I can see the status bar

Chapter 530 Accident

Regardless of whether the allergic reaction represented by the wheal is caused by vancomycin, Qian Aiwu's symptoms are not comparable to the traditional concept of "antibiotic allergy".As far as Sun Lien knows, antibiotic allergies usually occur very quickly, and the results are quite serious, and there may even be fatal reactions such as laryngeal edema, shock, and even cardiac arrest.

During his internship in the emergency department of the Affiliated Hospital of Ningyuan Medical College, Sun Lien once saw a severe allergic case.The patient was a young mother whose child was only one and a half years old.She was rushed to the hospital by a bus.

The one-and-a-half-year-old child was taken to a nearby children's hospital for treatment because of a fever. The doctor infused him with 50 units of penicillin at a rate of [-] units per kilogram after a skin test confirmed that the child was not allergic to penicillin. To combat the symptoms of upper respiratory tract infection.After the infusion, the young mother got on the bus with her baby in her arms, ready to go home.

One-and-a-half-year-old children do not yet have perfect excretion tolerance.Like children of the same age, he felt a little urge to urinate in the car, so he urinated smoothly on the bus.Unfortunately, his diaper was a little loose, and the urine just dripped on the back of his mother's hand.

And this young mother is allergic to penicillin.

Tens of seconds later, the passengers in the car were horrified to find that a mother with a child in her arms had collapsed on the floor of the car, her eyes were closed and her face was blue.

The bus driver remained calm in the face of danger. After confirming that someone on the bus had a sudden illness, he flicked the steering wheel and rushed out to the nearest hospital with his double flashing lights. Two minutes later, the bus stopped on the emergency channel of the affiliated hospital honking its horn.The doctors and nurses who heard the movement immediately found the young mother lying on the ground.

In the case of laryngeal edema, in order to save her life as soon as possible, the doctors immediately performed a tracheotomy for her and started chest compressions.After judging that she might have a severe allergy, she was given epinephrine.On the other hand, Sun Li'en practiced the rescue all the way. Finally, when the family members were talking, the doctors realized that the source of her allergy might be penicillin, and the source of penicillin...was her son's urine.

Drug allergies can be fatal.Sun Lien remembered this firmly, and for the first time realized how low the allergy dose caused by antibiotics might be.This habit has been brought into his later work. Once a patient has an allergic reaction, Sun Lien's first move must be to stop the medication and then re-evaluate the patient's condition.

But... can drugs cause delayed hypersensitivity?Sun Lien is really not sure about this, he only knows that some food intake may cause delayed allergy, but drugs, especially intravenous antibiotics should not have the possibility of delayed allergy, right?
"I'm not sure about vancomycin, but there are indeed reports of this happening with other drugs." Han Wenping thought for a moment after listening to Sun Lien's inquiry, "Since you still have time to make calls, the patient's allergies should still be normal." It's not serious, is it?"

"The current patient's symptoms are wheals, and it cannot be confirmed that it must be a drug allergy caused by vancomycin." Sun Lien said, "The situation is still manageable, it's just itching—the range of her wheals is not too large. .”

"I'll go there now. Is vancomycin still used? If you are using it, stop it immediately." Han Wenping immediately made a decision, "I'll take someone to see it."

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Han Wenping trotted all the way to the diagnostic center with two pharmacists. In the sweltering summer night, all three of them were sweating profusely.The black shirt on Director Han's body was almost drenched after running for such a distance, and the situation of the other two clinical pharmacists was even worse - the fatter pharmacist even had his white coat soaked with sweat.

"How is it? Are you still awake?" Han Wenping didn't even bother to wipe off his sweat after running to the diagnostic center, and asked straightforwardly, "Has the wheal extended to the neck?"

"No." Sun Lien shook his head. Seeing that Han Wenping was holding two boxes of epinephrine in his hands, he couldn't help becoming nervous, "We still have more than a dozen boxes of epinephrine here...isn't it enough?"

"I just took two boxes by chance." Han Wenping glanced at Sun Lien, "What are you thinking? Use a dozen boxes together, you want her heart to be blown to pieces?"

"That's good." Sun Lien breathed a sigh of relief, "Director Han, are you going to see the patient?"

"Yeah." Han Wenping nodded, pointed out the door, "You lead the way."

A professional is a professional.Han Wenping didn't even catch his breath, so he first thought about seeing the patient.The other two clinical pharmacists skillfully took out a pen and paper from their pockets, and opened their mobile phones to take pictures and record them.

"Although there is no report of delayed allergy to vancomycin, there have been reports of delayed red man syndrome." Han Wenping spread the knowledge for Sun Lien as soon as possible while walking, "Have you heard of red man syndrome?" ?It’s a severe allergic reaction, and patients have large red spots on their face and neck, or even their entire torso.”

"Director Han, this patient is not erythema, but a wheal." Sun Lien corrected, "So it shouldn't be... red man syndrome, right?"

Han Wenping shook his head, "When the first case of vancomycin allergy was reported, there was no mention of red man syndrome and erythema - the main symptoms at that time were itching, urticaria, chest pain and vascular collapse. Subsequent reports also included a series of symptoms including hypotension, fever, and headache."

Sun Li'en quickened his pace, "That is to say...can't be ruled out?"

"It's really impossible to rule it out. If you want to rule it out, you have to stop the vancomycin first, and then see the patient's reaction." Han Wenping also accelerated the pace, "First stop the drug first, and you prescribed loratadine? Then The effect of the thing is not strong enough, at least promethazine hydrochloride injection and dexamethasone should be used for allergies. Then monitor her vital signs. If there are other symptoms, then add cetirizine.”

Han Wenping followed Sun Lien to the ward, where the head nurse Zhong Yu was applying calamine lotion on Qian Aiwu's back.Seeing the four big men barging in, he raised his eyebrows and shouted, "Why can't you even knock on the door before entering the room? Forgot the rule that you must knock on the door before entering the women's ward?"

Han Wenping glanced at Sun Lien, then stepped back decisively, apologizing as he retreated, "I'm sorry, I thought Dr. Sun had already said that..."

"Xiao Han?" Qian Aiwu, who was lying on the bed enduring the itching, suddenly raised his head, twisted his body and tried to look in Han Wenping's direction, "Are you Xiao Han?"

"Sister Qian?" Han Wenping's eyes widened, and after carefully identifying the raised face, he said in shock, "Why is it you?"

　The chapter name is wrong, I will contact the editor to modify it as soon as possible (but there is a high probability that it will wait until after the festival)

　　Sorry for the late second...

　　There is a high probability that there will be only one chapter in the update on the 3rd, so I will inform you in advance.The owed content should be returned by the 5th at the latest
　　
　
(End of this chapter)