I can see the status bar

Chapter 164 An Uneasy Night
"So you came back?" Liu Tangchun half leaned on his seat, looking at Sun Lien in front of him with sympathetic eyes.He really had some sympathy for his disciple.Accidents happen every day these days, I really don't know which god this kid has collided with.

Sun Li'en had a bitter face, not knowing whether he should put on a pitiful expression, or simply pretend that he didn't care about being generous.He has already decided that after the busy days, he will go to a famous mountain and ancient temple to worship, in order to wash away this inexplicable bad luck.

"All right, all right." Liu Tangchun waved his hand, "Go to sleep in the duty room." He suddenly thought for a while and said, "Xu is on duty today, go over and say hello to him, and if necessary, change with him." It’s time to be on duty. After all, Xiao Xu is a lesbian, and she’s also a supernatural doctor..." Liu Tangchun paused, and then continued, "Usually these supernatural doctors are held in their hands as treasures, but now it’s good , come to my place and have to work night shift on the front line..."

Neurosurgery doctors require steady hands and calm hearts.From the stage of university education, the professors of Shenwai University have been instilling such a point of view in the students-neurosurgeons should not only avoid doing physical work as much as possible, but also ensure sufficient rest time.After all, surgical precision in the field of neurosurgery is frighteningly high. With a slight shake of the hand, the patient's life may have to be confessed on the stage.Insufficient rest and overuse of muscles can lead to poor precision of hand movements.So this situation can even be seen as taboo.

However, Xu Yourong didn't seem to care about this at all. Since he came to Sun Lien's treatment group, Xu Yourong has been on two night shifts.Moreover, he was very active during the usual rescue process, and had no awareness of "avoiding physical labor" at all.No wonder Liu Tangchun felt a little sorry.That's why Sun Li'en was asked to share the pressure on duty - after all, Sun Li'en was not a supernatural doctor, even if he was so tired that his hands trembled, he wouldn't delay chest compressions.

Sun Lien wandered into the emergency room, and greeted Xu Yourong.A group of doctors on duty in the emergency room expressed their cordial "condolences" to Sun Lien.And everyone believed that the main reason for Sun Lien's recent misfortune was that his character was completely exhausted by Hu Jia.If you want to transfer luck, it is serious to treat everyone to dinner quickly.

"Go and rest first." Xu Yourong looked at his watch, it was now 08:30 in the evening, "Exactly, you sleep for four hours, and get up at 02:30 to take over for me. Then I will get up at 06:30 to take over , ready to make a handover with the day shift doctor."

The first half of the night is actually easier to get through than the second half.But of course Sun Lien would not be dissatisfied with this arrangement, after all, the two slept for the same length of time.And after two o'clock in the morning, there are generally fewer patients sent to the hospital.

Taking off his coat in the lounge, Sun Li'en got into the quilt and began to urge himself to fall asleep quickly.As for Xu Yourong, sitting behind the duty desk outside, she lowered her head and flipped through the materials that Dr. Pascal had finished reading in the afternoon.

"Dinglingling!" After reading the information for half an hour, the red phone in front of Xu Yourong suddenly rang.She took the phone with her left hand, closed the document in front of her with her right hand, and then took out a pen to record, "The emergency room of the Fourth Central Hospital, what's the matter?"

"Understood." Five seconds later, Xu Yourong hung up the phone, and said to Zhong Yu, a nurse at the side, "Forecast a patient, unconscious, no obvious trauma, low-grade fever, difficulty breathing. Arrive at the hospital in 10 minutes."

Zhong Yu nodded, and took out new protective clothing from the cabinet beside him.The patient previously accepted by the Second Hospital has been confirmed to be infected with H7N9 avian influenza. According to the current plan, the entire Ningyuan City is in the IV public health emergency response mechanism.All hospital emergency departments should transfer patients with high fever and respiratory symptoms to the fever clinic for isolation diagnosis.Once diagnosed, the patient should be immediately referred to a designated hospital for treatment.

The patient reported on the phone had difficulty breathing, but his body temperature was a low-grade fever, that is, the patient's body temperature was lower than 38 degrees.According to regulations, there is no need to send to a fever clinic for treatment.However, according to regulations, and also out of consideration for the safety of medical staff, the Fourth Central Hospital will still require doctors to take adequate protective measures when receiving such patients.

Disposable transparent protective glasses and N95-level masks are all necessary protective equipment.And these protective equipment, which obviously exceeded the prescribed requirements, were naturally sponsored by Dean Song.More than one-fifth of the funds sponsored by Mine and Billiton to the Fourth Central Hospital are spent on these places.

"Send the patient directly to the clean room." In terms of administrative level, the Department of Infectious Diseases of the Fourth Central Hospital is much higher than that of other hospitals.Moreover, their continuous propaganda (threats) in their usual work, coupled with the power to deduct people's performance, has indeed made many front-line medical staff more careful. After all, in the winter environment, the virus is inherently more serious than other conditions are more likely to survive.In order to prevent the cold, people seldom open windows to breathe in winter. This series of objective factors will indeed lead to a high incidence of infectious diseases.So Xu Yourong still arranged the room and route for the quarantine inspection, although she really felt that since the patient's body temperature hadn't reached 38 degrees, the significance of this measure didn't seem to be very great.

The preparations are being carried out in an orderly manner. By the time the patient is sent to the emergency room, other patients on the transfer channel have been evacuated into the positive pressure area of ​​the emergency room.From the electromagnetic door of the rescue room to the clean room, all the 12 beds on the passage were cleared.

"The patient is female, about 50 years old, undocumented, unconscious. Blood oxygen saturation is 92%, blood pressure is 150/90, heart rate is 120, body temperature is 37.4°C." Wearing an ordinary mask, probably because of the intense breathing, half of the mask on the face of the first responder was blown off, exposing two nostrils.I don't know what the purpose of this mask is.He pushed the car in with his head down, and pointed to the policeman who followed behind him, "The patient was found fainted by the side of the road, with no obvious physical injuries. Passers-by then called the police, and comrades from the police station rushed to the scene and beat him up." Emergency call."

"How long has it been since you found out that you fainted?" Under the guidance of the nurse, the patient was pushed directly into the clean room.Xu Yourong put on blue latex gloves, and checked the patient's pupil reaction with a small flashlight. "Have you found any family members?"

"Not yet." The policeman who followed into the clean room looked young, probably a rookie who had just graduated from the police academy.He answered Xu Yourong's question nervously, "We received the alarm 20 minutes ago, which is about eight o'clock... around eight forty." He simply took out a small notepad from his pocket and looked at it. After confirming the content, he nodded. "We received a call at 5:[-] and arrived at the scene five minutes later, and the person was already lying on the ground."

After Xu Yourong finished the basic examination, he turned around and said, "Please go with our nurse and give her a number first..." At this point, Xu Yourong suddenly didn't know what to say.After all, this patient doesn't even have a name, so I really don't know what to do with this registration.

"I'll just take him with me." Zhong Yu volunteered, she had been working in the emergency room for a long time, and she could tell from Xu Yourong's appearance that she was in trouble. "I am quite familiar with the registration process of patients without identity."

In fact, many patients who cannot obtain their identity can be seen in the hospital every year.Some of these people are mentally ill, some are homeless, and some are really desperate.And for those patients, the hospital will still accept them if they need emergency treatment.And provide medical assistance within a certain range.And this process is called "unidentified patient treatment process".

It should be noted that this emergency service is limited to patients requiring emergency care.Unidentified patients whose condition is not urgent will be sent to the relief center of the Civil Affairs Bureau instead of the emergency department of the hospital.After the medical staff confirmed that the patient's condition was urgent, they would report to the medical office and register in arrears, and mark the patient as "Anonymous", and write "rescue" on the bed card.If an emergency examination of a patient is required, it will also be examined with an "Anonymous" sign.

As for the expenses incurred in this series of medical treatment, if the identity of the patient cannot be verified in the end, it will be paid by the disease emergency relief fund every six months.

When Zhong Yu was at the triage desk, he often dealt with such patients.Now in the emergency room, the ability to deal with this situation has not fallen at all.She took the little policeman out to register, while Xu Yourong continued to check the patient's physical signs.

Anonymous's three-concave syndrome is very obvious.Although she was still inhaling oxygen in the ambulance, her blood oxygen saturation is still only 92%, and the situation is not optimistic.

"You're breathing pure oxygen now?" Xu Yourong and Xiao Guo frowned after confirming the situation, "Call the Imaging Department to come and take a bed film." In order to save some time, Xu Yourong gave the order order, while still doing other physical examinations. "Check a whole blood, get twelve leads, take an electrocardiogram, check a major biochemistry, add five items of infection..." She paused, and patted Anonymous's shoulder with both hands, "Wake up! You know Where are you?"

Nameless's eyelids moved, as if he still had some reaction to the shoulder pat.But he still couldn't open his eyes.

Imaging doctors rushed to the scene quickly.This time it was not Luo Ge, but another middle-aged radiologist surnamed Huang.After learning the basic situation, he also put on a mask.

"Just take a chest X-ray?" Dr. Huang skillfully pushed over the bedside X-ray. He frowned and looked at the patient and asked, "Should we wait for an emergency CT? Sudden coma may be a cerebral hemorrhage." ah."

"Take a chest X-ray first." Senior doctors in the auxiliary department are indeed very sensitive to certain diseases, but Xu Yourong doesn't think that this anonymous person has a problem like cerebral hemorrhage.The pupils on both sides of the patient responded well to light, and the pupils did not dilate or respond asymmetrically on both sides. At least the possibility of cerebral hemorrhage is not high now.

The results of the bed X-ray came out quickly, and the X-ray confirmed that the patient had atelectasis on one side of the lung. At the same time, the X-ray showed infiltration of the middle lung lobe and lobe-shaped shadows of the lower lung.

"Lung cancer?" Xu Yourong frowned. Her knowledge of lung cancer was far inferior to that of other emergency doctors, let alone compared with Rachel - Rachel is an expert in oncology.After thinking for a while, she decided to call the doctors of respiratory medicine for a consultation.

Wang Yin, the chief physician in the Department of Respiratory Medicine, glanced at the X-rays and shook his head, denying the possibility of lung cancer. "The boundary is clear, it doesn't look like lung cancer. This is severe pneumonia..." He suddenly turned his head and asked, "What's the patient's oxygen saturation? What's the temperature?"

"The body temperature is 37.4°C, and the blood oxygen saturation is 92%." Xu Yourong replied, "The patient is already inhaling pure oxygen."

"Severe pneumonia is the most likely." Wang Yin handed back the X-ray, "I suggest taking anti-infection treatment first, and then do a sputum culture to confirm the type of infection."

Naturally, Xu Yourong would not have any opinion on the specialist's advice.As soon as Wang Yin left, Xu Yourong, who got the blood routine examination report, noticed something unusual in the report. "Leukocytes decreased, platelets decreased, neutrophils decreased."

"Cefepime hydrochloride, 1g, mixed with 200ml 0.9% sodium chloride solution for intravenous injection. Then add a bottle of imipenem cilastatin sodium, 1000mg, mixed with 200ml 0.9% sodium chloride solution for intravenous drip... She paused and said emphatically, "Imipenem comes next, pay attention to the injection speed."

Cefepime hydrochloride is a fourth-generation cephalosporin antibiotic that is very effective against neutropenic infections.And imipenem is a miracle drug with a clinical effective rate of 93.0% in the treatment of severe lower respiratory tract infection.These two drugs are clinically "use with caution" controlled antibiotics.In order to prolong the effectiveness of antibiotics as much as possible and reduce the chance of drug-resistant bacteria being born, these two drugs are rarely prescribed to patients by doctors.But Xu Yourong's behavior at this time was really a reaction of last resort.

Anonymous's symptoms were very serious, but if he had to wait for the results of the sputum culture, it would have been several days.Judging from her current oxygen saturation of 92%, if the development of infection and pneumonia cannot be controlled as soon as possible, she may have to rely on a ventilator in a few hours.

Xu Yourong looked at the inspection report in her hand. Although she had already made the correct response, she still felt a little uneasy.The combination of the severity of the patient's condition and the not-too-high body temperature made her vaguely feel that something was wrong.

Could it be because the patient's immunity is poor, so they cannot make an obvious immune response?Xu Yourong pondered for a moment, then decided to give Wu Mingshi another bottle of gamma globulin injection.The combination of this human blood preparation and antibiotics can effectively improve the effectiveness of antibiotics in treating severe bacterial infections.

After finishing the arrangements, Xu Yourong breathed a sigh of relief, dealing with emergency patients by himself is indeed somewhat tiring.

　Today's update is also 4000+
　　
　
(End of this chapter)