"Okay. ”

Zhang Tianyang responded and casually opened the past medical records of the 40 beds.

40 beds, male, 36 years old, two years ago, found that blood pressure was elevated, the highest systolic blood pressure could reach 180mmHg, did not pay attention, did not take medication regularly.

A month ago, the patient suddenly felt dizzy, his limbs were weak, he couldn't speak, and his back against the wall slowly slipped down, and his family found him an hour later and took him to a local hospital, where the specific treatment was unknown......

"Only 36 years old, so high blood pressure at such a young age?"

Continuing on, I had a history of dialysis for kidney failure for 5 years, and the frequency of dialysis was twice a week......

"Suddenly I had a bad feeling. ”

Zhang Tianyang quickly finished flipping through it, pulled a blank piece of paper and hurried to see the patient.

"40 beds, here...... Huh, the intensive care unit?"

The Department of Nephrology has about 80 beds, 72 general beds, 4 VIP single beds, and 4 intensive care unit beds.

Only the most critically ill patients are admitted here.

There was a chuckle in my heart, and the bad premonition was amplified again.

The area of the intensive care ward is twice that of the ordinary ward, and the four beds are separated by special curtains, and Zhang Tianyang rushed in.

"40 beds, Guo xx, I'm here to ask about the medical history, is it you?"

The head of the hospital bed was shaken up forty-five degrees, and the eldest brother, whose face was a little dark, was half lying and half leaning, and reacted slowly for a long time when he heard the words.

"Huh? ah...... It's me. ”

I'll go!

Zhang Tianyang burst into a foul mouth in his heart.

The pre-perception is tested!

This big brother is not only slow to react, but he is especially starting to roll his eyes!

"Oh my God, how long has he been slow to react and roll his eyes like this?"

The family member of the 40th bed is an old lady with gray hair, who is said to be the mother of the 40th bed.

The old lady didn't have the consciousness that her son was about to die, and she was still smiling on her face.

"I don't know, he seems to have been like this all along. ”

I'm special!

On the opposite side was an old lady with a wrinkled face, and Zhang Tianyang didn't want to murder her, so he could only ask patiently and slowly.

"When was the last time he had dialysis?"

"I don't know, he's in charge of his own business. ”

The little old lady was still happy, Zhang Tianyang complained frantically in his heart, his face was calm on the surface, and his tone was hurried.

"Brother Guo, when was the last time you had dialysis?"

"Ahh......h Last week, last week...... Three?"

"Do you remember how much you did each dialysis session, and how much weight you gained between dialysis sessions?"

"I see, it seems to be, low-sodium dialysis, and the amount, the quantity is ......"

The history is very difficult, but these are important information that is closely related to treatment and management, and it must be asked.

"How much does your blood pressure usually fluctuate, do you have any medicine that you have been taking?"

“......”

Finally, he simply asked for the most critical information, and Zhang Tianyang decisively decided to deal with it first, and then ask the rest when the patient's condition was stable.

"Family, I have to tell you that the patient is not doing well and needs to be dealt with immediately. ”

"I'll bring a couple of consent forms later, and you and the patient will have to sign them. ”

Zhang Tianyang hurriedly pulled the white paper full of handwriting, and ran to the nurse's station first.

"Sister nurse, please establish intravenous access to the 40th bed, the patient is late but the condition is relatively serious, and I am sorry to delay you from work. ”

Zhang Tianyang apologized when he was justified, and the nurse was forced to "work overtime" without complaint.

"It's okay, I'll go now, did you give a doctor's order?"

"It's in a hurry, I didn't have time to open it, don't worry, I'll make it up later!

By the way, please give him a blood routine, six ions, liver and kidney function, and four preoperative tests, and I will make up the doctor's order, thank you!"

Zhang Tianyang's voice fell, and the person had already walked quickly to the doctor's office.

"Senior sister!"

Senior Sister Liang, who was about to get off work, was stopped by Zhang Tianyang, with a slight impatience on her face.

"Senior sister, 40 beds are a kidney failure regular dialysis for five years, twice a week, this patient has high blood pressure, the last dialysis was four days ago, now people are not very clear, I think I need dialysis immediately, can you please call the professor?"

Patients in the Department of Nephrology need to make an appointment in person for dialysis or bedside dialysis in a fixed bed downstairs.

If it weren't for Zhang Tianyang not having Professor Liu's phone, he really didn't want to trouble this senior sister who was extremely cold to him.

"Regular dialysis twice a week, four days before the last dialysis session, okay?

Senior Sister Liang frowned, "Senior brother, I heard them say that you have only been in the clinic for a week, and there are criteria for judging the patient's state of consciousness, have you done it?"

"Most of the patients in the nephrology department have to do dialysis, and their conditions are quite serious, so you don't have to make such a fuss. ”

"Senior sister!"

Zhang Tianyang couldn't help but raise his voice.

Of course, he could hear the meaning of Senior Sister Liang's words, but he just felt that he had just been clinically ill-sighted, and he would make a fuss about a little illness.

This is indeed a common problem that interns can't avoid, and many novice doctors who have just started the clinic feel that the startling cases are actually small things that do not require emergency treatment and will be relieved by themselves in the eyes of senior doctors.

But this patient is really serious!

"Senior sister, in this way, you go to see the patient, and if you think you really should do it, we will call the professor, and if you don't think you need it, then I will buy milk tea for my senior sister tomorrow to make amends!"

As soon as these words came out, Senior Sister Liang's brows furrowed.

Isn't this a naked threat? This junior brother is too ignorant!

Senior Sister Liang sentenced Zhang Tianyang to death in her heart, but she turned around and walked towards the intensive care unit.

Of course, Senior Sister Liang didn't forget to add a sentence in her mouth, "You don't need to buy milk tea, I don't like to get tired." ”

The implication is that you must be making a fuss, senior sister doesn't care about you, but she also refuses your kindness to apologize, and if there are these little things in the future, don't delay my mother from work!

Zhang Tianyang thought about the patient, was not angry, walked two steps faster, raised his hand in front of Senior Sister Liang and helped her open the curtains around the 40 beds.

The little nurse had diligently begun to place intravenous access to the back of the 40-bed piercing hand, which made Senior Sister Liang feel more and more that Zhang Tianyang was making too much of a fuss.

On the hospital bed, the confusion of the 40-bed brother seemed to be a little more serious, he couldn't even roll his eyes, and his eyes were squinted so that there was almost a slit left.

Senior Sister Liang casually looked at the hospital bed.

"40 beds, you ......"

The second half of the sentence was swallowed in my stomach.

Don't say anything about the criteria for judging the state of consciousness, this big brother is simply visible to the naked eye that there is a problem!

"Senior sister, phone. ”

Zhang Tianyang gently reminded him, and Senior Sister Liang woke up instantly.

I saw that Senior Sister Liang's breath of "I'm going to get off work, I'm so lazy, I don't want to take care of things" suddenly changed, and instantly became serious.

"I'll call Professor Liu now! Senior brother, hurry up and get the consent form! Remember to check the blood urgently!"