Chapter 44: I Know

Fortunately, an hour passed, the hemodialysis was over, and by the time the patient was pushed back, he had regained a little sense of consciousness and the person had woken up, which reassured Charlotte.

Now that the patient was awake and did not need to stay in the emergency room, Charlotte transferred her to the general intensive care unit.

However, the nurse continued to ask the patient to give 10mg of intravenous atropine, because under the powerful effect of hemodialysis, although many poisons in the patient's blood were eliminated, the drugs in the body were also excreted from the body at the same time, so after all, the drugs should be replenished as soon as possible to maintain the efficacy.

After pushing the drug, Charlotte changed the injection of atropine every half hour to once an hour. Now the patient's condition is much better, and the need for drugs to maintain atropine is much lower. If overdosed, atropine poisoning is also a dangerous and troublesome thing.

In this way, after Charlotte's careful medication, two hours later, the patient was finally fully conscious. Charlotte did another careful physical examination, and the breathing sound in both lungs was very thick, but she could no longer hear any noticeable sounds. The heart rate is maintained at 100-120 beats per minute, the diameter of the two pupils is about 2.5 mm, the skin is dry, the face is slightly red, and the person is a little irritable!

I am very satisfied, now the atropineization is maintained very well, and there is no excessive situation, as long as this situation can be maintained for 24 hours, then the patient is basically out of danger! Because the risk of rebound within 24 hours is the highest, and now it cannot be sloppy. The risk of rebound after 24 hours is greatly reduced!

At this time, the patient's husband breathed a sigh of relief and took Charlotte's hand to thank him, but Charlotte didn't dare to be careless and hurriedly reminded him, "Your wife is temporarily stable now, but you still have to take care of it, because the poisoning is so serious, the condition may rebound at any time!

The man hurriedly nodded and agreed: "The doctor has worked hard, I will observe carefully, and I will inform the doctor of your situation immediately!"

Charlotte didn't feel comfortable returning to the office until she listened to the other party's words. Today, he did his best, but it was really hard!

Charlotte returned to the office. She had been busy all day today and hadn't drunk much water, so she poured a cup of hot tea and sat down in her chair, feeling deeply relieved. If it's like this every day, it's too hard!

Charlotte, however, today is not easy. After sitting for less than an hour, the phone rang again: "Dr. Charlotte, please go to the intensive care unit immediately, Dr. Charlotte, please go to the intensive care unit immediately!"

Charlotte was surprised, wasn't she..."Bounce back?"

Charlotte nervously ran to the intensive care unit with a stethoscope and secretly asked herself, is there a problem with the medication?

Charlotte walked into the intensive care unit with a confused attitude. At this time, the patient's husband saw Charlotte coming in and panicked: "Doctor, come and see, my wife is dizzy again, and she can't wake up when she screams." Please help me take a look!"

Charlotte's heart was tight. She searched for the past, holding a flashlight to illuminate her pupils. Now that she's shrunk to about 1mm, she's starting to sweat all over her body again. Gradually, her heart rate began to slow down to about 90 beats per minute.

It really rebounded, Charlotte sighed, and there were at most one or two rebounds in ten cases of pesticide poisoning. This woman is damned, if you don't bounce back, who will?

Carefully put the box in your pocket, and you can reach the gate of the division in a few minutes. I thought, "I don't know where Zhao Tian is at this time! It stands to reason that it should be almost there!"

Soon I saw the gate of the university. Charlotte drove the car to the door cleanly, parked the car in one place, turned off the engine, and then sat in the car and waited for Zhao Tian to come over.

Just a minute later, I suddenly heard two gunshots from the division, followed by screams. Charlotte was stunned and thought to herself, "What's going on!"

After waiting for a while, she suddenly remembered that Cen Yunying and Yan Han were still in school, Charlotte tightened, pushed open the door and ran in, and as soon as she entered the school gate, she saw a group of students from the Normal University screaming and running away.

Seeing this situation, Xia Luo's face sank, and he whispered in his heart: "Min, don't have an accident!"

Atropineization is an important indicator of drug rescue, which is mainly reflected in: (1) the patient's pupils are larger than before, dry mouth and dry skin, flushing of the face, decreased or absent rales in the lungs, and increased heart rate. And only when atropine is achieved can the treatment work, otherwise it will be difficult for the patient to be saved!

Charlotte looked and another bucket was filled with liquid washed out of the patient's stomach. Now the whole bucket is light brown and black, and a strong garlic smell wafts out of it.

Charlotte looked at the bucket full of brown and black things, shook her head, and sighed. Looking at this, the patient drank at least half a bottle of methamidophos, maybe a whole bottle. I really admire her courage for such a terrible thing. You can drink!

After waiting for a few minutes, the patient's sweat subsided a little, but his whole body was still wet. Atropinization seems to be a long way off and needs to be continued with dosing. Charlotte then ordered: "Atropine 5mg intravenous push." Use 20ml of 10% glucose, pralidome 1.0 and push again!"

After the medicine was advanced, I waited for ten minutes and the patient did not sweat visibly. Charlotte took a small flashlight and took a picture of the patient's pupils. Lin Lei's pupils were now much larger than before. It has changed from the tip size to about 1.5mm!

Listen to the lungs again, there are still a lot of sounds in the lungs, but a little less than before! Heart rate is about 86 beats per minute!

In order to achieve atropine, it seems necessary to continue the use of drugs. Charlotte confessed: "Continue to push atropine 5mg intravenously, add 10 glucose 250ml, and pralidoxime 1.0 intravenous drip!"

After that, I looked again, and the liquid in the patient's stomach was flushed out, and now the water in the bucket had begun to take on a light gray color, and it was no longer the brownish-black color. It seemed that a lot of water had finally been washed out, so I asked the nurse who was doing gastric lavage, "How much water did you wash?"

The nurse glanced at the bucket next to her and replied, "There's already a bucket and a half!"

"Hmm... Keep going until the water is completely clear!" the patient's stomach had been washed with nearly two buckets of water. Or this light gray. This woman is really cruel. She even swallowed a bottle and went in!

After pushing atropine three times. The patient's skin finally began to dry, his face flushed, and his pupils returned to about 2mm!

According to this situation, the patient has successfully achieved atropine, then the next drugs can be reduced! And the atropine can be successfully achieved within half an hour, which greatly increases the chance of the patient being saved!

At this time, the gastric lavage nurse also reported: "The liquid has been completely removed!

Charlotte looked at the liquid that had been washed out of the bucket, then nodded and smiled: "Pull out the gastric tube! Then push 2mg of atropine every half hour to observe the changes in vital signs! Notify me immediately if there is anything!"

The nurses nodded in agreement, and Charlotte pushed open the door and went out. There were a lot of people at the door. When Charlotte came out, the man rushed over and nervously asked, "Doctor, how is my wife?"

Charlotte nodded. "It's been stable for a while, but it hasn't woken up yet, so it's still in danger, so we need to keep watching!

He then took the man back to the office, signed a critical illness notice, and then asked the man to accompany him to the emergency room.

After the critical illness notice was signed, Charlotte breathed a sigh of relief. I'm not sure if the patient can be saved. I just look at the current situation, and I hope that the overall is still great!

I just wrote my verbal medical order on the medical record, and wrote the rescue record just now, and then improved the course of the disease record for the first time, and finally solved it temporarily!

I haven't looked at my watch for half an hour. Charlotte went to the emergency room to see a patient. At that time, the patient had not yet woken up, and there were still patches of atropine on her face, but her hands kept groping unconsciously!

Charlotte sighed. At this time, the laboratory has issued a cholinesterase test result, but cholinesterase is only 30% of the normal value.

Seeing that the patient's cholinesterase was so low, Charlotte had no choice but to explain to the nurse next to her: "Do hemodialysis immediately! Dialysis of toxins in the blood!"

On Charlotte's orders, the nurse quickly prepared the cart and ordered the patient's family to lift the patient onto the cart!

Charlotte hurriedly ordered: "Take off the patient's clothes contaminated with pesticides so that they are not absorbed into the skin, quickly!"

The three nurses quickly took off the pesticide-smelling clothes on the patient's upper body, leaving only a pair of underwear.

Charlotte saw that her clothes had been taken off, and explained calmly: "Immediately wash the stomach and continue to inhale oxygen with low flow and low concentration!"

Three nurses split up, one starting to intubate the stomach and one to prescribe oxygen to administer oxygen to the patient through the nasal cannula.

Soon, oxygen was inhaled, and the gastric tube was inserted smoothly. As the switch of the electric gastric lavage machine is turned on, the water in the bucket begins to pour into the patient's stomach in a steady stream.

Seeing that gastric lavage has begun, the antidote is about to be used. Charlotte whispered: "The doctor's order from the rescue doctor began to record: atropine 10mg intravenous push, 10% glucose 20ml plus pralidoxime 1.0 intravenous push, and blood was drawn to test cholinesterase activity!"

Atropine is an anticholinergic drug, which can effectively inhibit the combination of organophosphorus and other poisons with cholinesterase in the human body, thereby relieving the inhibition of cholinesterase by toxins, thereby preventing further poisoning of the human body and has a detoxification effect.

Phosphatidylcholine is a special antidote to organophosphate poisoning, which can revive the inhibited cholinesterase and increase the activity of cholinesterase in the human body, thereby playing a detoxifying role.

Hospitals can often estimate a patient's toxicity by taking blood to measure cholinesterase activity, which can be used to guide treatment and medication!

Under Charlotte's command, the nurses cleanly dispensed medicines, pushed, and drew blood, and it was completed in one minute! Charlotte looked at it and nodded secretly, only a hospital of this level in an affiliated secondary hospital would have such efficiency, if it was a former suburban hospital, it would take at least two minutes or more to complete!

Seeing that the two drugs have been slowly injected into the patient's body, I am now waiting for the drugs to take effect, hoping that the patient can achieve atropine as soon as possible.

Hemodialysis is a treatment in which a machine extracts a person's blood, then cleans and filters the impurities and toxins in the blood before re-injecting it into the body. It has a good effect on some early poisoning diseases!

Charlotte saw that the patient's poisoning was extremely serious, but under the control of the drug, the effect was still not obvious, so she had to use this method to assist in treatment, hoping to help the patient remove the poison from the blood as soon as possible and recover as soon as possible! This is the last resort. If it still doesn't have enough effect on the patient, it's really hard to save him!

While quickly taking out his mobile phone to call Cen Yunying, he fled from the crowd.

However, it was only twenty or thirty meters from the front. At this time, it is very rare for students to be scattered all over the country. In the distance, I saw a man in a navy uniform lying on the ground, bleeding all over the ground. Not far away, there were three policemen with guns and blocked two hostage-taking gangsters!

Two vicious thugs put their left hand around the two girls' necks and their right hand against their heads. While shouting threats to the police to make the other party back off, he slowly retreated, preparing to retreat into a school building behind him.

Charlotte looked at the two girls and was shocked. Much like Cen Yunying and Yan Han, they ran very fast.

Take a closer look here. I was really afraid of something, the two people who were taken hostage were Cen Yunying and Yan Han. It has to be ready to come out. They just met two thugs on the road and were held hostage by each other!

At this time, Cen Yunying's face turned pale with fright, but she was frightened and shed tears, but she was stunned and didn't dare to cry out loud.

The words came out softly. Instead, it made the two murderous gangsters become cold, and even the three policemen next to them felt a chill down their backs.

Director Wu on the other end of the phone was stunned. Lian Youer asked herself. This is a decision made by Xiang Sihui. What are you yelling at me?"

I was slightly annoyed, and replied in a stiff tone: "Lian You'er, the decision on Xia Luo's reinstatement was personally issued by Dean Hong Lang. I just made it happen. If you have any questions, please consult Xiang Sihui!"

"What?" I heard that Charlotte was indeed reinstated, and it was a decision made by Dean Hong Lang. This Xu Zijiang's face was red and white, and this time he lost his face. Just now, he vowed to make a strong statement to all journalists!

Ju Liangping didn't expect Shi Siyu's movements to be so neat, so he called, and her mother agreed. There was really no other excuse, so she smiled and nodded helplessly: "Okay, let's fight again in the afternoon!"

Shi Siyu smiled confidently and said, "Then you should be busy first, I'll call you after work!" After that, he turned around and left with a smile. But the moment I turned around, my eyes quickly swept over the crystal sapphire pendant on Ju Liangping's chest, and my eyes were cold. I said, "Be sure to find someone who is giving the necklace." The whole hospital knew I was chasing Ryohei. I want to see who wants to lose face!"

At this time, Charlotte, who was writing medical records in the office, sneezed for no reason. Charlotte rubbed her nose in frustration and whispered, "Who is talking bad about me at this time......"

Looking around, I saw that no one noticed him. I quickly lowered my head and continued to write endless medical records every day, but I didn't know that some troubles had begun to creep in.

Charlotte was halfway through her medical records when she heard the phone ring: "Dr. Charlotte, please go to the emergency room immediately!"

Charlotte sighed. It seems that a new patient has arrived. Reluctantly, she put down her pen, picked up her stethoscope and walked out.

As soon as I walked to the door of the emergency room, I smelled a strong smell of pesticides. Charlotte was taken aback and walked in quickly.

I saw a group of people around the emergency bed, and the nurses hurriedly drove the crowd out.

No sooner had the crowd rushed to the door than Charlotte entered. A man rushed out of the crowd, took Charlotte's hand and shouted, "Doctor, please save my wife, don't let her die!"

Charlotte shook off her hand and walked briskly over to the bed. The patient is dizzy, foams at the mouth, and smells like garlic. She had some bottom in her heart. She quickly turned her head and asked the man, "What kind of pesticide does your wife eat?"

The man was stunned, turned his head and shouted to a group of people outside the door: "What pesticide did my wife eat, which of you saw it!"

The people next to you all looked at me, I looked at you, no one made a sound, only one woman couldn't see the answer, and whispered back: "When I found your wife, I didn't see the pesticide bottle, I don't know where I lost it!"

Charlotte listened and knew she couldn't find out what kind of pesticide it was. She nodded and kicked the man out the door. She said to the man, "You wait outside, we'll do our best to save it!"

Closing the door, Charlotte smelled the strong smell of garlic in the emergency room and knew that it was methamidophos poisoning, because when she was a child in the countryside, she saw someone killing rice with methamidophos, and she could often smell that garlic smell. He just wanted to know where the woman got the insecticide from, as methamidophos had been banned in the country.

However, saving people is important. Charlotte hurriedly explained to the nurse: "Gastric lavage immediately!"

At Charlotte's command, the nurse quickly began to prepare the gastric lavage equipment.

And this time, Charlotte quickly took time out to check on the patient, and although his heart had been analyzed to be methamidophos poisoning, he was still not 100% sure!

However, this kind of life-saving thing needs to be very careful, because if the poison taken by the patient is miscalculated, there will inevitably be an error in the medication, and it is likely to kill someone!

At this time, the patient was already delirious, lying on the bed sweating profusely and foaming at the mouth.

Charlotte observed that the patient's jaw was tightly closed, the neck was stiff, and the whole body was convulsed, all of which were obvious manifestations of organophosphate pesticide poisoning.

Charlotte uses a small flashlight to illuminate the patient's pupils, which are extremely narrow, the size of a pinpoint. Charlotte nodded secretly, according to these conditions, it should be organophosphate poisoning, and it is severe poisoning, which needs to be rescued immediately. At this time, it is a race against time. If you rescue early, you will have a silver lining!

At this time, the nurses were already preparing the gastric lavage machine and clean water, waiting for Charlotte to give orders.

However, he couldn't understand why Honglang, a good old man, let Charlotte be reinstated after only two or three days without giving himself face, and he didn't communicate with himself privately.