I can see the status bar

Chapter 1103 Become Stupid (Blood Donation Plus Series 075, 076)

本章加更是为了感谢书友“孤独的苏联老兵”在2020年4月23日所捐献的全血，以及盟主“星云若雨忘了账号”在2019年10月17日所捐献的全血而加更。之后还有两章为“星云若雨忘了账号”加更的章节。

After connecting Wu Xiuli with the tubes necessary for CRRT treatment, Sun Lien turned around and went to the nurse's station to bring a wheelchair for Shen Guohua to sit down.The old man probably wouldn't want to leave the ward for a while - he was holding his wife's hand by the bed, talking in a low voice.

"You can stay here for a while, but you have to go back to the North Sixth District to rest and sleep at night." Sun Li'en could see that even if the old man was tired, he probably wouldn't take the initiative to leave.So, he deliberately made things clear in advance, "You and aunt can only chat for half an hour at most, don't keep pulling her to talk. Her blood oxygen is not very good now, and talking too much is not good for her health. "

Shen Guohua asked with some embarrassment and embarrassment, "Then... don't let her answer, can I just talk to her?"

"This... It's best not to take too long." Sun Li'en said helplessly, "She must stay awake when she listens to you. How about this, let her sleep after you see her sleepy. Sleeping more now is good for her The body is good."

To put it bluntly, Shen Guohua reluctantly agreed to the arrangement of "I will watch it for a while, but try to keep quiet and let Wu Xiuli sleep, and I must return to the North Sixth District at five o'clock in the afternoon".

After arranging these things, Sun Lien was about to go back to the red zone office to adjust the doctor's order, but he was called for emergency treatment halfway - the blood oxygen saturation and blood pressure of the patient in the second bed suddenly dropped, and his heart rate also began to soar rapidly.The alarm sounded at the workstation in the red zone pulled over a dozen doctors and nurses.

The patient in the second bed is a skinny 43-year-old middle-aged man who has been in poor condition since he was admitted to the hospital on February 2.During the two days of the 4th and 7th, the vital signs were unstable and there was a crisis requiring rescue. On the 9th, the patient experienced tachycardia and on the 7th, bradycardia.

The situation this time seemed to be different from the previous ones. When Sun Lien arrived at the second bed, Yuan Ping'an and others were already on the scene directing the rescue.

The patient's vital signs have been the focus of doctors' attention due to pre-existing alcoholic cirrhosis.Liver-protecting drugs such as polyene phosphatidylcholine have become an important part of his treatment, but this is only to prevent his liver function from deteriorating too quickly and too severely.

With oxygen saturation and blood pressure falling but heart rate rising rapidly, it was clear that this patient was bleeding heavily, most likely in the lungs.

Yuan Ping'an has asked the blood bank to send blood urgently for support, and has used vitamin K for this patient.The samples for urgent blood coagulation time testing have also been sent down, and the current rescue method is mainly to maintain blood volume through rapid infusion of crystalloid.

After looking at the patient's status bar, Sun Lien said to Yuan Ping'an, "Pull the atomizer over, add [-] mg of epinephrine and [-] ml of normal saline, and inhale it for him first. The bleeding stops."

Fiberoptic bronchoscopy is the most ideal treatment for respiratory bleeding, but because the patient's vital signs are unstable, neither Yuan Ping'an nor Sun Lien dare to immediately hand over the patient to a doctor in the Department of Respiratory Medicine for treatment.They must now stabilize the patient's vital signs, at least wait until the blood volume replenishes.

For emergency doctors, bleeding patients are always the most troublesome category.Especially for patients whose bleeding affects the heart and oxygen saturation at the same time, the situation is often a little more difficult-commonly used hemostatic drugs cannot stop the bleeding in time and effectively most of the time, and stronger hemostatic methods are beyond the emergency department The scope of treatment that can be given.If you want patients with severe bleeding to receive other treatments, you first need to stabilize their vital signs, so in the emergency department, there are often scenes such as "I don't have a mask, so I have to go out to buy a mask, but because I don't have a mask, I can't go out. If you can’t go out, you can’t buy a mask” is an unsolvable cycle.

Therefore, as a qualified emergency doctor, Sun Lien immediately thought of a hemostatic technique that was often used in local primary hospitals-adrenaline.

Adrenaline is usually a very important first aid drug in the emergency room. It can promote the increase of heart contractility, accelerate breathing, expand the blood vessels in the heart, liver and other organs, and shrink the blood vessels on the skin and mucous membranes. Drug of choice for rescue of anaphylactic shock.

Oral adrenaline, on the other hand, mainly uses the ability of this drug to efficiently shrink the mucous membrane and small blood vessels to stop bleeding-this treatment is very useful for less serious upper gastrointestinal bleeding.

When bronchoscopy is used to treat bleeding, epinephrine is also a very useful hemostatic agent.But the problem now is that the second bed that uses tracheotomy and intubation has no room for bronchoscopy at all.

Faced with the "death cycle" of buying masks, Sun Lien decided to use his brains and move the mask factory directly to the homes of people who needed masks—through the ventilator tube after the tracheotomy, the atomized adrenaline was sent directly to 2 into the bronchi of bed patients.

As long as the bleeding can be stopped, other matters can be discussed later.Save your life first, then you can think about other things.

Apart from adrenaline nebulization, Sun Lien did not intervene in Yuan Pingan's other rescue plans.It's not because the two beds are no longer worth saving, but because Yuan Ping'an's plan really has no other room for adjustment.

Just such a patient, who was using tracheotomy mechanical ventilation due to severe viral pneumonia, and caused pulmonary hemorrhage due to alcoholic liver cirrhosis and lung injury caused by the ventilator...It is actually very difficult to treat such a patient .

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After tossing and tossing for more than an hour, the blood on the second bed was temporarily stopped, but as the price, Yuan Ping'an was so tired that he could hardly stand up.

"Go and rest." Although the four-hour shift time has not yet arrived, Sun Lien decided to ask his colleagues to rest for a while, "Go to the green area to lie down for a while, and then go back to the hotel together when the bus arrives. "

"No need." Yuan Ping'an shook his head, "I just didn't sleep well yesterday, just take it easy."

Zhou Ce glanced at Yuan Ping'an from the side, and then asked with a smile, "Anyway, you have to take it easy, so why not just take off your protective clothing and go to the green zone—it's time for rotation in five or ten minutes."

Yuan Pingan couldn't figure out the relationship between "rotation in five or 10 minutes" and "take off protective clothing and go to the green zone" for a long time.Sun Lien sighed, called Xiao Guo, a nurse from the nurse station, and pointed at Yuan Pingan to Guo Yulai, "Brother Yuan may be a little short of oxygen today, you should keep an eye on him and get him out of the cabin to rest as soon as possible. If he doesn't Ken, you just lift him out - be careful when you lift, don't tear the protective suit."

Guo Yulai nodded in agreement, then blocked Yuan Ping'an with his "huge" body, and said in a muffled voice, "Brother Yuan, you have to rest."

"Director Sun, I'm really fine...Xiao Tian, ​​don't block me!" Yuan Pingan tried to bypass Guo Yulai's chest muscles in front of him, but this move was blocked by Xiao Guo.

Guo Yulai said helplessly, "Brother Yuan, you are really exhausted——I am Guo Yulai."

After tossing for a while, Yuan Pingan was finally persuaded by Sun Lien and Guo Yulai—mainly because of Xiao Guo’s good body—and decided to go to the green zone to rest for a while.Looking at Yuan Ping'an's back, Sun Li'en pondered for a few seconds, and decided to take Yuan Ping'an to go on a business trip with him when he changed shifts.

According to Zhu Minhua's feedback, Liu Lianzhi's condition has improved after being on ECMO. He is now able to open his eyes and have some simple exchanges with doctors.But because the lung lesion area is still very large, now Zhu Minhua and the others don't even have the idea of ​​temporarily turning off ECMO to let Liu Lianzhi try to rely on his own breathing to maintain blood oxygen.

Professor Zhu felt that Liu Lianzhi would have to stabilize for about three days before considering the issue of gradually going offline.

There are about 10 minutes to change shifts, and Sun Lien was about to use his mobile phone to tell Zhu Minhua that he would go there with Yuan Pingan later, when a somewhat familiar voice suddenly sounded behind Sun Lien, "Sun Lien Doctor, are you free now?"

Turning his head, Sun Li'en saw Qian Guojian wearing a hospital gown with an expectant expression on his face.

"I was discharged from the hospital this afternoon. I just heard from the Sixth District that Director Sun and your shift will be changing today. I'm afraid I won't be able to meet you if it's later...Can we take a photo together?"

Qian Guojian held his mobile phone in his hand, and his expression was a little embarrassed, "If I disturb your work, I can come back later..."

"You're going to be discharged from the hospital?" Sun Li'en was stunned for a moment, and then suddenly became happy, "It's a good thing! Take a photo together, right? No problem! Wait a minute, I'll call your bed nurse over and let's take a photo together."

The term "bed nurse" is usually not a problem in the inpatient department, but when the medical team takes over, "bed nurse" has become a "fake name".All nurses are expected to take care of all patients.The very young 14-bed patient before—that is, the 22-year-old boy who voluntarily asked to be transferred to the North Sixth District to give up his bed to patients who need more outside—he tried to pass his own medical treatment before being transferred to the North Sixth District. Memory remembers these doctors and nurses from Ningyuan.In this way, he can invite everyone to eat a bowl of excellent hot dry noodles after he is discharged from the hospital and after the epidemic is over.

But this attempt failed after three hours, and the young man finally took his mobile phone and started taking pictures of every doctor and nurse who entered the ward.After taking pictures, he discovered that the names written on many nurses were nicknames or nicknames—anyway, Guo Yulai’s protective clothing said "Xiaoyu", and he didn't know which part of Xiaoguo could be worthy of this name .

Under Sun Lien's positive "response", the doctors and nurses present rushed to take part in the photoshoot.Everyone has heard a little bit about Qian Guojian. Such a patient who repeatedly refused treatment before and even lost the desire to survive is now about to be discharged from the hospital.This sense of accomplishment can make all doctors happy to eat an extra bowl of rice.

After finishing the group photo, everyone enthusiastically encouraged Qian Guojian to work hard to live a good life.Sun Li'en took advantage of this moment and began to enter the buffer zone to take off his protective clothing—he just suddenly remembered a question, wondering if Zhu Minhua was on duty now.If he took Yuan Pingan there but couldn't see Professor Zhu, the effect of cheering Yuan Pingan would be greatly reduced.

Fortunately, Yuan Ping'an himself or Sun Lien's luck is not bad, Zhu Minhua said in WeChat that he is preparing to be on duty, and he is still in the hotel.

"Brother Yuan, let's go, I'll take you to a place." After confirming that the master is in the hospital, Sun Lien happily pushed open the door of the green area lounge, and then dragged the drowsy Yuan Pingan out of the bed, "The car is almost here, hurry up, or you won't be able to catch up if you're late."

"What?" Yuan Pingan, who had just fallen asleep, didn't recover. He looked at Sun Lien with sleepy eyes, and it took several seconds to realize who it was, "What are you doing?"

"Go to meet an acquaintance." Sun Li'en urged enthusiastically, "I have other things to do later, let's go quickly."

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"Mr. Zhu?" Yuan Pingan, who was confused all the way and fell asleep at least three times, saw a familiar figure at the gate of the high-tech campus of Tongde Hospital.With a bald head and a height of 1.7 meters, he likes to walk around with his hands behind his back when waiting for others.Coupled with the bold words "Capital Tongxie Hospital" printed on the jacket on his back, Yuan Ping'an recognized Zhu Minhua's figure at a glance from dozens of meters away.

"I didn't know that Professor Zhu was here until I came here for a consultation." Sun Li'en solved the mystery with great interest, and even slipped over the fact that he was too busy to tell Yuan Ping'an, "You It's been a long time since I met Professor Zhu, right?"

Yuan Ping'an had indeed not met Professor Zhu for a long time.A few years ago, when he and Yanan got their marriage certificate, Yuan Pingan went back to the hospital with something like wedding candy, but he and Zhu Minhua only met once at that time.

As Yuan Ping'an's doctoral supervisor, Zhu Minhua has always liked his student very much.When Yuan Ping'an abducted a flower from the orthopedics department of the Tongxie, the carpenters in the orthopedics department were filled with righteous indignation, wishing to dismantle all the joints of Yuan Ping'an's body and reinstall them.It was Zhu Minhua who heard the news and came forward to organize a social gathering between the two departments.Then he was fed a lot of meat and vegetables on the wine table, which finally settled the matter.

Zhu Minhua, who works in the emergency department and also teaches at Tongxie Medical College, really has nothing to say to Yuan Ping'an.But when the pair of master and apprentice met in Yunhe, the scene was a little...embarrassing.

Yuan Ping'an's current state is more than excited but not awake enough. I don't know if it's because he and his wife have been separated for too long, or because he hasn't had a good rest recently. — Zhu Minhua, an old emergency doctor, felt a little distressed.

"You can't rest well." Zhu Minhua patted Yuan Ping'an's shoulder, and said earnestly to his students, "If you stay up too late, you will become stupid."

　Recently, I have to find time to prepare a monthly pass episode, so I will only update 8K twice today... Sorry, everyone.

　　The monthly ticket is currently tentatively scheduled to be about the story of Rachel and Xu Yourong before they met, and I will try to publish it as soon as possible after the event starts~
　　
　
(End of this chapter)