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The patient with sepsis was still more concerned with Liu Banxia's mind, and after breakfast the next day, he came to the ICU of the emergency department.

"Last night I had a new CT scan of my lungs, and the right side of my lung was completely white. Su Hongbo said.

"The development is much faster than we expected, and I just finished communicating with my family and got on the membrane lung machine. Tell the lab to do it, quickly isolate the infectious bacteria, and find out the sensitive drugs. ”

"At present, there are manifestations of heart failure, liver failure, and kidney failure, although we have tried to adjust it with drugs, but the effect is not very obvious. ”

Liu Banxia frowned, even if this was the expected development of the course of the disease, but it developed too quickly.

"Thank you for your hard work, try to maintain the patient's vital signs as much as possible, and buy some more time. Liu Banxia said.

Su Hongbo nodded, "This is natural, and if you go to the extracorporeal membrane lung, you will be able to buy more time." Hopefully it's a regular strain, or it's too dangerous. ”

"And your cirrhosis patient, who has been getting worse since yesterday afternoon. Tomorrow you will discuss with the family whether to go to the ICU or to the general ward. ”

"Deteriorating so quickly?" asked Liu Banxia in surprise.

"His cirrhosis was already severe, and this laceration was even worse. The body is also a little poor, and the estimated time you gave at the beginning is not bad. It's just that that's the ideal situation, and it's just a normal development now. Su Hongbo said.

"Okay, I'll talk to the patient's family in a moment. Liu Banxia looked helpless.

Transferring to a general ward is actually waiting to die, and you don't need to waste so much money in the ICU ward. It can also set aside one last time for the family, even if it makes people worry more.

His situation is different from that of this patient with sepsis, who only needs to isolate the infected bacteria and find sensitive drugs, and the symptomatic treatment will have an immediate effect.

What about him? He can only change his liver.

That's the essential difference.

"Teacher Liu, why don't I go and talk to the patient's family. Liu Yiqing, who was following Liu Banxia, spoke.

"Can you hold on?" asked Liu Banxia.

Liu Yiqing nodded, his eyes were very firm.

"Okay, then you can contact you, I'll leave it to you. Liu Banxia glanced at her and gave permission.

This kind of communication is a difficult thing, and even doctors who have been practicing medicine for many years can have a headache when facing it.

"Mr. Liu, Dr. Chen of the Department of Pediatrics called you to come for a consultation. As soon as she returned to the emergency center, Zhou Qian greeted her.

"Okay, let them call me if there's something here, I'll take a look at the pediatrics first. Liu Banxia responded.

The heart is also heavy, and it must be another complicated case. Even if the relationship with Chen Hongyang has been repaired, ordinary illnesses will not call themselves for consultation.

"Dr. Chen, I'm here. After finding Chen Hongyang, Liu Banxia said.

"The case was complicated, a 9-year-old boy who came to the hospital with a nosebleed in the afternoon. He has a history of nosebleeds, abdominal pain, breathing pain, and insomnia. Chen Hongyang said.

"After receiving the consultation, it was found that the child was bleeding nonstop, and after burning to stop the bleeding, it was found that the child's nasal mucosa was a little thin. After inquiry, I learned that I had used fluticasone propionate because of the symptoms of dyspnea, which should be the main cause of the thinning of the nasal mucosa. ”

It was at this time that the condition changed, and the child coughed violently and coughed up blood. Although I thought it was caused by nasal bleeding and reflux, I still took a chest X-ray of the child. ”

"The results shown in the film showed no inflammation, and no symptoms of pulmonary embolism and cystic fibrosis were found. Now the child's body temperature is somewhat elevated and it is difficult to breathe. ”

"Have you had an abdominal cavity and heart examination, have you also done a bronchoscopy?" asked Liu Banxia.

"The abdominal cavity was examined, everything was normal, and the cardiac auscultation was normal. I also did a bronchoscopy, and it was because I didn't see any bleeding spots that I took an X-ray. Chen Hongyang said.

"The blood test results showed that the white blood cell index was slightly high, and there should still be some inflammation. Otherwise, I wouldn't have had difficulty breathing, but I don't know exactly what caused this inflammation. ”

"Dr. Meng, the child's body temperature has risen again, it is now 39.2, and the blood oxygen has also dropped to 95. Then the nurse came running.

Chen Hongyang hurriedly ran to the hospital bed, and Liu Banxia followed behind.

"Doctor, I just coughed again. But this time there was no blood, but it was more difficult to breathe. The child's mother said.

"I'll take a look first. After Chen Hongyang finished speaking, he began to auscultate the child.

Liu Banxia picked up the film at the head of the bed and plugged it into the viewing lamp to watch it.

The film is very clean, indicating that everything is normal in the lungs, without any inflammation.

Ding!Quest posted: Kids with breathless problems

Open-ended task: At the invitation of the pediatric Chen Hongyang, the child still had dyspnea and deteriorated condition despite the absence of lung inflammation on chest X-ray, and needed further diagnosis. Task rewards will be awarded based on the diagnosis results

"If you give oxygen first, your body temperature will rise and your blood oxygen will decrease, which is not a good phenomenon. I gave Tylenol and gave me a CT, and I had to check it if I didn't want to do more. Chen Hongyang, who had finished the order, came over.

Liu Banxia nodded, "It's so clean to look at from this film." I wondered if it could be caused by some lesions in the abdominal cavity?"

"Add a laparoscan CT, the child's body temperature rises so quickly, I always feel that the disease is very dangerous. The child has a history of abdominal pain, right? Could it be carcinoid?"

Chen Hongyang frowned, "Your consideration is not unreasonable, but the child is currently only showing high fever, difficulty breathing, and a history of abdominal pain." The skin color is currently normal, and there is no abdominal and chest pain. ”

"And the child had a history of breathing pain, so I personally still tend to have a problem with the lungs or bronchi in the chest. Wait and see, wait for the chest CT scan to be done?"

Liu Banxia nodded, "I just thought of it by chance, the cases I have been in contact with in the past two days are very complicated, and this idea just now is almost the same as a dead horse being a live horse doctor." ”

"Hey...... , you think about it quite reliably, and you also have consistent symptoms. However, we have a great deal of difficulty in receiving pediatric treatments, and the more instrumental tests we do, the stronger the parents' backlash will be. Chen Hongyang said with a wry smile.

"They felt that every examination was a harm to the child, and they originally planned to take a CT scan directly, but at that time there were too many people waiting to take it, so they changed it to an X-ray. ”

Liu Banxia understands this very well, if the child's parents suffer such a crime, they may not care very much. But when it comes to the children, it's a big deal.

The mood will become very urgent, so you must be very cautious when opening the examination.

Just now he himself forgot to take into account this stubble, and then cooperate with his parents, if you check out the thirteen tricks and are not diagnosed, the outbreak at that time will be even more terrifying.

To paraphrase a popular saying, if you are given so much trust, you can do whatever you want, and you can't diagnose it, delaying the child's condition, you are a betrayal.

"Do you think we're making a big fuss? What if it's a nasal problem?" Chen Hongyang said suddenly.

"What if the child has poor articulation skills, and when he says pain in breath, he doesn't mean the respiratory tract but the nasal cavity?

"No, this shouldn't be possible. The child only showed signs of poor breathing, and did not have symptoms of runny nose or head discomfort. If you have sinusitis, you will have this kind of manifestation. ”

Liu Banxia patted him on the shoulder, "Let's wait for the CT results, I'm more inclined to your judgment." Didn't I come into contact with a small patient with sinus polyps before, and there was a joke that made me, and I felt that the performance was very different from the little patient just now. ”

He knew that Chen Hongyang was really in a hurry, so he behaved a little out of shape. That's the pressure of working in pediatrics, and it's the kind that accompanies you all the time.

Liu Banxia didn't leave in a hurry, at present, this little patient needs to be diagnosed and treated, so he is here to wait for the CT film to come out.

"Mr. Liu, I have finished communicating with the patient's family. They said they had to think about it, and it was a bad decision. At this time, Liu Yiqing came over.

"Okay, then don't go yet, there is a small patient here whose situation is a little complicated, you can look through the case yourself. Liu Banxia said casually.

"Is this going to focus on cultivation?" asked Chen Hongyang.

"They all have to be trained well, and they will be sent to the ICU and pediatric rotation later, what's going on?" Liu Banxia said.

"That relationship is good, I'm not afraid of more helpers here. Chen Hongyang said.

"Especially for us pediatricians, in fact, a lot of times we do both internal and external work. There is indeed a need for some outstanding people, and there will be more pediatric patients in the future, and we also need personnel to supplement it. ”

"Take your time, there is only a limit to the support we can give now. The biggest principle is to keep excellent interns. Liu Banxia said.

"At present, the batch of interns in our emergency center are all personally selected by the dean, and their foundation is not bad. The next wave is not sure what will happen, and it is impossible to enjoy such a high standard of preferential treatment every time. ”

"It's difficult, who wants to do it as a pediatrician?" Chen Hongyang said with a wry smile.

Liu Banxia grinned, it was the same thing. Otherwise, there would be no shortage of pediatricians all over the country, and the work here is not only tiring, but also an ordeal.

To take care of the children, but also to deal with the children's parents and elders, that heart is more than a burden.

After waiting for a while, the child's CT film was taken, and Chen Hongyang clicked on it directly on the computer.

The CT film was also very clean, and there was no sign of inflammation at all, which made the two of them even more worried.

Unless, as Liu Banxia said, take an abdominal CT to see if there is a carcinoid tumor. However, the current indications are not obvious enough, will the re-shooting have broken through the bottom line in the hearts of the child's parents?