The patient is in a coma and the family members are not present, which is actually a very tricky situation.

If the patient is awake, treatment can be done with the patient's consent.

If the family member is present, treatment can also be done with the family's consent.

If the patient is unconscious, the family is not there, and the patient wakes up after treatment, well, it's great.

I was afraid, the patient was in a coma, his family was not there, he went to treatment, and finally he didn't wake up.

In this case, if the family members who are belated choose to make a fuss, regardless of whether the hospital is responsible or not, they will definitely not be able to run away with dirty water.

After all, the patient is dying from you!

I can't tell all over my mouth.

This is not the indifference of being a doctor, but the experience of countless predecessors in exchange for the lessons of blood.

Sympathy is sympathy, and the safety of one's own life is not worthy of sympathy?

"What should I do?"

Zhang Tianyang looked at Professor Yang and waited for instructions.

Even if he wanted to treat the patient again, he didn't have that right.

As an intern, even if all the diagnoses and orders he gives will be implemented to the patient in the end, it still needs to be reviewed by a regular doctor.

This is also the reason why Zheng Hualiang has to pestle in the clinic no matter how salted the fish is in the dermatology clinic.

This is also the reason why even though Zhang Tianyang has proven his ability in the emergency medical department, the patients he handles still need to see the doctor twice.

Now the patient has been returned to the emergency room.

The responsibility is borne by Professor Yang.

That's why Zhang Tianyang specially asked her whether she could be saved.

Save, the patient may or may not live, and the doctor is at risk of being held accountable.

If you don't save it, the patient will definitely not live, but the doctor is not responsible.

But as soon as Zhang Tianyang's voice fell, Professor Yang made a decision.

Xiao Deng, you go to contact the medical staff, and we will rescue you first. ”

"Good!"

The two little white coats responded, and then quickly dispersed, each performing its own duties.

Senior Brother Deng rushed to the landline and began to contact the medical staff on duty who had recently appeared at a high rate.

Professor Yang has already begun to give verbal orders at the bedside.

Zhang Tianyang rushed to the computer and began to enter Professor Yang's oral medical instructions into the computer.

Then a series of examinations such as blood routine, liver and kidney function, infection indicators, cardiac enzyme spectrum, etc., were quickly prescribed, and bedside ultrasound was also ordered.

By the way, I also improved the chief complaint, medical history and physical examination of this little brother who had just not been written.

Fingers flutter on the keyboard, and soon, the information is entered.

Zhang Tianyang walked up to Professor Yang and observed the patient's condition.

Brother Li Yueban's little brother was lying on the flat car, some spacious body filled the entire flat car, and cold sweat was still oozing from his fleshy face, even in a coma, he still showed a painful look.

At the foot of the bed, with two white coats, his eyes constantly scanned back and forth between the dripping monitor and the patient's body.

At the bedside, Nurse Ouyang took a trainee nurse to the left and the right, dispensing and injecting medicine according to the verbal instructions of the white coat.

The atmosphere in the emergency room was very solemn, and no one spoke except for Senior Brother Deng, who was on call to contact the medical duty.

Time is lost minute by minute, and all operations are in order.

The venous blood is drawn through the soft, thin tubes into red, yellow, and blue cap tubes.

Arterial blood also flows rapidly through a needle and is collected in preparation for arterial blood gas analysis.

The low-flow oxygen is delivered through a pipe connected to the nose, so that the little brother can inhale it effortlessly.

A sufficient amount of saline is quickly replenished into the little brother's body through the intravenous channel, rapidly expanding the blood volume.

Soon, half a bag of liquid had already entered the blood vessels, and Nurse Ouyang followed the doctor's instructions to connect the intravenous pump that had been prepared earlier.

Sodium nitroprusside, which was adjusted in concentration and pumping speed, slowly entered, starting with the smallest amount, and at the same time closely observed the blood pressure of Li Yueban's little brother.

In view of the fact that the little brother's situation was discovered by Zhang Tianyang in time, it was not too late to send it in, and the pH value of arterial blood gas was not outrageous, and there was no need to correct acidosis for the time being.

Rehydration, vasoactive drugs, and, if necessary, correction of acidosis.

So far, the symptomatic treatment of shock has been used.

The rest is to treat the cause.

Only when the cause of shock is relieved will Li Yueban's condition not deteriorate further.

But what exactly is the cause?

I don't know.

The doctor is not a god, and when the results of the examination are not yet available, he can only rely on his own experience to "guess" which cause is most likely.

And this guess, Zhang Tianyang and Professor Yang's faces are a little not good-looking.

Urinary stones generally do not cause shock.

After all, stones can hurt so much that few people can endure the pain without going to the doctor.

If there is one that can be carried, or if the pain is not sensitive, it may be because the stone blocks the ureter, so that the urine that should be eliminated accumulates in the renal pelvis, and finally causes hydronephrosis.

So, once it progresses to the point of shock, the patient is very dangerous.

Like this little brother Li Yueban, Zhang Tianyang has two main considerations for his shock.

"Mr. Yang, I have two thoughts about this patient's shock. ”

Zhang Tianyang spoke quickly.

"The first, severe pain, which leads to a drop in blood pressure, which in turn causes painful shock. ”

If that's really possible, that's easy.

Pain relief is the treatment of the cause, and after the pain is relieved, the little brother's condition will naturally get better.

"Second, kidney stones lead to ureteral obstruction, which in turn leads to infection, which eventually leads to septic shock. ”

If that's the case, it's bad!

The mortality rate of shock is 20%, which is close to 1 in 5.

And the septic shock caused by this kidney stone is more ferocious and rapid.

Because the entire kidney is made up of blood vessels, infected bacteria are quickly absorbed into the bloodstream, causing the body to take a sharp turn for the worse.

Even with antibiotics, it is not always possible to control the infection before the patient's body is finished.

After Zhang Tianyang finished talking about his guess, he turned his head and glanced at Professor Yang, and both of them saw the solemnity in each other's eyes.

The situation is urgent, so I can't think about it.

In either case, take the medicine first.

"Shupu is deeply resistant to infection!

Indomethacin 100mg anal administration!

Atropine 0.5mg intramuscularly!

Furosemide 20mg intramuscularly!"

Anti-infection, analgesic, and diuretic three-pronged.

In addition, it is also necessary to get the results of various inspections and tests as soon as possible.

Professor Yang Chong's face was serious, and he quickly gave orders.

"Go, call the laboratory department to hurry up and get the blood test results!

Is the bedside ultrasound coming! Urge! Hurry!"

"I'm rushing!"

As soon as Zhang Tianyang's voice fell, the door of the rescue room was knocked on from outside.

When the induction door was opened, the white coat of the laboratory department pushed the B-ultrasound machine next to the bed, and it was outside.

"Come on, come and see!"

Zhang Tianyang slipped out under his feet and helped move the machine to the side of the bed.

Then quickly lift the little brother's clothes, apply the gel, and debug the machine.

When the white coat in the laboratory department just reacted and was about to scold Zhang Tianyang, "Don't mess with the machine, it's very expensive", Zhang Tianyang had already grabbed the probe and pressed the little brother's stomach.

"It's too late!"

We must quickly find out the condition of the kidneys of the little brother, if the water accumulation is serious, it may be the most terrible septic shock!

If that's the case, the bedside pyelocentesis won't be able to escape!

A blurry black and white picture was displayed on the screen, and at the same time, Senior Brother Deng had just hung up the call with the laboratory department.

"Urged, the laboratory department has cut the queue, and the results of the two infections are out!"

Zhang Tianyang didn't reply, "Say!"

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