"Vitamins, have you checked them?" asked Zheng Ren.

"Vitamins?" Su Yun was stunned for a moment.

In the ICU, the habit of emergency rescue, there is no such thing as vitamin checking, except for some special disease.

Trauma, on the other hand, is not a special disease.

"Vitamin B1 deficiency, I'm thinking about that now. Zheng Ren said: "Stop the patient's tranquilizer for a while." ”

"......" Su Yun was slightly stunned.

"I want to see if the patient has oculomotor paralysis when he is agitated. ”

Extraocular muscle paralysis innervated by the oculomotor nerve may cause symptoms such as abnormal ocular position and dilated pupils and loss of light response.

Su Yungang wanted to refute, but suddenly recalled the picture of Yang Lili's eyes trembling when she was awake.

He muttered for a few minutes, then suddenly raised his head, his eyes lit up, "Boss, I think you're right." ”

Director Qian and the other directors of the consultation were stunned.

Are these two young men joking?

The city is still waiting for today's report on the condition, and they ......

If it weren't for Su Yun's early display of emergency first aid in the ICU that surpassed everyone's level, if it weren't for Zheng Ren's extremely high surgical level in previous emergency surgeries, I am afraid that he would have been sprayed with saliva a long time ago.

Vitamin B1 deficiency?

Are you kidding.

"Xiao Zheng, Xiao Su, don't be kidding. Director Qian's voice was deep, expressing his dissatisfaction.

"Director Qian, no kidding. Su Yun smiled.

Zheng Ren's words cleared the fog in front of him, and the sky was clear.

Sometimes, it's just a little bit worse. Once that layer of window paper is pierced, it is actually nothing in retrospect.

"What does the patient's symptoms have to do with vitamin B1 deficiency!" said the chief of the medical department angrily: "Is beriberi disease?!

"Pathophysiology, I've learned it all. Su Yun looked around, and there was a mocking smile on the corner of his mouth, "This vitamin B1 deficiency is commonly known as beriberi, and that's right." ”

As he spoke, the smile on the corner of his mouth became more and more intense, and the starlight in the eyes of many little nurses in the ICU was twinkling.

"Vitamin B1 is also known as thiamine, and thiamine is absorbed in the intestine and phosphorylated by enzymes to produce thiamine pyrophosphate.

Thiamine pyrophosphate is an important coenzyme in the tricarboxylic acid cycle for pyruvate decarboxylation with a ketoglutarate and a coenzyme for erythrocyte ketone alcohol transferase. ”

A series of professional terms, like thunder rolling from the sky, emerged from the void and fell on the heads of everyone present.

Director Qian groaned, and what Xiao Su said seemed to be a train of thought.

The face of the Chief of the Medical Service was ugly because ...... He didn't understand it at all.

His position is very important, and he is responsible for the integration of various rescue links, handling medical disputes, and controlling the quality of medical care.

But the time out of the clinic is too long, and the pathophysiology and the like have long been forgotten.

Su Yun ignored the thoughts of the big men present, and continued: "In the brain tissue and myocardial tissue with strong metabolism, glucose and pyruvate metabolism must have enough vitamin B1 to participate, otherwise it will be difficult for pyruvate to enter the tricarboxylic acid cycle due to thiamine pyrophosphate deficiency.

Retention of excessive amounts of pyruvate in the bloodstream leads to dilation of the surrounding arterioles, decreased peripheral resistance, increased venous added flow, and increased cardiac output and cardiac workload. ”

Huh? Finally, when it comes to right heart output and cardiac load?

The Chief of the Medical Service pretended to be thinking, and at this time no one could see that he did not understand.

But...... Can't this damn guy be simpler?

"So, I ......" Su Yun's smooth tone paused for a moment, "My boss said that considering Yang Lili's restlessness and psychological symptoms, it should be a complication caused by vitamin B1 deficiency." ”

After speaking, Su Yun glanced at Zheng Ren.

"I'm right, boss. ”

That's basically what it means. Zheng Ren was not polite, and then said, "It is recommended to inject 100mg of vitamin B1 intramuscularly, but the absorption of intramuscular drugs by the body is relatively slow, you can try to inject 20ml of normal saline 50mg of vitamin B1 intravenously at the same time as intramuscular injection." ”

"The first dose was a little bigger on the first day, no problem. Zheng Rendao.

The directors present and the chief of the medical department looked at each other in confusion, but in the eyes of the other party, they were at a loss.

Although not everyone agrees with Zheng Ren and Su Yun's statement, if you want to spray, you have to have a reason not to.

People explain things and judgments clearly, and they explain it very clearly from the perspective of biochemistry.

I don't understand it, but I just think it's amazing.

So what to do?

What else can I do?

"Let's try it, there's no other way. Director Qian said.

He has been in contact with Su Yun for the longest time and knows Su Yun as a person. Under normal circumstances, once Su Yun has that kind of under-beaten expression on his face, it means that what he said is right.

At this time, don't refute, even the big director, in front of a reasoned illness, will be slapped in the face.

Besides, the intake of dozens of milligrams of vitamin B1 will definitely not have a negative impact on Yang Lili's condition.

"Half an hour later, stop the tranquilizer. Zheng Ren got up and explained the last sentence.

"Okay, boss. Su Yun went to give a doctor's order.

Looking at the back of Zheng Ren leaving, Director Qian vaguely sighed.

This is a baby tiger that has reached adulthood.

With this kind of momentum, the director who has been going through the years will not have it.

Medical treatment, there is no absolute certainty, who dares to say such a certain thing? Whatever you say, you will soon be slapped in the face, or the kind of slap on the left and right on the right, and you will be beaten into a pig's head in a few strokes.

Director Qian has only seen this kind of temperament in a few professors in the imperial capital and the demon capital, and the first hospital of the city ...... There has never been such a person.

Su Yun gave the doctor's order, and the little nurse was busy carrying it out, and then injected vitamin B1 intravenously and injected a muscle injection.

After glancing at the time, Su Yun sat down on the chair next to the bed and looked at Yang Lili intently.

Half an hour, the time the boss said should be fine. When the time comes, the tranquilizer will be reduced, and when the tranquilizer metabolism in Yang Lili's body is almost complete, it should be 2 hours later.

If it is true that the oculomotor symptoms caused by vitamin B1 deficiency, as well as cardiovascular symptoms, will definitely be improved.

This diagnosis is really interesting.

……

At the same time, in the large operating room, the orthopedic surgery to remove the vertebral body is underway.

"Xiao Zhou, is it exactly what was embolized yesterday?" asked Professor Tian of the Imperial Capital of Orthopedics as he opened his skin.

Dr. Zhou said, "The embolization time is relatively long, because we only have one interventional doctor here. Success or not, I can't tell. However, in the past, he embolized a patient with peritoneal hematoma after a pelvic fracture, and the effect was quite good. ”

"Well, there are relatively few interventional doctors, so it would be nice to have one. Professor Tian began to bluntly separate the muscle tissue, carefully avoiding a place where the capillaries were dense.