I can see health

Chapter 48 Digitalis poisoning?
Close the website and close the computer.

Lu Chen continued to read books on ECG interpretation.

He still has no idea about the abnormal ECG of the 12-bed patient this morning.

Do we really have to wait until tomorrow morning for Sun Guoguo to answer?

Lu Chen was a little unwilling.

"Lu Chen, let's eat chicken together, four lack one, come?"

Now the battle royale game is very good, and the other three people in the dormitory are playing games with their mobile phones.

Lu Chen smiled and shook his head, "No, you guys can play, I'm not very good at it."

"Hey, that's fine."

A few roommates were having fun, while Lu Chen kept flipping through the electrocardiogram manual.

Start reviewing the principle of electrocardiogram, check the specific meaning of each waveform change, and then find out various examples to interpret...

At eleven o'clock at night, the moon and stars are thin.

The night was already deep.

The lights in the dormitory were turned off, only the desk lamp in front of Lu Chen's desk was on.

The halo of the desk lamp shone on Lu Chen's face.

He slowly began to have a clue about the abnormal electrocardiogram in bed 12.

The characteristics of the electrocardiogram of the 12-bed patient: sinus bradycardia, atrial premature beats, ST-segment downslope depression, T wave flattening and QT interval shortening, the measured value is 280ms.

Isn't this a "fishhook" change?

Lu Chen's eyes lit up, but then he became suspicious again.

The "fishhook-like" changes in the electrocardiogram are usually due to the digitalis effect caused by poisoning caused by the overdose of "digital" drugs.

But according to the patient's own description, she is not taking any medicine at all.

Not to mention the "digital" cardiotonic drugs!

This drug is only used by patients with heart disease and heart failure.

Now the possible cause of the patient has been identified, but another difficulty has arisen.

Time passed by minute by minute.

After all, Lu Chen couldn't resist the deep drowsiness and fell asleep slowly.

……

Silent all night.

The next day.

Lu Chen came to the department at seven o'clock to measure the blood pressure of the four patients he was in charge of.

The mental state of the 10-bed elderly man was much better than the previous day.

He lay flat on the bed, breathing steadily, without the slightest irritability, and even greeted Lu Chen proactively.

"Doctor Lu, did you come to check the ward so early?"

"It's getting late. Daddy, did you still cough up red phlegm last night?"

The old man shook his head, "No, the cough is white sticky phlegm."

Lu Chen nodded, then took a mercury sphygmomanometer and measured his blood pressure.

Blood pressure is around 140/80mmHg, which has dropped a little compared to yesterday morning.

After taking the blood pressure, it is to auscultate the lungs.

Auscultation of the lungs is mainly to judge whether the dry and wet rales in the lungs have decreased.

Especially for patients with heart failure and lung infection, it is extremely important to auscultate the changes of rales in the lungs!

Wet rales can still be heard in both lungs of the 10-bed elderly man, but compared with yesterday, it has decreased a lot!

This shows that the elderly's condition is gradually improving.

……

And the aunt with the 12-bed was wandering in the corridor early in the morning.

Seeing Lu Chen coming, he dragged him to question again.

"Doctor Lu, how is my illness now?"

It was strange to say that she was always alone, and Lu Chen had never met her family members.

"Auntie, don't be in a hurry." Lu Chen said, "We will make a decision after our superior doctor checks the room this morning."

Lu Chen asked the 12-bed patient again if he had taken "digital" drugs.

The 12-bed patient continued to deny it repeatedly.

"Doctor Lu, I was not sick before, why should I take medicine?"

Looking at her appearance, Lu Chen shouldn't have lied.

Then this is a bit strange!

There is no way to ingest "digitalis" at all!

The patients in the other two wards were in stable condition and received no special treatment.

……

07:30am.

Everyone else from the same group came, including the two interns.

"Junior brother, do you see what that electrocardiogram is?"

Sun Guoguo walked into the doctor's office and said to Lu Chen with a smile.

"Senior sister, is this a change like a fishhook?" Lu Chen tentatively replied.

Sun Guoguo nodded in relief.

"Yes, the electrocardiogram of the patient in bed 12 is a typical fishhook-like change! It is also the effect of digitalis overdose!"

"Senior sister, but this patient denies taking any medicine!" Lu Chen wondered.

For patients with digitalis poisoning, it is very important to take such drugs orally for a long time, causing a kind of accumulated toxicity, and the use of small doses is not toxic.

If it is really considered to be "digitalis" poisoning, then the patient will definitely ingest "digitalis" through the gastrointestinal tract.

But now it seems that this possibility does not seem to be true.

"So that's what I'm wondering about." Sun Guoguo mused, "However, what we need to do now is to perfect the measurement of digitalis in serum to determine whether there is a possibility of digitalis poisoning, then treat it, and finally look for it. Cause!"

When the cause is not understood, the most important thing is to treat the symptoms, stabilize the patient's state, and then slowly find the cause.

Others in the same group were also attracted by the discussion between Lu Chen and Sun Guoguo, and several of them picked up the electrocardiogram of the 12-bed patient to watch.

……

Eight in the morning.

After the shift was over, Li Yao still did not come to the department today.

Sun Guoguo led the crowd to start rounds.

Come to bed number 10.

The old woman took out a small bamboo basket from the bedside table in the ward, and there were a dozen eggs in the basket.

The size of the egg looks very large, and there is still a little dirt on it.

"Doctor Sun, I asked someone from my hometown to bring this to you."

The old woman was holding the bamboo basket tremblingly, with one hand covering the bottom of the basket, tightly protecting the bamboo basket.

"No, thank you, mother-in-law." Sun Guoguo quickly refused, waved her hand and said, "You can take it home and eat it yourself."

"Doctor Sun, don't look at the poor appearance of these eggs, they are our own native eggs." The old lady handed the bamboo basket to Sun Guoguo's hand, "Native eggs are very nutritious!"

Seeing that the refusal was fruitless, Sun Guoguo had no choice but to accept the bamboo basket and hand it to Lu Chen.

"Junior brother, you take it back to the department and keep it. The friends in the group can get it if they want it."

Clinically, patients' red envelopes are absolutely unacceptable!
However, some local products and fruits brought by some patients cannot be refused, and a small portion can be accepted as appropriate.

"Grandmother, Daddy's condition is stable now, but you can't drink so much water for him in the future." Sun Guoguo pointed to the 500ML large water glass on the bedside table.

Patients with heart failure must strictly control their water intake.

In many patients, it is because of drinking too much water that the heart load is increased, which induces heart failure.

"Thank you, Dr. Sun, when can we leave the hospital?" the old lady asked.

"Not yet, probably in another four or five days." Sun Guoguo pondered for a moment and said.

(End of this chapter)