There is a process for patient admission. In all fairness, in order to maintain the status quo, the patient's treatment decision was handed over to Sun Lien, and Feng Chujie was the first to do it. In case something goes wrong during the treatment, the final responsibility has to be borne by Feng Chujie, who is the patient's attending doctor.

Although everyone is familiar with each other, this kind of thing still can't be casual.

Sun Lien found Liu Pingchuan, who was in a meeting, without any psychological pressure, and reported the current situation to him. Liu Pingchuan raised his eyebrows when he heard this, "Is there really a problem?" God is pitiful, he handed over this case to Sun Lien, in fact, the fundamental purpose is to be lazy - there is a case to delay Sun Lien's time first, so that he can delay the work of summarizing the cases and transferring rare diseases to Sun Lien to deal with them a little.

"There's a problem. Sun Lien took out his mobile phone, "The patient has subcutaneous pneumotena in the thoraco, abdomen, and pelvis, and fascial edema. The scope is relatively large, and the only thing that is fortunate is that because Dean Liu, you found it early enough, her infection is not particularly serious. ”

Another explanation that is not particularly serious is that "I can't die now, but I won't be able to say it later". Liu Pingchuan obviously understood what Sun Lien meant, he frowned and thought about it, "What is the opinion of the gynecology department? They are willing to transfer this patient out, right?"

"That's right. Sun Lien nodded, "The question now is, how do I take patients from this emergency outpatient department?" The emergency department of the four hospitals has its own inpatient department, but strictly speaking, it still belongs to the category of emergency observation. These are two different concepts from hospitalization – at least for patients, there is a huge difference in reimbursement from Medicare.

For a family with stage 3 cancer, every penny may be the difference between life and death. If you can save a little for others, it's better to save a little.

Liu Pingchuan rubbed his head with a headache, and he even wanted to take out his brain and rub it. I obviously wanted to save trouble, but I ended up causing myself more trouble.

"Well, then, you turn people out of God. Let there be accommodation for this patient. I'll go to Dean Song and get a charter. "After thinking about it, the thought of saving my life still overshadowed the attempt to save trouble. Liu Pingchuan sighed and took out his mobile phone, first said hello to the inpatient department outside the gods, and then called Song Wen again.

"When will the hospital office vacate the room over there?" On the phone, Dean Liu seemed to be discussing some specific details with Song Wen. Sun Lien nodded to the other doctors in the conference room with some embarrassment—he interrupted the meeting in the middle of the meeting. And it seems that there will be no way for the meeting to continue for a while.

After suffering in the eyes of many doctors for about fifteen minutes, Sun Lien finally got the final treatment advice from Liu Pingchuan's mouth, "First transfer the person to the outer god for treatment." The inpatient ward prepared for your treatment team will be ready for use in two days - four beds, and Dean Song's opinion is to prepare three nurses, including a head nurse. The head nurse is appointed by the Nursing Department, and other nurse candidates can consider your opinions. ”

He glanced at Sun Lien, "Okay, hurry up and go see a doctor—Director Sun." ”

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"How is it?What treatment plan did Dean Liu give?" Sun Lien returned to the small conference room, and Xu Yourong and the others were anxiously waiting for the follow-up treatment plan brought by Sun Lien. Doctors in the imaging department gave advice, "thoraco-abdominal and pelvic infection, intestinal edema". The patient urgently needed follow-up treatment, but in the emergency room, she could only receive basic anti-infective treatment, and nothing else was available.

Dean Liu...... Gave us an inpatient unit. But it doesn't work now. Sun Lien used the fastest speed to get himself out of the shock and conveyed the opinions of the hospital management as accurately as possible. "First, transfer the patient to Shenwai for hospitalization, and Dr. Xu, you will be the main treatment. At the end of the two days, we will be given two wards to receive patients – and three nurses. ”

Zhou Ce smiled and grasped the key point in the conversation, "Then won't you really become Director Sun in the future?" ”

"I'll talk about it if I'm not really good. Sun Lien didn't want to continue the topic, he really felt a little embarrassed, "How is the patient?"

"The heart rate is still going up, and now it's 135. The situation is not so good. When it came to serious things, several doctors who were still laughing suddenly became serious, "Her blood pressure is dropping, and it has now dropped to 65/85, and her blood gas indicates metabolic acidosis, and she has used sodium bicarbonate solution for fluid resuscitation and correction of acidosis." However, the infection progressed much faster than we expected. ”

"Sepsis has to be considered. Sun Lien frowned, "What did the doctor in the imaging department say? Have you found the source of infection?"

There are four priorities for the symptomatic treatment of sepsis, the first of which is to accurately understand the patient's disease status, that is, to monitor. But at present, Qian Aiwu is still in the emergency room and will be transferred to the Shenwai inpatient department. At this time, it is difficult to get on a full set of monitoring equipment - it is difficult to move when it will be transferred.

The second is early fluid resuscitation. For patients with hypovolemia and tissue hypoperfusion, the sooner effective fluid resuscitation is performed, the higher the survival rate. This point, Xu Yourong and others have already done it in front of Sun Lien. Not only did they perform fluid resuscitation on the patient, but they were also correcting Qian Aiwu's acidosis. This provides a very good opportunity and platform for subsequent treatment.

The third point is that controlling the infection is more troublesome. Because it takes time to culture the bacteria, Sun was first treated with empiric antibiotics. The use of imipenem cilastatin sodium to fight infection is already the limit of what doctors can do now. But this is obviously not enough, the infection progresses too quickly.

The only way to turn the tide is to find the source of the infection and slow the rate of progression of the infection by surgical removal or aggressive drainage.

"The imaging department did not give a specific infected organ. Xu Yourong's answer was very helpless, "We have also seen the results, in addition to intestinal edema, there is also a large amount of gas in the subcutaneous tissue." It is very difficult to find the source of infection with CT scanning. ”

"Then transfer the person to the surgical inpatient unit first. Sun Lien made a decision, "It's useless to let people lie here now." ”

"Are you going with us?" Xu Yourong quickly called Xiao Guo, the first coolie nurse in the rescue room, and asked Sun Lien while arranging the transfer, "Or do you have other examinations to do?"

Sun Lien pondered for a moment, "You go first, I'll give someone a call." ”

Seeing a few people leave the rescue room with the bed, Sun Lien sneaked to the door of the rescue hall with the phone and called Wu Youqian, "Dean Wu, can you let me use the picture recognition function of the old thing?"