073 extrapyramidal reaction
"The emergency doctor clearly said he had a cerebral infarction. Why did you become a cerebral infarction again? You are both doctors in the same hospital, how can you say something completely different?"
"Your doctors, can't you even find out the cause of such a disease? One is a cerebral infarction, the other is not a cerebral infarction, isn't your Xihua Hospital claimed to be the best hospital in our Kunnan Province? How can you not even find out the cause of such a disease?" The little girl was obviously an acute child, and as soon as she heard Yuntian say that it was not a cerebral infarction, she began to ask questions urgently.
"Don't worry, listen to what I'm saying. Yun Tian said helplessly.
I obviously wanted to explain it well, but I didn't expect the little girl to look small, but she was so anxious.
"The patient had two lacunar infarctions. But it was old-fashioned, and it didn't match his current condition. Therefore, his tongue problem should not be caused by cerebral infarction. Yun Tian's words were interrupted and he was blamed again, but he still had no choice but to continue to explain to his family in a good voice.
"Good people, it will be like this in the evening, what is the reason why you should explain it clearly!" The little girl was obviously very anxious, and the person who was fine in the morning suddenly became so sick in the afternoon.
At first, I thought it was a joke with myself, but I didn't expect that my tongue really couldn't be taken back.
I was anxious and hurriedly brought someone to the hospital. After a long meal, it was said that it was a cerebral infarction, and I was even more frightened.
Cerebral infarction is a fatal disease. How could he have a cerebral infarction at such a young age, but the little girl was in a hurry.
hurriedly contacted the family, and the old people in the family were so anxious to rush to the city. It's good to say it, say it is the middle of the night, and I have to wait until tomorrow morning to talk about it, and then I persuaded the old people on both sides.
But when I arrived at the department, the doctor said that it was not caused by a cerebral infarction.
What the hell is this strange disease! The little girl felt that she was going crazy!
"Did you take any medicine today?" Yun Tian did not answer the family's questions, but began to carefully inquire about the situation before the onset of the disease.
"This morning, I said that I had a cold at night and didn't want to eat, so I went to the community health station and prescribed a few antiemetic pills, and I didn't take any other medicine. The little girl replied patiently after thinking about it.
"Antiemetics have nothing to do with this, right? But I don't see anything wrong with this film except for cerebral infarction. What do you suspect?" Dr. Huang took the film from Yun Tian's hand and reviewed it several times, and indeed as Yun Tian said, there was indeed no other problem on the film except for two old cerebral infarctions.
Listening to Yuntian start to ask about his medical history, Dr. Huang not only had no diagnosis and treatment ideas for a while, but also couldn't figure out Yuntian's diagnosis ideas. So I just asked directly.
"What antiemetic medicine do you take?Do you still have any medicine?" Yun Tian ignored Dr. Huang, now is not the time to explain his diagnosis and treatment ideas, he must first determine the patient's condition.
"The medicine is all gone, but the prescription from the doctor is still there. The little girl rummaged through her pockets in a panic, and it took a long time to find a crumpled prescription paper and hand it to Yuntian.
"Metoclopramide tablets, the doctor prescribed you nine tablets, which is a three-day supply, have you all eaten them?" Yun Tian saw the prescription and basically clarified his judgment in his heart.
"After eating it, he kept vomiting and couldn't stop it, so I asked him to take a few more tablets, and the effect of this medicine was not bad, and he didn't vomit after eating. The little girl replied.
"You can't take medicine like this, your young man is not caused by cerebral infarction, but a drug-induced extravertebral reaction. Yun Tian raised the prescription slip in his hand and said.
"Extravertebral reactions? Yes, his performance is indeed extrapyramidal reactions. After all, Dr. Huang came from the Department of Neurology, and after listening to Yuntian's diagnosis, he also woke up to the fact that the patient's condition was indeed an obvious extrapyramidal reaction.
"What does extrapyramidal reaction have to do with metoclopramide?" "A common problem among clinicians is that they are not familiar with the uncommon adverse effects of drugs. What's more, it is still a drug that is not commonly used in my own department.
"Go through the pharmacopoeia. Yun Tian didn't bother to explain to Dr. Huang.
"The patient's condition is not caused by cerebral infarction, but the extrapyramidal reaction caused by taking too many antiemetics during the day, as long as the rehydration dilutes the blood concentration and accelerates the drug metabolism, it can be recovered. However, it is better to go to the neurology department for treatment in this case, and if there are any other complications, it is better to deal with them in the neurology department, so I recommend that you transfer to the neurology department for treatment. Yun Tian turned his head and continued to explain to the little girl.
"It's just caused by taking too many antiemetic drugs, not a cerebral infarction?" the little girl was a little excited. After all, cerebral infarction means a fatal illness for ordinary people, but if you take too much medicine, the condition will be much milder.
"Yes, but severe extrapyramidal reactions can cause respiratory failure and may be life-threatening, so it is necessary to treat it quickly. Yun Tian recognized the little girl's understanding, but still focused on the harm and severity of the extrapyramidal reaction.
In the past few days at the hospital, Yuntian has gradually gained some experience in dealing with the doctor-patient relationship.
Anything that may arise must be accounted for. In this way, it is possible to avoid a misunderstanding between the doctor and the patient.
Just like the current case, the family heard that it was not a cerebral infarction, but that they had taken too many antiemetic drugs, and they were easily relieved, and they could not understand the harm of extrapyramidal reactions.
Therefore, Yuncai timely reminds the patient of possible problems and the severity of extrapyramidal reactions, so that the family can be mentally prepared for the possible situation of the patient.
Transferring the patient to the neurology department was another long toss, and it was already five o'clock in the morning after everything was handled.
"Doctor Xiaoyun, you go to the duty room to sleep for a while, it's still early. Zhao Yuyan saw that Yuntian had finished dealing with the patient, and came over and suggested.
"There is only one bed in the duty room!" Dr. Huang refused to respond to Zhao Yuyan's proposal.
The duty room is like a dog kennel every day, every time I beg this little nurse to help tidy it up, no one is willing to agree, today I finally thickened the mattress, and it was fragrant, I only slept for half a night, how can I let it out!
"You can go and sleep in the 26-bed room, and the bed that was made at noon has not been removed. Zhao Yuyan smiled sweetly at Dr. Huang.
Dr. Huang was eager to ask. 26 beds are piled up with sundries, and they are generally not given to patients! Today, at noon, I only put a quilt on my bed, and I didn't even have a quilt to pad!
But when the words came to his lips, Dr. Huang swallowed them back.
You can't ask this, and if you do, it's definitely a shame for yourself!
"I'd better go back to the dorm room and squint for a while. Yuntian rejected Zhao Yuyan's kindness, he didn't have the habit of drilling into Dr. Huang's hot quilt!
"Jingle bell~" As soon as Yuntian's voice fell, the hand bell rang.
Five o'clock in the morning, so early, whose call?