It was the first time Chen Gong had encountered this kind of thing.

Standing in place for a while, breathing rapidly, a little unwilling.

Boy!

Where are you coming to see a doctor?

You are clearly here to kill your relatives in righteousness!

All right?

But...... Chen Gong has no way to sway the other party's thoughts, it is illegal to force the other party to buy and sell, let alone compulsory medical treatment!

This woman's attitude really made Chen Gong a little puzzled.

Is this your own son?

Even if it's an elimination method, you have to do a check, right?

Besides, whether it is a serum iron SI test or an abdominal X-ray, it is very cheap, and it can be solved for 180 yuan.

Although Chen Gong didn't dare to be 100% sure that the other party must have had iron poisoning.

But clinical diagnosis, no one is good who is a fairy?

It is impossible to say that it can be diagnosed all at once, and it is 100% confirmed.

Therefore, the logic of modern medical diagnosis and treatment is still such a process of exclusion and contraction judgment.

"Team Leader Chen, you ...... Don't be offended. Wu Xueyu couldn't help but say.

Yang Hui nodded and laughed at himself: "Yes, let's ...... here That's the case. ”

Chen Gong heard the sound and was a little lost.

The establishment of the doctor-patient relationship is first and foremost trust.

If there is not enough trust, it is difficult to proceed with the next step of treatment.

No matter how capable you are, in the final analysis, people don't want to believe it, and you have nothing to do.

Speaking of this, Chen Gong looked at the test sheet on the computer screen and pondered.

He didn't feel like he had made a mistake.

According to the patient's current symptoms and laboratory test sheets, nine times out of ten it is iron poisoning.

Thinking of this, Chen Gong hesitated, picked up the other party's registered phone, and sent a message.

Although this woman is arrogant and unreasonable, she ...... The child is innocent.

This is a two-year-old child, and if it leads to serious complications due to the delay in the optimal treatment period, it will be more than worth the loss.

Yang Hui and Wu Xueyu saw Chen Gong's operation, and couldn't help but say to Chen Gong:

"Team Leader Chen, you are really a good doctor!"

"But...... I think it's a shame that you're here! ”

"However, I have a doubt, you are so sure that the patient is suffering from iron poisoning, if not...... What to do? ”

"You also saw that the family is so fierce......"

Chen Gong glanced at Wu Xueyu, smiled, shook his head and said, "Wrong is wrong!" ”

"However, it doesn't matter if you're wrong, at most scold me."

"I even wish I was wrong."

"But it's a pity...... Hey......"

Chen Gong shook his head, got up and returned to the office.

Sitting in the chair, Chen Gong pondered for a long time, and it is undeniable that there has been a crisis of trust in patients' doubts about the hospital and doctors.

This situation continues to develop dangerously.

What to do?

Chen Gong was a little worried.

He's just a team leader, how can he solve the problem at hand?

……

……

That night, Chen Gong ushered in the first serious night shift in his life.

Although I followed Zhao Xi before, I also experienced it.

However, there is still a big gap between dealing with emergency patients and dealing with surgical patients independently.

At around seven o'clock in the evening, Chen Gong was busy dealing with several trauma patients and had not yet had time to eat.

When I returned to the office, I saw Wu Xueyu walking in with a lunch box in his hand.

After seeing Chen Gong, Wu Xueyu smiled awkwardly:

"Team Leader Chen, my mother sent me some dumplings, I can't eat them alone, thinking that you are too busy to eat, so I sent them to you."

Seeing this, Chen Gong immediately laughed: "You're welcome, I'll just order a takeout, it's not necessary to run all the way." ”

Wu Xueyu scratched his head: "No...... In fact...... I want to work the night shift with you. ”

"I can learn more."

"I know, Team Leader Chen, you have real skills, I am a surgical background, in the emergency department, in fact...... Quite nervous. ”

"Today's patient, I'll be honest...... Who would have thought it was iron poisoning? ”

"I checked in the afternoon, and it seems that the patient's condition is really the same as you predicted."

"So ......"

"I want to follow you and learn a little more, or else...... In the future, I will also engage in emergency medicine, and I don't understand anything. ”

"Don't treat other people's patients."

When Chen Gong heard this, he couldn't help but feel good when he looked at the young man in front of him who was about the same age as Qin Ge, but was extremely humble and studious.

"Okay, then it's hard for you."

"Hehe......"

While speaking, Chen Gong sat on the chair, Wu Xueyu took a pair of disposable chopsticks and handed them to Chen Gong, smiled and picked up a book and read it.

Emergency Surgery.

Although the book is a 2014 version, Chen Gong knows that the version has fallen a lot behind.

It can only be said that the pace of innovation in domestic emergency medicine is too slow.

In other words, not only domestic, but also internationally, although emergency surgery has only been tinkered with in recent years, it is still difficult to have too many reforms.

Thinking of this, Chen Gong took out his notebook and handed it to Wu Xueyu.

"Here are some of my own emergency surgery experiences, which I have compiled according to the guidelines and the latest surgical and emergency cases."

"If you're interested, take a good look and maybe it will help you."

Hearing Chen Gong's words, Wu Xueyu took the book with both hands excitedly, and there was a little more excitement in his eyes.

"Thank you, Team Leader Chen!"

"Thank you!"

"Hey, hey."

After finishing speaking, Wu Xueyu picked up the notebook, walked aside, and did not disturb Chen Gong, and read it carefully.

Chen Gong ate dumplings, but he didn't take it seriously.

It's just that......

At about nine o'clock in the evening, suddenly a hurried sound sounded outside the door.

"Hurry, hurry!"

"Hurry up!"

"Help, doctor, anyone?"

Hearing the movement outside, Wu Xueyu hurriedly got up and ran outside.

Seeing this, Chen Gong followed out quickly.

In the middle of the night, it was obvious that something unexpected had happened.

When he came out, he saw that the nurse had already pushed a hospital bed out of the hospital bed, which was a child, followed by two adults and an old lady.

When Chen Gong saw this, he naturally recognized it.

Isn't this the same little boy who came today?

Did it really get sick?

After coming in, the old lady was sweating profusely, and when she saw Chen Gong, tears flowed down her eyes.

"Doctor, Dr. Chen!"

"You save the doll."

"As you said, the child slept until now this afternoon, and when he woke up, he began to vomit, and there was blood in it!"

"And, unconscious."

"We were sent to the Provincial People's Hospital, and we had to be examined for half a day, and the doctors there couldn't find the cause at all."

"That's when I thought about the message you sent me."

"No, send the child over quickly."

"As you said, the child is really in a coma!"

"Please, save the child."

When Chen Gong heard this, he hurriedly said to Wu Xueyu: "Xiao Wu, send the child to the custody room." ”

"Get on the monitor, check some blood pressure, and temperature."

"By the way, get your serum iron checked."

"Hurry up!"

Wu Xueyu was young after all, his steps were fast, and he hurriedly pushed the child and walked towards the custody room.

Don't dare to delay in the slightest.

Let's be honest!

Wu Xueyu's admiration for Chen Gong at this time was to the extreme.

In the evening, the two also chatted about the patient's situation, and Team Leader Chen estimated that if the child became ill, it would be around nine o'clock!

Wu Xueyu didn't take it seriously at that time.

After all...... This, he thought, was a bit too mysterious.

How can any doctor predict a disease so accurately?

Wu Xueyu's master's supervisors can't do this.

How old is this Team Leader Chen?

How can it be?

However, at this moment, when he saw the patient's condition, Wu Xueyu's heart was really shocked.

At nine o'clock, the symptoms were exactly the same, and sure enough, there was a coma.

At this moment, Wu Xueyu's footsteps did not dare to stop at all.

Because according to Chen Gong's prediction, this disease, once it exceeds 12 hours.

The development of the disease is bound to be more rapid.

At that point, leukocytosis, coma, and even delayed shock can occur.

Here, Chen Gong was not idle, and beckoned a little nurse to help the family go through the formalities.

On duty tonight at the nurses' station is the old nurse He Ling.

He Ling was transferred from the emergency department of the original cancer hospital, and her strength is good.

Or it can be said that this time the personnel transfer is a bit special.

There are a lot of nurses transferred, most of them are young and middle-aged powerful people, and their level is very skilled in dealing with various clinical things after clinical training.

But!

In comparison, the level of doctors is a bit overwhelming.

Except for a few pillars who are indeed at the deputy director level, most of the young doctors are performing poorly.

Therefore, the nurses in the past few days have even looked down on these doctors.

However, fortunately, He Ling and they are very cooperative.

For Chen Gong, a young team leader who has just arrived, everyone still gave some respect.

Soon, preparations began to be coordinated.

He Ling also hurriedly followed Wu Xueyu towards the rescue room.

On Chen Gong's side, he was not in a hurry, but began to prepare for medicine.

Although serum iron has not yet been detected, it is ...... Chen Gong estimated that the patient's condition was similar to what he had guessed.

Therefore, the medicine that Chen Gong needs to prepare is more special.

Hospitals may not be able to find them.

So, Chen Gong found the patient's family, the child's father.

"You go buy two catties of eggs and a carton of milk now."

"Hurry up, hurry up."

Hearing Chen Gong's words, the man was stunned for a moment, and then hurriedly nodded: "Okay, I'll go now!" ”

"That's right...... Dr. Chan, please don't ...... Don't mind. ”

"My wife...... Ay...... There are many offenses today. ”

"I'm so sorry."

"We're in a hurry today."

"Actually......"

Chen Gong waved his hand: "You go quickly!" ”

The woman also glanced at Chen Gong with some embarrassment at this time, not to mention how embarrassed and guilty she was.

Chen Gong didn't mind, but got up and walked towards the doctor's office.

Hurry up and prescribe medication.

For patients with this type of iron poisoning, it is necessary to perform the "iron removal" related procedure in time.

Iron is absorbed more slowly.

In the intestine takes managers 24-48 hours of the process.

The patient absorbed it at about 10 o'clock this morning, so that within 12 hours, there is still the possibility of vomiting and gastric lavage.

But!

Regarding the gastric lavage of this iron agent, Chen Gong has his own ideas.

At this time...... The child's mother walked in, looking uneasy.

After coming in, he hurriedly said to Chen Gong:

"Dr. Chen, I'm so sorry!"

"I apologize to you."

"Today I was really angry, too anxious, so ...... It's a bit presumptuous to speak to you. ”

"Because before, my husband came to your hospital because of a stomachache, and he did a lot of tests, but nothing came out."

"I ...... I just have some ideas for your hospital. ”

"I know, it's my fault, it's the bad influence on you."

"I'm sorry, please forgive me."

"Of course...... You don't have to forgive me, I hope you can save the child. ”

Chen Gong didn't make a sound, but nodded and said:

"Since you are a nutritionist, you should know that acidic fruits cannot be steamed in an iron pot, right?"

"There's some chemical reaction that happens to make low-iron compounds."

"After long-term use, this compound will be absorbed by the body and produce symptoms of iron poisoning."

Hearing Chen Gong's words, the woman lowered her head embarrassedly and kept admitting her mistakes.

After Chen Gong finished prescribing the medicine, he turned to look at the woman and said:

"That's it!"

"It doesn't matter if these things matter, I don't mind what you think about our hospital."

"But I want you to learn to respect people."

After speaking, Chen Gong got up and walked towards the rescue room.

And at this time in the rescue room.

After Wu Xueyu finished measuring the child's body temperature, he suddenly exclaimed!

"Temperature: 38.5!"

"Blood pressure: 68/40 mm!"

"Holy!"

Nurse He Ling was busy at this time, and was startled by Wu Xueyu's voice, frowning slightly: "Doctor Wu, what are you doing here?" ”

"What a fuss, you can't hold your breath?"

Nurse He Ling was a little disappointed, to be honest, after coming here, He Ling really couldn't say anything about the level of doctors here.

Because...... It's so ordinary!

Or did you see a good doctor in the original hospital?

After coming here, seeing the level of these emergency doctors, He Ling was a little speechless.

At this time, seeing Wu Xueyu's fuss, he couldn't help but sigh.

Wu Xueyu then said:

"No, no!"

"Sister He, you misunderstood."

"Team Leader Chen is really amazing!"

He Ling was slightly stunned: "Chen Gong? What does it have to do with him? ”

Wu Xueyu told me about today's events, and then said.

"When the two of us were eating and chatting just now, Team Leader Chen predicted that the patient would become ill at about nine o'clock, and there would be signs of hypotension and shock."

"Blood pressure will not exceed 70/40 mm Hg."

"Moreover, even the body temperature can be predicted accurately!"

"It's simply amazing!"

"Team Leader Chen is too good!"

Wu Xueyu was really scared.

Chen Gong's level is far beyond the range of Wu Xueyu's ability to imagine.

He really couldn't think of it, why could Chen Gong even predict this?

When He Ling heard Wu Xueyu's words, she was also completely stunned.

She looked at Wu Xueyu with a little surprise, and couldn't help but say, "Really fake?" ”

"Don't lie to me!"

"When I was in the emergency department of the cancer hospital, I was a master, but ...... I've never heard of such a person. ”

"How is that possible?"

Wu Xueyu said excitedly: "Really! ”

"I'm not lying!"

At this time, there was a sound of pushing the door, and Chen Gong walked in from outside.

Hearing Wu Xueyu's words, he couldn't help but ask: "What kind of deception?" ”

Seeing this, Wu Xueyu hurriedly said: "Team Leader Chen, it's exactly the same as you expected!" ”

"Blood pressure, heart rate, body temperature!"

"It's pretty much the same!"

"How did you do that?"

When Chen Gong heard this, he couldn't help but smile and shook his head.

All of this naturally comes down to the same operation that was done for Ma Shushu at the beginning.

Chen Gong was very involved at that time, and the operation was extremely difficult.

So!

At that time, after Chen Gong completed the operation, he received a special reward.

"Poison Medicine: Lv6!"

Poison medicine at the level of an academic leader.

Similarly, it was such a skill that strengthened Chen Gong's idea of coming to the emergency department.

Although poisoning medicine has developed in recent years, it is ...... Globally, there is a lack of an absolutely representative academic leader.

Although more and more people have paid attention to it in recent years, it is ...... So far, only one academician has been born in the field of poison medicine in China.

Moreover, even in many emergency internal medicine, things such as gastric lavage for poisoning rescue have not been updated.

Chen Gong heard this and smiled: "Okay, what is there to praise about this." ”

"This is the law of disease occurrence and development."

"It's like if you have a cold, how many degrees of fever will you have, and when will the temperature rise...... A truth. ”

"After iron poisoning, there is actually a very predictable development process."

"In general, about 12 hours after iron poisoning is taken internally, hypoglycemia and metabolic acidosis occur due to cell damage caused by iron supplements.

Therefore, at this time, there is usually a fever, but this fever is very stable, basically maintaining in the range of 38.5 degrees Celsius.

At the same time, leukocytosis and coma will also begin to appear.

And if it is a child, it is delayed shock! ”

"You just have to remember this thing!"

After finishing speaking, Chen Gong looked at all the signs of the patient, as well as the electrocardiogram blood pressure indicators.

Pondered slightly.

He Ling looked at Chen Gong's eyes at this time, a little surprised.

She didn't expect that Chen Gong was so young and could have such a level?

It's a little unbelievable!

After hesitating for a moment, He Ling looked at Chen Gong and asked:

"Dr. Chen, do you predict one more?"

"Let me see it too!"

Chen Gong glanced at He Ling and knew what the other party was thinking.

However, he didn't mind, after all...... With the cooperation of nurses, the work can be carried out in the future.

I couldn't help but smile: "If I hadn't mispredicted, the child's serum iron would be as high as about 89.5 μmol/L (500 μg/dl), which would not be much higher." ”

As soon as these words came out, He Ling suddenly rolled her eyes.

"How could this have been predicted?"

Chen Gong didn't explain.

This is because if the serum iron concentration is too high at this time, the amount of bleeding will increase again, not the way it is now.

It didn't take long!

The nurse brought in the test sheets.

"Dr. Chen, the test results are in!"

"The patient's serum iron concentration is 90!"

When Chen Gong heard this, he didn't care, but continued to configure the medicine in his hand.

And He Ling and Wu Xueyu were completely stunned.

He really guessed it?!

This......

For a while, He Ling looked at Chen Gong with a little more shock in her eyes.

Now, hearing Chen Gong's words, He Ling was completely dead.

She knew that she should have met a master!

At this time, the family members outside the door began to knock on the door, and after the nurse came in, she looked at Chen Gong and said embarrassedly:

Director Chen...... Patient...... The family brought eggs and milk ......"

Chen Gong was stunned: "Take it in?" ”

The nurse couldn't help but laugh: "I can't take it!" ”

"The other party bought a lot!"

Chen Gong was stunned for a moment, and when he came out to take a look, he was immediately dumbfounded.

There were four or five cartons of milk in front of him, and two baskets of eggs.

This is like a gift, placed at the door of the custody room.

Chen Gong suddenly rolled his eyes: "Why are you buying so many of this?" ”

Man: "You asked me to buy it!" ”

"I'm thinking about buying more."

Chen Gong was speechless: "......"

He uses these things...... Could it be for eating?

He hurriedly beckoned the nurse to ask the patient's family to take it away, just to bring in a few eggs and a few bottles of milk.

Wu Xueyu looked at Chen Gong: "Team Leader Chen, what are you...... Configure your own medicines? ”

Chen Gong nodded.

"Hmm!"

"The rescue of general poisoned patients is mainly divided into two major steps."

"The first step is emergency treatment."

"The second step, medication."

"There are also several steps to emergency management."

"First, it prevents absorption, but the method should be selected according to different toxicity, the patient is iron poisoning, and a large amount of egg white and milk can promote the formation of a ferritin complex of free iron, which can prevent absorption."

"Second, inducing vomiting, actively, the tongue depressor stimulates the epiglottis, throat, etc., so that the patient can vomit out the iron he is taking as much as possible. However, this needs to be done in a conscious state. ”

"Third, gastric lavage."

After speaking, Chen Gong took out the medicine and handed it to He Ling: "Head nurse, this is the medicine I have configured, you can just come to gastric lavage." ”

"Xiao Wu, you remember this plan, and you can use it for iron poisoning in the future."

"Gastric lavage with 2% sodium bicarbonate solution can turn ferrous sulfate into less corrosive ferrous carbonate."

"Fourth, catharsis: use sodium sulfate to catharsis."

"The last step, and the most critical, is intravenous perfusion therapy: supporting tissue perfusion, correcting severe acidosis and shock, preventing liver and kidney damage, promoting iron excretion, and hemodialysis for severe poisoning."

These are not guidelines, and they don't appear on the guidelines at all.

In Europe and the United States, emergency treatment is actually not as good as in China.

Why?

This brings us to the geographical gap.

Because the Chinese are too awesome.

Dare to eat anything.

Therefore, this has led to the world's leading experience of Chinese poisoning.

Which one is stronger in detoxification?

China's Yunnan is all great!

No way, when it comes to detoxification, we're really far ahead.

Of course, not only in Yunnan, but also in Fujian, the hospitals are not bad.

Therefore, the poisoning medicine in China is much more perfect than that in foreign countries.

……

Here, He Ling is very cooperative with Chen Gong.

With the child, the treatment and gastric lavage quickly began.

This step-by-step operation is hearty.

Chen Gong also saw the role of excellent emergency nurses.

If the doctor is the brain center, the nurse is the executive power.

No matter what plan your doctor gives, you still need a nurse to carry it out.

This is the value and meaning of the existence of excellent nurses.

So don't underestimate nurses, emergency nurses...... It's really not to be underestimated, and many times it's not bad compared to the level of doctors.

A skilled and experienced emergency nurse can fully cope with many emergencies in the emergency department.

Soon!

After deferoxamine is used, the excretion of iron in the body is accelerated to reduce serum iron levels.

About an hour later, the child in bed woke up.

Seeing this, He Ling and Wu Xueyu immediately laughed excitedly.

There's nothing more fulfilling than this kind of thing.

Seeing this, Chen Gong waved his hand at Wu Xueyu: "Go and inform the patient's family." ”

"The patient is awake."

"Don't worry."

Wu Xueyu heard the sound and ran outside happily.

Young people can't pretend to have something to do in their hearts, what is good, and they are anxious to share.

Seeing this, He Ling couldn't help but give Chen Gong a thumbs up.

"Dr. Chen, you're amazing!"

"But...... You are not at all as mature and steady as you should be at this age. ”

Chen Gong waved his hand: "I look young." ”

To be honest, no one in the department knows how old Chen Gong is.

It's a mystery.

After learning that the child was getting better, the family was overjoyed and happy.

After Chen Gong came out, he just waved his hand and went back to the office.

And the pile of things sent by the patient's family was also placed at the nurses' station.

Say nothing and take it away.

The child still needs to continue to observe, and drain the iron, so he must have stayed and observed tonight.

But there is no need to stay in the ICU anymore.

He was sent to the observation ward and waited.

……

……

The next day.

It's time for the early shift.

Jiao Liming walked into the office and was about to start the shift.

Suddenly, a woman came in the door, holding a pennant in her hand.

"Dr. Chen, thank you so much!"

In everyone's surprise, Chen Gong finally received the first pennant in his life.

Hung on the wall of the office.

So far, the Third Emergency Department has successfully broken the pennant shortage and won the first pennant since the establishment of the department.

When Jiao Liming saw this, he was naturally overjoyed.

On the same day, Chen Gong naturally received a lot of praise.

After work, Chen Gong was about to go home.

Jiao Liming patted Chen Gong's shoulder with a smile and smiled slightly: "Chen Gong, good job!" ”

"You're off to a good start!"

Chen Gong smiled slightly: "Take your time!" ”

Jiao Liming heard the sound and nodded excitedly.

Why wouldn't he want to build something great here?

For a while, I was also full of confidence.

However, here Chen Gong is preparing to leave.

Suddenly!

A crisp phone rang.

At the nurse's station, a nurse answered the phone and ran over in a hurry.

"Director Jiao, it's not good!"

"There was an accident at the West Valley mine."

"Let's send a car over immediately!"

Hearing this, Jiao Liming's face changed.

He hurriedly returned to the office and said to everyone:

"There was an accident in the West Valley mining area, and a person in charge came and immediately followed the car."

"Whose class is it today?"

Hearing Jiao Liming's words, the faces of everyone at the scene suddenly changed.

Unexpected ...... at the Mine

Isn't that a trivial matter?

A forty-year-old middle-aged man stood up: "My class! ”

After Jiao Liming saw the other party, he immediately frowned.

Because the person on duty today is the person in charge of the emergency internal medicine department, Gu Haichang, the leader of the group.

Gu Haichang is an emergency internal medicine specialist, and after he came, he was also Jiao Liming's left arm and right arm.

But......

The other party is also a little difficult for this kind of traumatic accident.

At this time, Jiao Liming shifted his vision to the leader of the second group.

"Director Qian, are you going?"

Qian Jianhua stood up and coughed, as if he was about to say something.

But Chen Gong said directly to Wu Xueyu.

"Xiao Wu!"

"Pack your things and get ready to go."

After finishing speaking, Chen Gong nodded at Jiao Liming: "Director Jiao, I'll go!" ”

After speaking, Chen Gong didn't have anything to say, got up and put on the white coat he had just taken off, and walked outside with Xiao Wu.

At this time, after He Ling handed over the shift, she was also ready to get off work.

Seeing this, Chen Gong called directly: "Sister He, will you go out with us?" ”

He Ling couldn't help but say, nodded and put on her hat: "Okay!" ”

While talking, the ambulance was already at the door.

Chen Gong and the others quickly got into the car and rushed towards the mining area.

……

ps: Remember, the iron pot must not be steamed acidic food or fruits, there are really many cases in this life.

The purpose of medicine is also of popular science significance, and I hope to take it as a warning.

(End of chapter)