I can see the status bar

Chapter 490 Asking for help off the field (third change)

There is a corresponding process for patient admission and treatment.In all fairness, Feng Chujie was the first to resign if the patient's treatment decisions were to be handed over to Sun Lien while maintaining the status quo.In case something goes wrong during the treatment, Feng Chujie, who is the patient's doctor in charge, will bear the final responsibility.

Although everyone is familiar with each other, this kind of thing cannot be done casually.

Sun Lien found Liu Pingchuan who was in a meeting without psychological pressure, and reported the current situation to him.Liu Pingchuan raised his eyebrows when he heard this, "Is there really a problem?" Goodness behold, he handed over this case to Sun Lien, in fact, the fundamental purpose was to be lazy - there is a case that delays Sun Lien's time first, so that he can summarize the case and The work of calling out rare diseases and handing them over to Sun Li'en was delayed a little.

"There is a problem." Sun Li'en took out his mobile phone, "The patient's chest, abdomen and pelvic cavity has subcutaneous tissue gas accumulation and fascial edema. The area is relatively large. The only good thing is that because you discovered it early enough, Dean Liu, she The infection is not particularly serious."

Another explanation that is not particularly serious is "I can't die now, but it's hard to say later."Liu Pingchuan obviously understood what Sun Lien meant, he frowned and thought for a while, "What's the opinion of the gynecology department? They are willing to transfer this patient, right?"

"That's right." Sun Li'en nodded, "The question now is, how do I pick up patients in this emergency department? Are they hospitalized in the emergency department?" The emergency department of the Fourth Hospital has its own inpatient department, but strictly speaking, it is still under observation in the emergency department. category.This and hospitalization are two concepts-at least for patients, there is a huge difference in medical insurance reimbursement.

For a family of patients with stage III cancer, every penny may mean the difference between life and death.If you can save a little for others, it's better to save a little.

Liu Pingchuan rubbed his head with some headaches, he even wished to take out his brain and rub it.He obviously wanted to save trouble, but in the end he caused even more trouble for himself.

"How about this, you transfer the person to the gods first. Let Yourong take this patient. I'll go to Dean Song to get a charter." After much deliberation, the idea of ​​saving life still outweighed the attempt to save trouble.Sighing, Liu Pingchuan took out his mobile phone, first said hello to Shenwai's inpatient department, and then called Song Wen.

"When will the hospital office vacate the room over there?" On the phone, Dean Liu seemed to be discussing some specific details with Song Wen.On the other hand, Sun Li'en nodded embarrassedly towards the other doctors in the meeting room - he interrupted the meeting halfway through.And it seems that this meeting will not be able to continue for a while.

After suffering for about 15 minutes under the eyes of many doctors, Sun Lien finally got the final treatment advice from Liu Pingchuan, "Transfer the person to Shenwai for treatment first. The inpatient ward prepared for your treatment team can be put into use in two days. ——Four beds, Dean Song’s opinion is to prepare three nurses, including a head nurse. The head nurse is appointed by the Nursing Department, and other nurse candidates can consider your opinions.”

He glanced at Sun Lien, "Okay, hurry up and see a doctor—Director Sun."

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"How is it? What treatment plan did Dean Liu give?" Sun Lien returned to the small conference room, where Xu Yourong and others were anxiously waiting for the follow-up treatment plan brought by Sun Lien.The doctor in the imaging department gave advice, "thoracoabdominal pelvic infection, intestinal edema".The patient urgently needs follow-up treatment, but in the emergency room, she can only get basic anti-infection treatment, and other means can't be used.

"Dean Liu... gave us an inpatient department. But it can't be used now." Sun Lien used the fastest speed to get himself out of the shock, and conveyed the opinions of the hospital management as accurately as possible. "First transfer the patient to Shenwai hospital for treatment, Dr. Xu, you will be the attending doctor. Two days later, we will be given two wards in the hospital to receive patients - and three nurses will be specially allocated."

Zhou Ce caught the point of the conversation with a smile, "Then you will really become Director Sun in the future? Independent inpatient department, this is amazing."

"Let's talk about it later." Sun Li'en didn't want to continue this topic, he really felt a little embarrassed, "How is the patient's condition?"

"The heart rate is still rising, and it has reached 135 now. The situation is not good." Speaking of serious business, several doctors who were still laughing suddenly became serious, "Her blood pressure is dropping, and it has dropped to 65/ 85, blood gas showed metabolic acidosis, and sodium bicarbonate solution was used for fluid resuscitation and acidosis was corrected. However, the infection progressed much faster than we expected."

"Sepsis must be considered." Sun Lien frowned, "What did the doctor in the imaging department say? Have you found the source of infection?"

There are four key points in the symptomatic treatment of sepsis. The first is to accurately understand the patient's disease status, that is, monitoring.But Qian Aiwu is still in the emergency room and will be transferred to the Shenwai Inpatient Department soon.At this time, it is difficult to install a full set of monitoring equipment-it will be difficult to move when it will be transferred.

The second is early fluid resuscitation.For patients with decreased blood volume and hypoperfusion of tissues and organs, the earlier effective fluid resuscitation is performed, the higher the survival rate will be.This point Xu Yourong and others have already done ahead of Sun Lien.They not only performed fluid resuscitation on the patient, but also corrected Qian Aiwu's acidosis.This provides a very good opportunity and platform for subsequent treatment.

The third point is to control infection is more troublesome.Since bacterial culture takes time, Sun Lien first underwent empirical antibiotic treatment.Anti-infection with imipenem and cilastatin sodium is the limit that doctors can do now.But this is obviously not enough, the patient's infection is progressing too fast.

To completely reverse the situation, the only way now is to find the source of the infection and remove it surgically or through active drainage to slow down the progress of the infection.

"The radiology department didn't give the specific infected organ." Xu Yourong replied helplessly, "We have also seen the results of the impact. In addition to intestinal edema, there is also a large amount of gas in the subcutaneous tissue. I want to find it with CT. The source of infection is very difficult."

"Then transfer the person to the surgical inpatient department first." Sun Lien made a decision, "It's useless to let people lie here now."

"Are you going with us?" Xu Yourong quickly called Xiao Guo, the nurse in charge of the first coolie in the emergency room, and asked Sun Li'en while arranging the transfer, "Is there any other examination to be done?"

Sun Li'en pondered for a moment, "You guys go first, I'll come as soon as I give someone a call."

Watching several people leave the emergency room with the bed, Sun Lien took the phone and walked to the door of the emergency hall where no one was there, and called Wu Youqian, "President Wu, can I use the old thing's image recognition function?"

(End of this chapter)