there, and his heartbeat was normal, so he was greatly relieved.

As long as he didn't die and the miraculous Dean Chen was there when he was taken to the hospital, he wouldn't worry about anything.

"Old Yu, drive quickly, the patient's condition is not right and needs to be rescued immediately."

Upon hearing this, the driver, Old Yu, stepped on the accelerator to the bottom, and the ambulance rushed into the People's Hospital at a high speed, and rushed all the way to the door of the emergency room.

Chen Qi and the others had already heard the loud siren of the ambulance from a distance, and they were already waiting at the door pushing the emergency bed.

Seeing that the patient had fainted and convulsed, the little doctors and nurses who participated in the rescue for the first time became nervous.

Chen Qi became serious when he saw the patient arrived, and asked:

"How is the patient?"

"The patient is a 22-year-old female. One hour ago, due to an unknown cause, she suddenly fainted and lost consciousness, mixed with convulsions. According to colleagues, the patient had a history of head trauma a week ago, but there was no coma and vomiting at that time."

Chen Qi deliberately wanted to treat this first patient as a textbook demonstration, so the instructions he gave were all in accordance with the diagnosis and treatment norms.

"Chen Li, measure your blood pressure immediately; Xiao Chang, take an electrocardiogram immediately; Wang Lin, immediately open two venous channels and put on normal saline first. Yi Zewen, you prepare a diazepam mixed with 10ML normal saline for IV push."

Just when Chen Qi was considering whether to take some other anti-epileptic drugs, the patient's convulsions suddenly stopped, and suddenly he changed from rough to calm.

Everyone was taken aback. The patient stopped smoking before taking any medication?

Chen Qi immediately took out a small flashlight, and took a look at the patient's pupils on both sides. Fortunately, at this time, the pupils were opposite to the light, and they were equal in size and round.

"Dean Chen, the blood pressure is only 98/52mmHg, and the heart rate is 110 beats/min."

The blood pressure is low for unknown reasons.

Just as Chen Qi was contemplating, Yi Zewen next to him couldn't help asking: "Chen Tou, does this look like epilepsy?"

"It's hard to say now, I can only say it's doubtful. You can see that the patient's seizures were not accompanied by vomiting, and the frequency of the twitches was not right. There was no tonic seizures. Of course, it may be a small seizure or something like that.

Considering that the patient has a history of traumatic brain injury, he had two disturbances of consciousness and convulsions today, we absolutely cannot rule out brain problems. Brain CT is a must. By the way, are the family members of the patient here? "

Manager Xie quickly raised his hand: "I am the manager, the leader of Comrade Bai Xue's unit. My surname is Xie. Her family has not arrived yet."

What emergency patients are most afraid of is not having a companion, or not having a family member who can make the decision and sign, so that the next step of treatment will be difficult.

"The manager is fine too. Let me tell you, this patient is in critical condition and is now unconscious and comatose. We don't rule out cerebral hemorrhage or other possibilities. The most serious case may even cause cardiac and respiratory arrest in a short period of time.

Let’s explain it this way. The brainstem of the brain controls the life center of the human body and is the most important thing in all organs. If there is damage there, the consequences will be unimaginable, and the person may simply disappear today. "

Doctors, especially emergency doctors, like to speak of the seriousness of the condition, or to say the worst in advance.

In this way, many medical disputes after the event can be avoided. At the same time, the family members know it well and can actively cooperate with the follow-up treatment.

In the 1980s, without mobile phones and the Internet, it was very troublesome to find a person in a big city. Sometimes, human flesh was needed to find someone. It was not certain when the family members would arrive.

So sometimes it is not an exaggeration to say that it is an ordinary goodbye.

Manager Xie can be regarded as a responsible person, so he gritted his teeth and nodded:

"Okay, listen to your doctor. I'll take care of anything. In addition, Comrade Bai Xue is a regular employee of our department store and enjoys public medical care. You don't have to worry about medical expenses. Try to rescue him as much as possible, and you must rescue him back."

As soon as these words came out, Chen Qi was relieved, the money was in place, the leader agreed, and the rescue could be done according to his ideas.

"Okay, thank you, manager, don't worry, we will do our best."

Everyone in the rescue room acted quickly and all entered a fighting state.

In order to facilitate the rescue, Chen Qi asked the nurse to open another venous channel for the patient, which means to give an extra injection. In case a large amount of blood transfusion is required, it will be much more convenient to have an extra needle for infusion.

At the same time, blood was drawn for routine tests.

Chen Qi approached the patient's head again and called her name loudly: "Bai Xue, Bai Xue, can you hear me?"

The patient still didn't respond. Manager Xie was very worried at this scene, thinking that the female employee was dying.

"Oh, what can I do? I was fine before I went to work this morning, but now I'm about to die suddenly. How can I explain to my family? Oh, what a pity, what can I do? Come, we will not see each other for the last time."

Manager Xie was heartbroken there, while Chen Qi was busy continuing the inspection:

When the flashlight was illuminated again, the pupils were still equal in size and round, and the light reflex still existed.

Chen Qi felt a little relieved, because a severe traumatic brain injury may cause the pupils to be dilated or even dull or disappear, which means that one foot has stepped on the gate of hell.

Even if he does not die, the prognosis will be very unfavorable.

At this time, Zhu Zhongyi from the emergency department rushed in through the back door, "President Chen, the CT room is ready."

"Okay, send it to the CT room for a brain CT examination immediately."

For the sake of safety, Chen Qi originally planned to let Yi Zewen and Zhang Xing go with the patient, but after thinking about it for a while, it was not safe, so he went to the battle himself.

A total of 5 doctors, a nurse, followed by Manager Xie as the unit representative.

And prepared all kinds of rescue medicines:

Epinephrine (rescue cardiac arrest), norepinephrine (increase blood pressure), diazepam (anti-epilepsy), nicothamide (excited breathing), atropine (increase heart rate), etc. bring them all.

Chen Qi had his own considerations, because he didn't know the situation in the brain, the patient's heartbeat and breathing could collapse at any time, and a delay of even a second could lead to an irreversible situation.

Especially now that the family members haven't arrived at the scene, there can't be any mistakes. With more people, cardiopulmonary resuscitation is more convenient, and the rescue will not be in the dilemma of insufficient manpower.

So the common people who came to the People's Hospital to see a doctor today saw a female patient pushed out from the back door of the emergency department, surrounded by a large group of doctors, and there was a clearer shouting for everyone to get out of the way.

Many people have discussed:

"Yo, what's the matter with this man?"

"Could it be someone dying? I'm in a hurry to see a doctor."

"That's not necessarily the case. I think the woman is still moving. She must be related to some leader's family. She doesn't need to queue up."

"Yeah, it's so unfair. We've been waiting for three days for CT, and they can do it as soon as they come, hum."

Chen Qi didn't care what others thought. After rushing into the CT room, he manipulated the machine and began to carefully examine it. Bai Xue didn't know that the young doctor in front of him wanted 50,000 US dollars.

Big bucks.

Fortunately, things were not as bad as Chen Qi thought.

As soon as Bai Xue arrived at the CT room, she woke up leisurely, and the first thing she said when she woke up was: "Where am I?"

Chen Qi suddenly had a strange feeling in his heart, wondering if the patient had some mental problems?

After all, patients with mental illness also twitch.

Otherwise, how do you explain dizziness for a while, not dizzy for a while; vaping for a while, and suddenly stop for a while? This comes as soon as it is said, and leaves as soon as it is said, without warning?

But the most important thing as a doctor is to be patient. You can doubt in your heart, but don't show it, otherwise you will be beaten easily.

"Bai Xue, right? You are in the People's Hospital now. You fainted again just now. Now we need to do a CT scan of your head. Don't worry, Manager Xie from your department store next to you has been with you all the time, and your unit has notified you The family will come as soon as possible."

Stabilizing the patient's emotions and allowing the patient to cooperate with the treatment are the basic skills of a doctor.

Upon hearing this, Bai Xue knew that she was in a bad situation, so she nodded lightly: "Okay, I see, thank you doctor."

Head CT done.

Chen Qi couldn't wait for the film to come out, so he stared at the display screen (picture tube TV), frame by frame, and found no obvious cerebral hemorrhage lesions.

Chen Qi breathed a sigh of relief, and said to his subordinates and Manager Xie:

"Fortunately, it was not a cerebral hemorrhage, and no obvious skull fracture was seen. It is estimated that the impact did not cause obvious damage at that time, and the most serious situation did not occur."

If the brain really bleeds, or if the blood stasis must be removed, it will involve a craniotomy. This kind of brain surgery, not to mention the Yuezhong People's Hospital, even the provincial hospital dare not do it lightly.

Then only paralysis, or death is a choice.

Then a new problem comes.

The patient fainted twice successively, had disturbance of consciousness, and had convulsions. If it was not cerebral hemorrhage, what would be the reason?

The doctors all breathed a sigh of relief, but Manager Xie still frowned, and asked cautiously:

"Doctor, could Bai Xue have epileptic seizures? In the unit, many old employees said so. You also know that if a girl like her gets this kind of disease, her life will be ruined."

Manager Xie's question made sense. After ruling out the problem in his head, Chen Qi himself thought about it in the same way.

A patient who faints for no apparent reason and then goes into convulsions would be considered epilepsy by any doctor.

The so-called epilepsy refers to the abnormal discharge of neurons in the brain.

To put it simply, the brain was short-circuited at that time, sending out many abnormal electrical signals, which led to abnormalities in the patient's sensation, movement, consciousness, spirit, and behavior.

Mild seizures, the patient may still be awake.

Severe epileptic seizures, such as grand mal epileptic seizures, the patient will have disturbance of consciousness, accompanied by violent convulsions, typically foaming at the mouth, eyeballs turned up, contraction of the masticatory muscles to open the mouth and then violently close, and may bite the tip of the tongue.

Excluding the problem of the brain, to be honest, this Baixue is more suitable for this symptom. Although it is not so exaggerated, who can guarantee that it is not a small seizure or a moderate seizure?

And there are data showing that 50%-60% of epilepsy patients are teenagers, and Bai Xue is only 22 years old this year, and in later generations, she is only a college student.

If it's just epileptic seizures, Chen Qi is not worried, because this disease usually does not kill people immediately. (family members don't think so)

What Chen Qi is worried about is that there are other reasons behind the patient's disturbance of consciousness and convulsions.

For example, heart disease.

Don't think that coma and convulsions can only be caused by brain diseases, and heart diseases can also have similar manifestations.

For example, if a patient has a tachyarrhythmia attack, or a severe slow arrhythmia, the heart will not pump enough blood, the brain will suffer from ischemia and hypoxia, brain dysfunction, and transient coma and convulsions will also occur.

This is the so-called Aspen Syndrome.

When Chen Qi expressed his doubts, Zhang Xing thought for a while and said:

"But the electrocardiogram we did just now, I remember that there was no obvious abnormality in the electrocardiogram."

"No, no, there was no abnormality at the time, which doesn't mean it has been normal all the time. If it is really Asperger's syndrome, it may be suddenly terminated. This must be monitored with ECG. If the patient falls into coma and convulsions again, And the ECG monitoring can capture abnormal ECG activity, so it is a real hammer."

As soon as Chen Qi said this, the surrounding doctors immediately became nervous again.

If the patient is epileptic, at most, he will have to vape a few more times, and it will not be life-threatening.

But if it is Asperger's syndrome, it is a heart problem, then it is really possible to die suddenly, and the heartbeat will stop at any time.

"Asper syndrome" is also called cardiogenic cerebral ischemic syndrome, which refers to a sudden onset of severe, fatal slow or rapid arrhythmia, which causes a sharp decrease in cardiac output in a short period of time, resulting in severe cerebral insufficiency. bleeding, loss of consciousness and fainting.

The syndrome is unrelated to changes in body position and often occurs very suddenly due to syncope caused by sudden severe tachycardia or bradycardia.

Now the doctors began to worry. If the patient died at home or at work, although it would be a pity, it would have nothing to do with the hospital, and the doctors would not have to bear any responsibility.

But if he died in the emergency department, then the emergency department must have nothing to do with it, and none of the doctors who received the treatment could escape.

Now everyone in the CT room is worried, wondering what is the cause of the disease?