(Thanks to friends Elf, Vermilion, Silent Guard, Naughty Dragon 1976, Book Friend 20190727205832637, and Likeicewolf Monthly Pass for encouragement)

Today's interview really consumed a lot of Liu Banxia's energy, even when he watched the cases of patients admitted to the hospital, he was a little absent-minded.

The phone rang and a WeChat message was received.

"How's it going on the show?" it was sent by Jojo.

"It felt okay, the host said my suit was very good. Liu Banxia replied.

"Look, I picked it, it's fine. After Qiao Qiao replied, he also sent a very arrogant and laughing emoji.

Liu Banxia is happy, this girl is sometimes a little naughty.

But from the bottom of his heart, he really felt that he owed Qiaoqiao. Now I look forward to stepping down as the general manager of the hospital, so that at least I can have more time to play with Qiaoqiao.

"Teacher Liu, Teacher Wei called you for a consultation. At this time, Huang Bo walked in.

"Okay, I'll go. What's the situation?" Liu Banxia responded.

"The 43-year-old female patient was in a coma while awaiting treatment. Blood pressure 104/86, heart rate 72. ECG is normal, blood tests are normal. Huang Bo said quickly.

Liu Banxia frowned, it seemed that this patient's situation was a little complicated.

"How's the situation?" asked Liu Banxia after coming to the side of the consultation bed.

"The blood test and urine test are all normal, and liver failure, diabetic acid-ketosis and alcohol poisoning have been ruled out, and now some people don't know what to do. Wang Huan, who was also here, said.

"What's the scar on her face, could it be caused by trauma?" Liu Banxia asked.

"The patient's family said that he was injured in a car accident while riding an electric car the year before last, and that metal was implanted. However, both Dr. Wang and I feel that the current coma is not directly related to the implanted injury. Wei Yuan said.

"You help determine if it's the brain or the abdomen, and the abdominal ultrasound doesn't show any problems. Her friend also said that it was normal to see him when he went to work in the morning, and said that he was a little uncomfortable in the afternoon. ”

"I don't have any good ideas, so I can only investigate slowly. Liu Banxia said with a wry smile.

"Both of you are here, and the physical examination must have found nothing unusual. The brain, the neck, the spine, the chest, the abdomen, the pelvis, one by one?"

It's a little helpless to say this, and there really isn't much to do in the face of such a patient. You have to check them from top to bottom.

"We think the same way, but this kind of examination may deepen the conflict with the patient's family. Now I'm very emotional, and if more than two tests haven't been confirmed, it's hard to continue doing it. Wei Yuan said.

Liu Banxia understood why he called himself over.

The normal order of inspection is known, and it is checked one by one from top to bottom. However, if you do too many tests, it may involve over-medical treatment.

Now the discussion of this matter is still so intense, so they both have to be cautious.

"What do you think is more likely to cause the disease?" asked Liu Banxia.

"We were thinking about tumors, so we planned to do a combined CT of the chest and abdomen first. However, the second test is difficult to determine, whether it is to examine the spine or the head, or the pelvis. Wang Huan said.

Liu Banxia grinned, "If you don't think about me, you will throw this hot potato for me." Thoracoabdominal and pelvic bars, considering that it is a female patient? There is also a high chance of pelvic problems. ”

“OK? Then it was decided. The diagnosis is out, and I'll add you vegetables in the evening. Wei Yuan nodded.

"Gotta add good dishes. Liu Banxia said.

Call yourself over to help make a decision? It's not that these two are timid and afraid of receiving complaints. Do you want one more person to refer to? Able to avoid possible medical disputes in advance.

Especially now that patients are still in this condition, after a time-consuming and expensive examination? The cause of the disease has still not been found, and the family members of the family have to be anxious.

"How was today's interview?" Wei Yuan asked curiously.

"I can only say that it puts a lot of pressure on me. Liu Banxia said.

"The environment is comfortable? The opening is warm? But the questions asked by the moderator are still very poignant. After this interview, I decided that I would never be on TV again. ”

"Caused such a big psychological shadow?" Wei Yuan said with a smile.

"But isn't it, I'm worried that I'll say something bad. That's going to be broadcast, not like the two of us chattering like we are now. Liu Banxia said.

"Nothing, I'll go back first? There's also a stack of cases and discharge documents to sign. Worried? If I had 48 hours in the day, at least I wouldn't be so tired. ”

"Boil, that's how we got through it back then. It's just that there weren't as many emergency patients as there are now, and you're young anyway. Wei Yuan quipped.

Liu Banxia, who returned to the office, continued to work, and now there are more patients in the emergency center? Coming and going, each one has to be looked at.

But his mind can't be completely still? I'm still thinking about the patient just now. You have to think about it in advance, if there is no problem with the chest, abdomen and pelvis? You have to talk to the patient's family about the next test.

Judging by the patient's clothing, it is not a wealthy family. If only the rich could do it? They don't care how much money is spent on inspections? I'm afraid you'll be less examined.

Not very productive today? There are so many things on my mind.

was busy, Wang Huan walked in, "The chest and abdomen CT examination is normal, and now I am doing pelvis." ”

Liu Banxia grinned, "It's really going to the most difficult situation, and then wait." ”

"Didi...... Didi Di ......"

Before Liu Banxia could continue, the alarm in the emergency center went off.

Wang Huan and Liu Banxia didn't think much about it, and ran out directly, which was an alarm that a certain patient had a high-risk situation.

"What's the situation?" asked Liu Banxia after coming outside.

"7 beds, there was an eight-year-old with respiratory failure. Zhou Li, who was running over, said.

"It's been a day. Liu Banxia muttered, and ran directly to the edge of bed 7.

"Oxygen, 10 units of etomidate, 50 units of skolin, intubation. Chen Hongyang, who was guarding the bedside, said.

"Intubation is complete, blood oxygen 86. Liu Man, an intern in the Department of Pediatrics, reported after the intubation.

"1/100,000 nitric oxide inhalation treatment, sent to the emergency room for chest X-ray. Chen Hongyang said.

Liu Banxia gave up his position and asked the nurses to push the gurney to the emergency room.

Chen Hongyang frowned, "The patient is 8 years old, with high fever and cough. The medical history is about a week, I have taken cold medicine at home, the effect is not good, after auscultation, it is judged that there is a slight pneumonia, and antibiotic treatment is given. ”

"The child is in poor health and has a history of allergies. In addition, in the previous allergen test, the test result was that there were multiple allergies, and there were many allergens. ”

"About 27 minutes after the infusion, respiratory failure. An allergic reaction to the drug has been ruled out, and if the blood oxygen still can't be raised, I plan to go to the extracorporeal membrane lung. ”

Although the previous matter can be regarded as a revelation, he doesn't want to report to Liu Banxia, after all, the level of the two is much different.

It's just that for this little patient, he doesn't have much bottom in his heart. If the blood oxygen can't be raised, the little patient will have a big problem.

"Is it such a severe allergic reaction? Then his usual life must have been very hard. Liu Banxia frowned and said.

"Usually his parents do a good job of protecting him, and he will have his own special dishes and chopsticks. He is also rarely allowed to go out, which is to reduce allergic reactions. Chen Hongyang said.

"Let's see how the effect of intubation and nitric oxide is, if you go to the extracorporeal membrane lung, it will not only incur a lot of costs, but also have a great hindrance in the later treatment. Liu Banxia said.

Chen Hongyang didn't speak, and he agreed in his heart.

Otherwise, he wouldn't talk to Liu Banxia about this, but the child's blood oxygen is very problematic, and this is also a situation that needs to be solved at present.

"Teacher Chen, nitric oxide didn't work, the child's blood oxygen did not rise, and the child had a rash on his arm. At this time, Liu Man walked out of the rescue room.

"Let's prepare the extracorporeal membrane lung machine. Chen Hongyang said.

Liu Banxia frowned slightly, although he knew that Chen Hongyang was also good to the child, but it was still a bit hasty to make a decision so early. In particular, the child has a rash on his arm, which is a new symptom, is it an allergy to hospital bed sheets and the like?

As the nurses began to prepare the extracorporeal membrane lung machine, he followed him into the emergency room and carefully examined the rash on the little patient's arm.

"Dr. Chen, do you think this patient will have hypertrophic hyperplasia? Liu Banxia said.

"I observed that the child also had two rashes on the other arm and one on the left leg. If it's some kind of allergic reaction, in an environment like a hospital, it should be systemic, right?"

"But when I looked at the child's head, I didn't find any rash. I think it's because the child has mastocytosis, so he secretes a lot of histamine in his body, which causes the current reaction. ”

"If you use extracorporeal membrane lungs and let your blood flow through the machine, you can go into anaphylactic shock. The inflammation he now shows in his lungs may not be caused by an infection, but rather a collection of mast cells. ”

"Is that what you can tell by these rashes? The child's blood oxygen has now dropped to 84. Chen Hongyang frowned and said.

"But compared to the child's life, I think I should try something else. For example, will PLV improve the child's current absorption effect?" Liu Banxia said.

Listening to the conversation between the two, even though the nurses on the side had prepared the extracorporeal membrane lung machine, they didn't dare to ask whether they should use it or not.

This is the case now, the two doctors have a difference of opinion, and they are both very powerful doctors. One is the deputy chief physician of the Department of Pediatrics, and the other is the chief inpatient.

Even if their ranks are much worse, in terms of the rights of the emergency center, Liu Banxia is slightly higher than Chen Hongyang.