I can see health

Chapter 299

Wang Xiaodong stood up immediately and ran out of the office.

Seeing this, Lu Chen followed closely behind.

It was the first time for Cheng Peng and Xiao Lin to come to the emergency department, when had they seen such a battle!

The two were stunned for a moment, then followed Lu Chen's footsteps and ran out.

……

Lu Chen followed Wang Xiaodong to the rescue room of the emergency ward.

"What's the patient's condition?"

As soon as he entered the emergency room, Wang Xiaodong asked aloud.

The nurse next to the ward immediately said: "A couple each drank a bottle of dichlorvos, transferred from the hospital below!"

At this time, Lu Chen also came to the hospital bed.

At this moment, the woman's health is 36, while the man's is 52.

In addition, there was a medical record of the local hospital beside the bed, and Lu Chen quickly took out the medical record.

All the information of the two patients also appeared in front of Lu Chen.

About an hour earlier, two patients had been found lying unconscious at home.

There were two empty bottles of dichlorvos beside them.

Dichlorvos (DDVP) is an organic compound belonging to organophosphate insecticides.

The family members immediately dialed 120 and went to the local hospital for gastric lavage, endotracheal intubation and ventilator-assisted ventilation, and applied pralidoxime iodine 1.5g, atropine and other treatments.

After the man was intubated, he regained consciousness, but remained agitated.

On the way, the woman suddenly suffered respiratory and cardiac arrest, and she recovered after giving chest compressions for about 10 minutes.

He was transferred to the emergency department of Jinghua Second Hospital for further treatment because hemoperfusion and other treatment measures were needed next.

……

Lu Chen immediately told Wang Xiaodong briefly what he had learned about the medical history.

Wang Xiaodong nodded, and immediately stepped forward to conduct a preliminary physical examination on the two of them one by one.

Both were intubated.

The man's consciousness is already awake, but the woman is still in a coma.

"Nurse, give the patient an emergency blood test immediately, a routine set, and also check blood gas analysis and cholinesterase!" Wang Xiaodong ordered.

"Got it!" Gong Nannan nodded.

At this time, the man regained his consciousness, but his mood was particularly irritable.

"The man's lungs have obvious moist rales!" Wang Xiaodong frowned, "Immediately use a long Tuo Ning and a Tropin."

"Received, one intramuscular injection of Changtonin and one intravenous injection of atropine."

"Open another venous access, hang up pralidoxime, and then use medicinal charcoal and mannitol."

……

On the other hand, the situation of women is much more serious than that of men!
Not only did she not wake up, but her vital signs were extremely unstable, her heart rate was 60 beats per minute, and her blood pressure was 85/54mmHg.

"Both of them are about to prepare blood perfusion!"

Although the situation of men is relatively better, but it cannot avoid the occurrence of delayed polyneuropathy!

Wang Xiaodong stared at the two patients with a pair of eyes, not daring to relax in the slightest!
The rescue is proceeding in an orderly manner.

……

With Lu Chen's assistance, Wang Xiaodong's rescue process went smoothly.

This kind of rescue does not mean that the more people the better, too many people will affect the efficiency.

So Cheng Peng and Xiao Lin stood aside, staring blankly at Lu Chen and Wang Xiaodong's rescue.

Wang Xiaodong was their superior doctor, so he had nothing to say.

But as a newcomer to the emergency department, why is Lu Chen so familiar with the rescue process?
Cheng Peng was not surprised, but Xiao Lin was very surprised.

……

At this moment, Lu Chen noticed that the female patient's heart rate was slowing down!
"Senior Brother Wang, look at this female patient..."

Surprised, Wang Xiaodong looked at the ECG monitor of the female patient.

Her heart rate went from 60 beats per minute, to 50 beats per minute, and finally dropped to 45 beats per minute.

In Lu Chen's eyes, her HP is also slowly decreasing, from 36 before to 32!

Wang Xiaodong said in a deep voice: "Immediately give 250ml of sodium bicarbonate intravenous infusion and 5mg of atropine intravenously!"

The effect of atropine is very fast, basically as long as the static push, the heart rate will rise.

But for this female patient, after the static push and injection of atropine, the patient's heart rate did not rise significantly!

At this time, the blood oxygen saturation of the female patient also continued to drop, only 80%!

"Ready to board!"

Wang Xiaodong immediately placed a catheter for hemofiltration.

However, no one expected that after the female patient got on the plane, her heart rate continued to drop!
"Crap, I can't keep it up!" Wang Xiaodong cursed secretly.

……

"Heart stopped!"

Lu Chen suddenly shouted, he has been paying attention to the ECG monitor by the bed.

He was the closest to the hospital bed, stepped forward immediately, and performed chest compressions.

And Wang Xiaodong kept urging the nurse: "Keep pushing the atropine, keep pushing!"

Atropine 5mg, 5mg, 5mg, 5mg static push...

Lu Chen pressed the button beside the bed for about 10 minutes, and the patient's heart rate returned to sinus rhythm, and the blood pressure rose to 101/90mmHg.

"Continue to push atropine, and then give 4g of pralidoxime iodide slowly intravenously." Wang Xiaodong ordered.

Lu Chen also breathed a sigh of relief, but there was still a tight string in his heart, not daring to relax.

This female patient is not only poisoned by organophosphorus pesticides, but also has cardiac arrest!
The treatment is much more complicated than that of the male patient!

"Adjust the parameters of the ventilator, increase the Peep to 7, adjust the frequency to 17, and adjust the tidal volume to 550ml." Wang Xiaodong began to adjust the ventilator.

The purpose of this is to increase the minute ventilation and promote the discharge of carbon dioxide, but the dead space will increase, which is not conducive to the discharge of carbon dioxide, because the expiratory time is sacrificed.

At this time, the laboratory indicators of the patient's urgent investigation came out.

The cholinesterase of both men and women was less than the minimum value, and the liver function of women was aspartate 1010, Gu Bing 999, lactic acid 11.1, and other examinations of men and women were normal.

Wang Xiaodong said: "Let's do it for now! It is escorted by a hemofiltration machine and can be stabilized under high replacement conditions."

At this time, the patient's blood oxygen saturation has been 100%.

Everyone present breathed a sigh of relief.

……

Three hours after the female patient got on the plane.

Blood gas analysis clock, lactic acid dropped to 5.0, Ph stabilized at 7.17, partial pressure of carbon dioxide dropped to 56!

The cholinesterase was retested every hour, all of which were less than the minimum value, and the patient's heart rate remained stable at around 120.

A piece of good!
"It feels like the patient is coming back!"

Lu Chen was standing beside the patient's bed, happy.

Suddenly, he saw that the patient's blood pressure and blood oxygen saturation could not be measured!
Lu Chen's face changed immediately, and he immediately auscultated the patient's lungs, and the moist rales increased.

Does the patient's heart rate drop?
But the blood pressure and blood oxygen saturation cannot be measured first?
Wang Xiaodong has also been paying attention to the changes in the patient's condition. He noticed the change in the patient's condition at the first time, and immediately ordered.

"Norepinephrine 18mg, micro pump, 5ml is the first recommended!"

invalid!

Advise 5mg atropine static push!invalid!

Advise 10mg atropine static push!invalid!

Advise 5mg atropine static push!invalid!

All treatments are ineffective!
Improve blood gas, lactic acid rises to 11, partial pressure of carbon dioxide rises to 90mmhg again, ph7.06!

With void, void, void.

Wang Xiaodong continued to give the doctor's order, 2mg long entrusted to push quietly!
After about 3 minutes, the patient's blood pressure can be measured!

50/30mmHg, blood oxygen saturation 100%.

Oxygen saturation is a normal ripple, proven to be real and effective!

"Continue to push Tuoning 4mg statically!"

At this time, the patient's blood pressure rose to 107/90, and the blood oxygen saturation was 100%!

"Brother, I think it's better to use less atropine!" Lu Chen frowned.

Wang Xiaodong also discovered the problem.

He immediately ordered the nurse to give 50mg atropine micropump 25ml per hour.

So the classic picture of rescuing organophosphorus pesticides appeared.

Wang Xiaodong gave the doctor's order alone, while Lu Chen, Cheng Peng, and Xiao Lin broke the atropine!

Soon the emergency pharmacy ran out of 260 atropines!

(End of this chapter)