I can see health

Chapter 39 Stuck in phlegm!
Everyone thinks that Lu Chen is being humble.

But after this episode, everyone had a good first impression of Lu Chen.

The department is actually a small society. There may be many dirty things among the leadership, but the doctors at the lower level are often very harmonious, and everyone appreciates people with strong abilities.

At this moment, Liu Mei suddenly walked into the ward quickly, her face was full of anxiety.

"Doctor Sun, the patient in bed 10 is ill again, you should go and see him!"

Another 10 beds!
Lu Chen frowned.

This patient had already suffered from heart failure once this morning. Could it be that he is suffering from heart failure again now?
Sun Guoguo heard the words, immediately stopped the ward rounds, and led everyone to the No. 10 hospital bed.

Sure enough, it was the same as the situation in the morning.

The patient was sitting on the bed, panting heavily, his face was pale, and his eyes were lifeless.

As soon as he approached the hospital bed, Lu Chen could hear the sound of phlegm coming from the patient's throat.

The phlegm sound was obvious, and it was conceivable that the patient's bronchus was full of thick sticky phlegm.

This is mainly due to pulmonary edema caused by heart failure, which causes lung infection.

Lu Chen looked at the ECG monitor beside the bed.

The blood pressure saturation is only 85%, the respiration reaches 42 beats/min, the heart rate is 125 beats/min, the blood pressure is not very high, only 140/76mmHg.

But at this time, a drop in blood pressure is not a good thing!

If the blood pressure drops too much, even if it is not less than 90/60mmHg, it also indicates the failure of the patient's heart pump function, which is often referred to as cardiogenic shock.

If a patient with heart failure cannot maintain blood pressure, then this patient is hopeless!

"Heart failure again! Liu Mei, push two furosemide immediately, and suck the patient's sputum at the same time!"

Sun Guoguo ordered immediately.

"receive."

With a serious expression, Liu Mei had already prepared the furosemide injection and pushed it directly into the patient's indwelling needle.

At the same time, another nurse quickly brought a sputum suction device, ready to suck sputum for the patient.

When a person is awake, it is very uncomfortable to suck sputum.

However, the patient currently has too much sputum to cough up, and it is completely blocked in the trachea. Not only will the oxygen saturation drop, but there is also a risk of suffocation at any time.

"Junior Sister Jiang, please contact the CCU (Cardiology Intensive Care Unit) on the fourth floor, we may have patients who need to be transferred!"

Sun Guoguo said to Jiang Qingyan who was at the side.

Jiang Qingyan nodded, and immediately ran out of the ward.

Meanwhile, the patient's family, the old woman, held Sun Guoguo's hand at this time.

"Dr. Sun, we don't go to CCU, we are poor, we don't have much money, and our son can't earn much money working in other places, so we can't go to CCU!"

The old lady held on to Sun Guoguo tightly, as if she had grasped the last straw.

"Before, I was treated well with Dr. Sun every time. We will treat it here. If you don't transfer it out, you must not transfer it to the CCU. There is 1 yuan a day, and we can't afford it!"

Sun Guoguo sighed, and said helplessly, "Grandma, the situation is different this time. Daddy's oxygen saturation is only 85%."

"If you don't need a ventilator, there is a risk of suffocation or even sudden death at any time, but we don't have a ventilator in the general ward, so we have to go to the CCU!"

The old woman shook her head desperately, her old wrinkled face was full of sadness and despair.

"Doctor Sun, even if I beg you, an old woman, we really have no money!"

Sun Guoguo pursed her lips and sighed slightly inwardly.

"Doctor Qu, you go to contact the patient's son, he is in critical condition on the phone! And it is recommended to transfer to CCU for treatment."

"it is good!"

As a senior attending doctor, Dr. Qu is more adept at communicating with patients. It is not wrong to leave it to her to report critical illnesses and communicate with her.

At this time, the nurse had finished sucking the sputum.

"Doctor Sun, the patient's phlegm is deep in the bronchi, and I can only suck out a little of the phlegm in the throat."

"Suck it one more time, forget it if it doesn't work!" Sun Guoguo continued.

The sputum of the elderly is already very viscous, and with the addition of several diuretics, the sputum is even more viscous.

Looking at the ECG monitoring by the eye bed, the blood oxygen saturation has been hovering around 85%.

The blood oxygen saturation of normal people should be above 96%. If it is lower than this index, whether there is an organic lesion should be considered.

It can't go on like this!

Sun Guoguo was a little anxious. If the ventilator was not used immediately, the patient's condition would probably get worse.

And when the patient has too much sputum, the effect of the non-invasive ventilator is not good, and the invasive ventilator may be used directly at that time.

"Liu Mei, push another half of Cedilan and one of Panding!"

"receive."

Cedilan is a cardiotonic needle, and it can be used as appropriate when diuretic and vasodilator drugs are not effective in treating heart failure.

The use of Cedilan starts with half a stick every time.

"Doctor Sun, the phlegm cannot be sucked out, and the patient feels very uncomfortable when he is awake." Another nurse said.

"Then don't suck for now." Sun Guoguo said, "Just put the suction device next to the bed, don't take it away, and keep it ready for use at any time."

"it is good."

The nurse nodded, and at the same time cleaned out the used sputum suction tube and replaced it with a clean one for use.

At this time, doctor Qu Yao returned to the ward, and whispered next to Sun Guoguo: "Dr. Sun, I have already contacted the family members by phone. His son understands the condition, but he refuses to be transferred to the CCU."

Sun Guoguo frowned.

This is really, there is no filial son in front of a long-term sick bed!
"I'll call the CCU, Junior Sister Ke, you can borrow a simple non-invasive ventilator from them." Sun Guoguo turned to Ke Yue.

"Okay, sister."

There is no ventilator in the general ward of the cardiology department, only in the intensive care unit.

After receiving Sun Guoguo's instructions, Ke Yue immediately ran to the CCU on the 4th floor to borrow a non-invasive ventilator.

"Dong Hao, you go and print the informed consent form and critical illness notice for refusing to be transferred to the CCU."

"receive."

Even if it is an old patient, even if the two old people are very good, there must be some communication.

Any medical behavior and examination that patients and their family members refuse, they need to be repeatedly informed of the risks and sign an informed consent form!

This is the most important way doctors can protect themselves!
Because Lu Chen had just entered the department and was not yet familiar with the affairs of the department, Sun Guoguo did not assign him any work.

……

About 5 minutes after the medication.

The patient's dyspnea symptoms did not improve.

At this moment, Lu Chen suddenly noticed that on the ECG monitor, the patient's blood oxygen saturation suddenly dropped from 85% to 80%, and jumped to 76% after a second!

Lu Chen immediately felt that something was wrong!
When I looked at the patient on the bed, I found that my father rolled his eyes upwards, his throat seemed to be blocked by something, and it suddenly became extremely difficult to breathe.

"Oops, it's stuck with phlegm!"

Lu Chen was shocked.

Sun Guoguo, who was at the side, also noticed something was wrong with the patient immediately, and she immediately shouted.

"Liu Mei, suck phlegm!"

At the same time, Lu Chen immediately ran to the bed and assisted Liu Mei to open the patient's mouth.

(End of this chapter)