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Chapter 875 Misdiagnosis? (Blood Donation Plus Series 046)

This chapter is added to thank the book friend "Sorrowful Wind and Fire" for donating 2020ml of whole blood on June 6, 12.He still has a chapter waiting to be added

Zhou Jun was already worried about this patient, but unfortunately, Zhou Jun himself was a doctor with a background in surgery.Even though Liu Tangchun followed Liu Tangchun for his doctorate, his research direction is still biased towards surgery.In the usual emergency clinical work, surgeons like Zhou Jun still have some advantages - after all, as a large emergency center, there are not a few trauma patients who are sent to the fourth hospital every day.Zhou Jun, who was born in surgery, even has some advantages when dealing with these patients.

But... Zhang Xiedi's situation is completely different, she is a real medical disease.And it's one of the more troublesome types of internal medicine—endocrine diseases.

As the current deputy director of the emergency department of the Great Emergency Center, and actually the director of the emergency department, when such family members of martyrs are sent, he is responsible for receiving patients, and as the doctor in charge is "the meaning of the question".

However, endocrine diseases are fundamentally at odds with Zhou Jun—as a deputy director of the emergency department with a background in surgery, he has mastered many methods for emergency treatment and rescue of endocrine disease crises.But diagnosing and treating an endocrine disease...he's really unprofessional.

Unlike Zhou Jun, Sun Lien is almost his mirror image—almost everything is reversed.Zhou Jun was born in surgery, and Sun Lien was born in internal medicine.Zhou Jun has an advantage in dealing with trauma patients, and Sun Lien... Anyway, with Zhou Jun's memory, Sun Lien's performance in the face of severe trauma patients is simply like a quail without a head-running around.

This view has been completely retained in Zhou Jun's mind since the first day Sun Lien entered the emergency department.But what he didn't expect was that Sun Li'en, a headless quail, could shine brightly in diagnosis.And before completing the regular training, he has made such a big name.

Zhou Jun had no bad thoughts about Sun Li'en's fame at all. On the contrary, he was very happy to see that his little junior brother, Gui Peisheng, who he brought with him before, could have such an achievement-how wonderful, if there is any uncertainty in the future Internal medicine patients, just go to Sun Lien directly!

Therefore, Zhou Jun, who finally found a chance, threw this "hot yam" to Sun Li'en without hesitation, and then hid aside to enjoy himself.As for how much headache his little junior brother will have - he doesn't care.

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"Didn't you go to the Department of Traditional Chinese Medicine for an injection?" In the office of the Comprehensive Diagnostic Center, Brunn, who was eating roasted duck legs, saw Sun Lien so surprised that he almost forgot to continue chewing the duck.He put down the lunch box, then wiped his oily hands and asked, "What happened to the patient behind you? There is also an emergency patient with a rare disease in the Chinese medicine department?"

Sun Lien glared at Brunn, "This is from the emergency department. If you are not going to help, then just eat your roast duck!"

"Oh." Bruen nodded, then sat back in his seat, and began to gnaw on the roasted duck leg.Now it's off-duty time, even capitalists can't deprive employees of the right to eat, right?
Sun Li'en first asked the nurses to send Zhang Xiedi to the room, and then began to write the progress record.It is not difficult to do these tasks, but the trouble is that it takes time.If it is an ordinary patient, perhaps these tasks can wait until tomorrow.But Zhang Xiedi's situation is different - her blood potassium has been low to close to the lower limit of normal, while blood chlorine and blood sodium are even lower than normal.If this situation is not reversed immediately, then if the situation continues... Her life may be in danger at any time.

An electrolyte imbalance can be fatal.

Patients belong to the type that may progress to critical and severe illness at any time, so they must be treated with care.It is always easier to prevent patients from becoming critically ill than to wait until they are critically ill.

"Test electrolytes every hour, and give her intravenous pump of 3% sodium chloride injection, one milliliter per hour." Sun Lien called the nurse, and the nurse instructed, "The main problem of this patient is dizziness, so we must Strengthen inspections."

Sun Lien is not only afraid of the consequences of hyponatremia and hypochloremia. For the elderly, vomiting is also a major factor of death.

When a person vomits, the intracranial pressure will rise rapidly, which may induce various cerebrovascular accidents.At the same time, the dirt in the mouth may be inhaled back into the lungs, causing severe aspiration pneumonia or even direct suffocation.

Strengthening patrols, although it cannot prevent Zhang Xiedi from vomiting, but at least it can respond quickly when she vomits, and minimize these risks as much as possible.

The nurse went to dispense the medicine with Sun Lien's medical order, and Sun Lien took out his mobile phone from his pocket, and then circled Ma Yongfang in the work group called "We are all famous detectives", "Doctor Ma, are you still here?" Are you in the hospital?"

After about ten seconds, there was a sound of footsteps outside the door, and Ma Yongfang's voice at the same time, "Dr. Sun, are you looking for me?"

"You haven't got off work yet?" Sun Li'en originally wanted to send an inspection report to the work group, and then ask Ma Yongfang's opinion, but since he is still in the hospital, it will be much more convenient. I found a patient, and I think the hyponatremia and hypochloremia are a bit strange, and it feels like the syndrome of abnormal secretion of antidiuretic hormone——Dr. Ma, please check for me.”

Ma Yongfang took the pathology report very naturally, and while flipping through the report, asked casually, "What's the patient's condition now?"

No wonder Zhou Jun said that he feels like a chief physician now.After being questioned by Ma Yongfang, Sun Li'en suddenly realized that this really felt like a superior doctor's ward rounds.He roughly talked about the current situation of the patient. Of course, he did not miss the history of Meniere's disease and hypertension.After talking about the situation, Sun Lien intends to induce Ma Yongfang's thinking and let her focus on the syndrome of abnormal secretion of antidiuretic hormone instead of studying the medical history of Meniere's disease. Chlorine and hyponatremia, right?"

"No." Ma Yongfang continued to look at the report, then nodded, "I feel that there may be something wrong with her previous diagnosis of Meniere's syndrome."

"...Ah?" When Sun Lien heard the first half of Ma Yongfang's sentence, he felt frustrated because he failed to induce his thoughts, but he didn't expect that there would be such a paragraph later, and he was suddenly surprised, "Why?"

"Although the etiology of Meniere's disease is still not very clear, the clinical treatment methods are relatively fixed—generally, anisodamine or scopolamine, combined with flunarizine, and sometimes diuretic and dehydrating drugs are also used for treatment. For example, hydrochlorothiazide or acetazolamide.” She looked up at Sun Li’en and said, “If diuretic and dehydrating drugs are used, then these drugs may also have an effect on antidiuretic hormone syndrome—they can resist antidiuretic hormone. , allowing the patient to return to a more normal metabolic state.”

(End of this chapter)