In the morning, Sun Lien walked to the hospital, and it was another day that was not particularly different from usual. I came to the emergency room early in the morning, and after handing over the shift with my colleagues who worked late yesterday, the next thing was the time for a less urgent consultation. Left and right are on duty, and Sun Lien prefers to have a constant stream of patients to see - so that it is not too boring.

However, it seems that it is because of the snow for several days in a row, and it seems that it is a working day. The ninth clinic, which is responsible for complex cases, was not open all morning. The emergency room is still busy, but most of the other patients go directly to the outpatient clinic - those who need to see an emergency department go directly to the emergency room, and it is basically not Sun Lien's turn to deal with it.

After sitting in the ninth clinic for two hours, Sun Lien put down the mobile phone that still had 45% power in his hand, no, he had to find something to do for himself.

Therefore, this person is born to be a cheap bone. Usually busy crying and shouting to death without touching his feet, when he really has no, he has to find something to do for himself. Anyway, men are big pigs' trotters, right?

Strictly speaking, doctors on call can't be fooled around. It's just that it doesn't seem to have a good chance of opening the ninth clinic today. Coupled with the phone posted at the door and the doctors in the surrounding clinics, Sun Lien's job of finding trouble for himself became logical.

Sun Lien, who had nothing to do, was wearing a white coat, with two hands behind his back, his upper body was naturally hunched a little, and then he shook a pair of black sneakers on his feet and walked towards the rescue hall - his steps were steady and his stride was not large, which was suitable for walking after dinner.

If you want to see the excitement, you have to go to the emergency hall. If you want to secretly observe the stories between various people and make up the stories between people, you must go to the infusion room. If you just want to chat with people, go to the inpatient department, catch two patients who smoke illegally on the rooftop and balcony, and they can tell you about your life experience for four or five hours.

The hospital is actually a large story box, and those patients are the wonderful beginnings of one after another. And for most of them, the story is far from the end it should be. Sun Lien had this habit when he was an intern, and he liked to look at these patients and guess their stories.

Always remind yourself that you are treating a living "person", and Sun Lien has always felt that this is very important.

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"You're simply not human!" Sun Lien slipped to the infusion area, and due to the response to national requirements, the outpatient clinic of the fourth hospital had already canceled the outpatient infusion - patients need to go to a secondary hospital or community hospital for infusion therapy. But the situation is a little different on the emergency side. Of course, patients receiving hundreds of beds in the emergency room can be treated with infusion, and patients who have been shunted from the emergency clinic can also be treated with infusion therapy in the observation area. Of course, this is not the point, the point is that the loud scolding that Sun Lien heard came from a young male nurse.

The male nurse wore a light blue male nurse uniform and held a bag of intravenous infusion fluids covered in a black plastic bag. His eyes widened, and he trembled and pointed to the nose of an old lady in her sixties, "What are you going to do?!

Sun Lien was taken aback when he heard this, the hand behind his back also loosened, the back of the slightly hunched back also straightened, and the steps under his feet walked quickly, "What's wrong?"

"Dr. Sun. The male nurse recognized Sun Lien, and when he saw Sun Lien coming over, his voice trembled, "She...... She ...... "She lasted for a long time, but she still didn't say what happened."

"This old lady is probably a little confused. The middle-aged woman sitting next to her who received the infusion shook her head and told Sun Lien what had happened.

The story itself is actually quite simple, the old lady was hospitalized this morning because of breathlessness, cough, stomach pain, and poor spirits. After an initial examination of the old lady, the emergency department determined that she had difficulty breathing due to elderly bronchial asthma. Therefore, aminophylline injection 2ml (0.25g) and cimetidine 2ml (0.2g) with 200ml of 5% glucose intravenous infusion were prescribed for the elderly.

The male nurse was holding a bottle of levofloxacin.

"When I checked the patient's name, she actually agreed!" The male nurse finally calmed down from her fear and anger, "I asked her three times, and it was not her name three times, but she said yes! If I hadn't had a little impression that this old lady had used aminophylline, I would have hung this bottle of levofloxacin on her!"

The old lady probably knew that she almost caused a big accident by agreeing blindly without understanding, but she still just said stubbornly, "I was the third infusion before, I thought it should be my turn for the third bottle......

Sun Lien only reacted at this time, why was the male nurse so nervous.

Aminophylline is an anti-asthma drug that has been used clinically for many years, and it is also the most widely used classic drug for asthma. However, the effective therapeutic concentration of aminophylline is very low, and the individual blood drug concentration varies greatly, which is a drug with a relatively narrow "treatment window", so blood drug concentration testing is required. To ensure that the level of the drug is not too high in the patient's body to cause adverse reactions, or too low to achieve a therapeutic effect.

As for cimetidine, it is a combination drug commonly used in clinical practice with aminophylline. This H2 receptor anti-caking agent can inhibit gastric acid secretion and prevent or alleviate peptic ulcers in asthma patients who use aminophylline - theophylline itself can damage the gastric mucosal barrier and stimulate gastric acid secretion, and asthma patients often suffer from peptic ulcers. On this basis, cimetidine is often used as an essential supplement for aminophylline in the treatment of asthma.

However, due to the fact that when cimetidine and aminophylline are dissolved in 5% glucose solution at the same time, the compatibility stability time is only four hours, so it cannot be safely used in clinical practice, so cimetidine infusion treatment can only be carried out after the aminophylline infusion is completed.

The bottle of levofloxacin, which is covered by a black plastic bag, belongs to the fluoroquinolone class of antibiotics, and they are the same as macrolide antibiotics, and when used in combination with aminophylline, it will cause a decrease in the clearance rate of theophylline, thereby increasing the serum concentration of theophylline.

As mentioned earlier, if the male nurse had given the old lady levofloxacin by mistake, the theophylline concentration in her serum would not have risen suddenly, but would have remained at a relatively high level for a long time. When she finishes the infusion and walks out of the hospital, she may have serious side effects or simply be poisoned because of the high theophylline blood concentration. The consequences were unimaginable.

"Alright, alright...... Forget it if it's okay. "In this case, the medical staff can't kick the patient hard to relieve the breath. In desperation, Sun Lien could only pat the male nurse on the shoulder, "Be careful next time, if you encounter this kind of patient who may not be able to hear clearly when you are older, you can ask the family to take out the registration list and the like." It's better to be more reassuring than to verbally check. ”