"You don't have to climb a mountain here, just burn incense, are you a patient with advanced tumors?"

Said a young female pilgrim. ”

"Are you young?" Wu Mian mused.

"I don't know the specifics, but I'm afraid, Uncle Xiao. Lin Daoshi said, "We have some equipment here, but we don't have medicine or anything." I've been thinking about getting a license, but it's too weird to get a license for a Taoist temple, and I haven't been able to get it if I keep dragging it out. ”

Wu Mian knows that medicine is not something that can be used casually, and it is not for his own family, once there is any drug reaction, it is illegal, and in serious cases, it is murder.

Practicing medicine without a license, that's a big deal!

Wu Mian didn't care very much, the pilgrims who could come to the incense were said to be in good health, and the possibility of transient syncope was the greatest.

When I came to the front door of the front mountain hall, there was a group of people surrounded by a group of people in the shade outside the door wall.

"Master, here!" a little Taoist priest shouted urgently, beckoning.

Wu Mian and Lin Daoshi walked over and saw a 24 or 5-year-old girl lying on the ground, she was wearing a suspender, and her exposed skin was spotted with red marks, and the roaring sound could be heard from her respiratory tract from a distance.

"......" Wu Mian was stunned for a moment, is this allergic?

In Lao Ou Mountain, you can inexplicably meet patients with allergies.

Wu Mian sighed and stepped forward from the crowd.

Flushed, generalized urticaria-like maculopapular rash in girls, shortness of breath, stridor, breathlessness, and cyanosis of the lips.

"Call 120. Wu Mian said.

"What?" Daoist Lin looked at Wu Mian in surprise, shouldn't Uncle Xiao come up and be cured with a few snaps, why do you call the 120 emergency number?

"Anaphylactic shock, not to the extent of laryngeal edema, hurry up. Wu Mian frowned and said in a cold voice.

"Oooh. Lin Daoist immediately arranged for someone to make a phone call.

"Do you have an endotracheal tube here? Wu Mian said.

Daoist Lin didn't have any ideas, and Wu Mian said what was what.

It's just that there are a lot of people here, and it's best not to let pilgrims hear anything like anaphylactic shock, after all, it's natural for a doctor in a white suit to say this. But if you say this in a Taoist robe, you feel a little nondescript.

These are all problems of details, but sometimes details determine success or failure, and we must be cautious, and Lin Daoshi has been cautious for so many years.

Wu Mian's nose twitched and asked, "Who is from her family?"

"I am. One boy said, "Chief, what's wrong with my girlfriend?"

"Did you spray mosquito repellent before going up the mountain?"

"yes. ”

"What brand of sunscreen did you touch?"

“......”

The people around were stunned, why did this little Taoist ask such a strange question?

"No less. Wu Mian looked at the girl and said, "You don't know that these two things can't be used together?"

“......”

The boy looked at Wu Mian dumbly.

"Uncle Junior, you are tired. Daoist Lin said suddenly.

The surroundings were quiet, Wu Mian knew that Daoist Lin was looking back to make up, and he didn't care very much, and said lightly, "The main ingredients of mosquito repellent water are DEET and alcohol, and sunscreen contains dipropylketone ......"

"Dipropylketone? what's that?" the boy asked, stunned.

"It is a styrene polymerization inhibitor and fragrance fixative, which can make spices give out a sweet smell, and is widely used in perfume and soap flavors. It can be used in sunscreen products in the cosmetics industry to improve the experience. Wu Mian explained briefly and continued, "A large amount of dipropylketone and DEET are mixed, plus the effect of alcohol causes allergies. ”

Lin Daoshi was also quite helpless, this was a godsend, but unfortunately the matter was urgent, and he couldn't pretend to be forced.

If you change yourself, Lao Oushan's prestige can rise again.

It's a pity, Uncle Xiao doesn't want to pretend to be a ghost, what if this is ......

said a thousand ways and ten thousand, and Daoist Lin could only be a pity, but he didn't dare to really say these things to Wu Mian.

He had a certain fear of Wu Mian in his heart, which at first came from the dictation of his old man, and as he came into contact with more and more, the more he couldn't understand this young man wearing sunglasses.

When you look at it with sunglasses, you know that it is an allergy caused by mosquito repellent and sunscreen, is this still human?

"Xiaoxi, come to Qianshan. ”

Lin Daoshi was thinking about it, Wu Mian made a phone call, "There is a patient with anaphylactic shock, let's send her to the hospital." ”

"Uncle Xiao, will you deliver it personally?"

"What should I do if my laryngeal edema is halfway through? The child just now has a chronic allergy, this is an acute allergy, you have to be careful. ”

......

......

The first hospital of the Medical University, the whole hospital consults.

Thoracic surgery, anesthesiology, respiratory medicine, and intensive care doctors sat in the office, and the level of consultation was also a bit high, which was personally presided over by Xue Chunhe, the vice president in charge of clinical practice, and Ma Ji, director of the medical department, was responsible for specific matters.

"Let me say a few words, the patient's diagnosis is very clear, adenoid cystic carcinoma of the lower trachea. The operation is not difficult, but the problem is that the surface of the tumor is rich in blood vessels, and it bleeds at the slightest touch, and if the tracheal tube is intubated, I am worried that there will be a large blood vessel rupture. Director Xu of the anesthesiology department said, Ren Haitao sat next to him, holding a notebook and making fake records.

This is the director's ranking problem, and if he doesn't take someone to take notes when he comes out of the whole hospital for consultation, it seems to be a head lower than others.

Today was just in time for Ren Haitao to be on duty, and he was not busy, so he temporarily acted as a secretary.

"Can't be anesthetized?" Xue Chunhe asked.

"Anesthesia is too risky. Director Xu of the Department of Anesthesiology replied.

Several people present were also very worried, but there was nothing good to be done.

The patient, a 78-year-old woman, came to the Department of Thoracic Surgery of the Second Hospital of the Medical University with the support of her family one week ago due to chest tightness, shortness of breath and dry cough for more than 2 months.

A 15mm×16mm neoorganism was seen at a distance of 2.5 cm from the carina, with a brittle texture and easy to bleed to the touch, and pathological biopsy confirmed the diagnosis of "adenoid cystic carcinoma of the lower trachea".

The diagnosis was clear, but the problem was how to remove it surgically.

The mass is 2.5 cm above the carina, and the endotracheal tube will inevitably be inserted here. Not to mention the hard endotracheal intubation, when I was doing a flexible bronchoscopy, the lens lightly touched the mass, and the surface of the tumor immediately began to bleed. The pathology was taken on the scalp, and the bleeding slowly stopped after half an hour covered with hemostatic gauze and hemostatic powder.

If this is tracheal intubation, it is estimated that as soon as the ventilator blows, the blood will be poured back, and the patient will have to be "drowned" by his own blood before the thoracotomy is completed.

The surgery to remove the tracheal mass is very simple, but even the most simple surgery is always without anesthesia.

The anesthesiology department has a multi-year-old stalk called Bang Ma. This is more than 300 years ago, when there was a first surgical operation in the West, because I was afraid that the patient would be in pain, I would stun with a stick and then perform the operation.

At that time, surgery was about the word "fast", and the shot was like the wind, and doing surgery was the same as killing pigs.

And in front of me is an old lady who is almost eighty, if it is ......