I can see the status bar

Chapter 518 Insufficient nutrition
The relationship between Xu Yourong and Penny is indeed very good.After hearing this request, she nodded and agreed almost without any hesitation, "No problem, I'll pick it up." Not only that, but she also thought about the future very intimately, "I think they may also I can’t go back, I’ll just open a room at the hotel in Sun City later. Pascal will probably spend the night in the hospital today, and I have to find a place to sleep for Isabella and Petunia.”

When a family suddenly encounters such an accident, the daily life of almost all members will disappear.Petunia and Todd went to the same school, so they probably already knew the fact that her brother was sent to the hospital.Now that it's time to leave school, the little girl doesn't know what to worry about.

It has to be said that the ability of women to calm people's hearts when facing children is simply unmatched by men.Sun Lien can accurately find out the cause of his/her discomfort when facing a crying child, but he can't coax a child who "want a mother" with a few words like other nurses.

In order for Xu Yourong to pick up Penny as soon as possible, Bruen kindly provided Xu Yourong with his motorcycle for use.The most amazing thing is that this unmarried member of the American Communist Party actually put a children's helmet in the car.

In Brunn's words, this is called "has a sense of crisis."

However, this proposal disappeared after Sun Lien popularized the traffic regulations to Brunn.Children under the age of 12 are not allowed to ride motorcycles due to national regulations.In the end, Xu Yourong could only borrow Sun Lien's Volvo, and had to drive to Dr. Pascal's house first, and get the child seat before talking.

Although troublesome, Xu Yourong didn't show any sign of impatience.

On the contrary, Sun Lien was a little impatient in the office of the director of the infection department.

"What's the matter with this medication, why do you need pulse medication?" Director Huang is a typical hospital department manager with a background of technocrat.The level of proficiency in the business within the scope of their own direct jurisdiction is not bad.But when the business involves cross-departmental work, he will show a very rigorous and professional attitude. At best, at worst, he is always skeptical of the professional level of other departments. The details of the digging have to be digged to death.

This kind of rigor is considered a mature and prudent move when there is enough time to consume.But when Qian Aiwu was waiting for medicine to fight necrotizing fasciitis, it was a bit out of place.

"Director Huang, the opinions of other doctors in the Department of Pharmacy and Infectious Diseases are below." Sun Lien carefully reminded, "I am an emergency physician, and I cannot answer these questions you asked." He quietly took a breath, tried his best to Calming down my emotions, "The medication plan is designed by the licensed pharmacist of the pharmacy department according to the patient's condition. I don't know the specific reason."

"Then I'll make a phone call first." Director Huang nodded, but there was no expression of dissatisfaction on his face. "This permission involves the management regulations of our hospital, so I have to figure it out before I can sign it."

Sun Li'en blinked in pain, and there was nothing wrong with what Director Huang said.But it is this meticulous energy that really makes those who are waiting to do things feel anxious from the bottom of their hearts.

"Hello, Sun Lien?" Sun Lien's phone rang. Fortunately, the phone was still in his hand, so that Sun Lien could cover his ears with lightning speed before the word "roast" of "roasted gluten" was fully pronounced. Line connected.The speed was so fast that even Director Han, who was on the phone, was a little surprised.He froze for a moment before continuing, "Is Director Huang back?"

"I'm back." Sun Li'en replied with a bitter face, "Director Huang asked a lot of questions about medication, but I couldn't answer any of them. As a result, Director Huang had to make a phone call first..."

Director Han Wenping laughed twice, "Don't take it to heart, Lao Huang has such a bad temper. It's useless even if you move Dean Song." He whispered, "I'll ask someone to send the medicine to you first. , Lao Huang will definitely sign it, it will only delay for a while."

Director Han is famous in the Fourth Hospital for his honesty. Sun Lien still had some concerns and planned to persuade him to wait, but Director Han had already hung up the phone in advance.

Although he was a little worried that it would be inappropriate for Director Han to do things so directly, Sun Li'en was actually a little fortunate in his heart.At least now that he knows that Qian Aiwu's treatment will not be delayed, he feels much more at ease.

However, it was the first time for Sun Lien to meet the head of the department who "it's useless to move Dean Song".There is no doubt about Song Wen's control over the departments below.Even Zhao Jianguo from the laboratory did not dare to directly confront Song Wen—he even dared not directly confront Liu Pingchuan.But Director Han's words were never watery.If he said it was useless, it must be really useless.

Why does Director Huang Hua have such confidence?Sun Li'en was a little confused, but he was sure that his confidence was definitely not because of his background or identity - just because of Dean Song's temper, he didn't care about his identity when he got angry?
"There is something wrong with this medication plan." Sun Lien was trying to guess the source of Director Huang Hua's confidence, but Director Huang who was sitting behind the table suddenly frowned and said, "Why did you use so many standard diaphragm bags of nutrient solution for her? "

The standard diaphragm bag nutrient solution is the main means of caloric supplementation for patients who have difficulty eating in clinical treatment.For patients who have been unable to eat by themselves for a long time, fat emulsion injection is the best and only way - you can't watch the patient starve to death because they are unable to eat because of coma?If it is only a short-term coma, it can be simply maintained with glucose injection.However, patients like Qian Aiwu who are in the third stage of cancer after surgery, have severe mixed infection, and then fall into a coma, have a much higher calorie requirement than ordinary people or even other patients.Her body will need nutritional support more than usual in order to get better as soon as possible.

"Eh..." Sun Lien was stunned for a while before answering after hearing this question, "Her nutritional needs are higher than other patients..."

"I know she needs more caloric supplements." Director Huang Hua continued, "My question is, why use a standard septum bag instead of separate input? She was in septic shock before, right?"

"The nutritional support strategy is formulated according to the recommendations of the gynecology department." Sun Lien also vaguely sensed that Director Huang Hua's question might be very important, "According to our calculations, her total daily calorie intake is sufficient - 4000kal per day... ..."

Director Huang shook his head in disappointment, and muttered to himself, "Why didn't you come to me for consultation earlier? Why didn't you ask the nutrition department to formulate a nutrition plan?" He raised his head, looked at Sun Li'en and said, "Although this problem The consequences may not be manifested yet, but if you go on like this, even if you really change your medicine, she may not be able to wake up properly."

"You mean..." Sun Li'en was really panicked. He tried his best to recall that when he went to see Qian Aiwu in the past few days, the status bar didn't mention the problem of malnutrition.

"You guys take nutrition too lightly and trust figures too lightly!" Director Huang shook his head while taking out a stack of documents from the filing cabinet beside him, "Fortunately, the time you came to find me is not counted. It's too late. Another week, this man will make you hungry!"

For patients with severe septic shock, Director Huang's experience is by no means worse than that of the emergency department.And when the professional scope is focused on nutritional support and long-term treatment, the emergency department is even worse than Director Huang.

"Such a patient is in a state of severe stress." Director Huang Hua pointed to the stool beside him and asked Sun Lien to sit down.On the other hand, he flipped through the information, and it looked like he was going to give Sun Lien a class. "The nutritional plan of the gynecology department is to infuse [-] calories of standard diaphragm bag nutrient solution per day. If this plan is only for patients after radical tumor surgery, it is barely enough. But she still has necrotizing fasciitis, which the body needs. At least [-] calories are enough, and more protein is needed.” He raised his head, looked at Sun Lien and shook his head again, “Only use standard diaphragm bag nutrient solution, enough calories, too much fat , too little protein. In order to synthesize enough protein to repair her body, her body consumes a lot more calories." Speaking of this, Director Huang seemed a little regretful, "It's very common for those of you who come from the emergency department to understand this. The doctors in the ICU don't bother to ask the nutrition department for consultation. But this habit is bad, very bad!"

According to general statistics, only 29% of patients receiving treatment in the ICU receive adequate energy supply.Most of the patients had insufficient energy supply, and about 56% of them had insufficient protein intake.On the one hand, this is because early enteral nutrition prescription (EEN) is unreasonable, delayed enteral nutrition (DEN) and enteral nutrition interruption caused by various reasons are related.The more important reason is actually because of the widespread promotion of nutrient solutions in standard diaphragm bags.

A good thing is the standard diaphragm bag nutrient solution, which comes prefilled with a mixture of fat emulsion, amino acids, and glucose.It is only necessary to squeeze the septum in the bag to mix the nutrient solution evenly before injecting the patient.The standard diaphragm bag nutrient solution at room temperature has a shelf life of up to 24 months, which is convenient for mass production and storage. More importantly, it avoids various pollution problems that may be caused by self-made nutrient solution in the hospital in the past.

But the things produced by this kind of standardization often have nothing to do with "individualized treatment".The standard diaphragm bag nutrient solution produced according to the standard formula cannot actually meet the protein needs of many severe stress patients.And because the nutrient solution is directly injected into blood vessels, patients with cardiovascular and cerebrovascular diseases and patients with metabolic disorder syndrome cannot use this nutrient solution.

Doctors in the ICU pay great attention to the disease itself, but often neglect the nutritional supply.In fact, most hospital departments have this problem.However, most of their patients can eat on their own, and even if there is a lack of voluntary nutrition, the patients can also take food by themselves.

Although there are still debates about whether EEN should be applied to patients with shock, at least one thing Director Huang can be sure of is that Qian Aiwu is not taking in enough calories, and his nutrition is not balanced enough.This may be one of the main reasons why her infection has not improved as expected so far.

(End of this chapter)