This doctor is great

Chapter 69 Emergency Consultation, Faint + Cardiac Arrest Patients
Emergency Department.

After Mr. Huang Li brought Zhou Mo to the anxious and busy emergency department, he went straight to the emergency room familiarly.

at this time,

Family members waited anxiously outside the emergency room.

Teacher Huang Li and Zhou Mo walked into the emergency room.

"Ms. Huang... Hey, you are Zhou Mo from last time, right?"

After Dr. Chen Dong saw Zhou Mo, he immediately recognized him.

"Senior Brother Chen..."

"what happened?"

Huang Li looked at the patient.

Lying on the hospital bed was a middle-aged man about 35 years old, wearing an oxygen mask, with his eyes closed.

"Blood pressure": 160/90mmHg,

"Heart rate": 128 beats/min...

"Blood oxygen saturation": 99%...

Chen Dong began to introduce: "The patient, 36 years old, suddenly passed out at home 53 minutes ago. The family members called an ambulance and sent him to the emergency department... When the ambulance arrived at the door of the hospital, the patient started to suffer from ventricular fibrillation. Yes, after defibrillation, epinephrine, and cardiopulmonary resuscitation, the spontaneous heartbeat was successfully restored..."

"Then an arterial blood gas analysis was performed on the spot..."

(Blood gas analysis is relatively fast. Blood is drawn to the machine on the spot, and the results come out immediately. The main purpose is to check acid-base, oxygen partial pressure, carbon dioxide partial pressure, ions, etc...)
"The pH measured at that time was only 7.2..."

Zhou Mo remembered that the normal value was 7.35-7.45.

Although this 7.2 is low, it is not serious.

"An electrocardiogram was done, but no major problems were found."

"Then there's heart and lung sounds, and there's nothing wrong with that."

"Considering that the patient's condition was a bit urgent, suddenly stopped beating and ventricular fibrillation, so I did a wide range of examinations on the patient, including blood routine, myocardial enzyme spectrum, liver function, kidney function...";
At this moment,
The rescue room opened again.

A middle-aged doctor walked in.

"Old Liu..."

Zhou Mo looked at his job card and realized that he was the attending doctor on duty in neurosurgery.

"Let me introduce the situation..."

"How is the patient?"

"........."

Senior brother Chen Dong in the emergency department looked bitter, and had to introduce it to Dr. Liu of the neurosurgery department again.

1 minutes later……

"Does the patient have any medical history of the brain? Does he have a history of hypertension, diabetes, hyperlipidemia, etc.?"

Teacher Huang Li asked.

General sudden dizziness,
Either there is a problem with the blood supply of the heart, or there is a problem with the brain itself, such as a tumor or cerebral infarction.

Senior Brother Chen Dong: "I asked, the patient is relatively young, and the family members said that there is no such medical history..."

Surprised: "The patient didn't say he bumped his head too much?"

Senior Brother Chen Dong shook his head, "No..."

Teacher Huang Li: "What about family genetic medical history?"

Senior Brother Chen Dong still shook his head: "No..."

As mentioned above, the patient is young, has no past medical history such as high blood pressure, and has not bumped his head, so it should be unlikely to have cerebral hemorrhage or cerebral infarction.

However, it can be considered that the patient has an arterial malformation in the brain, such as an aneurysm, and then rupture and bleeding may lead to coma.

Or maybe there's a heart problem.

Sometimes the electrocardiogram is not a panacea, and it may not be able to detect heart problems, otherwise B-ultrasound, CT and other equipment will not be used.

If there is a problem with the brain and cranium, it will be under the control of neurosurgery and neurology.

If it is said that there is a problem with the heart, then it belongs to the Department of Cardiology and Cardiac Surgery.

This is why this patient (fainting + ventricular fibrillation) will be consulted by doctors from the heart and the mind in the emergency department.

Zhou Mo stayed aside at this time, unable to intervene, so he simply took the 3m to the bedside and listened to the patient's heart and lungs.

After listening to it, there is really nothing wrong with it.

Teacher Huang Li looked at Zhou Mo and motioned for an inquiry.

Zhou Mo shook his head: "There is no problem with the heart and lungs."

Teacher Huang Li: "Did the blood test result come out?"

Senior Brother Chen Dong: "It should be soon, 30 minutes have passed now..."

The results of emergency examinations are generally quicker.

Huang Li pondered for a while, and said to Senior Brother Chen Dong: "The current situation is not clear enough...how about letting the patient's family members in? I think there is a woman of about the same age, who should be the patient's wife? Let her in, I asked some questions..."

Senior Brother Chen Dong nodded: "Okay."

quickly,

The patient's wife came in anxiously and rushed to the bedside. Seeing her husband lying unconscious on the bed, her heart was burning with anxiety.

"Doctor, how is my husband?"

The patient's wife grabbed Teacher Huang Li's hand and asked anxiously.

In fact, the patient's wife doesn't know which doctor is good, but seeing that Dr. Huang Li is a little bald, he must be older.

Teacher Huang Li: "..."

Feeling offended.

I'm not that old, I'm just a little bald!

Grumpy! !

(The pretty boy next to him, Dr. Liu, proudly touched his well-preserved jet-black hair·jpg)

Teacher Huang Li endured his irritability and squeezed out a smiling face: "You can rest assured for now, your husband's condition is still stable. I asked you to come in because I wanted to ask you some questions..."

The wife hurriedly said: "Doctor, ask!!"

Teacher Huang Li asked: "Before the accident, did the patient complain of chest tightness or pain?"

Symptoms of heart attack.

The wife and parents looked at each other, and finally shook their heads: "No..."

Teacher Huang Li nodded: "During this time, has your husband ever been sick?"

Wife: "Yes, I have a cold..."

Dr. Huang Li and Dr. Liu Shenwai looked at each other.

"cold?"

cold?

bacteria?Virus?
Viral encephalitis?
Explosive myocarditis?

Zhou Mo was also taken aback.

Also thought of fulminant myocarditis.

In the papers that Zhou Mo read, many patients with myocarditis were introduced, and they often had a history of "cold".

It probably means that the virus that causes a cold enters the blood, enters the heart, and then causes myocarditis.

(In fact, it can also be reversed, causing a cold due to myocarditis.)
Dr. Huang Li asked a few more questions, but couldn't find anything crucial.

Dr. Liu from Shenwai also asked the patient's wife a few questions, but also found nothing.

"I didn't find..."

"Then wait for the blood test results..."

"Clues should be seen from the blood draw..."

Several people began to wait.

The patient's wife crouched beside the bed, holding her husband's arm.

Zhou Mo's heart was moved, and he loved each other, feeling that this is the real couple.

At this moment,
"Dr. Chen, the patient's results are out!" an intern shouted.

Zhou Mo and the others cast their gazes over one after another.

ipad,

Senior Brother Chen Dong took the ipad and looked at it.

"what……"

"what happened?"

"White blood cells have exceeded 10 times... Several indicators of myocardial enzymes have increased several times..."

"This is normal. If you have a cold or a sudden cardiac arrest, there will definitely be problems. Is there anything else?"

"Hiss...there is a problem with the liver and kidney functions!"

"what is the problem?"

"Serum creatinine is 10 times higher, transaminase is 8 times higher, bilirubin is 5 times higher..."

"??!!!"

"Has the kidney function improved so much?"

Teacher Huang Li was startled.

Zhou Mo was also shocked.

Thought it was the heart, thought it was the brain, turned out to be the kidney...

.

Monthly ticket, recommended ticket feeding port.

(End of this chapter)