I can see the status bar

Chapter 379 Party Members
Streptomycin is the first-line antibiotic commonly used in clinical practice. As an aminoglycoside antibiotic, it is cheap to use and has a good anti-infection effect.The main reason why Sun Lien decided to use streptomycin and ciprofloxacin in combination was based on the plague diagnosis and treatment plan promulgated by the Health and Medical Commission in 11.

As a guiding document for plague treatment in health institutions, the plan specifies in detail the diagnosis method of the disease, the recommended dosage and type of medication, disinfection care and other arrangements.Within the allowable range, the maximum dose of intramuscular streptomycin combined with ciprofloxacin is actually a very strong anti-infection means.But Sun Li'en was not sure if this dose was enough - the symptoms of Tang Xingde and Hou Huiying were too severe.

"The results of blood routine, blood gas, liver function and kidney function have come out. All three patients have decreased platelet counts. Tang Xingde has acute liver injury and acute renal failure. His wife has acute renal failure and metabolic acidosis." Xu Yourong Shouted to Sun Li'en, she saw the inspection data in front of the computer.Paper checklists are still being printed.

"Send the kidney function data to Zhou Ce and ask for his opinion." Acute renal failure can range from mild to severe.Not every case of acute renal failure requires immediate attention.Things always have priority. Under life-threatening conditions, the key point is to deal with the patient's respiratory and circulatory system problems first.Without a kidney, the patients may die within a few days. According to the estimation that all three of them were infected with the plague two days ago, it is about one day before Yersinia pestis took their lives.But without a respiratory circulatory system, no one can live for more than 5 minutes.

Respiratory and circulatory problems were dealt with first, and then the attention was turned to the plague.Finally, deal with acute kidney injury and liver injury.This is the correct treatment plan to keep the family of three with the greatest chance of survival.

First save lives, then cure diseases.

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"Streptomycin cannot be used. The patient has acute renal failure." Zhou Ce called the emergency room directly. He also knew that Sun Lien had received three patients who were highly suspected of plague. Diagnosis and treatment options, streptomycin is the preferred recommended treatment drug.However, patients who have already shown impaired renal function need to avoid using streptomycin as much as possible - streptomycin does not directly metabolize or produce reactions in the human body, and mainly relies on renal excretion.If the patient has renal impairment, it is also T1/2 metabolism, and the original two-hour metabolism rate will be extended to more than 100 hours.However, if the human body is exposed to a high-concentration streptomycin environment for a long time, serious toxic and side effects may occur.After Zhou Ce discovered this, he immediately called the emergency room. He estimated that Sun Li'en was not particularly sensitive to this. "It can be treated with cefpiramide instead."

Cefpiramide is a third-generation cephalosporin antibiotic.Although there is still relatively little data on the use of third-generation cephalosporins to treat plague, many drug sensitivity tests have proved that Yersinia pestis is extremely sensitive to third-generation cephalosporins.Its sensitivity is even higher than traditional anti-plague antibiotics such as streptomycin and gentamicin.More importantly, after intravenous injection of cefpiramide, the blood concentration increases faster than intramuscular injection of streptomycin, and it is mainly excreted through bile, and it can still maintain good metabolism under the condition of renal insufficiency.

"Cefpiramide, right? Got it. Do you still need to continue using ciprofloxacin?" Sun Lien trusted Zhou Ce's suggestion very much, after all, his work experience was much richer than his own.Especially the drug experience under the condition of renal insufficiency, twenty Sun Li'en bundled together have more experience than Zhou Ce's one hair.

"Pneumonic plague is a severe case, and it must be used in combination. Fluoroquinolones are fine, and ciprofloxacin is no problem—even if there are minors among the patients, it's better to not grow taller than dead." .”

Tang Wen is an adult, so he is not afraid of the cartilage toxicity of ciprofloxacin.Sun Li'en adjusted the medication, and after watching the nurses infuse all three of them with the medication, he breathed a sigh of relief.

The next work will mainly depend on the hospital infection department and infectious disease department.Of course, because it is pneumonic plague, the Department of Respiratory Medicine also needs to support doctors to come down to participate in the treatment work.And the doctor who came to support had to be selected according to the tacit rules in the hospital.

Party members, who are married, have children, and are not the only child will be drawn as the first batch.Arrange down according to the level, and everyone will draw lots together.There are four signs for the director of the department, two for the deputy director, and one sign for the attending and hospitalization.After the lottery is drawn, call your family and explain a few words, and you have to go to rescue people immediately.This is how hospitals treat patients at high risk of infection.The doctors who were not selected will be selected as a second batch and another person will be selected as a reserve. In case the doctors drawn from the first batch cannot continue to perform their duties due to... some reasons, the doctors from the second batch will be the top ones.

In the face of probability, all beings are equal.

"All right, all right, let's get together and draw a lottery?" Huang Wenhui, the chief director of the Department of Respiratory Medicine, unceremoniously dispersed the people who were about to draw lots, "What's so good about this? What should I do? Just go."

Director Huang is 43 years old this year, and he is not tall, only about 1.5 meters long.But in the one-acre three-point land of the Department of Respiratory Medicine, Director Huang is the one with the most rules.Not only the rules are big, but the temper is also big.With her eyelids low, the best way to deal with a mistake is to admit it before she finds out.If Director Huang finds out about your problem, it won't be a matter of one or two sentences. According to Corey's experience, Director Huang can at least remember the problem of "the content of the case record is not objective enough" three times. Year.And take it out from time to time to teach those who made mistakes.

Such a serious person is generally not very popular.Director Huang Wenhui is no exception.Anyway, according to the rules, Director Huang had four lots to draw, and everyone had no objections.But who knew that director Huang, who was not popular this time, made such a decision.

"Why? Want to snatch it?" Director Huang is from Cantonese. He is dark, thin and short, and he doesn't look like someone who has given birth anyway. "Letting you people take care of plague patients is harmful to both others and yourself. Maybe you will put them to death." She stared, "Don't rob me if you don't have the skills!"

Everyone in the Department of Respiratory Medicine exchanged glances with each other. They were not sure whether Director Huang was really angry, or trying to make everyone accept this fact with this statement.

"I'm the director of the department, a party member, my child is in junior high school, and I have an older brother at home." Director Huang laughed, and poked his hand on his waist, "Which one of you can compare to me? It's okay, get out and wait for me to come back." Yes, I want to investigate the case!" After finishing speaking, Director Huang turned around, walked out of the office in a chic way, and walked towards the stairwell.

After confirming that there was no one around her, Huang Wenhui took out her mobile phone with trembling hands, dialed a number to her husband, and her voice trembled.

"There's plague, I'm going to have a consultation. You cook for the child these few days." Director Huang's voice was trembling, "It's okay, I'm fine, I... I'm not afraid!"

In the year of SARS, Director Huang had just graduated from his undergraduate degree and worked in the First Affiliated Hospital of Ningyuan Medical College. In that year, the First Affiliated Hospital was designated as the designated hospital for the treatment of SARS cases in Song'an Province.

"That's what Teacher Hou said that year. If he can do it, so can I..." Director Huang hung up the phone resolutely after saying this.He wiped his eyes with his sleeves, stomped his feet, and ran towards the rescue hall of the emergency department.

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"As a member of the Communist Party, I only have this privilege." Professor Hou Youning, who was once the director of the Department of Respiratory Medicine at the First Affiliated Hospital of Ningyuan Medical College, said so at the time, "When I can't do it anymore, you will draw lots!"

(End of this chapter)