Wei Dabao was prescribing in the emergency department, with a stack of medical records in front of him, with a sad face.

After receiving a notice from the hospital, all the doctors held a meeting in the past few days, and Section Chief Wu analyzed and explained the medical records.

also used analysis to analyze what his medical records were like Wei Dabao knew in his heart that he was going to be scolded when he held a meeting. As for being scolded as a dog or being scolded as a sieve, it depends on the mood of the little master.

"Dr. Wei. ”

Wei Dabao was opening the square, and a voice came from the door.

"Huh, little teacher...... Section Chief Wu, why are you here? You're too polite, just call me Dabao. Wei Dabao was frightened, stood up in a hurry, and the chair fell to the ground with a "bang" sound.

"Do we have endotracheal tubes for 15-20 month old children in our hospital?"

"......" Wei Dabao was stunned for a moment, and then smiled bitterly, "Section Chief Wu, there are no intubations for children, and only a few are prepared by the county hospital in our county, and they are not used often." The point is that no one does pediatric surgery, only in provincial capitals. ”

"Help me call 120 carts, with adrenaline, intravenous steroids and antihistamines, inhaled bronchodilators. After Wu Mian finished speaking, he turned around and left.

What the hell? Wei Dabao stood in place.

The long list of drug names that Wu Mian said just now, if he thought about it separately, he should be able to understand it. But together, Wei Dabao couldn't remember any of them.

"Dr. Wei, I can write here. Chu Zhixi turned around and came back, probably thinking that Wei Dabao couldn't figure it out, so he picked up the pen on the table and wrote a series of drug names on the prescription book.

"Take these to the 120 ambulance, and you can call. Wu Mian stood behind and said.

"Section Chief Wu, where is the ambulance?"

"County hospital. ”

"......" Wei Dabao watched Wu Mian turn around and leave, his mouth was extremely bitter.

Drive the 120 emergency to the county hospital, do you want to demonstrate? In the county, the county hospital is the big brother, although it has been sold recently, and the loss of personnel is serious. But there are still 3 catties of nails in the broken ship, how is it not better than himself.

No, there is a little ancestor who is afraid of something. After Wei Dabao figured it out in an instant, he took the piece of paper written by Chu Zhixi and began to call the 120 emergency number while preparing the medicine.

Even if the doctor in the hospital wants to use the 120 ambulance, he must call for the record. Otherwise, once a vehicle is assigned, the car can't get out, and there will be big trouble.

It's not like a long time ago, when the bus was used for private use, and there were people who drove the ambulance out to play.

Wei Dabao prepared things on this side, and Wu Mian frowned and strode out of the emergency department of Bajingzi Traditional Chinese Medicine Hospital. Sure enough, as Wu Mian expected, Bajingzi Traditional Chinese Medicine Hospital did not have pediatric endotracheal intubation.

"Lao Lin, where have you been? Wu Mian took out his mobile phone and made a call to Daoist Lin.

"Uncle Xiao, I'm almost at the foot of the mountain, and the child's breathing difficulties are getting worse, so I'm taking a picture of the video data and I'm about to send it to you. Daoist Lin said hurriedly.

"Send it to the county hospital, and I'll go over. ”

After Wu Mian finished speaking, he walked directly to the brown Skoda.

"It's so inconvenient. Wu Mian didn't know how to describe Bajingzi Traditional Chinese Medicine Hospital, so he could only sigh and say.

"No way, grassroots hospitals. Chu Zhixi said, seeing Wu Mian walking directly to the driver's seat, he hurriedly threw the key to Wu Mian and ran to the co-pilot.

It only takes about 15 minutes to get down from Laoyu Mountain to the county hospital.

Wu Mian felt that the mobile phone received WeChat, and while starting the car, he handed the mobile phone to Chu Zhixi.

"Take a look at the video materials sent by Lao Lin. ”

"Hmm. Chu Zhixi fastened his seat belt, picked up his mobile phone and began to flip through it.

"On CT scan, CT scans of the head and chest showed extensive subcutaneous emphysema, mediastinal emphysema, pneumopericardium, and even around the orbit, with proptosis. Chu Zhixi glanced at the film and said immediately.

"The test results showed that there was a slight inflammation and possible infection. ”

"The patient has no history of trauma......"

"How are medical records written?"

"No history of coughing, sneezing, severe vomiting, strenuous physical activity, or trauma. Chu Zhixi knew what Wu Mian was asking and quickly replied.

Wu Mian frowned, his eyes narrowed into a slit, staring at the road ahead, constantly honking his horn, and the car drove at the speed limit.

That is, Bajingzi, the flow of people is scarce, and the car can still be driven. If it is changed to the imperial capital, I am afraid that if Wu Mian rushes to the county hospital, the children will be cold.

However, there will be no such thing as a large tertiary hospital without tracheal intubation for young children in the imperial capital.

"Go on. Wu Mian said.

"The most important thing in differential diagnosis is trauma, and from the analysis of the medical records, the doctors who have seen him before should have taken this into account. Chu Zhixi said, "I think the medical history is credible." ”

"Then before the first onset of the disease, pharyngitis is considered to be present.

The infection involves the deep fascial space of the retropharyngeal, parapharyngeal, or submandibular space, and the gas spreads downward to the mediastinum through the intervertebral, anteriortracheal, and posteriorpharyngeal spaces under the action of deep breathing, coughing, and negative pressure in the chest.

However, the child only had simple pharyngitis and did not involve the deep fascial space, which was not based on sufficient evidence. ”

"Third, upward migration gases. Intestinal perforation of various causes, in which gas penetrates the diaphragmatic hiatus and enters the posterior mediastinum along the space around the aorta, azygous vein, thoracic duct, or esophagus.

There is no sign of intestinal rupture in the abdomen, which can be basically ruled out. ”

"Fourth, the child has a rare interstitial emphysema...... Brother, I think the triggers of interstitial emphysema may be an important factor. ”

"Infection, violent coughing, straining to hold your breath, or over-excitation from inhaling illegal drugs, etc., cause alveoli rupture and air enters the lung interstitium and enters the mediastinum along the vascular sheath within the lung interstitium, resulting in mediastinal emphysema. The possibility exists, and it can be significant. Wu Mian said.

"Later, the subpleural alveoli and bronchial tubes in the visceral pleura rupture, and the visceral pleura may remain intact or may not have pneumothorax findings. ”

"It just makes sense, but it's still a bit far-fetched. Wu Mian drove the car and went straight to the county hospital, constantly analyzing the existing situation.

Chu Zhixi said that there was a problematic point, and he asked again about the inspection that there was no problem.

9′43", brown Skoda Yedi drove to the emergency department of the county hospital.

"Nurse, do you have a pediatric endotracheal intubation?" Wu Mian asked as he strode into the emergency department.

"There is no emergency, and if there is, it is also in the operating room. The nurse looked through her mobile phone under the guide table and said absent-mindedly.

"How much is the phone number in the operating room. Wu Mian said in a deep voice.

"Who are you ......" The nurse looked up and said two words impatiently, pausing instantly.

"Hello. The nurse swiped to her feet and smiled.

"Operating room phone. ”

"*******" the nurse blurted out a number, "The anesthesiologist who can do pediatric anesthesia in our county hospital has recently resigned, may I ask you ......?"

Before he finished speaking, Wu Mian's figure had disappeared.