In the emergency room in the summer, the composition of patients in the emergency department has changed significantly compared to the winter. Patients in winter mainly suffer from cardiovascular and cerebrovascular accidents, fractures caused by accidental falls, and other injuries. As the summer came, the number of infected and poisoned patients increased significantly.

In the emergency room of the fourth hospital, three patients infected with dengue fever have been admitted today. In order to prevent mosquitoes from biting the three people and causing further transmission, the four hospitals deliberately gathered them together and provided them with mosquito nets. Dengue fever is a disease that does not have a high fatality rate from primary infection. However, it is dangerous if the patient is repeatedly infected in the hospital – there are four types of dengue virus, and if the virus type is different from the first and second infections, the patient will often have more severe symptoms.

Because of the presence of three dengue patients, the four hospitals had to separate the emergency rooms and set up a separate treatment area for the three of them—the same isolation room where the three plague patients had been treated.

Although this time it is only to prevent mosquitoes from entering, and there is no need to set up an airtight door, after all, it will involve a lot of human resources. As a result, the operational efficiency of the rescue room of the four hospitals has directly decreased by a large margin. According to Zhou's estimates, these three patients have reduced the capacity of the entire emergency room by at least 20%.

But you can't just transfer people to the infectious disease department upstairs. The Department of Infectious Diseases is currently full of beds, and Director Huang Hua of the Department of Infectious Diseases is asking the hospital office to assist in temporarily increasing the number of beds, but it will take time to convert the former reserve ward into a ready-to-use ward.

On the other hand, today's four hospitals seem to have provoked the inexplicable existence of some food safety supervisors. Since 5 p.m., six patients with severe diarrhea and abdominal pain have been sent to the emergency room in a row. Four of them were in serious condition – the most serious middle-aged man's skin was noticeably dry. If it weren't for the rapid test in place, Zhou Jun would even suspect that the patient had cholera.

For diarrhea and abdominal pain caused by food poisoning, doctors tend to treat them more by supporting vital signs than by forcing diarrhea. After the antibiotic kills the bacteria in the intestines, the patient should naturally return to normal and not have diarrhea all the time. Before the antibiotics are effective, the main content of treatment is to replenish the patient's fluids and electrolytes so that they do not really "pull" themselves to death.

Sun Lien rushed to the hospital to take over the treatment, but it was a pale, drunk, and somewhat delirious patient.

"This one was sent by 120. Zhou Jun briefly explained the situation to Sun Lien, "It is said that he suddenly fainted while drinking and eating supper with his family at night. After being taken to the hospital, the person woke up, but was unconscious. ”

Li Jianguo, male, 61 years old. Hypertension stage III (87693.33.25), hyperlipidemia (65846.45.37), mild acute alcoholism (02.11.51), D-2 mer rise (01.28.48), hypotension (01.22.38)" Sun Lien looked at this string of status bars, and a confused expression unconsciously appeared on his face.

There is no need to repeat the correctness of the status bar, and so far, all the prompts are 100% correct. But this was the first time he had seen such a direct inconsistency.

Why does a patient with stage 3 hypertension have low blood pressure? Sun Lien frowned and was confused for a few seconds, could it be that this founding uncle drank and forgot whether he had taken medicine, and then took too many blood pressure medicine?

"The patient's family has arrived, and you can go out and talk to them if you have to. Zhou Jun handed over the patient's case to Sun Lien, "After this patient is dealt with, you will take care of the three dengue patients." ”

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Entrusted by people, loyal to people. Sun Lien thought about it and decided to talk to the patient's family first to understand the situation. In the interval between understanding the situation, he asked the nurses to pull an electrocardiogram for Li Jianguo and measure his blood pressure again. Anyway, there is no need to issue a report, and then Sun Lien has to look at the picture himself, so there is no problem in leaving this work to the nurses.

"My dad definitely didn't take blood pressure medication anymore. There is no problem with repeated doses. "Li Jianguo's son is in his Chinese New Year's Eve and appears to be engaged in manual labor. "He usually takes his medicine very regularly, and he also has regular check-ups, and I have specially prepared a medicine box for him to take medicine every morning. There is absolutely no chance of eating it again in the evening. ”

"In order to clarify his problem, we need to do more checks. After all, he has stage 3 hypertension and is relatively old. Sun Lien tried his best to put the difficulties in front and said, "The first thing we will worry about in this kind of patient is his cardiovascular and cerebrovascular problems." If a person faints suddenly, it may be a cerebral infarction, or it may be due to insufficient blood supply due to a heart infarction. These two causes are the most dangerous, so be sure to rule them out first. ”

Li Jianguo's son nodded, "You are doctors, I definitely believe you." He thought for a moment and asked, "These tests ...... How much does it cost?"

"I'll pick the ones that are fast and cost less to do first. Sun Lien thought for a while and proposed, "Look at the ECG first, and if necessary, do a cardiovascular CT scan." This part is about 2,000 yuan - after the examination here, if you are sure that there is no problem with the cardiovascular part, then you have to go to an MRI to check the brain and do this scan...... It's about a thousand, but it will take a long time. ”

The examination will cost at least more than 2,000, and the follow-up treatment cost may not be able to withstand 30,000 or 50,000. But Li Jianguo only hesitated a little, and nodded in agreement with Sun Lien's opinion. "No problem, do you want to pay now?"

"I'll go back and open a payment bill, you can take the bill and go to the rescue hall to pay the bill. Sun Lien nodded, asked a few more questions about Li Jianguo's usual medication and physical condition, and then got up and said, "Wait until you hear someone call you, you can go into the emergency room to get the list." With that, he hurried back to the emergency room and began to check the results of the nurses' work.

"The electrocardiogram is normal, the blood pressure is 55/85......" Sun Lien frowned, the low blood pressure status in the status bar is indeed correct, it appears at the same time as the high blood pressure prompt, does this mean that the patient's blood pressure was very high before, but now for some reason suddenly fell into a state of low blood pressure?

Hypotension does have the potential to cause fainting and confusion, which makes sense. In the absence of traumatic hemorrhage, the patient went from stage 3 hypertension to the point of hypotension, which is not even explained by ordinary cerebral infarction.

Although Sun Lien really can't think of how low the probability of the nurses in the emergency room will be to make a mistake in measurement, there is still such a possibility. He sighed and asked for a blood pressure monitor to take another blood pressure test. But the right arm, which is usually measured, is now drawing blood — a test that Sun requested to confirm an increase in D-2 mer. So he walked around the bed and put the blood pressure monitor on Li Jianguo's left arm.

The blood pressure monitor in the emergency room is electronic, and although the accuracy is slightly lower than that of a traditional mercury blood pressure monitor, it is faster than the examination. After pressing the measurement switch, Sun Lien looked at the numbers displayed on the screen, and was so surprised that he even forgot to shut his mouth.

Blood pressure 90/155.