Back in 2002 as a doctor

Generally speaking, the little master uncle is the kind of person who is over his head, just these three words make Xiao Kai's mind flutter.

"Just kidding, we don't care about that." Zhou Congwen smiled.

"That's the way to say it, regardless of seniority, I can't compare to technology alone." Professor Qin said truthfully.

There is nothing embarrassing about it, Zhou Congwen has Mr. Huang's endorsement behind him, and no one will underestimate himself if he puts this sentence out to talk about things.

"It's enough to ask you for surgery, and it's the best choice. Isn't it a joke to ask me!" Professor Qin reprimanded.

With that said, the phone rang again.

The disgust in his eyes was even stronger, and he hung up the phone without thinking.

"It's not that serious. The academician workstation established by the boss is still getting up early, and its reputation is not well known. Just kidding, I recently went out to the outpatient clinic for a day, and I didn't even admit a single patient." Zhou Congwen laughed without embarrassment.

"If Dean Xiao hadn't sent me 10 patients, I would have missed the first kick."

"You are too young to be recognized by the patient." Professor Qin hit the mark. Seeing that Zhou Congwen didn't care about it, he said with a smile, "Don't worry, your level is one of the few in the imperial capital. Let alone the provincial capital.”

Before the words fell, the phone rang for the third time.

Professor Qin answered the phone and said coldly, "Dean Guan, what's the matter?"

"Professor Qin, Teacher Qin..."

From the opposite side came Dean Guan's panicked voice, and even changed his address twice, but he still didn't say anything.

Professor Qin felt something was wrong, and asked with a cold frown, "What's wrong?"

"The leadership situation is wrong!"

A faint gust of cold wind blew in from the door of the inpatient department, bringing snowflakes, hitting the hearts of the three of them.

The situation is not right!

The most serious complication after cardiac interventional surgery is heart rupture!

Zhou Congwen glanced at Xiao Kai, Xiao Kai shook his head.

This is a relatively elementary tacit understanding. Zhou Congwen asked Xiao Kai if they could do related emergency surgery, and Xiao Kai denied it without even thinking about it.

This is so special!

Zhou Congwen was speechless.

Is it related to yourself?Maybe.

Born to work hard, it is the same no matter where you go.

"I'll go back right away! You maintain the patient's vital signs first." Professor Qin said sharply, already anxious.

He hung up the phone and grabbed Zhou Congwen's hand, "Doctor Zhou, do me a favor."

Zhou Congwen nodded, and trotted behind Professor Qin.The two were not familiar with the hospital, and finally Xiao Kai took him back to the Department of Circulatory Medicine.

The two old men were in poor health, Zhou Congwen almost walked behind them.If it wasn't for unfamiliarity, Zhou Congwen really wanted to go back to the ward to see the situation.

Heart rupture, this is a fatal complication, and it cannot be delayed for a second, and it must be on stage immediately.

Even in extreme cases, it is also an option to open the chest at the head of the bed and stabilize the vital signs first.

Entering the circulatory medical ward, the crowd "marked" the location of the ward, and the sharp alarm sound of the monitor came from the crowd, telling Zhou Congwen what was going on inside.

Separated from the crowd, Zhou Congwen strode into the ward, and first looked at the ECG monitoring.

Blood pressure 68/32mmhG, ECG monitoring showed heart rate 48 beats/min, ventricular premature beat bigeminy, paroxysmal ventricular tachycardia.

Not a ruptured heart after coronary surgery!

Zhou Congwen then saw the patient.

The patient's face is swollen, especially the lips.

In 1993's "East Becomes West", Liang Yingdi's performance regardless of image was deeply rooted in the hearts of the people. Compared with the lips of Xidu played by Liang Yingdi in the movie, the patient's lips were obviously swollen and blue-purple.

In the movie, it is humorous and witty, but in the ward, accompanied by the alarm sound of the monitor, it looks extremely scary.

"Professor Qin, the leader doesn't know what's going on, it just happened like this all of a sudden." Dean Guan was already in a state of confusion, trembling, and told Professor Qin who ran in afterward about the situation.

Zhou Congwen walked to the bed and threw off the quilt.

"What are you doing!" A middle-aged man pressed Zhou Congwen's hand.

"Go away." Zhou Congwen became irritable, and cursed directly without looking at who it was.

When encountering an emergency, Zhou Congwen's temper became visibly irritable.

Chapter 0635 two out of ten thousand

"Inhale oxygen!" Zhou Congwen said afterward.

The middle-aged man was taken aback, "You know who I am..."

"Get out." Xiao Kai kicked the man on the back leg, almost kicking him to his knees.

"Rescue, didn't you see it!" Xiao Kai scolded sharply, "Head nurse, you are so deaf after breathing oxygen, you didn't hear me!"

The head nurse standing aside hurriedly ran to install the wall oxygen breathing equipment.

The equipment in Baishui No. [-] Hospital was okay. It was not an oxygen tank but a wall oxygen inhalation device. The equipment was installed soon, and the oxygen made a gurgling sound in the alcohol humidifier.

"5L/min." Zhou Congwen said, "Open the intravenous access, prepare the defibrillator, prepare the incision bag, from the ENT department."

"Hurry up!" Xiao Kai urged, holding a small whip to drive the surrounding doctors to run.

"Professor Zhou, are you allergic?" Xiao Kai asked in a low voice when Zhou Congwen had no further medical orders.

"Suspected to be allergic to contrast medium."

"Impossible, the patient has been in surgery for two hours!" Dean Guan was a little crazy, and his emotions were slightly out of control, and he said loudly.

Zhou Congwen frowned, "I don't understand delayed hypersensitivity, aren't you the dean with a medical background? You're fooling around."

Xiao Kai glanced at Zhou Congwen's lifted quilt, and saw that the patient's abdomen and limbs were covered with red maculopapules. He knew that it was most likely what Zhou Congwen said—delayed hypersensitivity caused by contrast medium.

"Dexamethasone 5mg IV."

"Promethazine 25mg IV."

"Epinephrine 0.1 mg subcutaneously."

"One more shot of adrenaline!"

"Ringer's solution, add high sugar, and turn on the speed to the maximum."

Zhou Congwen's cold eyes shuttled back and forth between the patient and the ECG monitoring, and the doctor's orders continued to be issued.

"One piece of calcium carbonate, add it to 100ml of salt water, and give it in quickly."

"Dopamine!"

"Is there a micropump?"

Xiao Kai was startled, and said in shame, "Professor Zhou, our hospital doesn't have micropumps yet."

"Boost, watch carefully." Zhou Congwen said.

"Okay." Xiao Kai responded without hesitation.

After all, he was once the backbone of clinical practice, so trivial matters like this are nothing to worry about.

Professor Qin should have been the busiest person, but with Zhou Congwen around, he seemed to have become a transparent person, watching Zhou Congwen direct the rescue.

After watching for a few minutes, Professor Qin knew that Zhou Congwen exuded a strong aura, but it was not because of his youthful vigor, but because he had extremely strong confidence in his own skills.

So when he saw that the patient's condition was not right, Zhou Congwen took over the rescue directly, without the slightest hesitation.

Five minutes later, the patient's blood pressure was 5/70mmHg, and the swelling of the face and lips eased slightly.

"Dexamethasone 10mg IV."

Although the patient's condition seemed to have stabilized, Zhou Congwen remained indifferent and focused.

"Promethazine 25 mg intramuscularly."

"Epinephrine 0.2 mg intravenously."

"Get the incision bag ready, Dean Xiao, take a look and be ready for tracheotomy at any time."

15 minutes passed quickly.

With the continuous injection of rescue medication, the patient's vital signs were "recovered", the alarm roar of the monitor gradually weakened, and the heavy breathing of other people in the room kept coming and going.

Another 15 minutes later, with a long breath, the patient "woke up".

The patient's subjective symptoms improved, and his spirit gradually improved. The skin rashes on the abdomen and limbs and the swelling on the face and face subsided. ECG monitoring showed blood pressure was 126/74mmHg, heart rate was 54 beats/min, and premature ventricular contractions were reduced compared with before.

"It's okay." Zhou Congwen said lightly.

"Delayed allergy to contrast medium? It's too late! How many hours has it been?!" Professor Qin said in astonishment.

The contrast medium contains iodine, and most patients will experience allergic reactions when injecting the contrast medium.

There were few cases in primary hospitals. At this time, the habit of doing skin tests before using contrast media had not yet formed, but Professor Qin saw many of them, and patients still had skin tests before surgery.

At that time, the skin test was negative, and Professor Qin didn't think much about it.

But the operation lasted nearly 3 hours, and Zhou Congwen performed one and a half operations after the operation, plus the time for chatting, it took 4 and a half hours.

It was a delayed-type allergic reaction, and it was late enough.

Fortunately, the patient's allergic reaction was manifested on the skin of the face and lips, and there was no throat edema that hindered breathing.

"I've seen the contrast medium, which is Bayer's new original drug iopromide. Do you use the same?" Zhou Congwen asked.

"..." Professor Qin concluded.

Contrast agents are just contrast agents. It is already the limit to do skin tests before surgery. Who has nothing to do to see what brand and what pharmaceutical factory produces it.

"Dean Xiao, check to see if it's iopromide." Zhou Congwen said sternly.

Xiao Kai went to check immediately, just like what Zhou Congwen said, it was indeed the original drug iopromide produced by Bayer.

"Professor Zhou, is it a drug problem? I stopped iopromide in the future, this is so scary." Xiao Kai said very unhappy, "I thought Bayer was a big pharmaceutical company..."

"No need." Zhou Congwen said lightly, "It's bad luck, I just caught up. Iopromide is a new drug developed by Bayer to avoid allergies to contrast media, and the effect is not bad."

"..." Xiao Kai didn't expect Zhou Congwen to say that.

In order to avoid allergies to contrast media, the medicines specially produced cannot completely guarantee that they will not be allergic. This is really fucked up.

He stared blankly at the patient, staring blankly at the swollen lips that had not completely subsided.

"Contrast agents are divided into ionic and nonionic. Iopromide is a monomeric nonionic contrast agent. This type of contrast agent has low osmotic pressure and low toxicity."

"..." Professor Qin was a little confused, Zhou Congwen even studied contrast agents?The principle of the new contrast agent is at your fingertips, and you can talk about it with eloquence.

"Bayer's study reported that the incidence of severe allergic reactions caused by iopromide was only 0.02%."

"0.02%? This is also..." Xiao Kai looked at the patient helplessly and sighed in his heart.

There is a 2/[-] chance of catching up, and it is a severe delayed allergy, which is called turmoil.

"The exact mechanism of anaphylactic shock caused by iopromide contrast agents has not been disclosed by Bayer. It may be related to the activation of antigen-antibody reactions, complement, and kinin systems. The released inflammatory factors increase vascular permeability and effectively circulate blood volume. Sudden drop and bronchospasm, laryngeal edema, etc."

"There is no laryngeal edema, everything is easy to say, and it is a blessing in misfortune. If there is, I probably won't be able to survive." Zhou Congwen said lightly.

Also.

Xiao Kai and Professor Qin agreed with Zhou Congwen's point of view.

If it is laryngeal edema, none of the doctors present can perform a tracheotomy. When the otolaryngologist rushes over, I am afraid that the person will already be gone.

This is indeed a blessing in misfortune.

Chapter 0636 The man

Wang Xueteng's mood recently is very complicated.

I "picked up" a treasure unknowingly, and I obviously didn't do anything, but the business volume was soaring, which made the branch managers in other regions drool with envy.

Originally, the Northeast region was a barren land in terms of sales, but after I came here, the business volume increased by leaps and bounds.

This is all a good thing, Wang Xueteng is too late to be happy.