Gao Yan is also in the operating room for emergency treatment. But this did not prevent Sun Lien from taking his test results and coming to Director Liu for help. In fact, it is not uncommon for junior doctors to fail to handle cases, after all, not all patients' symptoms are very typical and obvious. At this time, a more experienced senior physician is often required to rediagnose the patient.

Liu Tangchun usually runs to the rescue room when he is idle, but it is the first time he has seen Sun Lien come to ask for help. He took the test results handed by Sun Lien with some curiosity, "What kind of case is this? Director Sun, you can't handle it, and Dr. Xu can't handle it either?"

was teased by Liu Tangchun for two days in a row, and Sun Lien was already a little numb. He just said helplessly, "You can see before you talk." ”

The content of Gao Yan's case was written by Sun Lien, and it was summarized based on the content of the communication with Gao Yan's parents on the phone, as well as the preliminary diagnosis and treatment plan for Gao Yan in the lower-level community hospital. Writing medical records is a technical job, and it's also hard work. Counting the internship, Sun Lien has been writing the content of the case for seven or eight months in a row. It has been able to be detailed, objective and true, and there is no speculation.

"I'll see. Director Liu motioned for Sun Lien to put things like cases on the table in front of him, and he was still pulling the rice, and from time to time he used black coffee to bring food to his stomach. The eyes are already looking at the contents of the case at a glance. Since the implementation of electronic medical records, Comrade Liu finally does not have to look at the ghost drawings of other doctors to guess the content. This kind of great good news even made his originally thinning hair grow back a lot-in the previous ghost drawing talismans, sometimes Director Liu had to find a nurse to recognize them.

"It does look like an infection. "After reading the record, Director Liu has almost eaten a bowl of rice. Wiping his mouth with a tissue, Liu Tangchun nodded to the case and asked, "What do you think is wrong?"

"I can't tell. Sun Lien just felt that something was wrong in his heart, but he didn't understand what was wrong. "If there is anything unusual about it, it may be that when the patient is admitted in the morning, the family members who sent the patient here take the opportunity to run away. ”

"Ran away?" Liu Tangchun was also stunned, "What's going on?"

In the morning, Sun Lien told him from beginning to end. "At that time, the police were called, mainly because the patient's knife wound was unusual. ”

In general, if a patient is self-injurious, the medial aspect of the lower arm is usually affected. That is, this side of the wrist. And Gao Yan was cut until the flesh was blurred and the bones were exposed, but it was the outside of the lower arm - the back of the hand.

If someone were going to cut their own arm with a kitchen knife, then it would be the inside of his arm that would be slashed with the usual movements. Generally speaking, the outside of the arm is cut until the flesh is blurred, which is basically the scar left by protecting one's head and face with the arm after being attacked.

In addition to the unusual arm injury, the patient's disease process was problematic.

His disease worsened too slowly.

When he was seen at the community hospital, Gao Yan had a severe high fever. The body temperature is as high as 40.2°C. Complaints of headache, high fever, chills for more than four days. However, after two days of treatment, the high fever persisted. In addition, when I came to the Fourth Central Hospital for treatment, nearly a week has passed since Gao Yan's onset of the disease.

Viral meningitis has a rapid onset but is relatively easy to treat. Usually within a week, including the onset of illness, is enough to cure — or to transform into a more serious disease.

And Gao Yan was even able to walk into the emergency hall on his own with the support of the accompanying woman. This situation is in conflict with the diagnosis of viral encephalitis.

If it is bacterial meningitis, although the course of the disease can be corrected, the combination therapy of intravenous antibiotics + oral antibiotics provided by the community hospital should be able to directly solve the bacteria that invade the meninges.

After listening to Sun Lien's explanation, Liu Tangchun nodded, "There is indeed something wrong." He stood up, took his lab coat off the hanger, and said, "Let's go, go see the patient." ”

In the operating room, Gao Yan's upper arm repair has reached the stage of coming to an end. Tall and strong orthopedic carpenters are trimming his lower arm flaps. Although the flap of a sharp cut is much easier to repair than a tear, it is better aligned with the wound and promotes the healing of the suture wound. The carpenters are still delicately cutting the flesh and skin. It is necessary to ensure that the wound anastomosis is good, and to ensure that the wound tension is not increased due to too much incision. All in all, it's a meticulous job.

Liu Tangchun took Sun Lien and observed the progress of the operation downstairs in the observation room on the second floor.

"My vital signs aren't very stable. Liu Tangchun looked at the busy anesthesiologist downstairs, and suddenly muttered to himself. He pressed the intercom fixed to the side of the observation window and asked, "What are the patient's vital signs?"

Downstairs was busy with the zebra glasses doctor who had given Zhao Weihong a jugular venous catheter. He didn't bother to answer Liu Tangchun's question first, pushed his glasses and adjusted the dosage of the drug for a long time, then while staring at the monitor, he groped around the wall with his hand for a while, found the intercom, put it in his ear and said, "Director Liu, right? This patient sent by your department has a very poor response to anesthetics." There is no response under the normal dose of anesthesia, and the blood pressure drops as soon as the dose is slightly increased. ”

"Has the blood volume been replenished?" Liu Tangchun raised his eyebrows, for anesthesiologists, it is common for patients to occasionally experience anesthetic insensitivity. However, it is relatively rare that the anesthetic tolerance threshold is not high, and the anesthetic is not sensitive. His first reaction was that the patient's blood volume was insufficient.

"I have had 4 units of AB RH-negative blood transfusion. The zebra glasses doctor patted his thigh, "The heart rate is also normal, it shouldn't be a blood volume problem." ”

"Is there a problem with maintaining anesthesia?" Liu Tangchun also wondered, "Last year, the First Central Hospital reported that there seemed to be a problem with the calibration of the propofol content collected in their hospital. ”

The zebra glasses doctor shook his head and said, "We dare to use milk for patients with high intracranial pressure, and they are given aminoflurane and procaine." When the concentration of aminoflurane is less than 2%, blood pressure increases. Above 3.5%, the blood pressure will go down. This patient is going to die of trouble anyway, and I am sweating for a while. ”

At this moment, Sun Lien suddenly saw a strange touch of green in front of his eyes.

"Wait. Sun Lien, who found that something was wrong, hurriedly pulled Liu Tangchun's sleeve, "Director Liu, you let them take a look at the patient's urine bag." ”

"Urine bag?" Liu Tangchun repeated for some reason, and suddenly reacted to something, "Xiao Wang, you go to the patient and see the situation of the urine bag." ”

Dr. Zebra scratched his head, looked back at the monitor step by step, and walked over to the operating bed. He lowered his head and suddenly looked back at Liu Tangchun who was standing on the second floor in surprise. Then he bent down, picked up the urine bag from the side of the bed, and showed it to the two of them.

The urine in the urine bag is grass green.

.m.