When doctors have a simulated operating room

The doctor on duty at the night shift in the emergency department is called Huang Lei.

He still remembers the young man yelling and cursing outside the clinic a few days ago.

Unexpectedly, he was brought in by an ambulance in the middle of the night?

Other patients came in horizontally and left vertically.

But he came the other way, leaving vertically and coming in horizontally?

"What's the patient's condition?" Huang Lei asked.

The emergency doctor pointed to the patient's right calf and said:

"According to the description of the family, he was bathing in the river about five days ago and accidentally scratched his leg with dirt in the river.

I heard that he went to the Maternal and Child Health Hospital for a tetanus shot and was prescribed some anti-inflammatory drugs and went home.

As a result, the anti-inflammatory drugs were taken, not only did not get better, but the leg pain became more and more severe.

When we received the emergency call today, the family said that the person had fainted.

When we arrived at the scene, the patient was unconscious and did not respond.

The wound had begun to fester, and the color was not right, a little dark."

Huang Lei frowned and glanced at the young man's leg.

This look reminded him of the old lady with fasciitis not long ago!

"Xiao Li, bring the debridement bag!"

Huang Lei immediately told the nurse to prepare things.

He remembered that when the young man was in the hospital a few days ago, he took a look at the wound.

It was only three centimeters, and the wound was not deep.

But now, only a few days have passed, and the wound is not only red and swollen, but also oozing pus.

And the color is a bit yellowish-gray.

It really looks a bit like it!

Like fasciitis!

Huang Lei took off his mask and sniffed it a little closer. It did smell bad.

But the smell was not as strong as the old lady last time.

"Forget it, send him directly to the treatment room. I'll drain him first. His wound is already oozing pus. Let's deal with it quickly.

In addition, notify the general surgery department to come and take a look. If it's fasciitis, surgery is definitely needed."

In the treatment room, a basic admission physical examination was performed first.

The body temperature was 38.2 degrees Celsius, a little feverish.

Observe the wound again, pus is oozing, and there is a faint odor.

Soon, Huang Lei started to operate with gloves.

While draining and flushing, the nurse quickly established an intravenous channel for fluid infusion.

After the drainage, the person was sent for examination, blood routine, blood culture, and X-ray.

When the general surgeon arrived, the test results came out.

The two doctors saw that the white blood cell count was elevated, which was beyond doubt.

X-ray showed gas and a small amount of small bubble shadows under the skin of the right calf.

Renal function: blood urea nitrogen 7.1mmol/L (3.2-7.0mmol/L)

Elevated blood urea nitrogen can be seen in chronic nephritis, severe pyelonephritis, heart failure, shock, burns, etc.

But fortunately, this person's current blood pressure is not particularly high.

Huang Lei looked at the examination list and then at the ECG monitor. The blood pressure was hovering around 95/60mmhg.

"How about this, first give him a set of cefadroxil, and then a set of metronidazole, first give him a set, stabilize him and then go to the operating room?"

Huang Lei suggested.

Mainly because he saw that Zhang Yi also recommended the medication after the old lady with fasciitis last time.

The general surgeon shook his head:

"Surgery must be done first. Why should we give him a surgical debridement first? It turns out that he has fasciitis, so why not debride him quickly?

Are we going to wait until it's like the old lady last time?"

The last fasciitis surgery is known to the whole hospital.

No doctor in the general surgery department doesn't know about it.

And they are all learning from Zhang Yi.

Huang Lei glanced at the general surgeon after hearing this:

"Okay, let's send him to the operating room first."

What I didn't expect was that.

Just after the two of them finished discussing the treatment plan, something went wrong with the young man!

The nurse hurriedly said:

"Oh no! Doctor Huang, why did the patient's blood pressure suddenly drop?!"

Hearing the sound, the two doctors hurriedly looked at the ECG monitor.

The blood pressure was about 95/60mmhg just now, but it became 85/53mmhg in the blink of an eye!

Immediately, the first reaction of the two doctors was shock!

Or toxic shock!

This young man has been infected with bacteria for so many days, and ordinary oral cephalosporin has little effect.

Only by coming to the hospital and taking a combination of multiple antibiotics can the condition be controlled.

And the wound dressing must be changed every day.

Alas!

This young man, relying on his youth, thinks he is immune to all poisons.

This

It's done, something's wrong!

At this time, the ECG monitor also began to sound the alarm of low blood pressure and high heart rate.

Beep beep beep!

"First rescue, use a bottle of epinephrine first, and also establish an intravenous channel to infuse antibiotics while rescuing."

"Okay!" The nurse nodded quickly.

Immediately began to infuse fluids into the patient.

Outside the treatment room, the family members were still waiting there with a nervous look on their faces.

Huang Lei hurriedly walked out the door, called the family members in and said:

"Wei Dian's condition is suddenly bad now, shock, or toxic shock, which is a series of shock reactions caused by bacteria entering the blood.

The mortality rate is still very high. We will try our best to rescue, but I hope you as a family member should be mentally prepared."

The family member is a young girl, and the two have just been married for a short time.

She looks much younger than Wei Dian.

"Wow... No, wow... Doctor, Wei Dian can't die... Please save him! Please save him!"

When the family members saw the rescue scene, they immediately burst into tears.

But Huang Lei couldn't say what the result would be.

This guy should have been treated in the hospital a few days ago.

He remembered that Zhang Yi had persuaded this guy several times at that time.

But this guy didn't appreciate it and insisted that the hospital was cheating him out of money.

Oh!

Now that he has waited until it is so serious to come to the hospital, it may cost more money.

"We will do our best to save him. We just want to tell your family that he is in a very dangerous situation. If he has other family members, such as his parents, please notify them first.

Let the other family members come over, so that no matter what the result is, you can deal with it together as a family."

"Woo woo... Doctor, please save Wei Dian. We just got married... woo woo... The 'happiness' characters on the door have not been removed yet... Doctor, you must save him!"

Huang Lei could only nod and say, "We will do our best."

After the communication, the family members began to contact other family members outside.

In the treatment room, the doctor of general surgery has already started cardiopulmonary resuscitation.

"Give me an epinephrine and an Alamin!"

"Okay!"

Alamin is a blood pressure medicine.

Five minutes of rescue time passed quickly.

Rescue drugs and antibiotics were used.

The rescue of toxic shock must first find out the pathogenic bacteria, but this takes time.

They have to wait for the laboratory to find out before the doctors can prescribe the right medicine.

We can only use some antibiotics together.

Plus rescue drugs.

As a result, the patient showed no signs of improvement.

Huang Lei and the general surgeon were a little anxious.

They did rescue according to normal operations.

Why is there no effect at all?

What to do?

Last time I saw Zhang Yi rescue so easily, why did he have to encounter some difficult patients?

It's the same necrotizing fasciitis, but the area of ​​infection of this fasciitis may not be as large as that of the old lady.

As a result, this guy is more serious than the old lady?

What bad luck!

"What to do? How about calling a senior doctor to come and take a look?" said the general surgeon.

Huang Lei frowned and thought for a few seconds and then said:

"Wait, I'll call Zhang Yi."