"Well, very good! In addition to blood sugar control, what other treatments do you think should be given to this patient? Zhang Bihua was very satisfied with Zhou Can's answer.

Then test him.

"Although the patient's condition is improving, there is still the possibility of rebound. Fluids, correction of dehydration, and continuous low-dose intravenous insulin should be continued in an effort to correct the patient's electrolyte abnormalities. If the patient's pituitary gland lesion persists in refusing chemotherapy, surgery may be the only option. ”

After thinking about it for a long time, Zhou Can felt that if the patient's pituitary lesions were not effectively treated, just to treat diabetes, it would definitely not be better.

Diabetes insipidus and amenorrhea are caused by pituitary gland lesions.

If these two problems are left unchecked, the treatment of the patient will be anticlimactic.

Because active control of diabetic hyperosmolar coma and ketoacidosis can only save the patient's life.

"When the time comes, I will find a way to persuade the family." Director Zhang Bihua is likely to persuade his family, and I am afraid that this matter will have to be considered in the worst direction.

……

Approaching the end of work, Zhou Can got the news that the patient's thalamic-pituitary axis function test had the results, and the ACTH18.1pg/ml, which was significantly lower than the normal value of 46pg/ml.

Hemoglobin F16.12ug/ml, which is within the normal range.

E2 167.59pmol/L，T1.0nmol/L……

After reviewing the results of a series of evaluations of the patient, it has been confirmed that central amenorrhea is due to a pituitary lesion.

Now I hope that Director Zhang Bihua can persuade his family to receive radiotherapy.

When I got off work in the evening, my family still did not agree to receive radiotherapy, and they were resolute.

In this regard, Zhou Can is also helpless.

Obviously, the cause was found out, but the family refused to treat it, and the doctor was a little sore.

Xinxiang Women's and Children's Hospital also seems to want to publicize this case as a typical example, and specially sent people to do ideological work for families and patients.

The pregnant woman in the rescue room finally survived the most dangerous first six hours safely.

After getting off work, Director Zhang rushed to the rescue room to check on the pregnant woman's condition.

After reviewing, she was very satisfied with the work of the crisis management team.

"It's not easy to rescue this pregnant woman from death, and it's hard for you."

Director Zhang affirmed their work.

"Director Zhang, I want to stay on duty at night."

The medical staff of Xinxiang Women's and Children's Hospital were a little derelict in their duties, and it was difficult to reassure Zhou Can.

He volunteered to stay in the duty room of the hospital at night, and it was convenient to rescue him in time if there was any emergency.

Director Zhang was stunned, and then glanced at several medical staff at Xinxiang Women's and Children's Hospital. Whether it was a doctor or a nurse in the emergency room, she was laughing and laughing at work, and she frowned for a while.

However, she only came here for a few days, which is equivalent to a guest.

Naturally, other people's family affairs are not easy to manage.

This pregnant woman was finally rescued and handed over to the medical staff of Xinxiang Women's and Children's Hospital to take care of her, and there are indeed many unstable factors.

It's just that Zhou Cannai is a general, and he stays on night duty at night, although he only needs to take care of one patient, he is still very tired. If he doesn't have a good night's rest, his work status tomorrow will definitely be greatly affected.

"Although Dr. Zhou is the deputy leader of our crisis management team, he is actually responsible for the work of the team leader. If he is only allowed to work the night shift alone, it will definitely affect his work the next day. I am willing to stay and take turns with Dr. Chow. ”

Ji You took the initiative to stand up at this time.

Doctors and nurses work together, which is the most efficient solution.

"Okay! It's much better if there are two people on the night shift. I'll talk to Section Chief Tang and get you a special duty room. It is estimated that other doctors in our hospital will be able to use it in the future. ”

Director Zhang said this, obviously knowing that the medical staff of Xinxiang Women's and Children's Hospital were unreliable.

Talking to such an 'old Jianghu' is to save trouble.

After communicating with Section Chief Tang, a small room was temporarily vacated for them not far from the rescue room. It is a small room where futon and bed linen are placed. After a little cleaning, set up a simple folding bed, a small wooden table, and a chair.

A rudimentary makeshift duty room was laid out.

"Doctor Zhou, the conditions are a little simpler, please do more Haihan, and you will be settled."

Section Chief Tang smiled and said apologetically to Zhou Can.

"It's nice to have a place to lie down and sleep at night. It's us who have caused trouble for your hospital. ”

Although Zhou Can is a rich second generation, he has no problem with arrogance.

I don't pay attention to food, clothing and housing.

He can eat both a high-end meal of 10,000 yuan and a box lunch of 10 yuan. The environment in which to live, as long as it is not noisy and there is a bed, this is enough.

"Thank you Dr. Chow for your understanding! If you need anything, feel free to mention it to me. "Director Tang took out a business card as if he was playing a trick." This is a contemptible business card, and you can call my mobile phone number directly if you have something. ”

Anyone can see that Section Chief Tang's attitude towards Zhou Can is very unusual.

Not only polite, but also extremely welcoming.

Director Zhang and the others didn't think much about it when they saw it. Because Zhou Can did perform very well, he had a high hidden status in Section Chief Tang's mind, which was a normal thing.

Whether it is rescuing the sick child or the pregnant woman, Zhou Can is the main cadre and the most important hero.

The senior management of Xinxiang Women's and Children's Hospital didn't say anything, but they definitely had to look at Zhou Can twice in their hearts.

……

After dinner, Zhou Can was going back to the hotel to take a shower first, and by the way, he brought a medical book.

On duty at night, you must be at the bedside of a pregnant woman.

You don't have to keep staring at those monitoring devices, you only need to look at them once in a while. Because as long as the monitoring instrument detects a large change in the patient's vital signs, it will send out an alarm.

In addition, intravenous infusion dressing change, ventilator parameter adjustment, etc., all need to be operated by Zhou Can himself.

As a result, before he could get out of the hospital, his cell phone rang.

At first glance, the number was an unfamiliar mobile phone number.

"Okay, who is it?"

Zhou Can connected.

"Doctor Zhou, Doctor Zhou, I'm Doctor Pang! If the patient's blood oxygen drops suddenly, please come over quickly. ”

There was a hint of nervousness and panic in Dr. Pang's voice.

How about being an attending physician and having experience working in the intensive care unit, and being scared like this when the blood oxygen drops suddenly?

Zhou Can quickly turned around and rushed to the rescue room, but he was secretly thinking in his heart.

Dr. Pang's professionalism is not bad, and there are only two possibilities to scare her like this. Either she was negligent in her duties and had an accident, or after the patient's blood oxygen dropped, she took action, but it didn't work.

Rushing into the emergency room, Zhou Can saw that Dr. Pang and nurse Chen Qingling were rescuing the patient.

There were three doctors and nurses from Xinxiang Women's and Children's Hospital standing and watching.

"Wasn't it okay when I went to dinner? Why did the patient's blood oxygen suddenly drop so badly? ”

Zhou Can calmly observed the patient's vital signs, and his blood pressure did not drop significantly.

It shows that the situation is not as bad as imagined.

The patient is short and heavy in breath and has a cyanotic complexion.

Her lungs had already detected diffuse infiltrates after fat embolism, and her lung function was definitely not as good as normal.

But after getting on the ventilator, the situation has stabilized.

Sudden deterioration, what's going on?

In order to save this pregnant woman, Zhou Can has taken someone to guard her all day.

We don't want to fall short.

"I went out to the bathroom, and when I came back, I noticed that the patient's blood oxygen level was dropping." Chen Qingling replied.

Patient care in the intensive care unit is often one-on-one with nurses and one-to-three doctors.

What does that mean?

It means that a bed has at least one nurse to provide one-on-one care to patients. A doctor can manage up to three beds at the same time.

In fact, it is most appropriate for this pregnant woman to be sent to the intensive care unit, but it is only out of consideration for the patient's family economic conditions and that the pregnant woman has not yet passed the dangerous period that Zhou Can will work so hard to provide high-quality four-to-one services.

There are a total of five medical staff in the crisis management team, and Deputy Director Shi is just hanging a card.

The only people who really did the work were Zhou Can, Doctor Pang, and two nurses.

Because Zhou Can and Ji You are on night duty tonight, they will temporarily let Doctor Pang and Chen Qingling be on duty.

People have three urgencies, Chen Qingling went to the toilet while on duty, and no one could say anything about her.

At that time, Dr. Pang was present alone.

Zhou Can's gaze looked at Doctor Pang.

"I, I have been staying at the bedside, the patient's blood oxygen level has dropped, and I immediately took a series of emergency measures after I found out."

Her eyes were a little evasive.

Apparently not telling the truth.

This Doctor Pang was dissatisfied with Zhou Can being the deputy team leader, and now his work is still so slack, Zhou Can suddenly became a little angry.

"You just called me as soon as you noticed that the blood oxygen level was dropping, and the patient's oxygen saturation was able to drop below 70%?" Zhou Can's voice was full of anger.

A nurse from a nearby Xinxiang Women's and Children's Hospital muttered in a low voice, "I see that she seems to have been on the phone!" ”

Physician Pang saw that he couldn't argue, so he had to explain honestly.

"Just now I was standing next to the hospital bed, my home called, my mother has been sick in bed, I was a little uneasy, so I talked a little more. Probably all the attention was on talking to my mother, and with the fact that the pregnant woman wasn't in any danger for a day, I did let my guard down. When nurse Chen Qingling came back from the toilet and found that the patient's blood oxygen saturation had dropped to 85%, and the instrument was alarming, she quickly called me. ”

Dr. Pang also knew that this matter was wrong, and his attitude was not bad.

Now is not the time to hold accountable, the most important thing is to quickly find out the problem and save the patient.

"How long did it take from the time I found out that the patient's blood oxygen was alarmed to when you called me?"

"It's probably less than five minutes away. Dr. Pang did not get better after taking some emergency measures, but the blood oxygen fell faster, so she quickly called you. ”

Chen Qingling said beside him.

"In just a few minutes, the blood oxygen has dropped so badly, what first aid measures have you taken?"

Zhou Can asked Dr. Pang while looking for the cause.

"I increased the oxygen concentration and increased the oxygen flow ......"

Dr. Pang explained his rescue measures.

Zhou Can originally suspected that there was a problem with Dr. Pang's rescue measures, but after listening, he carefully checked the parameters of the ventilator and couldn't help but suddenly realize.

Quickly try to reduce the nebulization and adjust several parameters of the ventilator.

The patient was then checked again for problems with the intubation.

The oxygen saturation of the blood that had been rapidly declining slowly stabilized, and then rose up little by little.

After about 20 minutes, the patient's oxygen saturation rose to more than 95% and the alarm was lifted.

The pregnant woman's original cyanotic complexion also returned to normal.

It's just that the fingertips are still a little cyanotic.

Doctor Pang seemed to have survived a catastrophe of life and death, and breathed a long sigh of relief, and his originally gray and nervous face finally turned bloody. A hint of joy for the rest of her life after the catastrophe appeared on her face, and the fear in her eyes disappeared.

If something happened to the pregnant woman just now, Dr. Pang would probably have to bear some responsibility.

With Tuya Hospital's strict style of paying close attention to medical safety, her future was basically ruined. If you can continue to stay in Tuya Hospital and mix in the position of attending physician until you retire, then you will burn high incense.

"Dr. Zhou, why do you adjust the parameters of the ventilator, and the patient's blood oxygen saturation can stabilize, and then rise back?"

Physician Pang, an attending physician, used the honorific title for Zhou Can, a regular trainee, for the first time.

It is not only out of gratitude, but also out of heartfelt admiration for Zhou Can's skills.

"From the very beginning, it was not quite right for you to rush to increase the oxygen concentration and oxygen flow. Hurry up and not get there, have you ever heard of it? In the future, when Dr. Pang rescues such patients, it is best to combine the patient's condition. Then, you see that increasing the oxygen concentration and oxygen flow rate is not working, and blindly administer nebulized inhalation to the patient, which is even worse for the patient. ”

"The specific principle is that people's respiratory tracts have already flooded, and if you make another wave of artificial heavy rain, isn't this going to block her respiratory tract?"

Zhou Can did not hide his selfishness, but patiently explained the principle to Dr. Pang.

She may know these things, or she may not know them.

At that time, because she only cared about making phone calls, the patient's blood oxygen dropped to 85%, only to find out, out of instinct, she must have been very panicked in her heart.

When people are in a hurry and panicked, it is easy to lose proportion, and then the decisions they make are very easy to make mistakes.

Rushing to the doctor is not only for patients, but also for doctors.

After listening to Zhou Can's explanation, Dr. Pang carefully comprehended and deduced the pathological and physiological mechanisms, and after seven or eight minutes, he suddenly realized.

"I see...... Oops, blame me for being in a hurry! It almost made a big mistake. ”

After understanding the pathological mechanism, she patted her forehead again and again.

"Thank you Dr. Zhou for your advice, thank you!"

She thanked Zhou Can this time, which was from the bottom of her heart of surrender and gratitude.

This made Zhou Can a little difficult to clean her up again. Originally, I was thinking about reporting this matter to Director Zhang and teaching her a hard lesson. Seeing that she is not young, she is middle-aged, and there is an old mother who is sick in bed at home.

It would seem a bit cruel to really wipe out her work.

"Thank you, I don't have to. The most important thing in medical work is safety, and being able to rescue the patient this time does not mean that you will be so lucky in the next accident. I sincerely hope that Dr. Pang will cherish his job as a doctor. What kind of trust is it for patients to entrust their lives to us? You say yes, right? ”

Zhou Can didn't say anything serious, just knocked her a few words.

(End of chapter)