(Thanks to my friend Eternal Holy Emperor for his encouragement, thank you for my friend's empty, lonely, cold 671112, and stone's mood for encouragement)

"Liang Xiaolin pays attention to protecting the airway and tongue, Xu Dan 1 unit lorazepam. Liu Banxia, who was quick-eyed, hugged Han Miao, put him on the hospital bed, and lay on his side.

Teacher Song and Xiao Yue were scared, this time Han Miao's seizures were much more intense than in school, and this time Han Miao began to kick her legs.

Xu Dan, who heard the order, hurriedly looked for medicine, and Liang Xiaolin leaned over Han Miao's head.

"Dr. Liu, I'm here to help. Seeing that Liu Banxia was only pressing Han Miao's shoulder, Teacher Song was anxious.

"Don't move, you can't press her legs and arms now, it's easy to dislocate. Observe first to see if the sedative is effective. Liu Banxia hurriedly stopped.

Traditionally, people who encounter epilepsy will choose to hold their arms and legs to avoid injury, but sometimes this will hurt the patient more.

Epilepsy is involuntary, which means that the force cannot be controlled during the convulsions. When controlled, it is true that it will not kick or hit other people or objects, but it is likely to hurt itself.

The most important thing to do is to protect the airway and tongue. Some patients bite their tongue when they clench their teeth, or even bite them off. Some people have epilepsy that foams at the foam, which can also suffocate them.

After waiting for nearly a minute, Han Miao's body finally quieted down. Although he regained consciousness, he was too tired to do it.

"Dr. Liang, make an appointment for CT of the head with contrast. The symptoms of the seizure are similar to those of a cerebral hemorrhage. Liu Banxia said.

"Dr. Liu, she didn't fall on her head. Qiu Mingyuan said.

"It's hard to say yet, let's take a look first. Liu Banxia frowned and said.

In fact, he also had some doubts that if he had a cerebral hemorrhage, the CT scan he had just done could also be scanned. The only possibility is a delayed bleeding, possibly the first seizure that knocked on the head and the students didn't notice.

Now he also denied the judgment he made at the beginning, if it was a primary epilepsy, the reaction would not be so intense, and the seizures would not be so frequent.

"Doctor Liu, do you want someone to come over for a consultation? Xiao Yue spoke.

"It's not yet, and it's not clear if it's the cause of the head. Liu Banxia said.

If he hadn't experienced Uncle Cao, he would really have directly contacted Shenwai or Shennei. Now I have to be a responsible hospitalist, and I can't listen to the wind or rain. Multi-department consultation can only be achieved when the indications are clear, or if the cause cannot be found.

Xiao Yue glanced at him and didn't say anything, she didn't understand these things now.

"Dr. Liu, the blood test results are out. After waiting for a while, Shen Lin sent the blood test results over.

Liu Banxia took it and looked at it, frowning slightly. Judging by the current values, everything is normal. At first, he thought it might be caused by an infection, but the white blood cell count was within the normal range.

Now all we can count on is the enhanced CT scan results.

"Teacher Song, consider contacting her parents now. The condition is unknown, but it could be dangerous if seizures persist. Liu Banxia said.

Teacher Song nodded, "I've already contacted her father just now, and he will come by the nearest flight." Han Miao's grandmother has high blood pressure, and his father said don't tell her grandmother first. ”

"Okay, you're half a guardian anyway. I hope there is nothing wrong with the child, today's situation is a bit tricky. Liu Banxia said.

"Teacher Song, don't worry, Dr. Liu is very powerful. Last time my dad just blinked, Dr. Liu could see that my dad had a blood clot in his head. Qiu Mingyuan comforted.

"Hey...... It's almost noon, you two can eat first, I'll wait here. Teacher Song said.

"Teacher Song, let's wait for Miao Miao's results together. Xiao Yue said.

This time, the results came out quickly, and it was Wu Bo, a diagnostician in the radiology department, who called Liu Banxia directly, and the scan results were still non-abnormal.

Liu Banxia is a little sad, he really has no choice, so he can only call someone to come over for a consultation.

"Guys, I'm out of spells. Blood tests, urine tests, non-contrast CT scans, and contrast, everything is normal. Temperature is normal, auscultation is normal. No headaches, no chest tightness, no family history, you can help with a trick. So far, there have been two seizures. Liu Banxia said.

"Mr. Liu, could it be meningitis?" said Zhang Xiao, the chief treatment of Shenwai.

"Just now I was also thinking about meningitis or endocarditis, which can cause epilepsy. However, if these two diseases reach the level of epilepsy, there will definitely be other external manifestations. Bloomberg, the ruler of God, said.

All the tests are normal, and that's where the most abnormal thing is. Epilepsy is real, and if it is occasional or very infrequently, it can be classified as primary epilepsy.

"Why don't you do a waist puncture check, and then take an X-ray?" Wang Huan said.

"Think about it again, the lumbar puncture is a trauma examination, and the child's guardian is not there. X-rays can be taken, and I am thinking about whether to do a combined CT of the chest and abdomen, but I am worried that the cost of the test is too much, and it is difficult to explain when the parents arrive. Liu Banxia said with a wry smile.

The big guy's face also became bitter, which is indeed a problem.

It is because the indications of this child are very unclear, and if too many instrument tests are done, it is easy to cause disgust and contradictions among parents.

"Doctor Liu, you were the first to receive a consultation, how do you feel? Our doctor says something that is not good, sometimes it is based on experience, and the first feeling is often very important. Wei Yuan asked.

"My first instinct was primary epilepsy, and the second seizure ruled it out. Then I thought it was a cerebral hemorrhage based on the symptoms of her epilepsy, but the contrast-enhanced CT scan also showed normal. Liu Banxia said.

"Doctor Liu, Han Miao has epilepsy again. At this time, Xu Dan ran in.

Liu Banxia didn't hesitate and rushed out directly.

"Dr. Liu, has been injected with a unit of lorazepam, which is not stable and his vital signs are declining. Seeing Liu Banxia coming over, Liang Xiaolin said.

"Push the defibrillator to prevent the patient from ventricular fibrillation. Liu Banxia said.

"Tick ......"

At this time, a long beep came from the monitor.

"Oh no, cardiac arrest. Liang Xiaolin protects the airway, and I will do cardiopulmonary resuscitation. 1 unit of epinephrine. Liu Banxia said and directly started cardiopulmonary resuscitation.

"The defibrillator is coming. Zhou Li shouted.

"Charged, 200 joules. Liu Banxia, who was pressing, said.

"Charging Complete"

"Leave the hand"

"Smack"

"No response, stop jumping for 17 seconds. ”

"300 joules"

"Charging Complete"

"Leave the hand"

"Smack"

"There was a heartbeat, sinus rhythm was restored, blood pressure went up. Liang Xiaolin shouted in surprise.

Liu Banxia handed the defibrillator to Zhou Li, and the whole person almost sat down on the ground. I really didn't expect that epilepsy, which originally seemed to be ordinary, turned out to be life-threatening.

"Doctor Liu, we can't delay any longer, no matter what the test is, do everything you can. Zhang Xiao said.

"Do you think it is a small aneurysm or malformed blood vessel rupture in the head, which causes slow bleeding, so the CT scan and enhancement are not scanned?" asked Liu Banxia.

"Doctor Liu, although there is such a possibility, but the probability of this is very small, right?

"Nope. But the patient fell while running the morning before, and then had a mild seizure during the night. Liu Banxia said.

"Yesterday was nothing, but today the epilepsy is very strong. Now it's the third time, and it also caused cardiac arrest. ”

"We've ruled out a lot of possibilities, and we have to go back to epilepsy itself. My thought was that after the fall, the small aneurysm ruptured due to blood pressure, but the bleeding was small at that time, and it didn't have any effect. ”

"After a day off, the blood vessels that might have stopped bleeding regained re-bleeding because of the pressure of coping with the exam, and the bleeding was aggravated by epilepsy. ”

"But our CT scan didn't come out?" said Kaminai's Bloomberg.

"It's still because the blood vessels are too thin, so they didn't sweep it out. Anyway, we have to do a test, how about a direct angiogram?" asked Liu Banxia.

"We've ruled out a lot of impossibilities, but can we go back to the most appropriate possibility? Even if the amount of microvascular bleeding is large, it will be very troublesome to deal with. ”

Several people glanced at each other, although now they also felt that what Liu Banxia said had no basis, but only said it on the basis of his speculation that there was an aneurysm. However, combined with the current situation, this is also a good choice.

Children are like this now, and if you don't do anything, then the next time you have a seizure, it can really be life-threatening.

"OK, then it's decided. Just do an angiogram, and I went with it. Liu Banxia said.

This can be regarded as a clapper, he is a patient in the emergency department, and he is also the general inpatient of the emergency department, and he has this right.

Angiography is also very different from CT enhancement in that it injects a contrast agent into the blood vessels, because X-rays cannot penetrate the contrast agent, so it can diagnose vascular lesions more clearly.

However, angiography is an invasive test, and there are also many allergic reactions, which can be life-threatening. Liu Banxia's decision is really bold, it is not easy to make this decision, it is still for the sake of the patient.

Zhang Xiao and the others were not in a hurry to leave, and followed in.

As the developer is injected, the image slowly appears on the display. At the top right of the screen, a spot that is not very large looks so dazzling.

Xu Dan's request task is complete

Gain 300 XP and 500 Diagnostics Skill Mastery.

This mission is rated Perfect, gaining 1000 XP points, 500 diagnostic skill proficiency points, and 10 glory points

Liu Banxia let out a sigh, "Although the probability is very small, it really happened." Dr. Zhang, the next thing is your extra-divine life. ”

Zhang Xiao gave a thumbs up, "Serve, I'll prepare the operating room." ”

Zhang Xiao's words also represent everyone's voice, no matter what reason Liu Banxia thought about it at that time, at least it saved the child's life.