r18novel Chapter 207
Chapter 207
soon
X-ray results are in.
"How is that possible?"
"Isn't it a ruptured stomach?"
Seeing this result, all the doctors of the Great Northern Hospital were dumbfounded!
Several doctors have speculated that hemorrhagic shock caused by a ruptured gastric pouch.
However, the X-ray results clearly showed that the gastric pouch did not rupture except for excessive food accumulation.
Lin Feng frowned, except for the stomach, there was no problem in other parts.
If the cause cannot be identified, further treatment cannot be carried out.
subsequently
The urinalysis also came out.
Creatinine, urea, uric acid are higher than normal values...
Lin Feng considered the following diseases:
Inflammatory myopathy
Renal colic
Hematuria
suddenly
Lin Feng's spirit flashed and he thought of a disease!
"Rhabdomyolysis"!
This is a syndrome caused by severe damage to muscle tissue, patients may have obvious myalgia, fatigue, dark urine, severe cases can appear acute kidney injury, arrhythmia, and even death.
From Lin Feng's check-in experience, crayfish have a probability of causing "rhabdomyolysis".
What is the specific reason?
There is no definitive answer yet.
It may be 'shrimp powder', or the environment in which the crayfish are raised.
At this point,
Everyone in the city hospital is helpless, it can be said that the disease of this big fat man is a little complicated, there are many complications, but I don't know which disease is the root.
They looked at Lin Feng one by one.
Here, Lin Feng's strength is still widely recognized.
Lin Feng did not immediately say the conclusion of "rhabdomyolysis", but began to order.
"Go for a few tests right away:"
"First, creatase level determination!"
"Second, whole red blood cell count!"
"Third, kidney work!"
The emergency director nodded: "Okay, I'll order someone to do it right away!"
Lin Feng: "By the way, the crayfish and shrimp shells brought back are also brought for testing, to see what germs are, I think they may be infections caused by bacteria." "
The nurse quickly took the crayfish and sent it to the laboratory department.
......
At this point,
On the other side,
A small area 3 km away.
Qian Yuan, director of the Department of Cardiac Surgery at Great Northern Hospital, was having dinner at home.
Qian Yuan, one of the 100 support teams in the last explosion in the metal factory, is quite familiar with Lin Feng.
Today, he left work to enjoy the warmth of family with his wife and son.
suddenly
He felt a pang of chest pain.
Hands shake,
Snap ~~~Snap~~~~
The bowl fell directly and smashed a lot of pieces on the ground.
The whole person fell on the dining table at once.
Wives, sons, mothers, flabbergasted.
"Old money, old money!"
"Dad!!"
"What's going on!"
"Not good, it may be a heart problem, the first few times old money said that the heart hurts a little!"
At this time, although Qian Yuan's chest hurt, his consciousness was still very clear.
"Quick... Call...... To Xiao Liu (Qian Yuan's student), he was on duty, said... It could happen on my side... Heart attack, send an ambulance ... Come here!"
Qian Yuan finished with difficulty.
"Good, good, I'll hit right away. "
His wife was familiar with the students, so she picked up the phone and quickly called Xiao Liu on duty.
The cardiac surgery department, after receiving the call, suddenly fried the pan.
"Master, don't worry, I'll rush over right away!"
Xiao Liu took a few nurses, quickly went downstairs, got into the ambulance, and rushed to the community where Qian Yuan was.
Beep beep ~~~~
The ambulance quickly arrived at the complex within 7 minutes.
Take Qian Yuan downstairs and push it into an ambulance.
"Quick, go to Great Northern Hospital!"
Beep beep ~ ~ ~
Speeding towards Great Northern Hospital.
Qian Yuan hurriedly said: "Quick, pull me an electrocardiogram." "
Inside the ambulance, there are permanent electrocardiogram machines, defibrillators and other equipment.
Continued,
Soon, the ECG results came out,
Qian Yuan glanced at the electrocardiogram!
Sure enough, it was a myocardial infarction!
Qian Yuan: "Bring me some morphine (pain relief, sedation), nitroglycerin (dilation of coronary arteries)!"
"Yes!"
As the drug pushes into the vein.
Qian Yuan felt a little relieved.
But
Still doesn't work!
He still felt an unbearable burning in his throat, and the pain extended to his stomach!
Moreover, consciousness is not as clear as it was at the beginning.
Qian Yuan: "Who else is on duty outside the heart now?"
Xiao Liu: "I (deputy chief physician), and Xiao Chen (attending physician), but Xiao Chen went to the emergency department, and an emergency patient came over there and was consulting and treating..."
Money is far from suffering.
Finished calving!
This kind of medical power, the strength is not enough!
Qian Yuan felt that he might be blocked in the coronary arteries now, and ordinary doctors could not deal with it.
Qian Yuan: "Call the interventional department and ask who the interventional doctors are?"
Xiao Liu quickly called the intervention department, and soon there was feedback, only the main doctor was there, and the deputy director was not there...
Qian Yuan: ".................."
Pit ah!!
"Teacher, I will immediately call the director of intervention and several deputy directors outside the heart..."
"Good, as soon as possible!"
Qian Yuan felt that his state was getting worse and worse.
After 6 minutes,
The ambulance arrived at Great Northern Hospital.
Qian Yuan knew his condition and ordered.
"Don't go to the ordinary operating room, send it to the interventional operating room..."
"Yes!"
Qian Yuan was quickly sent to the interventional operating room.
Connect the ECG monitor... and other testing instruments.
ECG diagnosis: cardiac ischemia
Low heart rate...
Insufficient blood oxygen...
Decreased pulse pressure...
"Director Qian!"
"The anesthesiology department came to report!"
"Cardiology, arrive!"
The anesthesia, intracardiac, extracardial, ICU, interventional, and emergency doctors rushed into the operating room one after another, looking anxious.
Consultation!
However, among all these doctors, they are relatively low-level, with the most attending doctors and only one deputy director.
And Qian Yuan is the biggest doctor here, the head of the department.
Fortunately, Qian Yuan was still conscious at this time, and diagnosed for himself:
"I must have had an acute myocardial infarction... Make it for me right away..."
Before the words fell, he suddenly rolled his eyes.
Backbite............
The ECG becomes a straight line!
The breath is directly gone!
The condition has taken a turn for the worse!
"Director Qian!"
"Director Qian!"
"Defibrillator, CPR, quick!!"
Doctor by doctor, messy.
Fast CPR rescue.
But!
Except for CPR, many of them can't do it, or don't dare to do it.
I was so anxious that I was sweating profusely.
They are about to cry, they are just little doctors, this kind of rescue task, have not been done yet!
And the only deputy director is the deputy director of the emergency department, and the strength is very average.
Faced with such a situation, he can only do a little routine operation.
"Call those chief physicians immediately and see who can rush over!"
"Anesthesiology rapid endotracheal intubation, general anesthesia!"
"Mechanical ventilation!"
The deputy director of the emergency department ordered down one by one,
"By the way, just now Director Qian said, give him an image... Interventional Section, can you do it now?"
Interventional Department Leader: "Yes!"
Soon, CPR was done while the interventionist did the angiography.
However, because the radiation of the contrast machine is too large, it is necessary to wear specific lead clothing, so other doctors are pushed outside the operating room door.
Only doctors and nurses who do cardiopulmonary resuscitation and angiography remain in the interventional operating room.
1 minute...
5 minutes...
10 minutes...
20 minutes...
Through constant heart compressions and 4 defibrillators...
finally
"There is a heartbeat!"
"Good!!"
"Hold steady!!"
All the doctors and nurses immediately cheered.
However, there is also bad news.
The contrast agent has penetrated deep into the heart location, and after the projection of the contrast machine, a culprit was found:
The coronary artery on the right side of the heart is completely blocked!
Accompanied by a large amount of thrombosis!
"Oh my God!"
Everyone felt devastated on the spot!
It's a tingling scalp!
This disease is too exaggerated, right?
We are just small main treatment, where have we tried to face such a big disease?
Although Director Qian Yuan's heartbeat recovered, the signs were like stepping on the edge of a cliff, and the huge "complete blockage" would cause Director Qian to die at any time!
now
The only way: Dr. Qian Yuan must be immediately given interventional surgery, the thrombus is removed, put into a stent, propped up the artery, and re-circulates the blood vessel.
And time is tight!
It's not too much to say!
But!
In the past 20 minutes, one call after another was made, but nothing was good news.
There are very few doctors who can rush back in half an hour!!
"What to do?"
"Do you want us to go up?"
"But we don't have the ability!"
A group of masters, the heart is empty.
They didn't dare to go through this extremely difficult operation.
suddenly
"Lin Feng!"
The deputy director of the emergency department thought of Lin Feng, who was still rescuing the big fat patient in the emergency department!
Syllable~~
The deputy director of the emergency department patted himself on the head.
Chagrin!
How to forget Lin Feng!
Lin Feng's ability has long been transmitted here from the First Hospital of the City, and I heard that Lin Feng is also very good at interventional surgery!
"Don't panic, Lin Feng is rescuing the patient in the emergency department of our Great Northern Hospital, I will call immediately and ask him to come over!"
The deputy director of the emergency department shouted excitedly.
The others were stunned.
"What, Dr. Lin is in our hospital?"
"Great, Dr. Lin should be able to!"
"Quick, call him right away!"
One by one, they urged.
............
At this point,
1st floor, emergency department,
Time passes little by little,
The big fat patient kept showing various symptoms, but fortunately they were all controlled by Lin Feng's medication.
Fortunately, the results of various inspections are coming one after another.
The first result is:
Creatase level: 2000 times more than the upper limit of normal!
This is outrageous!
2000 times!
Lin Feng immediately decided that this was definitely "rhabdomyolysis"!
Because creatase levels are an important feature that distinguishes rhabdomyolysis from other diseases!
Subsequently, complete red blood cell count examination, renal function test...
The results of various examinations support this conclusion!
It didn't take long for
The result of adding crayfish is also out!
Salmonella in crayfish, as well as streptococcus index seriously exceeded the standard!
It should be rhabdomyolysis caused by bacterial invasion!
...
After Lin Feng's explanation,
Many doctors in the Great Northern Hospital understood one after another.
"It turned out to be 'rhabdomyolysis'!"
"It's the first time I've encountered this disease!"
"Doctor Lin, awesome!"
Next
Lin Feng began to work on the cause reduction.
First of all, antibacterial drugs are used in the past to destroy germs.
Second, because a large amount of fluid accumulates in the muscle tissue, it causes anterior shock (misdiagnosed as hemorrhagic shock at the time).
This shock, which has been stopped by the emergency infusion in front.
Soon, a symptom appears in front of you.
"No urine!"
This is a complication of rhabdomyolysis: "kidney failure"!
"Intravenous injection of mannitol. "
(Mannitol: also known as diuretic, dehydrating agent.) Can be diuretic, reduce intracranial pressure, intraocular pressure, dehydration drugs. Hyperosmolar dehydration agents. "Enter sodium bicarbonate solution to increase myoglobin dissolution in urine!"
Through dehydration, diuresis, rapid urination, relieve kidney failure.
Lin Feng assessed that it was not yet to the extent of hemodialysis.
"Not good, there is a complication again, right arm compartment syndrome!"
An emergency physician noticed the symptoms and shouted.
"Compartment syndrome": a series of early symptoms and signs of intraosteofascial muscles and nerves formed by the interosseous membrane, muscle septum and deep fascia, due to acute ischemia, hypoxia, hematoma and tissue edema, which increase the volume of indoor contents.
Lin Feng: "Measure the pressure!"
Doctor Guipei: "4.7kPa!"
High pressure!
If the fascia ruptures because it cannot withstand high pressure, it will cause big trouble.
Lin Feng was calm: "Scalpel!"
Take a scalpel and make a crisp and neat slash from the outside of the biceps tendon above the elbow socket of the patient's right arm to the elbow fossa.
The deep fascia is exposed to the line of sight, and it can be intuitively seen at this moment that the patient's fascia is bulging and has shown a bulge.
Lin Feng's hand rose and fell, directly cutting through the fascia.
The fascia, which originally appeared gray ischemia, suddenly restored blood supply and appeared reactive hyperemia.
Quickly suture the cut fascia.
"Increase plasma infusion!"
......
Just then...
A nurse broke into the emergency room.
"Doctor Lin Feng!"
"What's wrong?"
The nurse panted and said quickly: "Over there in the interventional department, Director Qian Yuan, director of cardiac surgery, acute myocardial infarction, coronary arteries are all blocked..."
"Director Qian Yuan?"
Lin Feng was stunned.
Acquaintance!
The last time the big explosion was emergency rescue, he supported the first hospital of the city, was very familiar with Lin Feng, had done seven or eight surgeries, and often wanted to fool Lin Feng into jumping to the Great Northern Hospital.
Not bad for Lin Feng.
It's a friend made over the years.
The nurse said urgently: "Now the interventional department said, no one can do interventional surgery, can you go over and take a look? Erm..."
It's not over yet,
Lin Feng had already rushed out of the rescue room quickly.
"You can handle this patient... I'm going to intervene on the Ko side..."
After that, the person had already rushed out of the emergency department.
。