......

"Nuoyan, fortunately, I heard what Dr. Su said, thank you!"

"There, Director Feng, this is my job, whenever a patient needs it, I will be the first to go. ”

"Well, fortunately, there are no patients with more serious mental illnesses, so they will have a headache, and they are afraid that something will happen in the hospital, then my responsibility will be great, you represent me, Yan Dong is estimated to be back soon, Bodhisattva bless, this extraordinary period must not have an accident!" I worried.

"No, don't we have it, does Director Feng have any other arrangements?"

"Not for the time being, I just came to thank you, you go and get busy first, I have notified all the departments, patients with mental illness or medical conflicts have notified you, it is estimated that you are busy." ”

"It's okay to be busy, it's good to be busy, at least fulfilling. ”

After Noyan left, Kiki came in a few minutes to make me a cup of tea.

"Brother, what are you busy with?" Kiki asked.

"Sister Yan is here, there are so many things to do, I feel powerless!"

"As your girlfriend, I can't help much. Kiki was a little depressed, or a little self-blaming.

"How can it be, don't think too much, your continuous improvement is helping me, in short, don't think about it, just like you make me a cup of tea or coffee when I'm upset, this is helping me release stress. ”

"Yes, then I'll soak you every day, okay?" Kiki said sweetly.

"Of course, I can't ask for it, go and learn more from Nuo Lan and Changxin, only talk about business during work hours, go quickly, go quickly." "I've already placed an eviction order.

Kiki stuck out her tongue and went out.

I felt a little tired, the weather was very good today, lying on the sofa and squinting, maybe I didn't sleep well, dizzy, tired, just fell asleep, not half an hour, Dr. Su called me, I dragged my tired body to answer the phone.

"What, dead? What are you kidding, what did you guys do, I'll come right over. ”

I just told Nuoyan that I don't want anything to happen, it's really unlucky, there is an accident in the emergency department again, this time it is estimated that it is not easy to get it, the dead are already dead, I don't know how to explain to Yan Musk, I quickly ran to the emergency department, found Su Lin, He Tiancheng and Kamata and Li Wanqiu are all rescuing, and Dr. Zhou and Dr. Xie are also actively communicating with their families.

"What's the matter, why am I carrying it like this. I complained.

"Director Feng, don't worry, this patient is too old, 75 years old, has a serious medical history, kidney failure, type 2 diabetes, diabetic foot, high blood pressure, transaminases, chronic heart failure, and the family only learned in communication that long-term use of digo xin (0.125mg/day) and simvastatin (40mg/day). Due to fever, cough, sore throat, he went to a community hospital and was diagnosed with an upper respiratory tract infection. I don't know how the doctor there did it, but he prescribed azithromycin tablets, 0.5g each time, once a day, and compound licorice tablets, 4 tablets each time, three times a day. As a result, after eating for three days, the heart blood supply was insufficient, and he suddenly fainted, and he was already dead when he was sent, and Dr. Pu and Dr. He should be rescued or rescued, I don't know how to tell the family, an old lady, should be a companion, and a man and a woman, should be their children. ”

"What were the drug factors that caused the patient's death?" I asked.

Eating azithromycin and compound licorice tablets and dying!!?

"Feng supervisor, when taking medication, it is necessary to take symptomatic medication according to the specific situation of the patient, and it is also necessary to pay attention to the contraindications between drugs. The use of azithromycin antibiotics should pay attention to the following points: first, the combination of azithromycin and compound licorice tablets is easy to cause arrhythmia, and all macrolides have serious adverse reactions such as QT prolonged ventricular fibrillation and torsade de pointes. It should not be used in patients with proarrhythmic states, such as uncorrected hypokalemia, hypomagnesemia. These two drugs can't come together in the first place, it's not the patient's problem, it's the doctor's problem, the diagnosis is fine, the treatment is wrong. ”

"My mother, think about how to explain it to the patient's family, after all, they all died in our hospital, if you don't deal with it well, how can you let me explain when Yan Musk Deer comes back?" I questioned.

"Okay, don't worry, I'll tell the patient!" Surin took the initiative to take responsibility.

"Doctor Xie, Doctor Zhou, come on, you go and receive other patients. ”

Dr. Xie and Dr. Zhou nodded in response, they just came, after all, they had never been in the emergency department, they were all outpatient before, and they didn't know how to explain to the patient's family in response to this kind of emergency, and they didn't buy it at all.

Su Lin said: "Hello, I am the person in charge of the emergency department, my name is Su Lin. ”

"If you have anything, just say it, don't force it, tell me how my grandfather is?" This woman is very beautiful, why do you talk with thorns.

"Don't worry, just now your husband said the specific situation, this patient has a history of serious heart disease, you should not be sent to the community hospital, the doctor there prescribed the wrong medicine, I think you listen to me carefully to analyze you, not to evade responsibility, after I finish speaking, you still have to insist on holding us accountable, we have nothing to say." ”

When the woman heard this, she thought for a while and said, "Say it!"

"Among the drugs taken by the patients is compound licorice tablets, the main ingredient of which is the decomposition of glycyrrhizin into glycyrrhetinic acid in the body, which has a mineralocorticoid-like effect. Potassium loss is caused by acting on the distal convoluted tubules of the kidney, and cases of hypokalemia can be seen in clinical practice. When azithromycin is used in combination with compound licorice tablets, attention should be paid to the changes in the QT interval of the ECG, and potassium should be appropriately supplemented to prevent adverse reactions. Simvastatin and atorvastatin are metabolized by the liver enzyme CYP3A4 and are CYP3A4A enzyme substrates, while macrolides such as azithromycin are CYP3A4 inhibitors. When azithromycin is used in combination with simvastatin, the daily dose of simvastatin must be controlled to less than 20 mg, while the patient is taking 40 mg, and macrolide antibiotics (azithromycin, clarithromycin), like aminoglycosides and quinolone antibiotics, can lead to the exacerbation of myasthenic symptoms and even induce the occurrence of crisis. These drugs are considered cautionary or contraindicated in the treatment of patients with myasthenia gravis if the doctor is aware that the patient has type 2 diabetes, In the case of kidney failure, prescribing azithromycin is tantamount to a crime, to tell you the truth, when you send the patient, the patient has died, we continue to rescue according to the process, we are also reasonable, look at your decision, we have no regrets, do what a doctor should do, the biggest problem is the medicine prescribed by the doctor in the community hospital, which is a typical case of death caused by the abuse of antibiotics. ”

The woman looked at her husband and wanted to ask for help, but her husband looked like the kind of honest person, who was stumbling and couldn't speak for a long time, and it was really embarrassing for him.

"If you want to be a fart, you might as well die. The woman scolded her husband.

Then he said to Dr. Su: "Okay, I don't bother you, everyone is dead, I think I will take it back to the bad luck, I will go to the community hospital for responsibility, my grandfather will temporarily put you here, and I will pick it up when the time comes." ”

"Okay, when the time comes, let's go to my community hospital, Mom, let's go, dead ghost, drive there!"

I called Surin to the office.

"That's not going to work, just if a patient dies, isn't that a trick for us?" I complained.

"Yes, but if you don't save yourself, you have to find something to say, and this kind of risk often exists, not only in our hospital, but also in other hospitals!"

"Is there any way to avoid risks, if we are rescued, we are God, and if we are rescued, we are the devil, fuck, how can this pot be backed, I think it is necessary to hire two turnstiles for this situation, otherwise we will fight with our hospital all day long, who can stand it?"

"This proposal is very good, I think we should also draft a division of responsibilities to avoid risks, so that the patient's family can accept it, we will give treatment, and if they don't accept it, let them transfer to the hospital, otherwise there will be more time to lose money, and it will have a certain impact on the reputation of the hospital.......

"I'll let Nuo Lan draft this immediately, this is very demanding for the person who wrote this letter of evasion of responsibility, I don't know if Nuo Lan can take it down, I don't have this kung fu, this day makes people panic, if it goes on like this, I'm going to have anxiety attacks. ”

"It's not like that, to be honest, we've been used to doing emergency departments for so many years, and we've seen a lot of life and death, some patients are really pitiful, and some patients don't deserve sympathy, and if we see it through, life and death are not so important. ”

"Yes, fortunately, this woman didn't trouble us today, if she really messes up the scriptures or something, and sues us for losing money, the lawsuit is very troublesome, it will be distracting, increase the intensity of work, by the way, you should find Liu Changxin for this matter. ”

Su Lin was puzzled: "What are you looking for her, she just looks like a graduate, she can handle this problem?" Su Lin was skeptical.

"Hey, don't underestimate people, if people really have the ability to deal with this matter, they were preempted by me, besides, she worked in a headhunting company before, and she still has some goods, next time you look for her in the emergency department, you can know if it's a mule or a horse to take it out, Yan Dong has been away for a few days, which makes me feel palpitating, and I don't know when she will come back." ”

"Okay, Yan Dong should be soon. ”

"By the way, Dr. Su, what do you think of the two new doctors, it doesn't look good, I don't doubt your level, it's just that they are not very professional when they explain to the patient's family, they are all studying Western medicine, and the common drugs such as compound licorice tablets and azithromycin can't be explained, and no one buys them, do you see?" I questioned.

"The profession is different, there is no comparison, it's good to adapt for a while, don't worry, Director Feng, I promise you that I won't let you down!"

"Well, I believe you, go back to the emergency department, I've worked hard for all of you during this time, I have a bad attitude, be more tolerant and tolerant. ”