I can see health

Chapter 81 Who Said The Endocrine Night Shift Is Good?

Lu Chen was shocked.

This is the only patient whose life value is below 60 that he has seen in the second endocrine area so far.

He walked forward quickly and glanced at the bedside card.

This is a patient admitted this morning, female, 56 years old.

The patient was lying half-lying on the bed, eyes closed, pale and short of breath.

The smell coming out of the mouth seems to be... the smell of rotten apples.

Yes, that's the taste!

The smell of rotten apples means diabetic ketoacidosis!

This is a common test site that undergraduates know!

Diabetic ketoacidosis is the most common acute complication of diabetes, and it is also an acute complication of various types of diabetes. It is mainly manifested by hyperglycemia, ketosis and acidosis.

The patient has three more and one less, and the symptoms of polydipsia, polyuria, polyphagia, and weight loss are gradually aggravated.

"Auntie, are you feeling okay now?" Lu Chen leaned down and asked softly.

The woman slowly opened her eyes, nodded weakly, and said, "Okay."

"Compared to when you were admitted to the hospital?"

"it is good."

It was actually better than when I was admitted to the hospital.

How bad was it when you were admitted to the hospital?
Sitting next to the hospital bed was a woman in her twenties with disheveled hair and a sad expression on her face.

"Doctor, how is my mother?"

Lu Chen shook his head slightly, but didn't say anything.

The patient was present, and he could not directly inform the condition.

The young woman frowned and said, "She's been talking nonsense just now, what's going on?"

"Nonsense?" Lu Chen's eyes flashed with surprise.

"It wasn't like this at home before, right?"

"No." The young woman shook her head slightly, "It just started today."

Lu Chen frowned. He suddenly felt that the "good" in the patient's mouth might be bad!
"Auntie, do you know where you are?"

"it is good."

"What is your name?"

"it is good……"

Totally irrelevant!
It was obvious that his mind had changed.

Lu Chen felt something was wrong, and immediately checked the patient.

The patient's lips and fingertips were cyanotic, the lungs had rough breath sounds, and many moist rales could be heard, the pulse was counted accurately, the heart sounds were low and blunt, and the extremities were clammy and cold.

Both lower extremities were edematous, and the left foot was swollen obviously. Partial skin damage, redness, and exudate were seen.

On the bedside ECG monitor.

The patient's heart rate was 128 beats per minute, and his respiration was 33 beats per minute.

The last blood pressure measurement was an hour ago, and the blood pressure was 93/65mmHg.

Lu Chen pressed the blood pressure measurement button on the ECG monitor.

Measure blood pressure again.

Blood pressure 72/40mmHg!

Shocked!
After the occurrence of diabetic ketoacidosis, the patient is fatigued, loss of appetite, nausea and vomiting, polyuria, dry mouth, headache, deep and rapid breathing, and the most characteristic is the smell of rotten apples in the exhalation.

In the later stage, due to severe dehydration, decreased urine output, dry skin, decreased blood pressure, increased heart rate, and cold limbs, there may be shock, disturbance of consciousness, and coma to varying degrees in the advanced stage.

Lu Chen judged that the patient was in a state of hypotensive shock!
And right now.

The life value on the patient's head was 46, and suddenly dropped again.

Becomes 42!

Lu Chen's eyelids twitched.

He quickly ran back to the duty room.

"Have you finished testing your blood sugar?" The female doctor on the night shift asked with a smile when she saw Lu Chen come back.

"Ms. Min, the patient in the emergency room is not doing well, her blood pressure is 72/40mmHg." Lu Chen said in a deep voice, "Go and see her."

"Huh?" The smile on Min Ling's face froze, and she quickly stood up, "What's the matter? I remember this is a patient with diabetic ketoacidosis."

She grabbed the stethoscope and walked out of the office.

"I just went to the emergency room and found that the patient's mental state was not right. I took a blood pressure test and found it was only 72/40mmHg!" Lu Chen immediately replied.

With a tense face, Min Ling quickly ran to the emergency ward opposite the nurse's station.

The nurse was also moved at this time, pushing the ambulance and ran over.

……

above the hospital bed.

The patient was still panting heavily, looking depressed.

"Open another venous channel! Quick rehydration!"

Min Ling ran to the emergency room and immediately saw that the patient's condition was not right.

Checked again and took blood pressure.

Min Ling determined that the patient was indeed in a state of hypotensive shock.

"Nurse, pump norepinephrine immediately!"

"receive."

"Student, this patient has diabetic ketoacidosis combined with acute heart failure, please consult the cardiology department and ICU immediately!" Min Ling turned to Lu Chen and said.

"it is good."

Lu Chen nodded. He hurried to the nurse's station and found the numbers of the Cardiology Department and the ICU.

Severe diabetic ketoacidosis is already very dangerous, and there is a risk of sudden death at any time.

What's more, there is actually an acute heart failure now!
Diabetic ketoacids require a lot of fluid replacement, but heart failure requires fluid restriction!
As a result, the treatment plan can be contradictory.

Lu Chen quickly called the Cardiology Department and the ICU for emergency consultation.

……

"It is recommended to transfer to ICU for further treatment!"

Doctors from the cardiology department and the IC ward came.

After seeing the patient, doctors from the two departments suggested transfer to ICU for treatment at the same time!

Stay in the original department and continue to replenish fluids, which may aggravate heart failure!
But without rehydration, the patient's severe acidosis cannot be corrected!

At present, only common treatment methods are used, and it is difficult for patients to recover.

Only by being transferred to the intensive care unit and using bedside CRRT and more advanced antibiotics if necessary, can there be a possibility of improvement.

……

Fortunately, the patient's family members were more willing to treat, and after signing the informed consent, they were transferred to the ICU.

Prepare emergency medicines and bedside monitors.

Lu Chen and the nurse pushed the bed and sent the patient to the ICU.

when the patient was pushed into the ICU.

Lu Chen saw that the HP on her head had dropped again!

Only 39 left!

Lu Chen couldn't help feeling a little thankful, fortunately, he discovered something wrong with the patient in time.

Otherwise, if it is delayed for a while, the patient's shock time will be prolonged, and the major organs will suffer from ischemia and hypoxia, and the gods will be hard to save.

"Thank you, doctor."

The patient's family members stood at the door of the ICU and thanked them repeatedly.

Lu Chen sighed slightly.

"Although he was admitted to the ICU in time, the patient's condition is still not very good. You have to be mentally prepared."

"Well, I know, your doctor has explained it many times."

Family members of patients are not ignorant people.

Moreover, the patient has many basic diseases, including many years of medical history of hypertension, diabetes, and coronary heart disease. They all know the patient's condition.

Lu Chen also learned from family members.

This time, after the patient had a sudden cold at home, he interrupted his insulin treatment, and continued to have nausea and vomiting, and stayed at home for four or five days.

It was not until today that he came to the hospital for treatment.

did not expect.

A small cold not only induces diabetic ketoacidosis, but also induces heart failure.

The superimposition of two major diseases has dealt a huge blow to the patient's body.

Back to the endocrinology ward.

Min Ling was not in the office. Lu Chen learned from the nurse that an emergency patient came to the ward.

Lu Chen suddenly wondered, who said that the night shift in the endocrinology department is easy to work?
　Thank you for your reward.

　　
　
(End of this chapter)