When the patient saw the director talking to him, he was slightly relieved and said: "I asked him what was going on, why my hand hurt more and more, and he said that he didn't care about his business, it was too annoying,—— you said that there was a problem with the epidemic prevention needle, and I also said that you cut my arm and didn't deal with it!" ”

Wu Hao waved his hand and said: "No problem, so let's do it, I'll check it for you, let's still say the same thing, solve the pain first, and don't do pointless disputes." Good no good? ”

The strong man nodded, and then followed Wu Hao and them into the treatment room. When the onlookers saw that there was no excitement, they dispersed.

The patient sat down in the treatment room, Wu Hao examined his arm, and after pressing and questioning, he found that the pain spread to the forearm and hand, and there were signs of septic shock such as irritability, anxiety, nervousness, pale complexion and skin, and cyanosis of the lips. glanced at Zhu Shan and said, "You need to make an incision to expand the incision here for exploration, and then do another drainage." ”

Although Wu Hao did not directly criticize Zhu Shan this time, it was already clear in his words that Zhu Shan's previous incision and drainage surgery was not complete. Zhu Shan couldn't help but blush.

Zhu Shan wanted to make up for his mistakes, and tried to make a smile on the patient: "I'm sorry, I didn't listen to what I said just now, please forgive me." However, your disease is really serious, and not only do you have to re-incision and drainage, but also infusion to fight the infection, so it is best to be hospitalized.

As soon as the patient heard that he was going to be hospitalized, he didn't care about the other party's apology, and immediately stared at the balls and shouted: "Live in a fart hospital, what's the matter with a preventive injection like this?" I still want to be hospitalized, and I don't need money for hospitalization? Besides, if we work part-time, we will deduct one day's wages for one day of absenteeism, who will be responsible for this loss? ”

Wu Hao hurriedly said: "It's no problem if you don't stay in the hospital, just stay in the observation room of our emergency center for infusion, come to infusion and prescribe medicine every day, and then you can go to work, but it's best not to use force on your right hand first." ”

The strong man still gave the director a lot of face, and nodded: "The outpatient treatment is almost the same." Okay, hurry up and treat, don't be verbose. ”

Wu Hao was about to re-cut and drain the drainage by himself, when his phone rang, and it was a call from the medical department to inform him to attend the temporary meeting of department heads.

Wu Hao said apologetically to the strong man: "I'm sorry, I have an urgent meeting, so let's let Dr. Zhu re-operate on you, right?" ”

"No! I don't want him to do it, what did he do last time he had surgery, and let him do it, do I still want this arm? Change a doctor! ”

"No problem!" Wu Hao immediately replied, pointing to Dai Yunyang next to him, "Let Dr. Dai redo the incision and drainage for you, right?" ”

The strong man turned his head to look at Dai Yunyang, and Dai Yunyang smiled at him. So the strong man nodded in agreement.

Although Dai Yunyang is classified as the Department of Emergency Medicine, the full-time emergency doctors are basically general practitioners, and they have to know a little bit about everything, and Dai Yunyang is certainly not a problem with this kind of incision and drainage.

Wu Hao hurried to the meeting.

Dai Yunyang brushed his hands and wore sterile gloves, first checked the place where the strong man's arm was infected, expanded the incision again with a scalpel, and at the same time cut and explored the corresponding part of the forearm, and saw that the muscle bulging incision was dark red, with less bleeding and poor elasticity. Therefore, two deep and superficial fascia of the upper limbs were incised, and the lost muscles and fascial tissues were excised to completely drain them.

After treatment, Dai Yunyang asked him to stay in the emergency room for observation, blood transfusion, and effective antibiotics and hormones.

The strong man didn't have any more arguments with Dai Yunyang and them, and honestly went to the infusion.

Zhu Shan and Dai Yunyang left the observation room, and Zhu Shan said to Dai Yunyang gratefully: "I really didn't expect that I would not be able to drain completely, what the hell!" - Thank you for solving this problem for me. ”

Dai Yunyang smiled bitterly: "It may not solve the trouble, his disease is infectious fascial syndrome, local and systemic infection, which will lead to muscle edema, ischemia and necrosis, it was not treated well in the early stage, and the best time for surgery was missed, and now the remedy is a little late, I am worried that his right upper limb will leave a scar contracture, and the function of the imaging arm, at that time, I am afraid that he will make a big fuss again." ”

Zhu Shan's face turned white: "What can I do about this?" ”

"Let's treat it first, and then we'll see."

Dai Yunyang continued to return to the clinic to receive patients.

While he was busy, the ICU ward nurse called him and said that the relevant test results of the female patient who was coughing up blood were out.

Dai Yunyang couldn't wait and asked, "What is the result?" ”

"Poison testing did not reveal rat poison ingredients. Blood gases and D-D dimers do not indicate pulmonary embolism or the presence of a hematologic disorder. ”

Although these were all in Dai Yunyang's judgment, he was still stunned for a moment, because this meant that the cause of the patient's coughing up blood had not yet been found.

What causes coughing up blood?

Dai Yunyang decided to take a look.

He went upstairs to the intensive care unit, took the test report from the nurse and read it carefully, just like the nurse said.

He wondered what was going on. Could it be an acute onset of a chronic disease such as a disease of the connective tissue system?

Dai Yunyang quickly dismissed this possibility, as the patient had no fever, rash, joint and muscle pain, and cough and phlegm.

Could it be an acute infectious disease? Like hemorrhagic fever?

He had the terrible Ebola virus in his head, which was characterized by bleeding, including vomiting blood. However, the patient did not bleed anywhere except vomiting blood, and Ebola bleeding was bleeding from all holes, and blood could flow out of all holes. In addition, the outbreak of Ebola is mainly in Africa, and after consultation, it was learned that the patient has no history of overseas travel, and there are no symptoms such as fever, rash, and three reds and three pains that can support other acute infectious diseases.

Dai Yunyang remembered the previous auscultation, the patient had wet rales in both lungs, the chest x-ray showed diffuse exudation, and although the bloody sputum coughed up was bright red, the bleeding color of the small arterial rupture was still pale in color, so the bleeding of tracheal or bronchial diseases was not supported. Rather, it should be extensive bleeding from the lungs.

Extensive bleeding?

A flash of inspiration flashed in Dai Yunyang's mind, yes, the consultation learned that the patient had had had a tooth extraction before, and had taken amoxicillin to reduce inflammation. INTERVIEWER Could it be caused by severe allergies?

Amoxicillin-induced allergic reactions include bleeding, although very few cases have been reported.

The more Dai Yunyang thought about it, the more he felt that there was such a possibility, and immediately decided to treat it with medication according to the shock caused by amoxicillin allergy.

Dai Yunyang immediately approached the patient's family and asked if the patient was allergic to penicillin. The patient's family said that the patient had another skin test for allergy two years ago, and then the doctor said that penicillin should not be given, and he never took it again.

This time confirmed Dai Yunyang's judgment, and he immediately issued a series of medical orders to speed up fluid rehydration, open the central vein, and give artificial colloidal fluid. At the same time, endotracheal intubation should pay attention to timely sputum suction, and in addition, 706 generations of plasma, compound sodium chloride and other corresponding treatments should be given. At the same time, attention should be paid to the patient's warmth, sedation, and oxygen inhalation.