Wine estate, Zhou Qiao got up in the morning, and saw that on the big terrace outside, Luo Ya was dancing towards the first rays of the morning sun.

Her body is slender, and her moves are slow and round, but they are endless, like flowing water, without the slightest sense of stagnation.

It turned out to be Tai Chi.

"When did you learn it?" Zhou Qiao asked in surprise.

Luo Ya smiled: "A while ago, I learned from a Chinese girl." There is something in this boxing method, and it is estimated that it will not work in actual combat, but it is still possible to strengthen the body. ”

She smiled slightly and said, "I don't know if I'm pregnant." If I'm pregnant, I can't do too strenuous exercises, so I'll play this set of punches to stretch my body. ”

She is used to exercising, and if she doesn't exercise for a day, she will be uncomfortable.

Zhou Qiao pondered for a few seconds and said, "I should be pregnant." If not, we'll do it next month. ”

Because, it seems that the ovulation period is only a few days. Of course, there are cases of sudden ovulation. But these days are actually the most probable.

And he's pretty confident in his abilities.

Seeing Zhou Qiao come out, Luo Ya came over to fight with him.

The two of them were in love, and they were thinking about whether to come up on this terrace when Luo Ya's phone rang.

At first glance, it was Dean Joachim Langlei calling, and Luo Ya didn't bother to answer, so she threw the phone directly to Zhou Qiao and said, "Work hard for a few more days." Wait a few days for you to leave and see what they do. ”

Zhou Qiao answered the phone with a smile, listened to a few words, and said, "Then I'll come over immediately." ”

returned the phone to Luo Ya and said, "You can also connect for a remote consultation in the future." ”

"It's just that you're working too hard." Luo Ya thought that Zhou Qiao was so dedicated, she should have something to say.

Zhou Qiao hugged her and kissed her: "I can't help you in other places, but I'm good at this kind of professional thing!" ”

Luo Ya glanced at him affectionately and said, "Then I won't send you away, I'll let Lu Xianna send you." ”

Zhou Qiao nodded, although he could drive himself, he preferred to take a car. In addition, Luo Ya is not worried about Zhou Qiao alone, and sending Lu Xianna also has the intention of protecting Zhou Qiao.

Luo Ya still has a few video conferences to be held, and she can't leave.

Lu Xianna was elated, and it was a great honor to be Zhou Qiao's driver again, chattering along the way, and it didn't take long for Zhou Qiao to come to Sequoia Tree Hospital.

Dean Joachim Langley was like a savior: "Dr. Zhou, Professor Zhou, you are finally here. Hurriedly welcomed Zhou Qiao in and took him to the consultation room.

Although Zhou Qiao had heard about the condition on the phone before, it was inconvenient after all, so he still wanted to listen to it in detail at this time.

The patient was a young girl, a native of Texas, who had just gotten married and had no children, and when the chemical plant exploded, she was not injured much, but choked on a few puffs of smoke before escaping in time.

I didn't feel hurt at the time, so I didn't go to the clinic or hospital.

Then, the next day, I felt unwell, my chest began to hurt, and every time it hurt, I also had the symptoms of difficulty breathing, which was the feeling of wanting to suffocate.

In addition, there are symptoms of nausea, vomiting, and back pain.

Then, her husband accompanied her to a clinic near her home, and after the doctor learned more about the situation, he arranged an X-ray examination for her, but the film was taken and no obvious abnormalities were found.

Eventually, the doctor diagnosed that it might be due to smoke inhalation, which caused respiratory infections and triggered asthma, which could progress to pneumonia, so she was prescribed painkillers, antibiotics, and albuterol aerosols for bronchial asthma and wheezing bronchitis.

And let her come back in three days for a follow-up appointment, of course, if her condition worsens, she can come at any time.

The patient did get much relieved after taking the drug, and thought it was fine, but unexpectedly, early this morning, the patient's condition worsened, and he fell in the restaurant and fell unconscious.

The patient's husband was so anxious that he immediately called an ambulance, thinking that the clinic was not good, and Sequoia Tree Hospital had recently treated many patients injured in the explosion of the chemical plant, and its excellent performance was also praised by the governor, and various media outlets carried a lot of coverage.

So, the patient was taken to Sequoia Tree Hospital.

After arriving, the emergency doctor found that the patient had low blood pressure, hypoxia, myocardial ischemia, syncope, and was not awake in first aid, and then arranged in the intensive care unit, put on a ventilator, and infused to save his life, and reported to the director of the department.

Because the cause is unknown, the situation is not optimistic, and the patient's life is in danger every minute, so the emergency department calls other departments, such as cardiac surgery, respiratory, medical imaging, interventional diagnosis and treatment, ultrasound, etc., for multidisciplinary consultation.

However, everyone had their own opinions, and when Zhou Qiao came in, the conference room was in full swing, and they were about to jump up and fight.

The head of the department of cardiac surgery thought that the doctors at that clinic must have diagnosed respiratory infections and asthma wrong.

If the patient's ECG shows myocardial ischemia-like changes, coronary insufficiency should be considered, and symptoms such as chest pain in the patient are most likely angina.

Therefore, coronary atherosclerotic heart disease should be considered, and electrocardiogram and cardiac ultrasound can be done.

The respiratory department believes that the patient has symptoms such as dyspnea and chest pain before coma, and the chest pain may not be angina, but may also be pleurisy-like chest pain, combined with a significant increase in blood white blood cells, an increase in the proportion of neutrophils, and most of them are pneumonia, and antibacterial therapy is considered.

"Be quiet!" Dean Joachim Langlei was very displeased, and then asked the attending physician to introduce Zhou Qiao's condition.

"Look what Dr. Zhou has to say." Everyone looked at it expectantly. Only Zhou Qiao can calm everyone's dispute.

Zhou Qiao listened to the introduction of his condition while flipping through the existing examination report.

"Doctor Zhou, what do you say?" Seeing Zhou Qiao muttering for a long time, Dean Joachim Langlei couldn't help but be a little anxious, and couldn't help but ask.

Zhou Qiao raised his head and said, "In the case of the patient, it is more likely to be a large-scale pulmonary embolism. Hurry up and do a V/Q scintigraphy and pulmonary angiography. ”

"Huh?" The doctors were stunned, how could it be neither heart disease nor pneumonia? Rather, pulmonary embolism?

However, they admired Zhou Qiao's strength, although they didn't know how Zhou Qiao was diagnosed, but they still took action immediately.

If it is really a massive pulmonary embolism, it is an acute and critical illness, and the slightest delay can be fatal.

Moreover, the symptoms of this disease are actually very subtle, and it is difficult for people with little experience to easily diagnose them.

Symptoms of pulmonary embolism can sometimes resemble a cold or muscle injury, such as chest pain, shortness of breath, sometimes swelling or pain in the legs, and sometimes a bloody cough.

Moreover, the patient is unconscious, and the patient's husband is vague, which makes the diagnosis more difficult.

"In addition, judging from the report, the patient has cardiac dysfunction, in order to prevent acute heart failure, dopamine is recommended, and the interventional department is prepared, and surgical thrombectomy may be required." Zhou Qiao stood up and walked towards the intensive care unit, and the others followed.

Intensive care unit.

After Zhou Qiao entered, he saw the patient lying on the bed, wearing a ventilator non-invasive mask, but after a closer look, he found that the ventilation effect was not ideal, and the oxygenation index was relatively low, only 270, and it was slowly declining.

The nurse said there were more than 300 just now.

The faces of the doctors just changed, what does this mean? It shows that the patient's condition is deteriorating all the time.

Especially the emergency doctor, I felt a sigh in my heart, the director and the dean should not blame me for not taking first aid measures in place, right?

In fact, when he was in charge of rescue before, a non-invasive mask was OK.

Zhou Qiao said: "Hurry up and do tracheal intubation!" ”

The doctor went into action.

The intensive care unit has ready-made equipment, laryngoscopes, intracatheter guidewires, suction tubes, dental pads, syringes, etc.

Since the patient is a woman and slightly petite, the average height of a girl in the United States is about 160.

The girl's airway is relatively tight and narrow, so the doctor chose a 6.5mm inner diameter trachea.

Soon, endotracheal intubation was completed.

But when the doctor saw it, the oxygenation was still low, and the blood oxygen saturation was only 69%, could it be that the tube was too thin? Or is the patient's lung damage severe?

Or is there something wrong with my operation?

His mind was racing, and he carefully reviewed it, and there were no anatomical knowledge, physiological knowledge, and various points of tracheal intubation. It's basically a textbook-level standard operation!

The thickness of the trachea should also be appropriate.

He looked at Zhou Qiao very helplessly.

Zhou Qiao said: "The airway pressure is too high, and you inserted it too deeply. ”

With a slight stretch of his hand, he pulled the endotracheal tube out slightly, and sure enough, immediately, the blood oxygen saturation soared to 95%, and the airway pressure returned to normal.

The Doctor: "......"

Other doctors: "......"

Thumbs up.

However, after the endotracheal intubation, the patient did not wake up, and as Zhou Qiao expected, he began to show signs of acute left heart failure, so the nurse followed the doctor's instructions and immediately gave dopamine and 3mg intravenous bolus.

A miraculous scene occurred, almost as soon as the nurse pulled out the needle, the patient slowly opened his eyes.

Doctors: "......" don't know how to express their admiration!

Sure enough, he is a top celebrity in North America, everyone is arguing, and he feels that he can't start the condition, and Dr. Zhou can easily handle it!

In the meantime, pulmonary ventilation/perfusion (V/Q) scintigraphy and pulmonary angiography have been scheduled.

It didn't take long for the test results to come out: pulmonary embolism!

Those two tests are the gold standard for pulmonary embolism. Looking at other X-rays, CT scans and the like, sometimes it is not necessarily obvious.

The medical staff: "......" admired him so much, and sure enough, it had to be Dr. Zhou!

Zhou Qiao waved his hand lightly, asking everyone not to be happy too early, the battle had just begun, and the patient was not out of danger yet.

Anticoagulation, thrombolysis.

For some large ones, which are really difficult to dissolve with drugs, there are only interventional means.

Zhou Qiao instructed the interventional doctor again, and in another room more than ten meters away, he guided step by step to remove the large thrombus in the pulmonary artery and the main branches, promote the recovery of right ventricular function, and improve symptoms.

After his condition stabilized slightly, the patient was transferred to the Department of Respiratory Medicine for further treatment.

Now, he is finally out of danger.

The patient's husband is very grateful, but the doctors are very suspicious, why is there a massive pulmonary embolism?

Although he inhaled a little smoke, the patient acted like he was okay that day.

It's not that you faint from the smoke or get poisoned.

Studied but cannot comprehend.

Everyone came to ask Zhou Qiao for advice, Zhou Qiao pondered for a while, and then asked the patient's husband: "Think about it carefully, in addition to the medicines prescribed by the doctor in the clinic, what other medicines have you taken?" ”

The patient's husband shook his head blankly and said, "No, I really didn't take other medicines." ”

Zhou Qiao asked, "Are you sure?" Think again. ”

The patient's husband thought carefully for a moment, and suddenly felt a little embarrassed.

"How?"

The other doctors also looked over and said to themselves, could it be that they had really taken other medicines? Why didn't we say it before, so we almost misdiagnosed.

The patient's husband said ashamedly: "After coming back from the clinic and buying medicine at the pharmacy, doesn't my wife feel very good?" So, we ...... again at night A few more times, she took some birth control pills. ”

Oh my God! The doctors fainted.

Are you all sick, and you still have this interest? What kind of husband is this, he doesn't pity the jade at all.

Zhou Qiao actually vaguely guessed. He didn't rely on the system, but he really studied the contraceptive pill and the side effects of various contraceptives, including some special conditions, such as inhaling smoke, which can induce and exacerbate pulmonary embolism.

Because, he has so many girls, they don't use T. He also thought about it, but several girls were willing to choose contraceptive pills, so he had to do more research and help them choose better drugs.

Even, Zhou Qiao made a very detailed comparison table, comparing the advantages and disadvantages and side effects of various contraceptives on the market.

Of course, taking birth control pills alone will not directly cause pulmonary embolism, and this case has its peculiarities.

……

In the evening, Zhou Qiao received a call from home, and his parents nagged him about some recent things that had happened at home.

First, the sister-in-law invited them to dinner, saying that after the little cousin entered the French nuclear power plant, he changed his mind and worked very hard, although he was still training, but he had already received two awards.

In addition, there is a basic salary during the training period, which is about 60% of the official salary, and more than 2,000 euros a month.

After the little cousin got the salary, he called half of the sister-in-law as soon as he got the salary, and the sister-in-law was so happy that she couldn't close her mouth, so she invited relatives and friends to dinner.

Then these days, there is a California governor of the United States to come to China, play around, come to Zhejiang Province and come to Zhuhai County to sit at home for a while, and give a lot of gifts, but the home is too "shabby", there is nothing valuable in return, so I had to give back a little tea.

Zhou Qiao said that he didn't need to care too much, Governor Hulk was very rich, so he just wanted to express his heart in return.

Although Zhou Qiao's parents had heard Zhou Qiao talk about it before, saying that they had many friends in the United States and were doing well, they always thought he was bragging, and this time they really believed it.

They're good friends with the governor, so what else do they have to worry about?

When Governor Hulk came to his house as a guest, some leaders from the province and county also came, and Zhou Qiao's old classmates, Zeng Haitao, the village party secretary, Fan Zhiyong, the village head, and Gong Xu also came to accompany him.

(End of chapter)