"One day is enough!" Nanako Chiba immediately stood up excitedly, walked out of the conference room quickly, and then ran towards the community hospital.

Elena followed, shouting from behind, "I'll drive you!" ”

Although the community hospital is only a few hundred meters away, usually everyone is not in a hurry, they all come and go on foot, but isn't the situation urgent now? Therefore, one foot on the gas pedal is definitely faster than walking.

"Okay, thanks."

Although Nanako Chiba got her driver's license, she just came to the United States and hasn't bought a car yet.

Zhou Qiao advanced her annual salary, 200,000 US dollars, but when she first arrived, she added her sister and various expenses, and she wanted to keep some money on her body and have a sense of security.

Then, Elena took her to the community hospital.

Hospitals in the United States are not as difficult to park as hospitals in China, and the parking lot of this community hospital is large enough, and there are not so many cars, so you can park at will.

Nanako Chiba came to the patient's bedside, checked the patient's current condition, kidney function and MIC and other related indicators, and asked Park Xiuzhu, who was on duty here, a few words, and then she knew it and adjusted the administration method of meropenem.

Elena asked, "Is this really going to work?" ”

"Yes, just try it." Nanako Chiba is confident.

Meropenem is actually a carbapenem antibacterial drug, which is suitable for adults and children Infections caused by single or multiple bacteria sensitive to meropenem: pneumonia (including hospital-acquired pneumonia), urinary tract infections, gynecological infections (such as endometritis and pelvic inflammatory disease), skin and soft tissue infections, meningitis, sepsis, etc.

Nanako Chiba carefully reviewed it, and according to the results of the blood culture, she thought that the previous drug selection was not wrong. Generally speaking, there is a risk that the test result will be wrong, but this probability is relatively small, and it cannot be questioned casually.

For example, 0.5~1g of the drug is dissolved in more than 100mL of liquid, and administered by intravenous infusion for 15~30min, with an interval of 6~12h.

The advantage of this approach is that the maximum plasma concentration can be achieved in a short period of time, but due to the short clearance half-life of meropenem, the plasma concentration is quickly lower than that of the pathogenic bacterium MIC, and because meropenem is a time-dependent drug, this traditional infusion method is less effective.

Stupidly administering according to the instructions, that's the lowest level.

In the specific use of drugs, it is necessary to make appropriate adjustments for different patients and different conditions.

It is naturally impossible for Nanako Chiba to use this "superficial" intermittent infusion method, nor does she use the ordinary 24-hour continuous infusion method, she uses the intermittent delayed infusion method, that is, the micropump continues to infuse for 3h, 3~4 times a day, which can ensure the safety and effectiveness of the drug to the greatest extent.

This is also the method that is commonly used in many major hospitals, including the University of Tokyo Faculty Hospital. Practice has proven that this method is quite effective.

If you want to use the version to explain, this is version 3.0 of the meropenem administration mode.

I thought I could do it, but who knows, the high fever comes and goes, and it can't go away.

At the meeting just now, Nanako Chiba's mind was racing, and she carefully reviewed it in her mind, and finally found out where the problem was.

That is, version 3.0 can increase %fT > MIC, but will reduce the peak concentration (Cmax) of the drug and delay the peak time, thus reducing the initial bactericidal ability.

Under great pressure and a desire to win, Nanako Chiba used her talent for pharmacokinetics to deduce two solutions to this situation in a short period of time, which can be called versions 4.0 and 5.0.

4.0 is an ingenious two-step infusion method, the first 500mg is dissolved with 50ml of 0.9% sodium chloride injection, the micropump is infused for 30min, and the second 500mg is dissolved with 50ml of 0.9% sodium chloride injection, and the micropump is infused for 4h.

However, after thinking about it, it was still not perfect, because the patient's condition was somewhat serious, and there were requirements for the treatment time, and the fever and surgery needed to be reduced as soon as possible.

So, on this basis, she made some modifications and derived version 5.0.

The first stage of version 5.0 is given at a constant speed, but the dosage of the drug is adjusted, and a part of the drug (about 1/3) in a single dose is quickly instilled within 30min, so that the blood concentration can quickly reach the peak and produce a bactericidal effect as soon as possible; In the second stage, the time is shortened, the intensity is increased, and the remaining drug (about 2/3) is slowly instilled at a constant rate within 2.5h, so that the blood concentration can be maintained as long as possible at the minimum inhibitory concentration of pathogenic bacteria, so as to maximize the efficacy.

Elena and Park so-joo work together to assist Nanako Chiba in adjusting medication and monitoring various data at the same time.

When the condition was urgent, they did not go back, and stayed by the patient's side.

The patient's family is grateful, but they are also very apprehensive.

Suddenly, three medical staff came and operated around the patient, which made them panic and thought that something was going to happen.

Seeing this, Elena went to reassure them: "It's just to adjust the medication and expect better results." ”

Some medical staff in the community hospital passed by and learned about the situation, and they couldn't help but mutter, "Is this really effective?"

A miraculous scene occurred, and the patient's high fever quickly subsided, and it did not recur until the evening.

Seeing that the adjusted administration method was effective, Nanako Chiba couldn't help but breathe a sigh of relief.

If she can't handle this "little thing", how can she be qualified to say that she has expertise in medication in the future? Not to mention being underestimated by Murphy and Stephanie, if Zhou Qiao feels that his level is not good, it will be a big loss!

Thankfully, it was eventually resolved.

Nanako Chiba has a rather sense of accomplishment.

Murphy and Stephanie received the news, and after a little discussion, they decided to have an overnight operation!

Because, time waits for no one. If it drags on any longer, the patient's life will be in danger at any time.

And the time for Nanako Chiba to get it done is far beyond their expectations!

The two of them gave a thumbs up to Nanako Chiba at the same time.

Nanako Chiba smiled and said, "I'll leave it to you next." ”

In terms of surgery, she couldn't help much, and only helped with the dosing plan after the operation.

Because she had to have an operation overnight, Aliel took Heimei to escort her in person.

Murphy and Stephanie put aside their usual cautions and worked together, they are both young masters of the peak of the master surgery, although the operation is difficult, but finally successfully completed.

Because the patient's persistent high fever is caused by infective endocarditis, he should still be hospitalized after surgery and receive standardized anti-infective therapy.

Murphy and Stephanie didn't care about the follow-up medication, they now trust Chiba Nanako very much, and they also admit that in this regard, Chiba Nanako has expertise.

Nanako Chiba won the title of "Little Expert in Medication".

……

After Zhou Qiao returned from Boston, he heard about it and expressed his congratulations to Nanako Chiba, congratulating her on her successful integration into the team.

Nanako Chiba pursed her lips and said in her heart, is this integrated into your harem group? Strangely, though, she didn't resist at all.

Nanako Chiba also thought about it in private, why is this?

Thinking about it, there is only one fact, that is, not only Zhou Jun is very attractive, but these beauties in the iris clinic are also attractive, which makes her can't help but have a good impression and want to be close.

Not to mention the twins Elena and Ava, their personalities are very milky, especially Elena, whose popularity is really good. And although Murphy and Stephanie have their own characteristics, the superb surgery and academic level make Nanako Chiba ashamed.

Although those two girls often compete secretly, they are only limited to medical skills and academics, and they usually do not have any bad thoughts about each other. I have to say it's very interesting.

Then, these four beauties are all quite good-looking, have graceful figures, and behead men and women...... Thinking of this, Nanako Chiba couldn't help but tremble.

Because, for the first time, she was horrified to find that she actually had a tendency to bend?

Turning a corner? Oh, my God!

But when you think about it, it's not like that at all. No way.

Because, Zhou Jun is more attractive to her!

As everyone knows, in the eyes of others, Nanako Chiba is also very attractive, beautiful, docile, well-behaved, the kind of gentleness unique to Japanese girls, it seems that no matter what she is asked to do, she will take the initiative to cooperate, and anyone can't help but want to pinch a few times.

Of course, the most important thing is that Nanako Chiba is not a vase, but has real skills, making up for the "shortcomings" of the Iris Clinic, and with her, the Iris Celestial Group has reached a higher level and become a truly top-notch medical celestial group.

Orientation team building is a tradition of the Iris Clinic, and due to the recent busy work, Zhou Qiao just led everyone to a dinner to welcome Nanako Chiba to join.

Zhou Qiao said that when he is free for Christmas or New Year, he will take everyone to check in at distant scenic spots.

This time, they went to a restaurant in Half Moon Bay, and the environment was very good, and they could eat while watching the sunset over the Pacific Ocean.

The Pacific Ocean is west of San Francisco, and they can't see the sunrise over the sea, but the sunset over the sea is also unique.

At dusk, the sunset seems to sprinkle a layer of gold dust on the surface of the Pacific Ocean, and the sky is gradually dyed with warm yellow and orange red colors, reflecting the sea water, and from time to time there are cargo ships or cruise ships passing by on the sea, creating golden ripples.

I have to say that eating in a picture-like environment can increase people's appetite even more.

Chiba Nanako also brought her sister Chiba Ruyin, Park Xiuzhu naturally wanted to bring Yun'er, although Yun'er is a few years different from Chiba Ruin, but the height is almost the same.

Yuna has light wavy curly hair, and Chiba Ruin has a double ponytail, and there are obvious Korean and Japanese styles in temperament and dressing.

Perhaps in the eyes of Europeans and Americans such as Rachel and Vivica, Japanese, Koreans and Chinese are similar, but in Zhou Qiao's eyes, they are clearly distinguished.

Just as Chiba Ryuin can see at a glance that Zhou Qiao is Chinese, Zhou Qiao's facial features, temperament, expression when speaking, and dressing style are also very different from Japanese and Koreans.

(End of chapter)