I can see the status bar

Chapter 95 Viral Meningitis (15)

Creatine kinase is an important kinase in the human body, and it is usually used in the detection of cardiovascular and cerebrovascular diseases such as myocardial infarction.Generally speaking, if creatine kinase is found to be elevated in blood routine, doctors will first think that the patient may have a myocardial infarction.

"Get an electrocardiogram, do a routine blood test, send an X-ray after hemostasis..." Sun Lien was arranging for follow-up examinations, when Gao Yan, who had been lying on the bed honestly, suddenly twitched, his whole back left the bed, and with his head and feet As a support point, the back is bent and arched!
The nurses who were busy next to Gao Yan were taken aback. This action did not seem to be something normal people could do.After a few seconds in the human arch bridge-like posture, Gao Yan suddenly softened as if the bones in his body had been pulled out, and then he began to suffer from severe muscle spasms, stiffness, and tremors all over the body.Foaming at the mouth, convulsions all over the body, and cyanotic complexion.This is a classic sign of a generalized seizure.

Without Sun Lien's reminder, the nurses jumped on Gao Yan again the moment Gao Yan had a seizure.They quickly untied Gao Yan's clothes.He turned his head to the side to prevent vomit from blocking the airway.

Gao Yan had a seizure for about 1 minute.All the medical staff leaned back, quietly waiting for Gao Yan's epileptic seizure to end.Contrary to common belief, seizures, while scary as they may seem, don't actually require much intervention.Especially for doctors, when a patient has a seizure, they only need to monitor the respiratory condition.No doctor would try to pry open a patient's mouth and stuff it with cotton or something—if a tongue is bitten during a seizure, there's no point in intervening afterwards.On the contrary, it is easy to injure the lower jaw in the process of prying open the mouth, or even pry off two teeth directly.As for the practice of pinching people, even doctors of traditional Chinese medicine would not recommend it.

Seizures are another powerful reminder of the patient's symptoms.Abnormal electrical activity in the cerebral cortex is the main cause of epilepsy symptoms.Seizures combined with elevated creatine kinase, and high cerebrospinal fluid pressure.Then the direction of suspicion should be meningitis or cerebral hemorrhage.

"Go for a CT scan first to see if there is any cerebral hemorrhage." The results of the blood routine test will take at least 10 minutes to come out.Before that, Gao Yan's life must be guaranteed first - cerebral hemorrhage will be fatal in a short time. "Xiao Guo, you go outside to find Liang Baobao, and ask him to take his family members to register first."

The precious O-negative blood was hung up, and Gao Yan's vital signs were fairly stable.But no one knows whether this stability can be maintained for a long time, or it will collapse directly at a certain moment without warning.

Time, time, and above all time.Sun Lien made a decision, he could wait for the registration, and CT had to do it immediately.If the symptoms are caused by cerebral hemorrhage, if the amount of bleeding continues to expand and cause brain herniation, the person cannot be rescued.He checked Gao Yan's pupils on both sides with a penlight, they were equal in size and responded well to light.

"Brother Sun..." Xiao Guo, the nurse who ran out of the door, came back again, "Brother Liang said that the family members are gone!"

Sun Lien's eyes widened, "Didn't he follow?"

Liang Baoan had indeed been following that woman.It's just that a four-legged husky runs faster than a two-legged person.After a few turns, the husky disappeared with the woman.

"I used to run really fast!" Liang Baoan, who was in his forties, wiped the sweat off his head in disbelief, panting heavily like a cow, "In the past, none of the young people from ten miles and eight villages could run faster than me. !"

"Anyway, I can't find his family members now." The nurse Xiao Guo said helplessly, "I'll check to see if he has an ID card on him.

The Fourth Central Hospital is a regional emergency center, and every year there is a special fund allocated by the provincial government to support the admission and treatment of patients who are in arrears.Although this fee is basically not enough every year, but fortunately there are donations from some charitable organizations to support, at least not to lose money every year.

Gao Yan's ID card was in his pocket.Xiao Guo went out to register for Gao Yan, and the old head Wu who was stationed in the Fourth Central Hospital finally rushed to the emergency room.He wanted to take away Xiao Guo's used ID card, and unlocked his mobile phone with Gao Yan's fingerprints, and began to look for the relatives' numbers in the call directory.Sun Lien and others pushed Gao Yan to the CT room.

The results of the urgent CT scan were straightforward—no abnormality was found, and no hemorrhage was found.

"Think about meningitis." Xu Yourong whispered, "I'll check his cerebrospinal fluid pressure."

Intracranial inflammation basically causes an increase in cerebrospinal fluid pressure.An increase in cerebrospinal fluid pressure means increased pressure in the ventricles of the brain, which puts the brain in a state of compression.

The brain is a delicate organ.As long as there is something slightly wrong, it can show all kinds of strange symptoms.Both hallucinations and seizures can be caused by increased pressure in the ventricles of the brain—or symptoms caused by encephalitis involving a specific area.

As soon as the patient was sent back to the emergency room, nurse Xiao Guo brought a piece of good news. "The system found the record that the patient received treatment two days ago. The patient had a high fever of 40.2 degrees Celsius two days ago. After going to the community hospital for examination, he received an intravenous infusion of antibiotics."

Thanks to the networked digital case system implemented by Ningyuan City.All community hospitals and large hospitals in the city have realized the sharing of medical records.Xiao Guo just took Gao Yan's ID card to register an account, and got the record of his treatment just a few days ago.

"The main complaint is high fever, chills, and headache. It was diagnosed as an upper respiratory tract infection, and I was given intravenous drip of cefuroxime, oral cefaclor, and oral ibuprofen." Xu Yourong quickly browsed the treatment methods of the lower-level hospital, "Antibiotics are ineffective, Viral encephalitis?"

Cefuroxime is a second-generation cephalosporin and an antibiotic commonly used clinically against unknown bacterial infections.It has a very good effect on most bacterial encephalitis.But obviously, it doesn't help Gao Yan's symptoms.

If it is not bacterial meningitis, then the object of suspicion naturally becomes viral meningitis.

"Please ask God for consultation." Sun Li'en thought for a while and made a decision. "I'll do a physical examination first. After a while, Dr. Xu, hurry up and do a lumbar puncture to measure the pressure of the cerebrospinal fluid."

The doctors in the emergency department and the doctors in the emergency department have the same hobby-knocking around on the patient with a small rubber-tipped hammer.This somewhat comical action is actually an important check.Observe whether the patient's reflex behavior is normal by tapping or scratching different parts.The reflex action is too small or too large, and the reflex area changes, all of which indicate different symptoms.In the case of suspected viral meningitis in patients, reflex examination is a valuable examination method.

Sun Lien used the wooden end of the cotton swab to scratch the outside of Gao Yan's right foot.The thumb of Gao Yan's right foot shrank slightly.Then, with the help of Xiao Guo, Sun Li'en moved Gao Yan's thigh to a position close to the edge of the bed, allowing his calf to hang down naturally.Lightly tapped his quadriceps with a percussion hammer.

After the knock, Gao Yan's calf kicked out violently.

Xu Yourong narrowed his eyes, "Knock on the top of your knee to see."

Sun Lien did so.With a light tap of the percussion hammer, Gao Yan's calf was kicked out again.

Also showed a positive Chaddock sign.Hyperreflexia of lower extremity tendons.

This means that Gao Yan's central nervous system has been damaged.

　It's on the shelves~ It's on the shelves~
　　Seriously criticize those friends who think Gao Yan is rabies.

　　Let's re-understand the incubation period of infectious diseases.

　　
　
(End of this chapter)