After returning from Hong Kong Island recently, Ye Nan's fighting kung fu has grown more and more obviously, and now he and Fang Wei are practicing their hands, and they can basically fight evenly between the top and bottom, which makes Fang Wei sigh, and shouts that he also wants to get a I Ching to wash the marrow, but he himself knows that this kind of thing is unavoidable, that is, he is just scratching his own hair.

Ye Nan and Fang Wei practiced for an hour, then went back to the room to take a bath and settle into the Gathering Spirit, recently Ye Nan's Gathering Spirit Determination Rank had just entered the middle stage of the lower grade of jade liquid, and it could be said that there was still a long way to go before he became a real master.

According to the experience of the Heavenly Rune Inheritance, even if so many thousands of years have passed, there will definitely be Jindan-level masters in this world, and he is 108,000 miles away from them.

Therefore, Ye Nan did not dare to relax at all, every time he practiced hard, with the influx of spiritual energy from the outside world, the pale white spiritual power source was gradually producing a faint change, and the color was getting deeper and deeper, and it was steadily advancing towards the later stage of the jade liquid lower grade!

In the past few days, this day is Sister Han Ling's main class again, as usual, Ye Nan is in charge, Han Ling makes a cup of hot tea by herself, and sits comfortably in the office touching a magazine and reading it with relish!

The other people were jealous, who let them not have a competent follow-up doctor like Ye Nan, they could only look at it with blank eyes and sighed, who called someone's life!

People drink tea, Ye Nan is now busy sweating, just the ambulance sent another patient with severe asthma, this patient is only fifteen or sixteen years old, sitting on the hospital bed, his face is bruised and cyanosis, nodding his head and breathing, and he can't stop coughing.

Ye Nan hurriedly asked the nurse to put the oxygen on it, and hurriedly asked the family members next to him about their medical history. The family said: "I had a history of asthma before, but this time after I caught a cold yesterday, it suddenly became serious today, so I rushed to the hospital." ”

Hearing that he had a history of asthma attacks before, Ye Nan breathed a sigh of relief, it didn't seem to be a sudden tracheal foreign body blockage or something. However, he quickly went to check it, and opened the patient's collar, and there was no distension in the jugular veins on both sides, and the rib cage was slightly distended.

I listened to the chest and lungs with a stethoscope, and the small whistling sound of the lungs like a blowing wind was mainly obvious when exhaling, and the exhalation time was significantly prolonged.

At this time, Ye Nan felt a little bottom in his heart, this was obviously a breathing difficulty caused by bronchial asthma, and it was mainly a serious asthma attack caused by a cold again.

Looking at the patient's severe breathing difficulties, Ye Nan knew that the other party's bronchospasm must be solved immediately in order to successfully control the symptoms of asthma.

If it is not controlled quickly, the patient is likely to develop a severe condition such as a pneumothorax due to asthma exacerbation.

After thinking about it, he explained the doctor's instructions to the nurse on the side: "5% glucose 100ml plus aminophylline 0.25mg intravenous infusion, and oral spray with salamitomol aerosol, and at the same time take blood for blood routine and blood gas analysis and testing!"

Aminophylline is a commonly used drug to relieve bronchospasm, and salambutol aerosol can quickly relieve asthma symptoms, and the combination of the two generally has good results.

The nurse hurriedly dealt with it according to Ye Nan's verbal instructions, and seeing that the nurse had started to take medicine, Ye Nan took the medical record folder and began to prescribe medical orders by himself.

In general, asthma is caused by bacterial infections, exposure to allergens, or changes in the weather.

The patient is mainly an asthma attack caused by a cold, and now there is a cough and other conditions, so the treatment must use antispasmodic drugs to control the symptoms, and quickly use anti-infection, anti-allergic and anti-inflammatory treatments to eradicate the cause, so that the disease can be well controlled.

Ye Nan considered it, and chose two powerful drugs of ceftriaxone and levofloxacin for anti-infection treatment, as for anti-inflammatory and anti-allergic aspects, it is necessary to choose glucocorticoid drugs, the use of this drug has many disadvantages and side effects, Ye Nan thought about it, or decided to observe it first, if the condition improves, then it will not be used for the time being.

Ye Nan, who had made up his mind, wrote down on the long-term doctor's order: continuous low-concentration oxygen inhalation, 100ml of normal saline plus 2.0g of ceftriaxone intravenous infusion BID (said twice), 5% glucose 250ml plus levofloxacin 0.5g intravenous infusion of QD (said once).

In addition to the blood routine and blood gas analysis tests that have just been drawn, a chest X-ray is also prescribed to understand the specific condition of the lungs, of course, this examination must wait for the patient's condition to be relieved.

It took ten minutes to prescribe the doctor's order, Ye Nan estimated that the patient's condition should be significantly relieved under the rapid action of salamibutol at this time, so he went over to take a look again, if the effect was not very good, then he had to find another way.

walked to the ward and took a look, fortunately, although the patient's asthma situation did not improve to the extent he imagined, it had been significantly alleviated compared to before, Ye Nan was relieved, basically there should not be too many problems now.

Seeing that the patient was getting better, Ye Nan also took the medical record folder back to the office to improve the medical record, and after half an hour, Ye Nan's medical record was almost written, and he was about to breathe a sigh of relief, when suddenly he heard the nurse outside running in and shouting: "Doctor Ye, the patient's asthma has worsened just now, and the family asked you to go and see it again!"

Ye Nan was shocked, it had only been half an hour, how could it have worsened when he had just been relieved? He quickly put down the pen in his hand and walked to the ward.

In the ward, Ye Nan looked at the patient, and indeed his current asthma was worse when he was just getting better, and sighed secretly: "The maintenance effect of salambutol aerosol is still too short, it seems that glucocorticoids are still necessary!"

Then he explained to the nurse who was waiting aside: "Now use 100ml of 5% glucose plus methylprednisolone intravenous drip immediately!"

The nurse ran out in response, but the family members on the side stared at Ye Nan and said angrily: "Doctor, what's the matter, my son has just gotten better, why did it get worse all of a sudden? You won't use the wrong medicine, right?"

Ye Nan smiled bitterly and explained: "Your child's condition improved just now because it was controlled by a strong aerosol, but it lasted for a short time, so I just added medicine to him, and now you spray him with an aerosol again, and the situation will get better slowly!"

Hearing Ye Nan's explanation, the family did not continue to trouble Ye Nan, but was taught a lesson by Sister Han Ling after returning to the office, she had just read Ye Nan's medical records and found a loophole in Ye Nan's medication!

Seeing Ye Nan coming in, he asked, "Ye Nan, why didn't you use a predator with him?" In this case, if you don't use it, he will definitely get worse!"

Ye Nan touched his head awkwardly and smiled: "I think glucocorticoid drugs can be used as little as possible, so I used other drugs first to observe first, I have just added them!"

"Hmm...... In the future, we must pay attention to the fact that patients like this must use glucocorticoid drugs, although it has certain side effects, but this medicine is indispensable in terms of treatment!" Han Ling looked at Ye Nan and said solemnly, she knew that Ye Nan still lacked some experience in this area, so she had the responsibility to correct Ye Nan's misconceptions in this regard as soon as possible.

After taking a sip of tea, he looked at Ye Nan and smiled, and said: "I know that you are also kind-hearted, and you want to try it with other drugs first, but you must be clear that the patient and his family will not understand your kindness, they will only see how the effect is, so you must pay attention next time, the medicine you should use must be used boldly, and you can't hesitate because of other considerations, in case you delay the condition, it will be a thing that outweighs the loss!"

Ye Nan nodded, indicating that he understood, he knew that Sister Han Ling was right, he sometimes took care of a lot of things, and in some aspects, he seemed a little indecisive, so he smiled and said: "Sister Han Ling, I know, I will pay attention to it in the future!"

Seeing that Ye Nan understood what he meant, Han Ling smiled and nodded: "It's good to understand, pay attention next time!"

Taking advantage of the fact that there is nothing to do now, Ye Nan hurriedly hurried to finish writing his medical records, or if he finished writing, if the patient came again, he would be too busy to win.

For the current patient, Ye Nan estimates that under the strong effect of methylprednisolone, as long as one or two hours pass, the asthma situation can generally be completely improved, but after using this drug, it must be continued for two to three days to maintain a good effect.

After an hour like this, Ye Nan hurriedly went to see it again, and now the family members saw that Ye Nan was obviously much more enthusiastic, because the patient's condition was as Ye Nan said, after adding the medicine in the back, there was no continued recurrence.

The family member smiled at Ye Nan with some embarrassment: "Doctor Ye, I'm really embarrassed just now, we don't understand this, please don't be surprised!"

Ye Nan smiled and nodded: "It's okay, I also understand your feelings, don't take it to heart, as long as the child is better, it's okay!"

(To be continued)