I can see the status bar

Chapter 588 is more serious than expected (July 7nd 2th update) Please subscribe

Although the prompts in the status bar are very simple, the patient's situation is not "simple" at all.Sun Li'en concluded at a glance that this young Catu man who had eaten ibuprofen was in a very bad condition.

At first glance, his condition looked a bit like epilepsy.Sudden onset, unconsciousness, foaming at the mouth, and convulsions all over the body are classic symptoms of epilepsy.Although there is no opisthotonus, epilepsy can be determined based on these four features alone.

But he has other problems.

Although the patient is black, Sun Lien remembers it very clearly - when he saw him a few hours ago, Mounten's lips were still bloodshot.And now... his lips were bruised, even darker than his skin.At the same time, the first symptom Sun Lien saw was profuse sweating.

It seems that it is not so much epilepsy as it is a heart and lung problem.Combined with the "sinus tachycardia" on the status bar, the first diagnosis that came to Sun Lien's mind was "exercise syncope".

Exercise-induced syncope is a type of syncope that may be induced by a variety of causes, including vascular decompression, gravitational shock, orthostatic hypotension, paroxysmal muscle weakness, primary consciousness, etc.But the duration of most exercise-induced syncope is very short, generally ranging from a few seconds to tens of seconds.Mounten's fainting had obviously passed that time limit - which means that his fainting is likely to indicate more serious consequences.

The diagnostic equipment carried by the medical team is limited, and the results of blood pressure and heart rate came out quickly - blood pressure 132/62mmHg, heart rate 130 beats/min, breathing 24 beats/min.

Fortunately, they also brought an electrocardiograph this time, and the results of a quick examination were quite straightforward—sinus tachyarrhythmia with towering T waves at the same time.

The patient's T wave in leads V2-5 had obvious "tent-like" features, and at the same time, the peak of the T wave became sharper, and the ascending and descending extremities were symmetrical.This is an obvious ECG feature of hyperkalemia.

"What was he doing before he fainted?" Sun Lien called Felipe to translate, and quickly asked about the medical history.The electrocardiographic features of hyperkalemia mean that although the patient currently has hyperkalemia, the high time is not long.If it is severe hyperkalemia, as the blood potassium continues to rise, the patient's T wave, P wave, and QRS voltage will continue to decline-instead, it will not show such an obvious and typical "tent-like" ECG.

"They are training and preparing to participate in the London Marathon next April." Felipe quickly translated the other party's answer and added, "Munten is the main runner, and he was doing today's marathon before he fainted. The eighth 1000-meter sprint training."

Sun Lien frowned and looked at Mounten who was still twitching. His condition was really not very good.And the problem is tricky—hyperkalemia has a high potential to trigger acute myocardial damage, which reduces the heart's ability to pump blood.But that doesn't match his heart rate and blood pressure.With such intensity of training in this season, there is of course the possibility of heat stroke, but the symptom of heat stroke should be hypokalemia, which does not match the performance of the electrocardiogram.

"Has he eaten today?" Sun Li'en looked at Mounten's lean long-distance runner's figure, and suddenly had a guess, "When did he eat?"

"This morning, I ate... a piece of chicken breast." Felipe translated, "His recent physical examination results showed that his body fat rate was a bit high, so the coach arranged a fat loss plan for him."

"A bit high? How much is that? How long has he been on a fat-reducing meal?" Sun Lien looked at this lean young man, and it was hard to believe that his body fat percentage was actually high.

"11%, their coach's request is that the body fat rate must be reduced to 4% in April." Felipe said, "This diet of eating only one piece of chicken breast in the morning has been going on for about five days."

Sun Lien did not continue to ask questions, but took out a blood glucose meter and blood glucose test strips from his medicine box.After taking a little blood from Mounten's fingertip, he quickly got an important parameter from this small instrument.

"The blood sugar level at the end of a random finger is 2.4mmol/L." Sun Lien looked at the data, muttered a few words in a low voice, then stood up, rummaged through the medicine box brought by the medical team, and asked in a voice, " Teacher Liu, have we brought 50 candies?"

"Here." Liu Tangchun took out glucose from a bag, "Is it severe hypoglycemia?"

"It's only 2.4, so it's no wonder he doesn't get dizzy." Sun Lien took the plastic bottle containing 50% glucose, skillfully pulled out a syringe, and drew 40ml of liquid from it, "I'll give him some sugar first to see the effect. "

Forty milliliters of a 40% dextrose solution was slowly pushed into Mounten's vein.After completing the static push, Liu Tangchun handed over another bag of 50% glucose and started intravenous drip maintenance.

Everyone, including the medical staff, looked nervously at Mounten, who was twitching on the ground. After about 20 minutes, his breathing rate decreased slightly.After almost half of the first bag of 10% glucose was infused, the young man opened his eyes.

All the locals cheered, except for an elderly woman who knelt beside Mounten and cried loudly, covering her mouth.This is his mother, a widow who looks at least in her 37s even though she is only 50 years old.

Seeing the patient gradually regain consciousness, Sun Li'en was quite happy at first.But the status bar is like a dead Chinese cat hiding in a dark corner, waiting to push the objects on the table to the ground, jumping out and swiping a wave of presence.

The "unconsciousness" above Mounten's head had just disappeared, and then a state of "irritability" was added.

At the same time, Mounten's breathing is still rapid, and the breathing rate of a normal person is about 16 to 18 times per minute.Mounten's breathing rate was as high as 27 breaths per minute when he was unconscious and is now around 25 breaths per minute when awake.At the same time, his lips were pale, and he retched twice from time to time.

What's more, the tremors in his lower extremities still haven't improved.Heart rate was also maintained at 140 beats/min.

Liu Tangchun frowned, and Sun Lien also fell into deep thought.

"We can't check blood gas here, we don't have this equipment." Liu Tangchun broke the calm first, and he said to Felipe, "This patient's condition is relatively serious, and he probably fainted not just because of hypoglycemia - there may be other Severe symptoms, but the specific problem cannot be determined, and further inspections at the camp must be performed to clarify."

Felipe translated to Mounten's mother, and then Sun Lien continued to add, "The treatment process may take a long time-we now initially suspect that his kidneys may be damaged, and his heart may also be damaged, but the specific It depends on the results of the inspection.”

Sun Li'en is not running the train with his mouth full of words to scare people. Just by the towering T wave and "tent-like" on the electrocardiogram, he can be sure that the patient currently has hyperkalemia.And it's likely that there's muscle damage—possibly even rhabdomyolysis—from a lot of exercise.

Hypoglycemic encephalopathy leads to exercise syncope, combined with rhabdomyolysis, which is Sun Lien's diagnosis.

(End of this chapter)