276 patients with hypotensive abdominal pain
Last night was a truly quiet night, and there wasn't even a single drunk patient. It was still a little cloudy, but it cleared up in the morning.
took out his mobile phone and glanced at it, but Qiao Qiao hadn't replied, so he had to send another message, "Hurry up and pick up the car, I can't afford to sell it if I have a scrap." ”
"Waiting, busy. ”
This time, Jojo replied quickly, followed by a short video. Jelly Bean's tail wagged like a hot wheel, and Yoyoda slipped in front of Jojo.
Think of Jelly Bean's heroic posture of chasing free running, and then think about the way Jojo chased after him, it seems to be quite cola.
Don't bother her yet, although Jelly Bean is very well-behaved, it's at home. When you go out for a walk, it's playtime, and you have to run happily.
At this time, if you send another message or something, maybe Jojo can let Jelly Bean go and kill himself in the hospital.
I had breakfast first, and then I took the time to send the materials I wrote yesterday to Sun Changhe, assistant to the dean. The assistant to the dean is also a really busy person.
Back in the emergency department, he seized all the time to read books.
After talking with Zhou Shuwen last night, he saw the direction of the future more clearly. It's just that the honor value is a little difficult to mix now, so I can only use all the time.
"Mr. Liu, some drunk patients came. At this time, Wang Chao shouted.
Liu Banxia looked up, good guy, there are more than a dozen people in this wave, all of whom are supporting each other. Looking at the time, it's not yet nine o'clock in the morning, and these guys are very strong in combat.
"Let's work hard, prepare the spare pots and buckets, and we will have to boil for the rest of the time. Liu Banxia commanded helplessly.
"Why? And they're too much, do they start drinking early in the morning?" asked Liang Xiaolin curiously.
"Isn't it the beginning of the school year, it's just that the new students haven't come yet. These seem to be students who have just finished military training, so don't be offended, just relax. Liu Banxia said.
"It's all young people, and when they drink, they fight together. I don't know what time I drank this meal, I had a hangover, and I was afraid that something would happen, so I came to the hospital. It's okay, you can be regarded as a good young man with culture and knowledge. ”
Liang Xiaolin rolled her eyes when she heard his complaint, such a scene can be encountered in the emergency department. And judging by the way this gang looks, it really wasn't sure when this meal was drunk last night.
However, this group is much easier to deal with than those who have just been drunk, and they are just unwell after a hangover. It doesn't throw up everywhere like other drunk patients.
It's just that a few of them also have to be treated with infusions, and all of them have symptoms of mild alcohol poisoning. Young people, they don't know moderation.
"Morita, it seems that the recent medical consumables are not as good as before. Especially the disposable infusion tube, the workmanship is obviously not as good as before. At this time, Wang Ying walked over.
Liu Banxia took the infusion tube and looked at it, as if it was indeed the case. The plastic bag in the outer packaging has become a little thin, and the workmanship of the control valve looks a little rough.
"Let's record it first, and I'll react to the hospital later. Aren't these consumables and gloves also supplied to us by the Taizheng Group?" asked Liu Banxia.
"Yes, it's always been good before, but this batch was just delivered. You just look at these packaging, as long as you are a little careless when you take them, they may be scratched. Wang Ying said.
"I just counted three of the boxes that were broken and unusable. There is nothing wrong with the needle, but the tube is soft. ”
"Cheng, I'll react. Recently, there are many people who come for infusion, and many freshmen report that they are not accustomed to the soil and water, and they have to come for infusion. Liu Banxia nodded.
"Doctor, doctor, my classmate fainted. ”
At this time, someone in the infusion area not far away shouted.
Liu Banxia hurriedly ran over, "Zhou Qianlian monitor, get off the shaker, and let the patient lie down." ”
After finishing speaking, Liu Banxia picked up a flashlight to check the patient's pupil reaction, which somewhat reassured him that there was no major problem. He carefully checked the patient's pulse and breathing, auscultated the heart, and frowned slightly.
After flattening, the breathing gradually became smoother, the pulse became stronger, and then the symptoms of fainting seemed to be fainting caused by low blood pressure.
"Dr. Liu, the patient's blood pressure is 70/90 and his heart rate is 100. Zhou Qian, who connected the monitor, said.
Liu Banxia nodded, and picked up the medical record book hanging on the bedside.
The patient was admitted to the hospital with abdominal pain, diarrhoea, and sweating, with a blood pressure of 90/120 and a temperature of 38.3 degrees Celsius. No past medical history, history of allergies.
There was a crackle in the lungs, a dry cough, and a slightly higher number of white blood cells in the blood test, and the diagnosis was pneumonia, and now the infusion is azithromycin. Receptionist, Qi Wentao.
"What's wrong with the patient?" At this time, Qi Wentao also walked over.
"The patient has just fainted, and I suspect it is caused by low blood pressure. Now my blood pressure is much lower than when I went to the doctor, have you checked the electrolytes?" asked Liu Banxia.
Qi Wentao shook his head, "Although I have diarrhea symptoms, but the diarrhea is no longer there after eating Enteritis Ling last night." When he went to bed yesterday afternoon, he slept with the air conditioner on. Then I woke up from freezing, so I judged it to be pneumonia. ”
"Zhou Qian, let's do a blood biochemistry again, hurry, send me a message directly when the results come out, this low blood pressure is obviously a little abnormal. Liu Banxia said.
"Doctor, is he alright?" asked the guy who was with the bed.
"I'll have to take another look, but I should be able to wake up in a moment. Did he have any other symptoms, when did he start to feel uncomfortable?" Liu Banxia said.
"I woke up in the morning and saw him on the couch, it was a bit hot, and then I brought him to the hospital. Something else uncomfortable...... , as if there is none. The guy said.
"Let's take a look at the latest test results first, his physique is quite burly, and this blood pressure is a little abnormal for him. Liu Banxia said.
"Usually he has always had a good physique, we are all from the sports institute, and we usually exercise and exercise a lot. The guy said.
Liu Banxia looked at the little medicine left in the infusion bag again, it should not be azithromycin caused by hypotension. Although this is also one of the adverse reactions, it has been lost for so long, and if there was a reaction, it would have been a long time ago, and it would not have waited until now.
"Doctor, he won't wake up, will he?" the young man asked worriedly.
"No, although his vital signs are a little low, they are very stable, and we will wait for the results of new blood tests. Liu Banxia comforted.
The patient is now in stable condition and he no longer needs to be given first aid. It should be fainting caused by low blood pressure, and now the blood pressure is controllable, and the patient can wait for it to recover on its own.
"Why didn't you think about taking a urine test for the patient?" asked Liu Banxia after coming to the side.
"I see that the indications for pneumonia are very clear in the patient. Qi Wentao said.
Liu Banxia didn't say anything more, and this was not Qi Wentao's absolute fault. Among the symptoms that did manifest themselves, except for abdominal pain and diarrhea, which were not consistent with pneumonia, everything else was consistent.
However, the patient's low blood pressure, coupled with abdominal pain and diarrhea, is really problematic.
Mission: Hypotensive fainting patient
Open-ended task: The patient suddenly faints with hypotension after infusion, and the host needs to find out the cause, and the task reward is issued according to the diagnosis results
"You take on another patient first, I'll take this patient. After thinking about it for a while, Liu Banxia said.
Qi Wentao glanced at him and didn't say anything.
This is the second time that Liu Banxia has taken over the patients he has received in a row, which makes him very uncomfortable. Even yesterday he didn't think he had anything to do with his treatment, and what did the nurse have to do with him as a surgeon if he couldn't do his job?
But Liu Banxia was hospitalized after all, and the patient just fainted again. Now I can determine that it is not caused by infusion, so it has nothing to do with me.
"You are all students of the Sports Academy, how old are you?" Liu Banxia came back again.
"It's my junior year at the beginning of school, and the two of us came back two days early to clean up the house. He came back yesterday and was fine when he came back. The young man said.
"Doctor, do you want to contact the school now? He won't be in danger of his life, right? He was talking to me just now, why did he faint and still not wake up. ”
"You take it safe first, and when the blood test results come out, we'll figure out what's going on. Liu Banxia comforted.
"He came back yesterday and was fine, what did you eat in the evening? He is showing some mixed symptoms now, and I am wondering if there is another cause for the fever. ”
"I didn't eat anything, so I went to the noodle restaurant on the edge of the community to eat two bowls of noodles, ordered fried peanuts and cucumbers, and drank a bottle of beer. The guy said.
"Then we were a little hungry during the night, so we ate some fruit and snacks together. At that time, he was fine, and when he got up in the morning, he lay on the sofa, saying that he had diarrhea. ”
Liu Banxia nodded, it seems that there is no problem with food, otherwise this young man would not be alive now.
But now he has to wait, wait for the latest blood test results to come out, it is impossible that there is no condition, he really thought he had eaten something wrong just now.
After waiting for a while, the patient had not yet woken up, but Liu Banxia's phone rang.
"Hello, I'm Liu Banxia. After connecting, Liu Banxia said.
"Dr. Liu, I'm Zhou Qian, just now this patient's blood potassium concentration reached 5.6, and the blood pH value also reached 7.1. Zhou Qian's voice was a little urgent.
"Damn. 5% sodium bicarbonate 250 ml, fast. ”
Liu Banxia couldn't help but burst into foul language.
He didn't expect that the patient would have symptoms of kidney failure and acidosis, and it was found in time, otherwise this young man's life would have been confessed here.
Even now he wasn't sure what would happen to the young man, because the cause had not yet been identified.