Although the status bar prompts are rudimentary, the patient's situation is anything but "simple". Sun Lien concluded at a glance that this young Katu who had eaten ibuprofen was in a very bad state.

At first glance, he looked like he was in a bit of an epilepsy. Sudden onset, confusion, foaming at the mouth, and convulsions are classic symptoms of epilepsy. Although there is no angular arch reflexion, these four features alone can conclude that it is epilepsy.

But he has other problems.

Although the patient was black, Sun remembered it very well - when he was seen a few hours earlier, Munten's lips were still bloody. And now...... His lips were bruised, and the color was even darker than his skin. At the same time, Sun Lien's first symptom was sweating profusely.

In this way, it looks more like a heart and lung problem than epilepsy. Combined with the "sinus tachyrhythmia" in the status bar, the first diagnosis that came to Sun Lien's mind was "exercise syncope".

Exercise-induced syncope is a type of syncope that can be triggered by a variety of causes, including vascular decompression, gravitational shock, orthostatic hypotension, paroxysmal muscle weakness, primary consciousness, and more. However, most of the motor syncope lasts for a short period of time, ranging from a few seconds to tens of seconds. Munten's syncope is clearly past that time limit – meaning it's likely that his syncope is heralding more serious consequences.

The medical team now had limited diagnostic equipment, and the results of blood pressure and heart rate came out quickly – blood pressure 132/62 mmHg, heart rate 130 beats/min, and breaths 24 breaths/minute.

Fortunately, this time they also brought an ECG, and the results of the quick test were quite straightforward - sinus tachyrhythmia, and there were towering T waves.

The patient's T wave in V2-5 has a distinct "tent-like" characteristic, with a pointed T wave crest and symmetrical ascending and descending limbs. This is a distinct ECG feature of hyperkalemia.

"What was he doing before he fainted?" Sun called Felipe to translate and quickly checked his medical history. Having this ECG feature of hyperkalemia means that although the patient currently has hyperkalemia, it has not been high for a long time. In the case of severe hyperkalemia, as potassium continues to rise, the patient's T and P waves and QRS voltage will continue to fall—instead of exhibiting the obvious and typical "tent-shaped" ECG.

"They are training to run the London Marathon next April. Felipe was quick to translate his answer, adding, "Munteng is the main rider and he was training for the eighth 1,000-meter sprint of the day before he fainted. ”

Sun Lien frowned and looked at Munten, who was still twitching, his condition was really not good. And it's a tricky problem – hyperkalemia has a high chance of causing acute heart muscle injury, which can reduce the heart's ability to pump blood. But it didn't match his heart rate and blood pressure. Now that this season is training at this intensity, there is certainly a possibility of heat stroke, but the manifestation of heat stroke should be low blood potassium, which is not in line with the ECG performance.

"Did he eat today?" Sun Lien looked at Manten's lean long-distance runner body, and suddenly had a guess, "When will you eat?"

"This morning, ate ...... Ate a piece of chicken breast. "His recent physical examination results were a bit high, so the coach arranged a fat loss program for him." ”

"It's a bit high? How much is that? How long has he been eating a fat loss meal?" Sun Lien looked at this lean young man, and it was hard to believe that his body fat percentage was actually high.

"11 percent, and their coach's request is that the body fat percentage must be reduced to 9 percent in April. "This recipe of eating only one chicken breast in the morning has been going on for about five days. ”

Sun Lien did not continue to ask questions, but took out a blood glucose meter and blood glucose test strip from his medical box. After taking a little blood from Munten's fingertips, he quickly got an important parameter from the tiny instrument.

"The blood glucose content at the end of the finger was 2.4 mmol/L. Sun Lien looked at this data, muttered a few words in a low voice, then stood up, rummaged through the medicine box brought by the medical team for a while, and then raised his voice and asked, "Teacher Liu, have we brought 50 sugar?"

"Here's it. Liu Tangchun took out glucose from a bag, "Is it severe hypoglycemia?"

"It's only 2.4, it's strange not to be dizzy. Sun Lien took the plastic bottle containing 50% concentration glucose, skillfully pulled out a syringe, and drew 40ml of liquid from it, "I'll give him a sugar supplement first to see the effect." ”

40 ml of 50% concentration glucose solution was slowly pushed into Manten's veins. After completing the static push, Liu Tangchun handed over another bag of 10% glucose and began intravenous infusion maintenance.

Everyone, including the paramedics, looked nervously at Munten, who was twitching on the ground, and after about twenty minutes, his breathing rate dropped slightly. After the first bag of 10% glucose was almost halfway infusion, the young man opened his eyes.

All the locals cheered, except for an elderly woman who knelt beside Munten and covered her mouth and cried. This was his mother, a widow who was only 37 years old but looked to be at least in her 50s.

Seeing the patient gradually wake up, Sun Lien was originally quite happy. But the status bar was like a Chinese angry cat hiding in a dark corner, waiting to push the objects on the table to the ground, jumping out and brushing a wave of presence.

The "unconsciousness" above Munten's head had just disappeared, and then a state of "irritability" had been added.

At the same time, Munten's breathing is still rapid, and the normal person's breathing rate is about 16~18 times per minute. When unconscious, Munten breathed at a rate of up to 27 breaths per minute, and now awake at about 25 breaths per minute. At the same time, his lips were pale, and he retched twice from time to time.

What's worse is that the tremors of his lower limb muscles still haven't improved. The heart rate is also maintained at 140 beats per minute.

Liu Tangchun frowned, and Sun Lien also fell into deep thought.

"We can't check blood gas here, we don't have this equipment. Liu Tangchun broke the calm first, and he said to Felipe, "This patient's condition is more serious, he should not just faint due to hypoglycemia - it is likely that there are other serious symptoms, but the specific problem cannot be determined, and it must be further examined in the camp to be clarified." ”

Felipe translated to Munten's mother, and then Sun Lien continued, "The treatment process may take a long time – we now have a preliminary suspicion that his kidneys may be damaged, and his heart may also be damaged, but the specific situation will depend on the results of the examination." ”

Sun Lien is not full of running trains to scare people, just based on the towering T waves on the ECG and the "tent-like", he can determine that the patient currently has hyperkalemia. And it's likely that it's because of a lot of exercise, which creates muscle damage – maybe even rhabdomyolysis.

Hypoglycemic encephalopathy leading to exercise-induced syncope with rhabdomyolysis is the diagnosis of Sun Lien.

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