When doctors have a simulated operating room
Chapter 546
The girl was born in a poor state, but she was still very young.
(Sorry, sorry, I have already made up the words in the previous chapter)
"Forget it! Don't smoke for now, send her to do a CT scan! CT scan of the brain, lungs and abdomen!"
"Okay!"
The CT scan of the brain is to see if the convulsions are related to the brain.
The CT scan of the lungs and abdomen is to see what the girl's lungs and abdomen are like.
Wang Yufei quickly returned to the office and began to give medical advice.
He was thinking about the girl's condition while typing on the keyboard.
Damn it.
It's really strange!
Isn't it a persistent convulsion after taking the medicine?
The drugs that can cause coma that can be bought on the market now are benzodiazepine sleeping pills.
This kind of medicine can only cause coma or convulsions at most, and then metabolic acidosis caused by convulsions?
Why are there so many more troubles now?
And coughing up blood!
Coughing up blood and vomiting blood are different.
Doctors should distinguish between coughing up blood and vomiting blood at the first time.
Coughing up blood means that there is a problem with the bronchi and lungs, and the blood in the bronchi and lungs is discharged during the coughing process.
The amount of coughed up blood is generally small, about a few milliliters or ten milliliters.
But vomiting blood is different.
Vomiting blood means that there is a problem with the esophagus and stomach.
Especially the rupture and bleeding of gastric varicose veins, this kind of vomiting is dozens or even one or two hundred milliliters.
It is very easy to have hemorrhagic shock.
Coughing up blood is coughing, vomiting blood is vomiting.
The symptoms of the two are also different.
Wang Xinhui, the girl, coughed up blood.
And there was blood in the throat...
This made Wang Yufei very puzzled.
Damn, what other medicine is there on the market that can cause coma, convulsions, and bronchial hemorrhage!
I can't think of it even if I rack my brains!
Wang Yufei thought about it and looked at the time.
12:23 in the morning.
Well... it's a bit late...
But...
I still have to trouble you, Zhang Yi!
...
On the other side.
Zhang Yi had already lain down to rest.
Suddenly, the phone rang, it was the same "Sunny Day" that never changed.
Zhang Yi opened his eyes, and he subconsciously became alert when he heard the ringing at night.
I always felt that it was from the hospital.
As a result, it was indeed from the hospital.
And it was Wang Yufei who was on duty today.
"Hello?"
"Zhang Yi? Did you sleep?"
Zhang Yi rolled his eyes: "Do you think I slept or not?!"
"Uh... it's like this, a little girl was sent to my emergency room, she was only fourteen years old, and she took pills to commit suicide after quarreling with her family.
First she was in a coma, then she was shaking, and then she had continuous convulsions.
She did a gastric lavage at their county hospital, but nothing came out, so she was sent to our Union Hospital for blood filtration.
She had ventricular fibrillation when she first came, and she survived the rescue.
And there's more, this girl was not only in a coma and convulsions, but also coughed up blood!
The blood splashed all over me!
The lactic acid is also high, He is already 15, and the carbon dioxide partial pressure is also high.
I suspect that the high carbon dioxide partial pressure is caused by problems with the lungs or bronchial tubes.
But I really can't think of any medicine that can cause coma, convulsions, acidosis, and coughing up blood? ?
Do you know? Do you know there is such a medicine? "
"You called to ask me if I have such a medicine? ? "
Wang Yufei nodded: "Yes, I have been sitting here thinking about it for a long time, and I almost want to re-read pharmacology. After thinking about it, I decided to call you to ask, maybe you know..."
Ahem, although I still don't want to admit that Zhang Yi is awesome.
But...
He is really awesome.
If you have something to do, you can find Zhang Yi.
Zhang Yi then fell into deep thought.
In his mind, he was also carefully reviewing every word Wang Yufei said.
Coma and convulsions after taking the medicine? Acidosis? And coughing up blood?
This really stumped Zhang Yi.
What medicine can cause coma, convulsions, and bleeding in the bronchi or lungs? ?
"Have you done a CT scan? What are the results?" Zhang Yi asked.
"I did, but the results haven't come out yet, but I guess there must be something wrong with the lungs, otherwise the carbon dioxide partial pressure wouldn't be that high."
"That's strange, what medicine can cause coma, convulsions, and coughing up blood?"
For a moment, Zhang Yi couldn't think of any medicine that could have such a powerful effect.
On the other end of the phone, Wang Yufei sighed and said:
"Forget it, if you can't think of it, I can only wait for the CT results. If it doesn't work, I'll call Director Kang to see.
You should rest first. Sorry to bother you.
. "
With that, Wang Yufei hung up the phone.
He still had to explain to the family members outside the door.
In addition, he could ask more questions to the family members to see if he could find out what medicine the girl had taken from her family members.
Outside the emergency room, Wang Yufei began to question the family members about the specific situation.
And what about Zhang Yi?
He couldn't sleep after hanging up the phone.
Zhang Yi was also curious about this special case.
No matter how much you hear, it's better to see it with your own eyes.
Zhang Yi simply got dressed and got up. He went to the hospital to see what he knew!
Do you still need to guess here??
...
"The child's condition is still very unclear. Although she has been rescued from ventricular fibrillation just now, there is a more serious problem now.
That is, coughing up blood, and there are quite a lot of blood clots in her throat, which even prevented her breathing.
If the blood clots are not cleared out, she may have ventricular fibrillation again.
The blood drug concentration test has not come out yet, and I don't know what medicine she took.
To save lives, the only way is to do blood filtration, but I can't guarantee the effect after doing blood filtration.
So... are you still sure you want to do it? "
Wang Yufei waved the informed consent form for blood filtration in front of the family members.
The family members nodded repeatedly:
"Do it! Do it! We all have to do it if there is a little hope, doctor... I only have this one daughter... If she dies, I won't live either!"
The family members cried and said.
Wang Yufei gave the informed consent form for blood filtration to the family members to sign, and then asked after signing:
"Does your child have a mobile phone? You can check her recent consumption and see what medicine she bought.
It would be best to find out what medicine she took, so that we can give a treatment plan as soon as possible. "
——
"Mobile phone? Yes... but... we don't know her phone password. This child is very rebellious. She ran away from home after a few words... woooo..."
The girl's mother stood there and wiped her tears.
She seemed to be regretting that if she had said less at the time, the child might not have run away in anger and even taken medicine.
While crying, she took out a mobile phone with a girlish pink shell from her bag.
She tried several passwords in a row but still got it wrong.
Wang Yufei stopped him quickly:
"Hey, don't try it yet. The phone will be locked after five wrong attempts.
Since your family members don't know, forget it. I will notify the doctor in the hemodialysis room to come down immediately."
"Okay, okay! Thank you, doctor, you've worked hard! "
The girl's mother nodded to thank Wang Yufei.
Just at this time, the girl's father came back from taking the girl for a checkup.
He was holding two CT scan results in his hand.
The girl was sent to the emergency room and continued to be given oxygen.
The family members followed Wang Yufei to the office to see the test results together.
"Doctor Wang...how is it? What's the condition of my daughter's lungs?"
The girl's father saw that Wang Yufei's expression was not right, and he was panicked.
Wang Yufei's eyes flashed with shock.
But he quickly suppressed it.
He could only sigh in his heart!
Good guy!
What the hell is going on??!
Why is the density of the pulmonary interstitial so high!!
Generally, if the density is so high...it means that it may be pulmonary edema!!
No!
How can this girl have pulmonary edema at such a young age??
This shadow is so dense It was so numb...
Wang Yufei was really confused.
Pulmonary edema? ?
Coughing up blood? ?
If it was pulmonary edema, coughing, chest tightness, and carbon dioxide retention were all possible.
But where did the coughing up blood come from?
What medicine would cause coma, convulsions, pulmonary edema, and coughing up blood?
Could it be that...
This girl had pulmonary edema before? ?
Thinking of this, Wang Yufei hurriedly asked the family members:
"Did Wang Xinhui have frequent coughs, fevers, or chest tightness before?"
The family members shook their heads again and again: "No, no! My daughter has no disease, otherwise how could she have such a loud voice every time she quarreled with me. ”
That’s strange!
No history of pulmonary edema?
Then why is the lung interstitial density so high??
Is this CT fake?
Or was it taken by mistake??
Wang Yufei looked at the name written on the list again, and it was indeed: Emergency Department (Emergency Check) Wang Xinhui.
“Doctor, what happened to my daughter? You said, we can bear it.”
When the girl’s mother asked this question, her eyes were red and tears almost fell again.
Wang Yufei sighed and said:
“Family members, first of all, there is no big problem with this abdominal CT.
Lungs... Look here, high-density shadows in the lung interstitium, which are usually CT manifestations of pulmonary edema.
Did your daughter really have no lung disease before? Or any history of heart disease? "
Before Wang Yufei finished speaking, the girl's mother started crying again.
"No, really no, doctor, although I always quarrel with my daughter, I still care about her and love her very much. She had a check-up when she was a child, and she didn't have any congenital diseases. She is very healthy."
On the side, the girl's father also nodded:
"Yes, our Huihui has no problem with her lungs, and she rarely has a fever or a cold. Although our family is not a wealthy family, we have never lacked everything that should be given to children to eat and drink. She has a good physique. "
Wang Yufei nodded, indicating that he understood.
Now, according to the description of the family, it can be confirmed that the girl had no history of heart and lung disease.
So how did pulmonary edema come about?
Is the high carbon dioxide partial pressure caused by pulmonary edema?
What about coughing up blood? How is coughing up blood caused?
Also, what kind of medicine can have such a miraculous effect?!
It can make people comatose, convulse, cough up blood, acidosis, and now pulmonary edema.
Numb, really numb.
Wang Yufei has a high degree of education. He has worked in the emergency department for so many years and followed Kang Yanming. I have also learned a lot.
But he has never heard of such a miraculous medicine!
At this moment, Wang Yufei even wants to search on Baidu!
See if Baidu can give him some answers...
Of course, no matter how much he thinks, doctors still have to rely on themselves.
Coincidentally, the results of the blood test are also out.
But only the results of blood routine, liver and kidney function and blood gas are out, and the results of blood drug concentration are not out yet.
First of all, the various indicators on the blood routine are not enough to reflect whether there is poisoning. At most, it can only see whether there is infection with other bacteria or viruses.
There is no big problem with the blood routine.
Secondly Liver and kidney function.
Hmm? Weird!
It was clearly drug poisoning, but the girl's liver and kidney function were fine!
Amazing!
Wang Yufei was more and more curious about what medicine the girl had taken!
It could cause so many complications, but the liver and kidney function was fine!
It was really weird!
Let's do blood gas analysis.
It might really be related to rescue oxygen inhalation and regulating acid-base balance.
Lactic acid dropped to 10mol/L.
Carbon dioxide partial pressure also dropped a little, from 75 to 65mmhg.
But it's still not Enough!
She is still in a state of acidosis!
No!
She still has to be intubated!
Otherwise, the carbon dioxide cannot be discharged and everything will be in vain!
Just when Wang Yufei's anxious brows were wrinkled into a 川-shaped muscle.
A figure suddenly appeared at the door of the office! !
Wang Yufei looked up.
When he saw that handsome face...
Suddenly, he became enlightened!
Zhang Yi! !
Ohmygod!
Zhang Yi is here! !
Wang Yufei was so excited that he hurriedly stepped forward and grabbed Zhang Yi's arm:
"Zhang Yi! Why are you here?!"
Zhang Yi glanced at him and said, "I am very curious about the girl you mentioned. I want to come and see what kind of medicine can cause so many complications? She is in a coma, convulsing, coughing up blood and acidosis."
Wang Yufei immediately handed the CT film on the table to Zhang Yi and added:
"Now there is another one, pulmonary edema!"
"Huh?! "Zhang Yi frowned and picked up the film to look at it.
Sure enough!
Zhang Yi also had a very surprised expression.
How could a teenage girl have such serious lung problems?
"This child has never had lung disease before. She didn't have a CT scan when she was in the county hospital. I made it up for her after she came to our hospital."
Zhang Yi was also a little confused when he heard it.
The family members on the side saw that Wang Yufei treated Zhang Yi as his elder brother, and they understood it instantly.
This more handsome doctor who came, although young, seems to be more awesome!
I quickly looked at Zhang Yi and said:
"Doctor! My daughter ran away from home after quarreling with me yesterday, and was sent back by her classmates today. Her classmates said that she took medicine and took a lot. I was scared when I heard it, and I hurriedly sent the child to the county hospital.
On the way to the hospital, the child was shaking all the time, and the whole person didn't respond even if I called him.
Then when we went to the hospital, the doctor immediately washed her stomach, but they said that nothing came out of the gastric lavage.
They said it was absorbed and that if she wanted to survive, she had to do dialysis.
But before she could do dialysis, my daughter started vomiting blood!
Then the doctor said that it couldn't be cured and asked us to rush to a big hospital. ”
The family members explained the cause of the incident.
The consequences were repeated.
Zhang Yi's expression was not relaxed at all after hearing this.
He also wondered if the drug was really absorbed, which caused the drug in the girl's body to react and cause so many complications?
But what kind of drug could have such a serious reaction?
Even though Zhang Yi had read so many books in the library, he had never seen such a drug?
Could it be that he had not read enough books? ?
"You should take me to see the girl first." After thinking for a while, Zhang Yi said.
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