"Liu Yiqing, how do you feel when you look at this chest X-ray?" asked Liu Banxia after the patient left.

"I also think that his pneumonia is not simple, especially the inflammation of the right lung. Liu Yiqing said.

"yes, the manifestations of lung inflammation are so different now. So light on the left, so severe on the right. It's only been three days since today? He must have been taking antibiotics at home at the same time as cold medicine. Liu Banxia said.

"If it's not a tricky germ, you can notify the laboratory and do a blood culture for the patient. Remind me when the patient comes back in a while, and then give me a talk. ”

"Teacher Liu, is it so serious?" asked Liu Yiqing curiously.

"There's nothing wrong with being careful. Where is the lung inflammation caused by a normal cold so bad? Anyway, I haven't seen it. Liu Banxia said.

"How was the child yesterday? I asked the nurse about it, and the nurse said that the parents were much more emotional after talking to you. It seems that you are leading the way in communicating with the patient's family. ”

"Teacher Liu, are you ...... , don't you want to ask me what?" Liu Yiqing asked after a slight hesitation.

"What do I ask? I don't have anything to ask. That's right, there really is. Have you thought about it? Will you stay in the second hospital in the future? I haven't gotten your vote yet, scratching my heart. Liu Banxia asked.

"Hmm...... , Mr. Liu, I want to stay in the Second Hospital. Will I be able to learn from you all the time after I stay?" asked Liu Yiqing.

Liu Banxia nodded, "I'm sure I'll be nailed to death in the emergency center, but I can't talk about learning." In fact, let's say it's teaching, it's more of a kind of discussion and exchange of medical skills. ”

"Your foundation is not bad, but you have experienced a little less than me. Now you have put a lot of pressure on Wang Chao, haven't you seen that this old boy has been so active recently. ”

"As long as you can put your heart down and eliminate external interference as much as possible, I don't think your achievements will be bad in the future. To have a brain, to have a hand, to have an attitude, to have an attitude, are all born to be a surgeon. ”

"Then I'll stay, I'm going to study hard. Liu Yiqing said.

"Success, fool a hardcore subordinate. Liu Banxia made a triumphant gesture.

Liu Yiqing was amused for a moment, and then his expression became serious again, "Teacher Liu......"

Liu Banxia waved his hand, "The patients who took the film are coming back one after another, you take the treatment, and I supervise." ”

"Oh......" Liu Yiqing responded, and obediently sat down in the position vacated by Liu Banxia.

I was connected to the clinic just now, and now the results of the filming will come out one after another. The symptoms of these patients in the back were not very serious, so it was just right for Liu Yiqing to come.

And he can also guess what Liu Yiqing is going to say, which should have something to do with what happened yesterday. But this matter is private, and he will not listen to it until Liu Yiqing thinks about it and then wants to say it.

Girls are often very emotional, although they are not much older than her, but in the hearts of these interns, they are also serious teachers.

The condition of these patients who came back one after another is indeed not very serious, and Liu Yiqing is also holding a handle in this regard. With Liu Banxia supervising on the side, the prescriptions she gave can also be used.

When the last patient was sent away, Liu Banxia gave her a thumbs up, and appropriate encouragement was still needed.

"Mr. Liu, you can eat first. At this time, Xu Hui walked in from outside.

"Liu Yiqing, let them eat first, I have to wait for the CT of the patient just now. Brother Hui, don't be in a hurry to leave for a while, stay and consult with me. Liu Banxia said.

"Is the situation serious?" asked Xu Hui.

Liu Banxia nodded, "The chest X-ray is here, and the body temperature is a little high." ”

Xu Hui leaned over and looked at the chest X-ray that Liu Banxia had reinserted, and frowned, "It's true that the infection is a bit serious, come back and call me later, I still have two patients." ”

Liu Banxia followed Xu Hui out of the consultation room, and he had to see if there was anything that needed to be dealt with outside. It's also very good, there are no complications.

It has to be said that the people in the emergency center have also been trained now, and if it is not a large-scale emergency accident, as long as it is not very short of manpower, he will generally not be called.

It's not the same as when the emergency center was first established, and at that time he was basically a presence that was often called. Everyone has experienced too little, and they don't have enough confidence.

After a little more waiting, the patient returned. Liu Banxia frowned, his symptoms should have become more serious, and now the frequency of panting is very high, which means that his breathlessness has worsened.

"Liu Yiqing, take your temperature again, and I'll auscultate again. Before the patient could speak, Liu Banxia spoke directly.

The patient was stunned, but sat down on the bed.

"Teacher Liu, your body temperature has risen to 39.4 degrees Celsius. After sweeping it with the temperature gun, Liu Yiqing's tone was a little higher.

Liu Banxia, who was auscultating, also frowned, but didn't say anything, but inserted the patient's CT film into the viewing lamp.

The CT film was seen more clearly, which made Liu Banxia's brows furrow even tighter. Then he took out the patient's chest x-ray and put it on as well.

It was evident that in the morning, the patient's lung infection had worsened.

"Your pneumonia is so bad that we're going to have to put you in the hospital. Liu Banxia looked at the patient.

"Give me some fever medicine, now I really can't stand the fever, and my head hurts a little. The patient said.

"Liu Yiqing, sputum culture, and then do a coagulation test. Tell them to hurry up, and then call Dr. Xu Hui to come over. Liu Banxia said.

"Doctor, am I serious?" The patient also felt that something was wrong.

Liu Banxia nodded, "It's not just very serious, it's already very serious." By the way, how did you pee yesterday and today?"

"I have a fever, and I don't go to the toilet much. The patient said with a wry smile.

Liu Banxia pinched his eyebrows, and the patient's words confirmed his guess even more.

"Mr. Liu, is the film coming out?" At this time, Xu Hui walked over.

"The one on the left is the CT that was just taken, and the one on the right is the chest X-ray that was taken in the morning. The patient has a body temperature of 39.4 degrees Celsius, a blood pressure of 55100, and a heart rate that I did not measure carefully, but it is estimated to be over 110. Less urine. Liu Banxia said in a deep voice.

"What about the others?" asked Xu Hui.

"I also did blood culture and phlegm culture. Liu Banxia said.

"I agree with you, let's send it to the ICU first. Xu Hui nodded.

"What, doctor, what's wrong with me?" the patient became agitated, and his breathing became more laborious.

"Although the results of the examination are not yet available, we now suspect that the infection caused by your pneumonia has been complicated by sepsis. Liu Banxia said.

"You can't be cared for properly in the rest of the wards, and you need to contact your family. Isn't that scaring you into seeing how quickly your condition progresses? ”

"The tetralogy of sepsis is high fever, increased heart rate, increased respiratory rate, and elevated peripheral blood white blood cells. If we don't adjust in time, the next step is septic shock and organ failure. ”

"Your heart sound is not very good now, and your blood pressure is still so low, so my heart has been affected a bit. I'm really not trying to scare you, just go straight to the ICU to be on the safe side. ”

"I ...... I'll get in touch with my family first. The patient said nervously, and his hands holding the phone were a little trembling.

Liu Banxia raised his arm and wiped his head, and he was in a hurry just now.

Sepsis is really terrible, not only is it easy to confuse at the beginning of the disease, but the disease progresses rapidly and the mortality rate is very high.

According to the current situation, this patient should have developed the second stage of sepsis, severe sepsis. Because there were already manifestations of low blood pressure, it was just that Liu Banxia didn't dare to explain these details to the patient just now.

The next stage, as he described, was shock, multiple organ failure, and death.

There is not much time left for them, because sepsis is caused by an infection of the lungs, and if you want to treat this disease, you need to determine what bacteria are causing it, and then see what drugs the bacteria are sensitive to, so you can treat the symptoms.

And there are really too many germs that can cause sepsis, bacteria, fungi, viruses, parasites, etc. And most of the common infectious diseases are pneumonia, peritonitis, cholangitis, cellulitis and so on.

Otherwise, why does the emergency department pay so much attention to patients with acute abdominal pain? It is afraid of complication with peritonitis, which will lead to a series of diseases.

It took more than five minutes for the patient to communicate with his family. Now the patient is sitting paralyzed on the bed, and there is not much strength in his body.

This is the fear of unknown diseases, even if Liu Banxia did not describe it in detail, can the people who go to the ICU be ordinary diseases?

"Sepsis?" asked Su Hongbo with a frown after sending the patient to the ICU.

He is a doctor in the ICU, and he is most afraid of encountering such patients.

Because such a patient will make you powerful, as long as you can't detect what the specific infection bacteria are, you can only use broad-spectrum antibiotics, and the effect is not very good.

"I've got the lab expedited and hopefully make it until tomorrow afternoon or evening. Liu Banxia said.

"And I have also obtained the permission of the patient, and the ventilator and extracorporeal membrane lung can be used directly when needed, and the family is also rushing over. ”

Su Hongbo nodded, "Okay." ”

This is the instruction of all-out treatment, and with this, he has more confidence. Because according to his experience, he will have to go to the extracorporeal membrane lung tonight.

Now that my breathing is already so bad, how long can I hold on?

This is the terrible thing about sepsis, it is easy to misdiagnose and it is very easy to confuse it with a cold. By the time you find out, there is already a certain course of disease.