I'm really an intern

Chapter 157 Death Questions

It turned out that it was the professor who came for the consultation.

No wonder it seems that age and temperament do not match the hospitalization!

After being reminded by Brother Deng, Zhang Tianyang finally understood why he looked so familiar.

More than a week ago, the girl who had fungal infection in her lungs from the Department of Internal Medicine invited the whole hospital for consultation. At that time, the director of the Department of Cardiology came.

Next to him, Senior Brother Deng was still pulling Zhang Tianyang and chatting in a low voice.

"The emergency department invites the cardiology department to consult. Usually, the hospital chief comes. Only the director of very serious patients will come to see."

It's really serious.

Zhang Tianyang agreed in his heart, and felt ventricular fibrillation. This is what happens when normal people are dying!

It was just a little bit short of people disappearing.

If you come a few minutes late and have ventricular fibrillation without monitoring, you will really die.

Can it be serious!

Zhang Tianyang was always in charge of rescuing this old man. Senior Brother Deng had been busy rescuing the other bed before and didn't understand the condition, so he sighed.

"Look at what the professor is wearing, he must be undergoing an operation, or he was called over just after the operation.

How sick is the patient! "

While sighing, he suddenly paused.

"Eh? Such a serious patient, you saved it yourself, junior brother???"

The incident happened suddenly. At that time, he and Professor Yang were busy rescuing the other bed. Zhang Tianyang did all the consent forms, medical orders, and treatment of the old man.

The doctor's order was reviewed by Professor Yang, but Brother Deng remembered that Professor Yang only took a look at it and did not change a single word.

Therefore, all the rescues were done by the younger brother!

"Awesome, junior brother!"

Senior Brother Deng looked at Zhang Tianyang with surprise in his eyes, but soon, his peripheral vision caught sight of the professor of cardiology behind Zhang Tianyang.

After observing the old man's vital signs, the other party had already picked up the patient's clothes and began to carefully listen to the heart sounds with a stethoscope.

It is estimated that soon, the doctor in charge of the bed will be called to ask about various situations!

Brother Deng was in a hurry.

He had rotated in the Department of Cardiology. Although he was not in the chief director's medical team, he had also watched the scene where the chief director cursed people.

"Junior brother, have you memorized all the test results of this patient? If you don't memorize them well, you have to copy them down. If you can't answer the questions later, it will be very miserable!"

It is the responsibility of the doctor in charge of the bed to understand the basic situation of the patient, especially this kind of consultation with relevant departments.

If the consulting doctor asks about the examination data and you can't answer it, the hot-tempered consulting doctor will scold you on the spot.

After all, people have to do so much work a day, and you invite me to come for a consultation, but you don’t even know the basic information of the patient. Is this just for fun?

The director is even more so.

Not to mention the director who was called directly from the operating room!

"Also, the head of the Cardiology Department likes to ask questions about the mechanism of the disease."

As if recalling some not-so-good memory, Senior Brother Deng shivered.

"But now they are not making ward rounds in their own department, they are here for consultation, so they probably won't ask these questions."

Brother Deng obviously regarded Zhang Tianyang as his own, and didn't want him to be scolded, so he took the time to pass on his experience.

But over there, the professor had already taken care of the patient and called back, "Who is the doctor who takes care of this patient?"

"it's me."

Zhang Tianyang blinked at Senior Brother Deng who still had a lot of words to say, and then took the initiative to walk up.

Brother Deng wanted to go forward, but he was a little afraid of the professor, so he could only look at the autumn water behind him, and clenched his fist with his right hand to cheer Zhang Tianyang up.

Sure enough, the professor started to attack.

"What's the matter with this patient? I haven't read the consultation form yet, but the hospital always told me that it was very serious. Let me tell you about his basic situation."

Brother Deng's fists were clenched immediately, for fear that Zhang Tianyang would not be able to stop the stormy scolding, and he was ready to step forward to make a rescue at any time.

But Zhang Tianyang didn't seem nervous at all.

"The patient is a 65-year-old male. He was admitted to the hospital and complained of abdominal pain and diarrhea for 7 hours. The contents were watery stools. During this period, he did not replenish water in time, accompanied by pale complexion and profuse sweating.

After being admitted to the hospital, he was admitted to the emergency room, and was temporarily given fluid replacement and anti-infection treatment, and ventricular fibrillation suddenly occurred four to ten minutes ago.

Immediately give chest compressions, electrical defibrillation, and endotracheal intubation.

Simultaneously give dopamine, norepinephrine, and epinephrine to strengthen the heart and excite.

Lidocaine, Esmolol antiarrhythmic.

Potassium chloride corrects electrolyte disturbances.

Magnesium sulfate sedative, antispasmodic therapy"

Zhang Tianyang explained in detail.

Not verbose, but necessary.

In many cases, what happened to a patient before, what treatment was given at that time, and what effect it has afterward, are what the receiving doctor really wants to know.

These details help doctors judge the condition and guide medication.

But many patients don't know what to ask.

I always feel that my current situation is right in front of you. Why do you ask those in the past?

Asking this is for the sake of healing!

But Zhang Tianyang's answer made the professor feel comfortable.

Not only is everything he wants to hear mentioned, but the language is also brief, and what should be skipped is never long-winded.

Just after stepping off the stage from the operation, the trace of anxiety caused by rushing over hurriedly disappeared in an instant.

Subconsciously, he nodded while listening.

“经过二10分钟的抢救后，患者恢复自主心率。现在他的血压波动于85-102/54-68mmHg，心率波动于78-99次/分，血氧饱和度100%。”

Zhang Tianyang continued to report on the situation of the old man, and at the same time handed over the consultation form in his hand.

"The results of the urgent blood test showed that the patient's white blood cells were elevated and the infection indicators were elevated."

There were too many specific inspection results, and he said it was a waste of time to tell them one by one, so it is better to let the professor read it by himself.

Zhang Tianyang only selected important results to report, and at the same time mixed his own judgment.

"Combined with the test results, it is considered that the previous diarrhea was bacterial diarrhea.

However, the patient had diarrhea for too long, and the electrolytes were checked and found that the blood potassium, sodium, calcium, and chlorine were all low, especially the blood potassium, which dropped to 2.8.

In addition, the patient has a history of hypertension and diabetes for 20 years, and his heart condition is not good.

Therefore, I think that this ventricular fibrillation is considered to be a combination of severe electrolyte disturbance and increased cardiac load in hypovolemic shock. "

Brother Deng listened with his ears behind him, only feeling that Zhang Tianyang's judgment was very reasonable.

But the director of the Cardiology Department was still carefully staring at the examination results on the consultation form just now, but at this moment he suddenly turned his head and stared at Zhang Tianyang.

Zhang Tianyang looked at him calmly, but Senior Brother Deng behind him instantly became extremely vigilant.

Here he is again!

This is the harbinger of the question of death!

Sure enough, the director of the cardiology department stared at Zhang Tianyang for a while, and then spoke suddenly.

"Then what do you think is the electrophysiological mechanism of this patient's sudden ventricular fibrillation?"

(End of this chapter)