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Chapter 589 Emergency Rescue (7th update on July 3) Please subscribe

Mounten's condition was very poor. Even if he was placed in the fourth hospital, he would be sent to the ICU for follow-up treatment.But for the medical team, the situation is a bit tricky.

As part of the medical project to support Politanvia, the medical team also brought a batch of relatively "advanced" medical equipment.These include three cardiopulmonary monitors, ventilators, dialysis machines and other equipment.But this batch is not the main aid equipment—they are more of a "teaching aid" role, demonstrating for local doctors during the use of the medical team, and allowing them to accumulate enough experience and technology.

Because of this, the number of life monitoring and support equipment carried by the medical team is very limited.Originally, 20 doctors had to be filled in the Department of Critical Care Medicine according to the setup of the tertiary hospitals, which was not enough.So everyone didn't think there was any problem at first.

Until Sun Lien came... the situation suddenly changed.

The necessary equipment of the Department of Critical Care Medicine, which was relatively well-off, was suddenly not enough.Originally, the medical team still had two dialysis machines and a cardiopulmonary monitor available for use, but after the old wizard injured in a serious car accident was brought in for treatment, the cardiopulmonary monitor was used up, and there was only one dialysis machine left, and the ventilator was gone. ——The medical team originally only had two ventilators. One dedicated anesthesia ventilator was placed in the operating room for operations, and the other was assigned to a little girl undergoing liver transplantation.The old wizard also needed ventilator support, and the one he was using had just been moved out of the operating room.

Mounten's condition is not very good, and Liu Tangchun knows very well that if he really has hypoglycemic encephalopathy combined with rhabdomyolysis, the treatment process in intensive care will take at least ten days. Hypoglycemic encephalopathy is not so important, just supplementing glucose in time.The real problem is rhabdomyolysis.

Rhabdomyolysis can cause several harms to the patient himself.First and foremost is the release of potassium from the mass of dead muscle cells.Excessive potassium concentration in the blood will directly inhibit the patient's myocardium, resulting in a decrease in the patient's myocardial tension.If this situation continues, arrhythmia is likely to occur and even directly lead to cardiac arrest.

The concentration of potassium in the blood also releases acetylcholine, which affects the patient's vagus nerve—and may even cause symptoms similar to organophosphate poisoning.Hyperkalemia can also affect the central nervous system of the patient at the same time, causing the patient to appear confused or restless.

In addition to hyperkalemia, rhabdomyolysis also causes large amounts of myoglobin to be released into the blood.These proteins block the work of the glomeruli, causing acute liver and kidney damage.Judging from the current situation, if this acute liver and kidney injury cannot be immediately intervened and treated symptomatically, it will inevitably lead to acute liver and kidney failure.

At present, in this village, apart from injecting 10% calcium gluconate to combat the effects of hyperkalemia on the heart, the medical team can do very little.Whether it is to inhibit the excessive secretion of acetylcholine, correct the metabolic acidosis caused by hyperkalemia, or clear the myoglobin in the patient's blood to protect the liver and kidney, these means cannot be provided by the patrolling medical team. of.

From the current point of view, whether the patient can tolerate the transfer is not the first thing to consider-if Mounten is left here for up to 48 hours, he will suffer from arrhythmia or acute renal failure caused by hyperkalemia And die.Now for Liu Tangchun, the top priority should be whether the remaining medical resources can handle the critically ill patients who may be sent again at any time after this patient is admitted.

To put it bluntly, if this worry is in China, it can be left to the patient's family to make the decision.After all, the cost of ICU treatment is extremely high, and even if the patient is transferred to the hospital in time, irreversible kidney failure or even liver failure may occur.However, the follow-up treatment is so difficult and expensive that a large number of family members of patients from poor families choose to give up.

But this is not in China, and what Liu Tangchun represents is not only the emergency department of the Fourth Central Hospital of Ningyuan City, Song'an Province.The medical teams sent abroad represent China and the country.Liu Tangchun was very clear about the weight of this weight.

"We currently lack sufficient medical equipment, and his condition is more serious." Liu Tangchun pondered for a moment before making a decision, "It's not a big problem for the medical team to use the current medical equipment for him first, but we have to think about it later. It will also be sent to the patients in the station."

Sun Li'en listened with a heavy heart, and he also knew the background of the medical team.If Mounten is treated, at least three precious life support and monitoring instruments, as well as one bed and the energy and time of at least two doctors will be occupied for a long time.The medical team is not unable to mobilize these medical resources, but if these resources and time are used on other patients, it is unknown how many people can be saved.

Even if Liu Tangchun decides to give up this young man, everyone will not have any complaints - at most, they will just blame themselves for not being capable enough.

"Let's transfer the patient to the station first. At least save his life first." Liu Tangchun continued, "Then immediately contact the Daishan Island and ask them to send a helicopter to transfer the patient so that he can receive follow-up treatment on the Daishan Island. "

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In one sentence, Liu Tangchun saved a disabled family and saved a woman's future life, but it also brought a lot of trouble to the medical team, the Daishan Island, the Politanvian government and the military.

The medical ship Daishan Island was dispatched by China to carry out humanitarian rescue missions at the request of the Politanvian government.As the world's first large-scale dedicated hospital ship, the equipment on board is very complete.It is even more advanced and professional than some ordinary tertiary hospitals.

但先进和专业的医疗船，所配备的直升机却仍然是上世纪70年代中期开始研制的直-8基本型直升机。作为13吨级的通用直升机，岱山岛号上的直-8拥有800千米左右的续航能力。

However, the Daishan Island is currently located at the mouth of the Lufuma River, and the straight-line distance from the Seventh Bureau camp is about 470 kilometers.The amount of fuel in the helicopter itself is not enough to support it to fly back and forth.If the patient transfer mission is to be carried out this time, the plane must either refuel at the Seventh Bureau Camp, or it must choose an airport during the flight to land and refuel.

This is just a little trouble in the actual operation.

Although the Daishan Island is a hospital ship, it still belongs to the naval order.Her helicopter is naturally also a military aircraft.For a foreign military aircraft to fly into a sovereign country and carry out humanitarian relief missions in that country's airspace, this requires very complicated and troublesome approvals—and it also requires the Politanvian side to initiate a request for assistance, and Once accepted by us, the approval process can begin.All in all, a lot of trouble.

But compared to a life, these troubles are just troubles.

Liu Tangchun's attitude is very firm, and the patient must be sent to the Daishan Island for follow-up treatment as soon as possible.The Daishan Island also made it clear that it is willing to receive patients—as long as the Polish side is willing to provide corresponding assistance.

As soon as the vehicle carrying Mounten arrived at the Seventh Bureau camp, Liu Tangchun took his translator and students into another vehicle and drove away—their destination was Port Melati.Director Liu had already informed the Politanvia authorities of the patient's situation on the way here, and requested corresponding assistance. However, Director Liu, who has been in Africa for almost two years, knows how slow and inefficient the local administrative agencies are. the point.So he decided to take people over to watch every process and step in person.

Anyway, the medical team is extremely popular in Politanvia and is deeply loved by local residents.Comrade Liu felt that it was not a loss at all to exchange his own face for the hope of a patient's life.

In the camp, Sun Lien and Hu Jia are organizing further rescue and treatment of Mounten.His arterial blood gas test came in just a few minutes ago, and the results were very bad.

Mounten's blood pH is 7.28, carbon dioxide partial pressure is 27.7mmHg, oxygen partial pressure is 88.6mmHg, potassium ion concentration is 5.53mmol/L, sodium ion concentration is 144mmol/L, residual alkali is -11.9mmol/L, blood lactic acid is 8.4mmol/L L.The blood routine results were not too optimistic. The white blood cell count was 17.81×10^9/L, the neutrophils were 7.88×10^9/L, the red blood cell count was 3.71×10^12/L, and the hemoglobin was 121g/L.

What is more worrying is his serum myoglobin and creatine kinase indicators.Among them, serum myoglobin is greater than 12000ng/ml, and creatine kinase is as high as 3814U/L.
While directing the patients to inhale oxygen, replenish fluids, and maintain the balance of water and electrolysis, Sun Lien also used the urine alkalinization technique and liver protection treatment that he had learned from Xu Yourong.On the other hand, he was also urging the laboratory to complete the urine routine examination as soon as possible—before performing renal replacement therapy on the patient, he must at least find out how seriously damaged Mounten's kidneys have been.

　Tomorrow... I really have to ask for leave.

　　The news I got from my girlfriend said that there will be many people accompanying me at the welcome banquet tomorrow.

　　Father Sanguan has high blood pressure, and he is prone to stomach upset after drinking too much alcohol.And my mother...although she could drink some when she was young, but now she has type [-] diabetes and coronary artery stent surgery, how dare she drink alcohol.

　　Then I'll go up there. . .I only measure a catty and a half, and when I drop it, I will finish the calculation.

　　Inner Mongolia...is a terrible place (Lanzhou people who have lived in the south for a long time are trembling)

　　
　
(End of this chapter)