Regardless of whether the allergic reaction represented by the wheal was caused by vancomycin, Qian Aiwu's symptoms are not close to the traditional concept of "antibiotic allergy". As far as Sun knows, antibiotic allergies generally occur very quickly, and the results are quite serious, and even fatal reactions such as laryngeal edema, shock, and even cardiac arrest may occur.

During his emergency department internship at the Affiliated Hospital of Ningyuan Medical College, Sun Lien once saw a severe case of allergies. The patient is a young mother with a child who is only one and a half years old. She was rushed to the hospital by a bus.

The one-and-a-half-year-old child was taken to a nearby children's hospital for treatment because of a fever, and after a skin test confirmed that the child was not allergic to penicillin, the doctor infused him with 500,000 units of penicillin at a level of 50,000 units per kilogram to combat the symptoms of upper respiratory tract infection. After the infusion, the young mother got on the bus with the baby in her arms and was ready to go home.

One-and-a-half-year-old children do not yet have the ability to tolerate excretion. Like children of the same age, he felt a little urinating on the bus, so he peed out smoothly on the bus. Unfortunately, his diapers were a little loose, and the urine was dripping on the back of his mother's hand.

And this young mother, allergic to penicillin.

Dozens of seconds later, the passengers on the bus were horrified to find a mother holding her child lying on the floor of the carriage with her eyes closed and her face purple.

The bus driver was in danger, and after making sure that someone on the bus had a sudden illness, he directly threw the steering wheel and drove to the nearest hospital with double flashes. Two minutes later, the bus honked its horn and stopped in the emergency aisle of the affiliated hospital. Hearing the movement, the doctors and nurses who rushed to the scene immediately found the young mother lying on the ground.

In order to save her life as soon as possible, the doctors immediately performed a tracheostomy and began chest compressions. After judging that she might have a severe allergy, she was given an injection of adrenaline. Sun Lien watched the rescue from the sidelines - and finally when the family talked, the doctors realized that the source of her allergy might be penicillin, and the source of penicillin ...... It's her son's urine.

Drug allergies can be fatal. Sun remembered this solidly, and for the first time realized how low the dose of allergy caused by antibiotics could be. This habit has also been carried over to his later work, once a patient has an allergic reaction, Sun Lien's first move must be to stop the medication, and then re-evaluate the patient's condition.

But...... Can drugs cause delayed allergies? Sun Lien is really unsure about this, he only knows that some food intake may cause delayed allergies, but drugs, especially intravenous antibiotics, should not have the possibility of delayed allergies, right?

"I'm not sure about vancomycin, but other drugs do report this happening. Han Wenping thought for a moment after listening to Sun Lien's inquiry, "Since you still have the time to call, the patient's allergies shouldn't be very serious, right?"

"The current patient's symptoms are wheals, and it is not confirmed that they must be allergic to the drug caused by vancomycin. Sun Lien said, "The situation is quite controllable, it's just an itch - her wheal range is not too large." ”

"I'll go over now, is vancomycin still on it? If it's still on it, stop it right away. Han Wenping immediately made a decision, "I'll take someone to take a look." ”

·

·

·

Han Wenping took two pharmacists to the diagnostic center at a trot, and in the sweltering summer night, all three of them ran out of sweat. The black shirt on Director Han's body was already almost soaked on such a stretch of the road, and the condition of the other two clinical pharmacists was even worse - the fat pharmacist was even soaked with sweat on the white coat behind his back.

"How is it? people are still awake, right?" Han Wenping didn't even bother to wipe his sweat after running to the diagnostic center, and asked bluntly, "Does the wheal extend near the neck?"

"Nope. Sun Lien shook his head, he saw Han Wenping holding two boxes of adrenaline in his hand, and he couldn't help but get nervous, "We still have more than a dozen boxes of adrenaline here...... Isn't it enough?"

"I just grabbed two boxes. Han Wenping glanced at Sun Lien, "What do you want? More than a dozen boxes are used together, do you want her heart to be blown to pieces?"

"That's good. Sun Lien breathed a sigh of relief, "Director Han, are you going to see a patient?"

"Hmm. Han Wenping nodded and pointed out the door, "You lead the way." ”

A professional is a professional. Han Wenping didn't even catch his breath, and first thought about seeing the patient's condition. The other two clinical pharmacists skillfully took out pen and paper from their pockets and swiped their mobile phones to take pictures.

"Although there have been no reports of late-onset allergy to vancomycin, late-onset red man syndrome has been reported. Han Wenping spread knowledge to Sun Lien as soon as possible as he walked, "Have you heard of red man syndrome? This is a severe allergic reaction, and large areas of erythema will appear on the patient's face, neck, and even the entire torso. ”

"Director Han, this patient is not erythema, it is a wheal. Sun Lien corrected, "So it shouldn't be...... Red man syndrome, right?"

Han Wenping shook his head, "When the first vancomycin allergy was reported, there was no mention of red man syndrome and erythema - the main symptoms at that time were described as itching all over the body, urticaria, chest pain and vascular collapse. Later reports also reported a series of symptoms such as low blood pressure, fever, and headache. ”

Sun Lien quickened his pace, "That is to say...... Can't rule it out?"

"There really can't be ruled out, and if you want to rule it out, you have to stop vancomycin first, and then see the patient's reaction. Han Wenping followed and quickened his pace, "First of all, stop the drug, you prescribed loratadine, right? The effect of that thing is not strong enough, at least it must be up to promethazine hydrochloride injection and dexamethasone anti-allergic." Her vital signs are then monitored. If there are other symptoms, then gastrorizine is necessary. ”

Han Wenping followed Sun Lien to the ward, where the head nurse, Zhong Yu, was applying calamine lotion to Qian Aiwu's back. Seeing four big men breaking in, he immediately counted down his eyebrows, and directly opened his mouth and scolded, "Why can't you even knock on the door before entering the house?"

Han Wenping glanced at Sun Lien, and then retreated very decisively outside the door, apologizing while retreating, "I'm sorry, I thought Dr. Sun had already said it in advance......"

"Xiao Han?" Qian Aiwu, who was lying on the bed and endured the itch, suddenly raised his head, twisted his body and tried to look in the direction of Han Wenping, "Are you Xiao Han?"

"Sister Qian?" Han Wenping's eyes widened, and after carefully identifying the raised face, he was shocked, "Why are you?"