Cao Shan was wearing rubber gloves and quickly pulled away the middle-aged man who was kneeling on the ground.

"Wash your hands and rinse under running water for at least five minutes. ”

But the middle-aged man seemed to have been carried away by grief, shouting, "I'm saving her! What are you pulling me for! Isn't it just a few words! People definitely can't die, they can't die!"

Cao Shan hurriedly hugged the middle-aged man and glanced at the king pigeon.

Wang Ge instantly understood, controlled the middle-aged man, and then handed the man over to his son.

"Listen to the doctor, go wash your father's hands, otherwise there is a danger of poisoning."

Despite what had happened at home, the young man maintained a rare sense of sanity in the midst of grief and anxiety, and he knew that he was still the biggest medical worker at the scene, so he immediately took his emotional father to wash his hands.

Cao Shan immediately started his own examination, and there was no need to think much about the situation at the scene, it must be dichlorvos organophosphorus pesticide poisoning, and it was absorbed orally through the digestive tract, and the situation was very dangerous.

In order not to contaminate the patient's eyeball during the examination, Cao Shan first checked the pupil before checking the pulse, heartbeat and breathing.

"Forty milligrams of atropine is given intravenously, which is faster, and atropine is achieved as quickly as possible. I'm done taking my blood pressure!"

In fact, after the patient's organophosphate poisoning, it is difficult to have an effective number definition of atropine in medicine, all based on the doctor's on-the-spot judgment, too little dosage will cause insufficient atropine, toxins will still be absorbed in the body, and continue to destroy internal organs, too much dosage will cause atropine poisoning, the situation is also more dangerous.

Now although this patient is a woman, but the body is relatively healthy, the weight is estimated to be more than 70 kilograms, and a large number of oral organophosphorus pesticides, more than ten minutes have passed, the body must have absorbed a large amount of toxins, and because of its sturdy body, it is estimated that the resistance to atropine is relatively high, so Cao Shan is extremely bold in the dosage of atropine, exceeding the conventional dosage.

"Forty milligrams of atropine intravenously, measure blood pressure!" Tian Yuqing repeated the doctor's order, and immediately started to move in his hand.

When getting out of the car, Tian Yuqing not only brought down the first aid kit, but also put the small box of atropine injection injections on the cart and brought it down together.

Without saying a word, she began to extract the potion. The packaging of atropine injection injections is sealed in glass vials, and although nurses often break the sealing tips of such glass bottles with their bare hands when administering medicine, in most cases, they only need to use force once or twice at a time, and one or two bottles are enough.

The dose of each vial of atropine injection is 0.5 milligrams, which means that Tian Yuqing has to break open the packaging of 80 bottles of atropine in a very short time, and for the sterile environment of the injection, it is necessary to reduce the exposure time of the liquid medicine in the air as much as possible.

Wang Ge hurried to Tian Yuqing, took a pair of disinfectant rubber gloves from the first aid kit and put them on, "I'll break the bottle, you draw the medicine, faster!"

Tian Yuqing gave Wang Ge a grateful look and nodded quickly.

The efficiency of the cooperation between the two is very fast, and it is almost less than a second to draw a bottle of atropine injection liquid. After more than a minute, Tian Yuqing's hand was filled with the needle on the syringe of 40 mg atropine injection, and finally successfully penetrated into the venous blood vessel on the inside of the patient's elbow.

The liquid medicine was injected quickly, but Tian Yuqing was not idle, took out the blood pressure monitor and immediately went to measure blood pressure.

Although in other cases, taking medicine first and then measuring blood pressure may cause misdiagnosis, but now the effect of the drug does not come so quickly, and the patient's blood pressure at this time is almost the same as after poisoning, so Cao Shan dared to let Tian Yuqing take medicine first.

After all, the data is false, but the fate is true, no matter what the results of the examination, the patient must be in a state of severe poisoning of dichlorvos organophosphorus pesticides, and the most important thing is to realize the atropine of the patient's body as quickly as possible.

"Purple complexion, constricted pupils of sweating, no reflex to light, muscle tremors, severe breathing disorders, crackles in the lungs, asthma sounds, tachycardia, atrial fibrillation, blood foam from the mouth and nose, the patient is in a deep coma, and has no reflex to external stimuli. The more Cao Shan said, the more serious his brows were twisted. He turned around and shouted at the young man who called the police.

"This is the first scene of the poisoning?"

"I haven't touched my mother......" The young man was desperately rinsing his hands for his father according to Cao Shan's instructions, one relative had fallen and was still being rescued, and the other relative must not have another accident!

Fortunately, his father also came to his senses a little, and stopped yelling, but kept crying bitterly.

"There was no vomit at the scene, and the medicine was not discharged at all!" Cao Shan turned over the patient's body and found a puddle of yellow viscous liquid under the patient's body, the smell was very obvious, even if it was mixed with the strong smell of pesticides. "There were no other obvious traumatic injuries to the fall, incontinence. Multiple erythematous changes on the neck. Confirmed organophosphate skin contact poisoning, oral digestive system poisoning, multi-organ failure, pulmonary edema. What is the blood pressure?"

Tian Yuqing put away the blood pressure monitor, "Twenty, fifty millimeters of Hg, it's almost impossible to measure!"

"There are more medicines, don't make mistakes in your busyness!" Cao Shan pressed Tian Yuqing's trembling hand.

Tian Yuqing was indeed a little anxious, she looked at Cao Shan's eyes and nodded, and wiped the beads of sweat oozing from her forehead with her sleeve.

"Open two large venous channels, norepinephrine 1 milligram intravenous injection, dexamethasone 5 milligrams intravenous injection, nicosamide 0.5 grams intravenous injection, furosemide 20 milligrams intravenous injection, dopamine 20 milligrams into 525 percent glucose injection rapid intravenous drip, 500 milliliters of normal saline rapid intravenous infusion. Cao Shan spoke very quickly, for fear of delaying a little time.

And Tian Yuqing also showed a very strong professionalism at the critical juncture, such a long doctor's order, complex drug combinations and dosages were actually word-for-word when the oral description was repeated, in order to save time, the drug injection was carried out while dictating.

The king pigeon acted as an infusion stent on the side, and all the infusion bags were held in his hands.

Tian Yuqing injected all the medicines in the shortest time, and Cao Shan waved his hand. "Get in the car and go back to the hospital!"

Wang Ge hurriedly handed over the infusion bag in his hand to Tian Yuqing, and then carried the patient onto the cart with Cao Shan.

"Master, I'll go to the hospital with me. ”

Wang Ge was dragged by him before he had time to close the car door, and after thinking about it, he felt that something was wrong, in case the father of the young man who was still at home, because his wife committed suicide by poisoning, felt that she could not live, and it was not interesting to live, and people were in a state of emotional control, and because of guilt, they turned out some pesticides to kill themselves, then it would be troublesome.

Although Wang Ge usually talks little, it does not mean that his emotional intelligence is low, this reason is still understood, and he quickly turned around and said, "Brother, it's okay for you to get in the car, bring your dad with you!"

The young man came back to his senses in an instant, almost caused a tragedy because of impulse, and hurriedly rushed back to the house to find his father, but fortunately his father had not done anything, and the old and the young got into the car together, and the king pigeon hurriedly jumped into the cab to start the car.

"Go on ECG monitoring, report vital signs every five minutes, and maintain atropine! Now help me prepare for the patient's gastric lavage!" Cao Shan conducted another examination on the patient after getting into the car, and found that the patient had not yet shown indicators of atropine, and he was thinking about whether to wait or supplement the dose of atropine.

"Well, wait a little longer, the effect is not so fast, the first dose is enough!" Cao Shan decided to believe in himself once, and said to himself, except for Tian Yuqing who knew a little more, no one in the car knew what he was talking to himself.

The king pigeon who was driving the car had just started the car and started with a catapult, because he saw that the Grim Reaper was already standing at the door of the family's small shop, staring at him gloomily, and the long-handled umbrella in his hand was still spinning around, gloomy and a little leisurely.

Although Wang Ge doesn't know any pharmacology and toxicology, he knows that since Cao Shan asked Tian Yuqing to bring a box of atropine, and injected a large dose of such drugs into the patient at the first time, then this kind of medicine must be useful, but it takes a certain amount of time for the internal circulation to take effect, and the effect of the medicine also needs to wait, as long as he can get rid of the god of death for a period of time, let the eighty bottles of atropine that he just made with great difficulty play an effect, maybe the patient can stabilize his vital signs, at least get rid of the pursuit of death, and his life can be saved。

However, long-term hypoxia will cause irreversible damage to the brain, and after recovery, there may be disorders in movement, language, consciousness, cognition and logic, memory will also be biased, and even the level of intelligence will regress, to a large extent, the quality of life cannot be guaranteed, but people are always alive, there is hope when they are alive, and everything else is empty.

Even if it wasn't for this life, not for this number, the king pigeon would never let the death behind him catch up with him.

Death clicked his footsteps, and all the vehicles on the road were nothing to him, flying directly through the air, very fast, and there was still no expression on his face, but he could see that he was very contemptuous, as if he was determined to achieve this soul, after all, it was only part of his job.

And Wang Ge is unwilling, just now Lao Tzu desperately broke eighty bottles of glass tubes, his arms are sore, not to mention, even if he is wearing rubber gloves on his hands, his fingers are about to rub out blisters, you kid with this attitude is like taking the patient away, just want to destroy the hope that these people want to save their lives, and it is too tender, right?

He picked up his intercom as he accelerated and debriefed.

"This is the No. 0110 of the Second Affiliated Hospital of Yaxiang, Xiang AGZ689, I have received a patient from Yuelu Avenue and am returning to the emergency department of the Second Affiliated Hospital of Yaxiang!" Then he pulled the intercom behind him.

Although Cao Shan was carrying out gastric lavage, he still discovered Wang Ge's actions, and shouted without looking back, "The patient has severe organophosphate poisoning, please prepare for blood drawing, blood routine examination, blood matching, hemodialysis, request a doctor above the director level of internal medicine for consultation, and arrange a high-dose atropine injection of five milligrams as much as possible, and the patient may have to maintain an atropine state for a long time." ”

There are no cars on the road, the weather is bright, and the water on the road has been evaporated by the strong sunlight when it rained a few days ago.

In addition to the siren that has been ringing, the king pigeon who hung up the intercom also pressed the horn on his car all the way, the sound of the horn of the special vehicle is very special, loud and heavy, with a strong sense of oppression, there is no private car on the road to let the king pigeon's ambulance go first.

Because the speed of the king pigeon has reached 120 kilometers per hour, which is already the highest speed limit on the highway, let alone the road in the city. If this is a collision, no matter what kind of social vehicle the other party is, it will definitely be seriously damaged.

These private car drivers think that the people in your ambulance don't want to die, and I want to die, so hide far away.

Of course, at this speed, the Grim Reaper could only follow the king pigeon's car and eat exhaust, and could not touch the ambulance at all. Although the process was slow, the distance between the ambulance and the Grim Reaper was widening little by little, which made the king pigeon feel a lot more relieved, and the accelerator under his feet was slightly loosened.

After Cao Shan went through the gastric lavage operation of the patient, poured a large amount of normal saline into the patient's stomach, and then extracted the stomach contents, a strong smell of pesticides permeated the whole car, and the smoked king pigeon was dizzy, and the king pigeon realized that something was wrong, and quickly opened the car window and increased the air volume of the air conditioner.

In this case, it is still a priority to ensure that other people in the car are not injured twice, and the temperature or something is secondary. A burst of fresh air instantly filled the entire ambulance, lifting everyone's spirits.

The family members of the two patients in the car also smelled the pungent smell, and such a large amount of poison entered their relatives, which made them worried.

"Don't be afraid, this is normal, the more things that come out, the less things that are absorbed into the human body, since I became a doctor, I have treated a total of four cases of organophosphate poisoning, and none of them have died. Cao Shan said that this was said to the young man's father, obviously to stabilize his emotions.

He conducted another examination on the patient, and the results were overjoyed, and the patient's physical condition indicators finally showed signs of matching atropine.

Patients with mild disease will have dilated pupils and flushed faces, significantly reduced rales in the lungs, and increased heart rate after atropineization. For severe patients, due to excessive hypoxia, the pupils may be rapidly scattered, pulmonary edema has appeared, the pulmonary rales will not disappear, and the face will not change significantly, but this patient has tachycardia, and now the heart rate has slowed down significantly, returned to normal low values, breathing has become deeper, and most importantly, blood pressure has also risen significantly.

Cao Shan's judgment just now was indeed correct! Cao Shan calmed down, raised his head and said, "Let's do another gastric lavage!"