When two extremes that should be in opposition to each other occur in a patient at the same time, the person who has the most headache must be the patient's doctor.

The specific cause of the symptom of systemic disseminated intravascular coagulation varies. But in general, it is caused by the human body incorrectly starting the blood clotting program under various conditions. A large number of clotting fibers and platelets are mistakenly activated in the blood vessels of the human body, so blood clots appear in the blood vessels in various parts of the body. These blood clots can affect normal blood flow, resulting in tissues in the body not getting enough blood, resulting in symptoms such as hypoxia.

The total amount of clotting substances in the human body is limited. When these clotting substances become blood clots in blood vessels throughout the body, there will be not enough coagulation substances in the places that really need to stop bleeding. As a result, the body tends to bleed spontaneously. After all, the human body is actually a place where all kinds of small mistakes often occur.

Our bodies are constantly damaged, and tissue cells are constantly repairing the damage. When the two sides reach a point of equilibrium, the human body is healthy. The DIC would upset this delicate balance once and for all. Where repair is needed, no repair material is available, and normal blood vessels are filled with blood clots that block blood flow.

For the treatment of DIC, in addition to "symptomatic treatment" and "supportive care", the most important tool is heparin. At the same time, it is necessary to replace blood volume as soon as possible, maintain blood pressure, and treat the underlying disorder that causes DIC.

The symptoms that happened to Wu Fenmei were actually very straightforward, and the severe infection caused by avian flu triggered blood clotting. According to Wu Fenmei's situation, she should be in the early stage of DIC now. Treatment is also obvious and straightforward – a small dose of heparin is given intravenously (50,100 units/hour) and crystalloid is replaced.

Liu Tangchun skillfully found heparin from the cart in the clean room, but because he was wearing protective clothing, it was really difficult for Comrade Liu to dispense medicine with his hands covered with several layers of gloves. So Sun Lien became Nurse Sun. Although he is clumsy in preparing medicine, it is always more convenient than Liu Tangchun.

"Just replace the medicine bottle!" Liu Tangchun looked at Sun Lien, who was about to give the patient another injection, and was angry. "You're afraid she's not bleeding enough, aren't you?" he shouted, pointing to the bottle of imipenem cilastatin sodium that was almost finished. After Sun Lien changed the medicine, he flew up and kicked Sun Lien's ass, "I'm usually quite clever, why are you clumsy now?"

Sun Lien rubbed his aching buttocks that had been kicked, and said with a wry smile, "I've been so tired these days, I feel like my brain is all wooden." ”

"Just look at the way you don't have the head to rush inside. Liu Tangchun snorted coldly, and Bi Tianhua, director of the Infection Office of the Outer Courtyard, interjected in time, "Old Liu, your gas cylinder will be empty in two minutes, come out quickly!"

The gas cylinder Liu Tangchun carries is not large, and the carbon fiber cylinder with a water volume of 1.5 liters can theoretically provide a battery life of about half an hour if it is only used for breathing. However, since the gas cylinder is directly connected to the positive pressure protective clothing, the theoretical safety time left for Comrade Liu is only 15 minutes. Thirteen minutes have passed since he entered the clean room, and Bi Tianhua was afraid that something would be wrong with Lao Liu's old bones, so he hurriedly called him out.

"They brought three cylinders, and this is my last. Liu Tangchun was also a little distressed, "You just go out with me." ”

"There is still a possibility of human-to-human transmission of avian influenza. Sun Lien's answer was a little unanswered, "Since whoever comes in has to take a risk, it is better to let me keep an eye on it for a while." This would at least reduce the number of doctors exposed to the risk. And this mask ......," he pointed to the N95 mask on his face, "and there are eight hours of effective defense, which is still plenty of time." ”

"Then be careful yourself. Liu Tangchun understands that this is the best solution at present. "I urged the laboratory department to arrange for the patient to be transferred to the hospital as soon as possible if the avian flu is confirmed. The patient needs to take the medication and tell me directly, I will give you the approval. ”

Sun Lien nodded. It's just that there was a wry smile in his heart, judging from the patient's current vital signs and condition, it is basically impossible to arrange a transfer. If she is forcibly transferred to the hospital, I am afraid that she will have an accident halfway.

Maybe when the patient's test results come out, her vital signs will be stable. Sun Lien thought so in his heart.

In addition to the main door, there is also a "hole" in the wall between the clean room and the outside world. Plexiglass doors are installed on both sides of the opening, which can be used to transport samples and medicines, as well as surgical instruments. Speaking of which, it would have been a bit strange to have such a clean room in the rescue room. I don't know what kind of mentality the designers had in the first place to put a class 100 clean room here.

Sun Lien hung up crystalloid solution for Wu Fenmei, and after seeing that the blood pressure did not change much, he added a norepinephrine intravenously with Liu Tangchun's consent. After watching Wu Fenmei's blood pressure gradually rise from 80/45 to 95/55, she relaxed a little.

There was no stool to make in the clean room, Sun Lien looked left and right, could only find a corner to lean on, and slowly sat on the ground. He was so tired.

When he was about to fall asleep in a daze, Sun Lien suddenly opened his eyes. He stood up vigilantly, looked at the status bar on Wu Fenmei's head, quickly picked up a syringe, and drew a tube of blood from Wu Fenmei's intravenous needle that was still slowly bleeding. The syringe was then sealed and placed in the transfer hole in the wall.

"Urgent check of kidney function. Sun Lien briefly and quickly instructed Xiao Guo, who was waiting outside, "Immediately invite Dr. Xu Ce from the Department of Nephrology to come for a consultation." ”

Xiao Guo didn't dare to delay, carefully picked up the syringe, and after putting a layer of plastic bag on the outside, he hurriedly turned around and rushed out of the rescue room.

And Sun Lien returned to Wu Fenmei's side, and the status bar was updated with a new status again, "Acute kidney function injury." ”

The kidneys are very sensitive organs, and they need a lot of blood to provide energy and oxygen to filter waste products from the body. As a result, acute kidney injury (AKI) occurs in nearly half of patients with DIC. Peramivir is a new type of drug, and the side effects and adverse reactions in humans have not been well studied. Although the drug itself will basically be excreted by the kidneys in the form of a prototype drug, it is uncertain whether it will increase the burden on the kidneys during the excretion process. Wu Fenmei's acute kidney impairment should be caused by DIC. But Sun Lien is still a little unsure whether the input speed of peramivir should be slowed down.

So he decided to call someone to help.

Hey Zhou Ce, that rotten boy came to the kidneys to make trouble, come and help!