When doctors have a simulated operating room
Chapter 437
The patient was in a coma and had a blurred consciousness.
"Blisters on my hands? And they are purple?"
Kang Yanming turned his head and looked at Zhang Yi after hearing this, both of them were puzzled.
However, their first reaction was also infection.
"Yes! Li Yong went out to answer the emergency call fifteen minutes ago and just arrived.
In addition to the blisters, the patient is also unconscious and confused!"
Hearing what the nurse said, Kang Yanming and Zhang Yi did not delay any longer and hurried to the ambulance at the door.
At the entrance of the noisy emergency building, in addition to the ambulance that had just stopped, there were many patients and their families who came to see the doctor.
When they saw the ambulance coming, they all stopped to watch.
Soon, the rear door opened, and Li Yong and another doctor ran down the car with a stretcher.
"Li Yong, what's the patient's condition?!"
Kang Yanming asked hurriedly as he watched Li Yong get off the car.
"He is indifferent, his blood pressure is as low as 90/50mmhg, his oxygen saturation is 90%, he has a fever, and his body temperature is 38.3℃!
In addition, the patient's heart rate is as high as 138! His breathing is also 24 times/minute, so be alert to shock at all times!"
Li Yong pushed the patient to the emergency room while describing his condition.
Suddenly, Li Yong continued, "By the way, Director, the family said that he had a history of colon cancer, and he had been receiving chemotherapy at the Sixth Hospital before."
"Colon cancer?!"
As soon as this was said, Zhang Yi was worried about the patient!
The immunity of chemotherapy patients will be affected, and patients who undergo long-term chemotherapy will have even lower immunity.
(Because chemotherapy drugs can kill cancer cells while also damaging the patient's own immune cells.)
Now, the uncle in front of me is very close to the symptoms of shock.
In addition, he is a patient who often undergoes chemotherapy. Once an infection occurs, the body cannot bear it at all, and he is very likely to die of infectious shock!
Moreover, the disease progresses very quickly. It is very likely that within one or two hours, the patient will be infected and die!
"Hurry up and check the blood routine, biochemistry, electrolytes, liver and kidney function! And urine routine, and electrocardiogram!"
Seeing that the patient's condition is not right, Kang Yanming immediately arranged for rescue work.
"Push the rescue car over! First, add a bottle of norepinephrine! In addition, add a group of dextran! Plus 500 ml of GS with 5 ml of hydrocortisone!"
Norepinephrine has the effect of dilating vascular tension. When the patient's blood pressure begins to drop, it is a good pressor.
Low molecular weight dextran can promote the body to absorb water outside the blood vessels to increase blood volume, increase and maintain blood pressure, and expand and maintain blood volume.
Hydrocortisone is a commonly used anti-inflammatory drug for septic shock, with multiple pharmacological effects such as anti-inflammatory, anti-toxic, anti-shock and immunosuppression.
There is nothing wrong with the rescue drugs prescribed by Kang Yanming.
They are all used to deal with the impending septic shock.
At this time, Zhang Yi also immediately put on a pair of gloves and walked to the patient to observe the condition of his hands.
"The whole arm is in a state of edema, with blisters and blood blisters locally, and the skin is wet and cold. The skin color is no longer normal but red and swollen with dark purple.
Director Kang, I suggest that you check it and add a blood culture. He needs to check what kind of infection he has."
After speaking, Zhang Yi looked at the family members who came to the hospital with the ambulance and asked:
"Family members, when did his hand start to have this condition?"
The family members shed tears and choked:
"Woo... It seems to have started last night...
He said before going to bed last night My hand felt a little swollen... We didn't pay much attention to it at the time.
But I thought that he had been undergoing chemotherapy, so I asked him to go to Dr. Huang in the Sixth Hospital early this morning to see him...
As a result... he said he was worried about spending money again... so he didn't go...
Oh my God!! Who knew that he would take a nap in the afternoon...
After waking up, he was not right! I called him but he didn't respond.
Then I lifted the quilt and saw that the color of his hand was very wrong! I called an ambulance immediately! "
The family member was a woman in her fifties.
Seeing her husband in such a serious condition, she cried so much that she couldn't speak clearly.
Zhang Yi comforted her:
"Family member, please don't cry first, we are already treating him now, and we will definitely do our best to treat him.
But I still have to make it clear to you that his current condition is very close to shock, and based on his past history and current symptoms, it is judged to be infectious shock.
Infectious
Once shock occurs, especially since he is a patient undergoing long-term chemotherapy for colon cancer...
I suggest you prepare for the worst, he may not be saved. "
The last sentence stunned the family members.
After two seconds of stunned silence, the family members reacted.
Then, tears poured down like a spring.
"No, no, no! ! Don't, doctor! ! Wuwu... please save him! !
Please! I...
Wuwu... If he dies, what will I do alone!
Oh, what should I do...
Doctor, please save him! ! ! Please..."
The family members were completely devastated. A colon cancer patient had been controlled for more than half a year with chemotherapy and drugs. They thought that there was hope for improvement, or that they could live a few more years with chemotherapy.
I didn't expect... such a thing would happen suddenly!!
Oh my God!
What should she do in the future!!
Listening to the miserable cries of the family members, Zhang Yi also felt very powerless.
Shock, no matter what type of shock, is very fatal.
For doctors, the rescue time of shock patients is very precious.
It's like playing tug-of-war with the King of Hell. You can only win if you are the fastest and use all your strength.
Otherwise, the King of Hell will take the person away.
This is just an ordinary shock patient. For the colon cancer patient in front of him, Patients...
Zhang Yi felt powerless.
Sometimes it is not because the doctor has good skills or high medical ethics that the patient can cure the disease.
Doctors can do nothing when encountering patients with this special constitution.
Just like the late stage of AIDS, a small cold can kill them.
So, Zhang Yi just wants to do his best.
The most effective treatment drugs will be selected.
But if the final outcome is still not good, it can only be said that this is the patient's fate.
Suddenly, Zhang Yi thought of something again.
After looking at the patient lying on the bed, he raised the patient's edematous and blistered hands again, observed for a while and asked:
"It's strange, why are only the hands like this, but there are no blisters on the body?
Is the specific cause of this patient's disease in the hands?
Because the hands are infected, it will gradually spread to the whole body?"
Thinking of this, Zhang Yi immediately looked up and asked the family:
"What was the condition of his hands last night? Can you describe it?"
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