Ningyuan, the Fourth Central Hospital, is brightly lit, and the patients and their families who come to see the doctor are still anxiously waiting for the doctor's treatment as usual.

"It's low again?" Liu Tangchun was busy sweating today, and the T-shirts on his body had been changed three times. The second city hospital, which is closest to the No. 4 Central Hospital, received a suspected case of avian influenza today - a worker at a chicken farm on the outskirts of the city did not wake up with a high fever, and at the same time a large number of poultry deaths were reported in the chicken farm. After the Ningyuan Municipal Center for Disease Control and Prevention sent the staff member to the fever clinic of the emergency department of the Second Municipal Hospital, it directly closed and isolated the emergency department of the Second Municipal Hospital. This has led to a lot of pressure on the Fourth Central Hospital. And "coincidentally" is that today the Fourth Central Hospital has also received a lot of seriously ill patients.

What Liu Tangchun is busy dealing with is the third patient with explosive myocarditis who was sent today. Of the first two patients, the most critical patient has been connected to ECMO (extracorporeal membrane oxygenation), while the other ECMO is working in the ICU, and only the last ECMO machine that can be used immediately in the fourth central hospital remains.

A set of machines, while in front of them are two patients with fulonishing myocarditis. Liu Tangchun was so anxious that he was about to curse. I managed to stabilize the two patients with the intensive care department and the doctors in the heart, but not long after they relaxed, bad news came from the emergency room - one of the patients' heart rate went down again.

"Have you arrived in the capital?" Liu Tangchun picked up his white coat and was about to run to the rescue room, but before he reached the door, he saw Liu Pingchuan who was swaying over with his hands behind his back. "What are you doing here, you're going to get off work?"

"The next ghost. Liu Tangchun angrily bypassed Liu Pingchuan and walked briskly towards the rescue room, "Three explosive myocarditis! There is only one ECMO left that can be used in the hospital, how can you let me get off work?"

Liu Pingchuan has long been surprised by Liu Tangchun's fiery personality. He hurriedly followed behind Liu Tangchun and explained, "The hospital bought a total of three ECMOs, and both of them were assigned to your emergency department.

"If you don't leave ECMO to me, will you want to let you go out of your mind?" Liu Tangchun snorted twice, "What are you doing behind my ass? I didn't call you for a consultation." ”

Liu Pingchuan smiled, "Didn't I listen to Lao Zhu of the Association, he plans to put his students in our hospital to study......"

"What old pig? is there anything else about the second senior brother here?" Liu Tangchun pretended to be confused, "Why can't I understand?"

After all, it is to poach people from Liu Tangchun, Liu Pingchuan's attitude is not ordinary, and his mentality is also very good, "Zhu Minhua's student, that young man named Yuan Ping'an." ”

Liu Tangchun hesitated for a few words, and was about to walk to the door of the rescue room, so he said directly, "Zhu Minhua has told me that Yuan Ping'an will come to our emergency department and have a long experience with Xiao Xu and Lien." Besides, Yuan Ping'an is a doctor in the direction of emergency medicine, so it is not like a neurosurgeon for him to be with you. ”

"Yuan Ping'an was going to take my doctorate back then. Liu Pingchuan sighed, cheered up and explained, "As a result, I suddenly decided to come to Ningyuan that year. In the end, there was really no way, so I entrusted him to Zhu Minhua. Now that people are chasing all the way from the capital to Ningyuan, they can't say anything if they drag it out, right?"

Liu Tangchun opened the door of the emergency room, "I don't care about this, anyway, he is now the resident general of the emergency department, and he is also my person when he comes to Ningyuan!" He strode into the emergency room and began to observe the patient's situation, "Tell me about the situation, who is in charge of the bed?"

Liu Tangchun was dealing with the situation urgently, and even if Liu Pingchuan had something big, he could only hold back his words first. There were just two patients suspected of spinal concussion in the emergency room, and since Liu Pingchuan appeared in the emergency room, the doctors in the emergency department just pulled the vice president to do a consultation - anyway, he didn't have time to call the doctors outside the gods to assist, and Xu Yourong was not in the hospital now. With the mentality of "don't use it in vain", Cao Yanhua, the attending doctor in charge of these two patients, simply stuffed the CT film that had just come out into Liu Pingchuan's hand, "Dean Liu, you can show this ......"

Liu Pingchuan frowned and looked at the CT, he had just finished watching the first film, and he supported the diagnosis of spinal concussion. Liu Tangchun's side was in chaos. A patient who was on IABP (intra-aortic balloon counterpulsation) circulatory support had a sudden myocardial infarction, and Liu Tangchun commanded the doctors to start the rescue.

"Charge, 150 joules, dodge!" Nurse Zhong Yu rushed over with a defibrillation board, and the two electrode plates were placed on the patient's right front chest and lower left ribs, and after confirming that everyone had pushed away enough distance, Nurse Zhong pressed the defibrillation button.

"It's still ventricular fibrillation, intubate first! Take 150 amiodarone over, do intravenous injection according to the flow rate of one hour, lidocaine 50 mg, intravenous bolus!" Liu Tangchun threw away the white coat he was holding in his hand, knelt on the side of the bed and began to do cardiopulmonary resuscitation, his gray hair rising and falling with the pressure of his body.

"Plug it in!" Cao Yanhua rushed over when Zhong Yu defibrillated. When Liu Tangchun was doing cardiopulmonary resuscitation, Cao Yanhua was already using a laryngoscope to do tracheal intubation. By the time Liu Tangchun reached the twelfth, Cao Yanhua had already completed tracheal intubation. The endotracheal tube was withdrawn and attached to the ventilator.

"Second defibrillation, charge 180J, dodge!" Zhong Yu started the second defibrillation. But the results are still not ideal. The patient's ventricular fibrillation disappears for only about 20 seconds and then falls back into ventricular fibrillation.

The one who fell into ventricular fibrillation on the bed was a young child. His name is Zhang Kai, he is 16 years old this year, and he is a senior student at Ningyuan No. 2 Senior High School. When it snowed heavily in Ningyuan two days ago, Zhang Kai, who had finished class, and a group of classmates played wildly on the playground for an afternoon. By the time I got home, my clothes and shoes were all soaked. After being severely reprimanded by his parents, he took a shower and changed into clean clothes. Unexpectedly, Zhang Kai started a fever that night, and at first the parents thought it was just that the child had a cold, and they didn't care much about it. Who knew that a weekend had passed, but Zhang Kai's condition was getting worse and worse. On Monday, his parents ordered him to wear a mask to school, and as soon as school ended in the afternoon, Zhang Kai was put in an ambulance by the school's teachers — he passed out.

In the Fourth Central Hospital, Zhang Kai was diagnosed with fulminant myocarditis. And what has always worried Liu Tangchun is the condition of this young little patient. Blood tests showed that Zhang Kai's creatine kinase index was as high as 1179 U/L, and creatine kinase isoenzyme was 150 U/L. Coupled with the fact that Zhang Kai urinated less than 100 milliliters on the day he was admitted to the hospital, Liu Tangchun determined that the child might have acute kidney injury. So I went on CRRT (continuous renal replacement therapy) again.

But the situation is still getting worse, and Zhang Kai once again fell into a state of ventricular fibrillation. The third defibrillation, the fourth defibrillation, the fifth defibrillation, and finally, by the sixth defibrillation, his heart was beating regularly. However, his blood pressure was frighteningly low, with a systolic blood pressure of 45 mm Hg and a diastolic blood pressure of only 30 mm Hg. The heart rate is about 90 beats per minute.

"The pupils on both sides are dilated and 7 mm in diameter. Cao Yanhua checked Zhang Kai's pupils and shook his head, "Director Liu, this patient ...... Trouble. ”

"What can I do then?" Liu Tangchun, who was wet with a set of T-shirts, was in a bad mood, "He is only 16 years old, if our measures can be put in place, he can survive this hurdle, and he will be able to live like ordinary people in the future." Resist, if you can't resist, you have to resist. As long as we can bear it, there is hope for him. ”

Taking advantage of Liu Tangchun's rest, Liu Pingchuan came over again, "Old Liu, all faces." At least you let Yuan Ping'an come to me to study for a few days. ”

Liu Tangchun snorted from his nose, "You can also see that there are so many things in my emergency room, and every patient is fatal." Give him to you, where can I go to find such a vacancy?"

Liu Pingchuan was anxious, "Don't kick your nose in the face if you are surnamed Liu! Yourong has been abducted by you to work in the rescue room......

"Then be an exchange. Liu Tangchun quickly stood up and patted Liu Pingchuan on the shoulder. "As long as Yuan Ping'an is willing, let him learn from you, I don't have any opinion at all. In exchange, you let Xu Yourong work with peace of mind during this time. He smiled and pushed Liu Pingchuan out, "You also know that Takeda is going to donate a diagnostic center, and let Yourong pick up the main beam when the time comes! Okay, I still have something to do here, so I'll talk about it here first." As soon as the words fell, he pushed Liu Pingchuan out of the rescue room, and closed the steel electromagnetic door by the way.

Liu Tangchun was about to laugh proudly, but he heard the alarm of the cardiopulmonary monitor behind him. When he turned around, Zhang Kai had ventricular fibrillation again.

"Oh, I'll it......" Rao is well-informed Liu Tangchun, seeing this situation, he still couldn't help but curse.

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The emergency rescue began again, and the doctor who did the chest compressions had changed three people back and forth, and everyone was so tired that they didn't even have the strength to speak. Even Xiao Guo, a male nurse, did a set of chest compressions, and the results were neither good nor too bad — although the patient still did not recover his ventricular tachycardia, at least he did not break Zhang Kai's ribs.

"Go to AutoPluse, it's not the way to go. Liu Tangchun wiped the sweat on his head, and he took another look at the condition of another myocarditis patient, although it was not good, but it was stable. The rescue has been going on for 50 minutes, and Zhang Kai has recovered eight heartbeats before and after, but each time it is no more than two minutes. If this continues, you will have to use the ECMO system. But if the last ECMO is used, it means that if another patient has the same condition, it will not be salvageable at all.

Liu Tangchun subconsciously opened his mouth and shouted Zhou Jun, and then he reacted that his beloved disciple was resting at home - Zhou Xiufang's matter hit Zhou Jun very hard. The arrangement for Zhou Jun's holiday was still made by Liu Tangchun. He was stunned, and shouted again, "Lien!" Then he suddenly shook his head and smiled bitterly, Sun Lien visited the difficult operation in the capital, calculated the time, and now he may have just taken the high-speed train......

"Director Liu, you call me?" The door of the rescue room was pushed open, and Sun Lien, wearing a new down jacket, carrying an old backpack, and two dark circles on his face, appeared in the rescue room. He looked at Liu Tangchun curiously, and pointed to the door of the rescue room behind him, "I just heard you calling me outside...... I just came in. ”