I can see health

Chapter 566 Lift the quilt early and have a look!

From morning to now, the emergency department has given the patient at least three diuretics (furosemide)!
However, the patient did not discharge a single drop of urine!

This made everyone present stunned.

Lu Chen and Xiao Shikang, who were about to leave, also stopped at this time.

"Go and see the old man with 12 beds!" Xiao Shikang said in a deep voice, he was really worried.

The Department of Cardiology pays the most attention to the urine output.

Patients with heart failure want to relieve their condition quickly, they all rely on urinating as much as possible to reduce the load on the heart.

So, Lu Chen, Xiao Shikang, and Dr. Fan Jian from the emergency department came to the bedside of the 12th bed together.

……

Come to the bed.

Lu Chen immediately squatted down to check the patient's urine bag.

Sure enough, there was only 300ml of liquid in the urine bag.

"What's going on here?" Fan Jian muttered to himself, and he checked the patient again, "Could it be acute renal failure?"

Xiao Shikang shook his head, "It doesn't look like it! The patient's urine output was normal two days ago, and it started to decrease since last night. In addition, although the patient's serum creatinine value has increased, it has not reached severe renal failure. the point."

If it's not kidney failure, then what could it be?

Lu Chen stood by the hospital bed, continued to check the patient's case, and fell into deep thought.

"Old Fan, tell me, could it be heart failure?" Fan Jian suddenly asked.

"It's not heart failure?" Xiao Shikang asked suspiciously, "Then what do you think it is?"

"Like a pulmonary embolism?" Fan Jian whispered. .

The patient has been bedridden for several years, and the blood flow in the blood vessels of the lower extremities is definitely not very good, and blood clots are prone to form.

Once the thrombus falls off, it may flow into the pulmonary artery, causing pulmonary embolism, leading to asthma, hypoxia and other manifestations.

Xiao Shikang frowned and said, "What you said makes sense, but even if it's a pulmonary embolism, when the patient's blood pressure is normal and the blood volume is sufficient, they should still urinate after taking diuretics, right?"

Fan Jian scratched his head, "That's right."

At this time, the family members of the patient couldn't help asking: "Doctor, he is still wheezing up to now, and it hasn't been relieved. It seems to be getting worse. What's going on, should it matter?"

It can be seen that the family members of the patient were very scared, and their lips were trembling during the speech.

"The old man has never suffered from heart failure before! Why is it so serious this time?!"

Hearing this, Lu Chen frowned deeply.

The words of the patient's family members caught his attention. Has this patient ever had heart failure before?

He looked at the old man, who was lying on the bed, unable to express himself at all because of aphasia and dementia.

Isn't it really heart failure?
Just as Lu Chen's thoughts were spinning rapidly, a prompt popped up on the system panel.

"Congratulations, breakthrough in clinical thinking ability!"

At the same time, countless diagnoses and differential diagnoses flashed through Lu Chen's mind.

All the medical records of this 12-bed old man passed quickly in Lu Chen's mind.

After just a few seconds, all ideas finally came together.

When Lu Chen re-examined the patient, he really found something different.

……

Although the cause of the patient was not found, it is impossible for Xiao Shikang and Lu Chen to stay in the emergency department all the time.

They still have a lot of patients in the inpatient ward, which need to be dealt with.

The patient can only be kept in the emergency department first, and then transferred to the cardiology department after his condition improves to slowly find out the cause.

Just when Xiao Shikang was about to leave the emergency department, Lu Chen unexpectedly walked back to the No. 12 hospital bed.

Xiao Shikang was about to call out to Lu Chen, but he saw him directly lift off the patient's quilt, exposing the patient's abdomen.

Xiao Shikang felt a little strange, and walked up to Lu Chen, "What's wrong?"

Lu Chen frowned, glanced at the patient's abdomen, and then squatted down to look at the urine bag, suddenly something was wrong with his face!
"Ms. Xiao, look at the patient's bladder..."

You don't need to use your hands at all, you can see the patient's lower abdomen swells very obviously!
At this time, Xiao Shikang also felt something was wrong.

Fan Jian, who was beside him, slapped his head, "Oh, I was so busy just now, I forgot to check the condition of my abdomen, I just listened to my heart and lungs."

"Let's percuss." Xiao Shikang's face was a little unsightly, "Be gentle, don't break your bladder."

At this time, a thousand mud horses galloped towards Fan Jian.

Bladder so big?Why?Is it urinary retention?

He settled down, and immediately started, gently touched the patient's lower abdomen, and lightly buckled it.

voiced sound!

The normal percussion sound in the abdomen should be a drum sound.

If it is dull, it proves that there is liquid in it!
Is it really urinary retention?

At the first moment, Fan Jian couldn't even believe what he was touching!
"Old Xiao, this... this..."

Xiao Shikang shook his head slightly, and said slowly: "I just checked, there is sediment in the patient's urinary catheter, and the urine is cloudy. Such a urinary catheter is very easy to block. If he is really blocked and can't urinate, then It's urine retention!"

"A few days ago, the patient's urine output was close to 2000ml every day, but today it is only about 300ml. If it is really urinary retention, the patient will suffocate to death!"

Although the old man on the hospital bed could not speak, he could definitely feel the discomfort caused by urinary retention!

So you will be short of breath, you will sweat profusely, and your blood pressure will increase.

As the saying goes, a living person cannot be suffocated by urine, but if the catheter is blocked and the urine does not come out, it is terrible!
At this time, the nurse has come to perform bladder irrigation.

After flushing, it turned out that the urinary catheter was blocked!
"My God!" The little nurse opened her mouth wide.

After unobstructed, the urine was continuously drawn out from the urinary catheter, and it was almost 500ml in a few strokes.

"Close the urinary catheter clamp first." Xiao Shikang said, "I'll urinate later."

If you excrete too much urine in a short time, the full bladder will shrink rapidly, which is likely to damage the bladder and cause hematuria.

The little nurse had lingering fears, and today she was also responsible for not discovering the blockage of the patient's urinary catheter in time.

Lu Chen finally breathed a sigh of relief!

The patient may have heart failure, but this heart failure is caused by the urine!
Xiao Shikang whispered to Fan Jian on the side: "Old Fan, if you had opened the quilt earlier, looked at the urinary catheter, looked at the abdomen, why did you end up here?"

In less than 2 minutes, the old man's shortness of breath gradually eased, and his blood pressure also dropped.

Safe!
The crisis is over!

Fan Jian's back was soaked, and his face was red.

He knew that if it wasn't for Lu Chen and Xiao Shikang's timely discovery, he would continue to treat it as heart failure and continue to use diuretics...

The urine will accumulate more and more, but it will be held in the bladder, which is really terrible!

As a doctor on duty, he has an unshirkable responsibility!
"Old Xiao, thank you for today!" Fan Jian said solemnly, "Please give me a good rub later."

Xiao Shikang shook his head slightly, "Lu Chen noticed it first, if you want to thank him, thank him well!"

Fan Jian looked at Lu Chen who was on the side, and made no secret of his gratitude, "Thank you, Doctor Lu! If you have anything to do in the future, come to me anytime."

Lu Chen smiled, "Teacher Fan, your emergency department is too busy, it is inevitable that there will be negligence, I understand."

Hearing this, Fan Jian felt better.

But in the profession of doctors, there can be no deviation in the slightest.

Many details cannot be omitted, otherwise, mistakes will eventually lead to big mistakes!

The patient's family members were also very reasonable. During this period of time, she also knew how tired the doctors were. They also took great pains to treat her old man's illness, and did not pursue Dr. Fan Jian.

But Lu Chen also knows that if others don't pursue this kind of thing, the person involved will remember it for a lifetime!

(End of this chapter)