"Forget it, let them go when everyone leaves, as long as you take proper medicine and control the temperature at about 38.5 or 38 degrees, it won't be a big problem."

Soon, a nightly hiccup passed.

……

The other side.

The Fifth Hospital of Jiangcheng City.

The family went to the night emergency office of the Second Hospital.

The doctor who received the treatment was almost forty years old, and he was much older than Lin Yi.

Therefore, the family members are also much relieved when they see this age.

It's great, it's finally not the young man who came to see us.

"Doctor, what should I do if my daughter has a recurrent fever of more than 39 degrees and can't go down??"

The doctor asked as he created a record of the examination on the computer:

"How old is the child? Have you taken any medicine before? Runny nose, fever, vomiting? ”

The family member looked at the child in his arms and said:

"I've eaten ibuprofen suspension, I have a little diarrhea, and then it's ...... And a little bit of coughing.

Doctor, can you do me a favor and prescribe medicine, infusion, or oral medicine?

My daughter has had a fever for two or three days, and I'm really afraid that my brain will burn out! ”

The young mother told a little lie.

In fact, her child did not have a cough, but in order to prevent the recurrence of the situation where the doctor did not prescribe medicine in the city hospital.

So the family made the situation a little more serious.

The doctor waved his hand, looked at the mercury thermometer that had been taken out of the girl's limb socket, and said:

"38.7 degrees, that's still quite high, so let's do it, there are many reasons for a cold and fever.

In addition, if you have a recurrent fever, do an X-ray to see the inflammation of your lungs.

Then do a screening for mycoplasma and chlamydia, and also draw a small tube of blood to see how the routine is.

However, there are no beds in the pediatric inpatient department of our hospital now, and all of them are full.

You'll have to get an emergency infusion first, and when your symptoms are a little mild, I can prescribe medicine for you to take home.

There are too many children who have caught a cold recently, and the hospital can't admit them quickly, so we can't accept you upstairs with a fever. ”

When the family heard this, not only did they not get angry, but they were very happy!

Look at this doctor!

As soon as I came, I gave the child infusion and medicine, and I wanted to arrange hospitalization!

What a good doctor!

"Okay, okay, we can all see the doctor's arrangement."

A strange hint flashed in the doctor's eyes.

He glanced at the young couple.

It's amazing!

Can your child be so happy when he is hospitalized for infusion?

I'm afraid it's not a brain problem!

Soon, the family took the child in their arms for a check-up.

There were almost no queues for the early morning checks.

So the results came out after ten minutes.

The doctor looked at it: "Well, there is no obvious shadow of inflammation in the lungs, it seems that your child is indeed mild."

In this way, I don't recommend infusion for mild cases, I'll prescribe oral medicine to you directly. ”

The family nodded again and again: "Okay, okay, I want anti-inflammatory and antiviral medicine, doctor, otherwise I'm afraid it won't work, then don't prescribe ibuprofen, there is still one at home." ”

The doctor nodded: "Don't worry, I will prescribe a little anti-inflammatory and antiviral medicine." ”

Then I saw the doctor fill in the name of the drug, dosage, taking time, and so on on on the computer.

After printing out the medicine list, the family rushed to get the medicine again.

As he walked, he discussed:

"Look at the medicine prescribed by this doctor, antiviral oral liquid, spoliton tablets, paediatric aminophen xanthamine granules and paediatric cough syrup!

What a responsible doctor! It's not much better than the surname Zhang in the city hospital! ”

"That's it, ibuprofen doesn't work after eating it, and we have to continue to eat it, it's a quack!

Can't you understand that the level of the city hospital is so low now? Actually let a young man who doesn't know anything come to the night shift?? ”

The two husbands and wives held the child all the way, hummed and chirped all the way to take the medicine, and then went home.

…………

Jiangcheng Central Hospital.

It was already evening when a patient with severe diarrhea suddenly came to the emergency room.

It is said that he ate raw seafood, and he ate a lot of it.

I started pulling in the afternoon, but I didn't come to the hospital because of work.

In the second half of the night, it was serious, and I pulled it once in half an hour, and I was sent to the hospital by my colleagues after pulling and vomiting.

When I came to the hospital, my whole face was pale, and I couldn't straighten my waist while covering my stomach.

And there are also manifestations of shortness of breath and even difficulty breathing!

Check the electrolytes, serious disorder!

Blood potassium is as low as 2.8mmol/L!

2.8mmol/L！

It's moderately low potassium at all!

Mild hypokalemia: within 3.5-3.0.

Moderately low potassium: within 3.0-2.5!

Severe hypokalemia: 2.5 or less!

The patient's value is 2.8, but 2.8 is already a dangerous number.

Potassium must be replenished right away!

If the diarrhea does not stop and goes down to 2.2 or less, then potassium can only be replaced with a central venous catheter.

However, because the blood potassium is too low, some patients may not be able to save it even if they use this method.

(Central venous catheterization is a rapid potassium infusion, but there are pros and cons.)

It can quickly replenish potassium and raise the blood potassium in the patient's body.

However, this is also the reason for this, and this rapid potassium supplementation method can also easily cause patients to suddenly become hyperkaloid.

The potassium ion is raised in a short period of time, and if hyperkalemia occurs in time if it is not observed, it is also easy to die suddenly.

Therefore, doctors in many small hospitals generally do not dare to take the risk of supplementing potassium in this way, but use more conservative arm veins to supplement.

However, the veins in the arm are relatively slow, and some patients with severe hypokalemia will not have any effect if the potassium supplementation rate is too slow, and the blood potassium will not rise, and they are prone to sudden death.

Therefore, this method of potassium supplementation still depends on the specific hospital equipment or the doctor. ）

Potassium is a double-edged sword.

It must not be missing, if it is missing, it will be weak, muscle weakness, listlessness, and in severe cases, it will be difficult to breathe, arrhythmia, heart failure and death.

But it can't be too high, too high can also lead to arrhythmia and sudden death.

Potassium deficiency is generally more common in eating too little potassium food, hyperthyroidism, or as in this patient, severe diarrhea, diarrhea and collapse.

High potassium is more common in kidney problems, the kidney filtration function is low, potassium can not be excreted and accumulated in the body, and it will also have problems over time.

The doctor on duty did not dare to delay and immediately gave the patient anti-inflammatory balanced electrolyte potassium supplementation treatment!

Anti-inflammatory drugs are infused first, followed by electrolytes plus potassium immediately.

2.8mmol/L, using the arm vein to control the drip rate can still slowly replenish potassium.

Now the main thing is to observe the patient's blood potassium status, abdominal pain, and diarrhea.

After waiting for hours.

At six o'clock in the morning, the patient's condition improved slightly.

After all, he is a young man, and his physical fitness is still relatively good.

At least the frequency of diarrhea gradually decreased, and the symptoms of dyspnea disappeared.

However, the blood potassium is still at 3.1mol/L.

Potassium in the blood has gone up a little, but it is still in a mildly low potassium state.

So the doctor on duty gave another order for potassium supplementation.

This time it is slowly supplemented, 10% potassium chloride is 15 ml, containing about 1.5 grams of potassium, with 5% 500 ml of sugar water intravenous drops.

The drip rate is 40 drops/min.

The normal drip rate is generally within 40-60 drops.

Adults should take between 3 and 6 grams of potassium per day, which can be increased according to the degree of potassium deficiency.

If the situation improves slightly, but the blood potassium is still between 3.3-3.5, then it can be changed to oral potassium supplementation, such as potassium chloride sustained-release tablets.

Under normal circumstances, as long as the potassium deficiency is not particularly severe, doctors such as mild potassium deficiency recommend oral potassium supplementation, and if necessary, intravenous potassium supplementation is selected depending on the situation.

When the nurse dispensed the liquid and then changed the liquid for the young man, the young man looked at the big bag of clear liquid and asked:

"Nurse...... How long am I going to lose? I'll ...... I have to go to work at eight o'clock......"

The nurse looked at him:

"Go to work? How can you go to work in this situation? Hurry up and ask for leave, you still have a lot of fluids, you have diarrhea like this, and you still want to go to work when it's so serious? ”

The nurse shook her head, not understanding what the young man was thinking.

After changing the fluid, the nurse continued:

"Remember, this bag of liquid must be infused slowly, it is estimated that it will take three or four hours to finish the infusion, and it will probably take the afternoon to finish all the liquid."

The guy frowned:

"Huh? I'm going to lose until the afternoon......"

He looked up at the clock on the wall of the rescue room, it was already seven o'clock.

It's already bright outside, and there's still an hour to go to work.

After a night of infusion, the guy actually felt that his body was much better.

I also have some strength in my body.

He asked, "Nurse, can you tell the doctor that I won't lose this bag of liquid?" I feel a lot better. ”

The nurse said with a serious expression:

"Definitely not, this is a medicine for you to treat, it is to maintain the acid-base balance of your body, otherwise you will have diarrhea and collapse, do you think you can be good just by infusing anti-inflammatory drugs?

All kinds of nutrients must be supplemented, otherwise you can get better so quickly?

And you're not completely well yet, do you still need to continue to rehydrate?

Lie down obediently for infusion, you can't take a day off and what, your body is the most important, you know? ”

After saying that, the nurse left the ward with the infusion curved plate.

But after walking two steps, he turned back and looked at the drip speed, and then said:

"You must remember, you have to lose this slowly, otherwise...... It's going to die! ”

The nurse's face was serious.

The guy had no choice but to nod helplessly.

After the nurse left, the colleague who sent the guy to the hospital next to him also stood up and said:

"Then Chen Lei, you can lose here, I also have to go to work, I will help you ask for leave."

The guy lying on the bed said with an embarrassed face:

"Hey, it's so annoying, I'll be out of duty if I ask for leave."

Full attendance is six hundred dollars.

His monthly salary adds up to barely enough to pay off his mortgage and car loan.

So 600 full attendance is a month's meal money for him.

Colleagues spread their hands and said:

"Hey, what can I do, you can't work sick either, right?"

The guy could only sigh silently.

Looking at the back of his colleague leaving, this guy named Chen Lei was remorseful at the moment.

Blame yourself for being greedy.

The boss sent seafood to treat the employees, and Chen Lei usually didn't have money to eat these, so he thought that it didn't cost anything anyway, so he ate more.

I didn't expect it!

I actually ate it and went to the hospital!

I don't know if I can find the leader to compensate for this matter.

However, if you want compensation, you are worried that your job will not be secured......

Ay!

It's so hard for social animals!

Chen Lei, who was lying on the bed, was still a little weak, but it was much better than when he first entered the hospital in the middle of the night.

After thinking about it for a long time, Chen Lei still wanted to go to work.

The main thing is that he doesn't want to lose the 600 yuan full attendance reward.

This would also be inappropriate to remove the needle.

So Chen Lei took advantage of the nurse's lack of attention and sped up the drip rate.

He thought to himself, the infusion will kill people?? I don't believe it!

I don't know if the infusion will die, but I will really die without money!

Housing loans, car loans, ......

He didn't dare to rest for a moment!

Immediately, Chen Lei ignored the nurse's advice and completely opened the liquid drops.

Click! Click! Click!

Looking at the transparent liquid that quickly dripped into his body, Chen Lei was in a happy mood.

As long as the bag of liquid is finished quickly, then when the liquid will be changed, you can directly pull out the needle and go to work.

It's a big deal to wait until the evening to get off work and then lose.

Thinking so, Chen Lei closed his eyes and prepared to take a nap.

……

Half an hour later, it was close to 7:45.

The nurse goes to the bedside of each resuscitating patient to check the drip rate of the fluid and the patient's condition.

Suddenly!

When she walked to Chen Lei's bed, she couldn't help but exclaim!

The nurse was shocked!

Immediately, while looking at the guardian, he shouted to the office:

"Dr. Sun!! Come and see this patient!! ”

The doctor on duty is surnamed Sun, and he has also been working in the emergency department for almost a decade.

The nurse was heard shouting, and he stood up with a slump as he was writing his shift record in the office!

Then strode towards the rescue room.

"What's wrong, what's wrong? What a fuss! ”

Dr. Sun glanced at the nurse and then turned his gaze to the hospital bed.

Immediately!

He gasped in fright!

"! Why is there no heartbeat!! "The heart rate monitor has become '0'!

"Dr. Sun, I just touched it...... Femoral artery ...... Already...... There is no pulsation anymore! ”

The nurse said nervously.

Then she looked up at the liquid in the infusion bag again!

Immediately, the nurse screamed in fright!

A big bag of sugar water with potassium!!

Lost so quickly!!

There will only be about thirty or forty milliliters left in the bag!!

"It's over, it's over! Medical malpractice! I...... Well? That's not right! I remember that I only adjusted the drip rate half an hour ago, which is a very slow 40 drops per minute! How could you lose so quickly?! ”

Dr. Sun looked up at the infusion bag and immediately knew what was going on!

"Are you sure you're setting the drip rate to 40 drops per minute?"

The nurse nodded affirmatively: "Yes, this is potassium, can I still not know?" ”

Doctor Sun frowned and said, "That should be the drip rate he adjusted without permission!" Let's hurry up first, open the airway, and bring the rescue medicine! ”

Dr. Sun immediately guessed why.

Each time potassium is supplemented, the nurse will tell the patient and family that they must not adjust the drip rate.

This medicine can kill people if it is lost too quickly.

Therefore, those patients and their families will naturally be afraid of this medicine, and even if they want to finish it quickly, they will not dare to move the drip rate at will.

But obviously, the young man in front of him is really not afraid of death!

I didn't listen to the nurse!

Ay!

What a wickedness!

The nurse will panic!

I'm afraid this guy will really die.

But......

Generous potassium supplementation in a short period of time...... Excessive extracellular potassium can cause arrhythmia, sudden death, and ......