Although he said some beautiful words, even Liu Tangchun did not dare to guarantee that his party could really take back the life of even a patient from the hands of death.

All eight patients who were still alive were transferred to the same large ward for intensive care, and the Chinese medical team was also divided into two groups, and Chen Tianyang came to the camp with three surgical doctors to help. The four doctors, plus Sun Lien, Liu Tangchun and Hu Chunbo, who were already in the camp, seven doctors and one nurse to take care of eight patients, it stands to reason that the manpower has been abundant to the point of some luxury.

But...... Under this level of supervision, patients continue to die one by one. By the evening, three of the eight patients had died from a herniation attack. There are still five patients left in the entire ward.

When they are usually in the hospital, doctors also have to deal with this kind of bad thing about patients dying all the time. But this kind of thing of three deaths in a row within a few hours is still too "exciting". Even Chen Tianyang felt an inexplicable upset - it was clear that the diagnosis was right, and the treatment plan was also right. But patients are dying one after another, and this outcome has a great impact on doctors.

"If I hadn't done my homework before I came, I would have felt that there was a problem with Sun Lien's diagnosis. Chen Tianyang sat in the corner, holding a cup of cold green tea in his hand and drinking, "This is also dying too fast." ”

"The mortality rate after an acute exacerbation is extremely high and the prognosis is extremely poor...... It's all written in the literature. But only after experiencing it can we understand what these two 'poles' mean. Hu Chunbo is also a little distracted, and his self-esteem as a doctor may still have some residues that cannot be seen in the original shape. And it's all broken to the point where you can't scoop it up on your knees with a spoon for half an hour.

"That's how it is to be a doctor. Liu Tangchun stretched his waist, and many successive chest compressions were ineffective, making him tired enough, "Don't think that you can save every patient." Do your best, and save one is one. ”

"There is no effective means at all, we can't even do our best to do this. Chen Tianyang has a different view on this, as a surgeon has long been accustomed to trying to control the situation as much as possible. I am a little unaccustomed to the attitude of "doing everything to know the destiny of heaven" in the emergency department. "Aside from pressing on their chest for twenty minutes while they're herniating, and breaking a few ribs by the way, we're going to have to think of something else, right?"

"How about a prophylactic craniotomy?" Sun Lien sat on the ground and gasped for a long time before raising his hand to try to speak, "The intracranial pressure of these patients rises too fast, and even mannitol cannot stop the intracranial pressure from rising." As a precautionary measure, would it be okay to remove a piece of their skulls first and release the cranial pressure?"

"It's not just the obstruction of cerebrospinal fluid flow in the ventricles that causes them to have increased intracranial pressure, but also a global cerebral inflammatory response. Hu Chunbo shook his head, "Simply taking out the skull bone flap is not very useful. ”

"Then add hormone pulse therapy. Suppress the inflammatory response first. Sun Lien shook his noodle-like arms, half serious and half angry, "With such a method, I have to die in front of them!"

He is the youngest emergency physician in the entire medical team. Sun Lien became the main force in the rescue process. Chest compressions and other work are all based on Sun Lien. Other doctors rotate on the side. But I don't know if it's because of professional habits, anyway, after seeing the chest compression posture of other doctors, Sun Lien got up from the ground angrily and continued to grab the position to do compressions - their posture is too non-standard.

The result of occupational disease is that Sun Lien is currently tired like a salted fish. If it weren't for Hu Jia who had been cheering Sun Lien by his side, and at the same time staring at the mask on his face, Sun Lien really wanted to pull the mask and lie on the ground to sleep.

Since we can't take a complete break, we can only look for solutions to the problem from other angles. Sun Lien was half-lying on the ground and gave his own solution, "Use a large dose of hormones to control the whole brain inflammation, and then cooperate with the upper craniotomy to release intracranial pressure." Take a two-pronged approach to buy time for amphotericin B to take effect. ”

"That's fine. But what is the amount of hormone to use?methylprednisolone 1000mg?" Chen Tianyang shook his head, "We have no experience in giving hormone shocks to Americans." ”

Liu Tangchun raised his eyelids and glanced at Chen Tianyang, "Before you came to Africa, did you have any experience in black healing?" he shook his waist and said to Sun Lien on the side, "You go and call Dr. Pascal and ask for his opinion-he is better at doing immunosuppressive programs." Then, he turned his head to Chen Tianyang and said, "You have experience in opening people's heads, right?"

"Is it really open?" Chen Tianyang asked with some surprise, "How do you do the formalities?"

"There were no procedures for rescue before. Humanitarian aid can be done as well as for the patients. Liu Tangchun waved his hand and said, "If you can't figure out how to open your skull, then call and ask Yourong, she is a good hand at opening people's heads." ”

·

·

·

Dr. Pascal was taken aback on the phone, "You found out...... More than 20 cases of concentrated primary amoebic meningitis?"

"More than twenty people have died. After we made a clear diagnosis and proved it correct, three more patients died of herniation due to increased intracranial pressure. Sun Lien sighed on the other end of the phone, "The situation is very urgent now, and we must find a way to curb their whole brain inflammatory response as soon as possible." Otherwise, the five remaining patients wouldn't have lasted long – if they hadn't, I suspect none of them would have been able to see the sun the day after tomorrow. ”

"A whole-body hormone rush is the way to go. Dr. Pascal immediately began to use his brain after hearing Sun Lien's request, "You guys have brought antimalarials this time, right? I mean dihydroartemisinin." ”

"Brought it. Sun Lien replied with some confusion, "But their symptoms have nothing to do with malaria." ”

"Dihydroartemisinin also has a suppressive effect on the immune system. On the other end of the phone, Dr. Pascal explained, "It's better for you to do 800mg of methylprednisolone directly and dihydroartemisinin together for an inhibition regimen." This combination is safer and works faster than artemisinin alone or methylprednisolone. ”

After confirming that Sun had memorized the regimen, Dr. Pascal continued, "I recommend intrathecal methylprednisolone, which has a better effect on the nervous system. ”

"We have given the patient intrathecal amphotericin B. Sun Lien looked a little embarrassed, "Take another 800mg of methylprednisolone...... Something is going to happen with this amount, right?"

"The dosage for rehabilitation is 20 mg each time and can be increased to 40 mg when fighting Sjögren's syndrome. Dr. Pascal on the other end of the phone said helplessly, "The total amount of cerebrospinal fluid in the human body is more than 100 milliliters and less than 200 milliliters, so let's inject 40mg intrathecally and then inject it intravenously." ”