When doctors have a simulated operating room

The doctor was shocked.

"What...what happened?!"

Wang Yufei, who was sitting opposite Zhang Yi, asked while chewing food.

"A patient with refractory hypokalemia came, and his blood potassium level was as low as 0.9."

"Ah? 0.9?!"

Wang Yufei was shocked when he heard this number.

Normal blood potassium is between 3.5-5.5.

Generally, doctors start to get nervous when they encounter patients with a blood potassium level of 3.0.

If it is below 2.0, they will worry about whether the patient will have sudden death, and they are afraid that the person will not be saved by then.

This is even more amazing, it is as outrageous as 0.9? ! ?

Then he will definitely not survive, right? ? !

Zhang Yi hadn't even taken two bites of rice when he stood up and went back to the emergency room.

Looking at Zhang Yi's hurriedly leaving back, Wang Yufei shouted: "Zhang Yi, aren't you going to eat a few more bites of rice? You haven't eaten much."

But Zhang Yi waved his hand without looking back: "Saving people is the most important thing."

"Hey! This person is really, he doesn't eat, and if he doesn't replenish his energy, how can you cope with the patient who needs to go to the operating room later? People are iron and rice is steel!"

While talking, Wang Yufei also ate big mouthfuls of rice again.

It is estimated that he swallowed the rice in his mouth without chewing it a few times.

In less than 30 seconds, Wang Yufei quickly finished his meal, wiped his mouth and rushed to the emergency room.

Although he was on duty on the second floor today, managing the patients who were hospitalized in the emergency room for infusion at night.

However, if something happened in the emergency room, he would have to come to help.

If the emergency room could be more relaxed, there would be fewer patients hospitalized on the second floor.

In the emergency room.

When Zhang Yi came in, the beds in the emergency room were almost full.

Some were in car accidents, had cerebral infarction and other surgeries, and were injured and unable to move and were waiting for orthopedic surgeons to take them away.

At this moment, several doctors on duty at noon were standing in front of bed 9, busy and confused.

Zhang Yi approached and saw clearly that the person lying on the bed was a young man in his early 20s.

Judging from his dress, he should be a student of some university in the capital.

But at this moment, he was already in a state of severe coma.

Below 2.5 is considered severe hypokalemia, but this guy's potassium level was as low as 0.9? ?

What caused it?

Just as Zhang Yi was about to ask about the patient's condition, a chaotic ECG wave suddenly appeared on the ECG monitor!

The entire monitoring alarm also sounded!

Beep beep!

"Arrhythmia! Bring the defibrillator!"

Immediately, Zhang Yi's first reaction was that it was arrhythmia caused by severe hypokalemia, ventricular fibrillation!

Ventricular fibrillation is a very dangerous signal.

The heart beats regularly, and frequencies within 60 to 100 times a minute are all normal myocardial contraction movements.

But ventricular fibrillation means that the myocardial contraction is weak and the muscles are shaking uncontrollably.

The consequence of cardiac fibrillation is that the heart does not eject blood or recycle blood, and the heart stops working after ventricular fibrillation.

If ventricular fibrillation is not eliminated in time, the person will die.

In less than 30 seconds, the doctor next to him had brought the defibrillator.

Zhang Yi quickly applied conductive gel and started defibrillation.

"150 joules!"

"150 joules are ready!"

Bang!

The current passed through the young man's chest, causing him to bounce up.

"150 joules!"

"150 joules are ready!"

Bang!

Another electric shock.

Zhang Yi looked back at the ECG waves on the monitor and found that the trembling waves had calmed down a little.

But the situation is still not optimistic.

0.9 blood potassium is really too low.

This is also the first patient with such low blood potassium that Zhang Yi has seen since he started working.

How could it be so ridiculously low?

Haven't you noticed it before? Haven't you come to the hospital for a check-up?

"Catheterize quickly! Prepare a large dose of 1000 ml of glucose with 3 grams of potassium! Intravenous drip! Faster!"

"Okay!"

"Take another lobeline and norepinephrine and push it directly into the vein!"

"Okay!"

While defibrillating, Zhang Yi also quickly instructed other rescue work.

Seeing that ventricular fibrillation had not been relieved, Zhang Yi felt a little panicked.

"Just 200 joules!"

"Okay, 200 joules are ready!"

Bang!

After increasing the current, the patient was in a coma, but he could still feel the pain of the current passing through his body.

He only whimpered twice.

Looking at the ECG monitor again, the ripples were indeed much more normal.

At this time, several doctors around

Relieved.

That was a close call!

Damn, this hypokalemia of 0.9 almost killed the patient!

"Where are the family members? Have they come?"

"They are outside. His roommates came with him. There seems to be a teacher as well."

Zhang Yi nodded and prepared to go out to communicate with his teachers and classmates.

Before leaving, he looked at the liquid on the infusion bag.

After confirming that potassium was infused, he told the nurse again: "The first bag should be a little faster, and the fastest drip rate is 60. Also, do a blood potassium test, and observe the blood potassium value and urine volume at any time. Tell me if there is any abnormality."

"Okay, Doctor Zhang."

Potassium supplementation cannot be rushed, but for blood potassium that is already so low, the drip rate can be a little faster than usual.

It will be fine if dynamic monitoring of blood potassium is done well.

If the hypokalemia is above 2.5 or above 3.0, it is only recommended to supplement potassium slowly.

Because once the drip rate becomes faster, blood potassium can easily rise to above 5.5.

Too high blood potassium is also fatal.

After stabilizing the young man's condition, Zhang Yi came to the door of the emergency room with a stack of notices.

Sure enough, there were several college students in their early twenties standing outside the door, and a middle-aged female teacher wearing glasses was waiting there anxiously.

"Are you Qin Fang's classmates and teachers?"

When they heard Zhang Yi's question, they hurried over: "Yes, yes, Doctor Zhang, how is Qin Fang?"

"It's very dangerous. He was just rescued once, but his blood potassium is too low, as low as 0.9..."

"0.9??! So low?"

"Yes, there may be a second ventricular fibrillation at any time. Ventricular fibrillation means heart muscle..."

"I understand, they are all medical students, they understand what you say about ventricular fibrillation."

Zhang Yi was slightly surprised: "You are also medical students?"

"Yes , School of Medicine, Yunlin University, and is a junior. "

"That's good. Since you are all studying medicine, it will be much easier for me to explain.

The current situation is very dangerous. I believe you all know that the blood potassium level is as low as 0.9. Even if he is sent to Union Hospital, it is not guaranteed that he can survive this critical period.

But we will do our best to rescue him. Now he is replenishing potassium. When the blood potassium level rises and the situation improves, we will notify you again.

This is the rescue record just now, and there is also a critical illness notice. Please sign it. "

As he said, Zhang Yi took out the notices.

Several classmates looked at each other, and they were a little afraid to sign.

In the end, it was the teacher who signed for him: "His family is not in the capital. He came to the capital from another place to study at university. But I have already notified his family. They will probably come around 7 or 8 in the evening."

Zhang Yi thought for a while and asked: "Give me his family's phone number, I will call and communicate in person. By the way, Qin Fang must have had some symptoms of hypokalemia before his hypokalemia became so serious, right?"

Unexpectedly, the teachers and classmates all shook their heads and said:

"No, Qin Fang was very healthy before, nothing happened. He was the most active one when he played basketball in his free time. I don't know what happened today. He suddenly said that he felt nauseous and wanted to vomit, and then he fell to the ground and convulsed in a few minutes. We thought it was epilepsy, but we didn't expect to find out that it was hypokalemia when we came to the hospital."