I can see the status bar

Chapter 612 Intrathecal Injection

Although he said some beautiful words, even Liu Tangchun couldn't guarantee that his group could really take back even one patient's life from the hands of death.

The eight patients who were still alive were all transferred to the same large ward for centralized care, and the Chinese medical team was also divided into two groups. Chen Tianyang brought three doctors from the surgical direction to the camp for assistance.Four doctors, together with Sun Li'en, Liu Tangchun and Hu Chunbo who were already in the camp, seven doctors and one nurse to take care of eight patients, logically speaking, the manpower is already sufficient to the point of luxury.

But... under this level of supervision, the patients still died one by one.By night, three of the eight patients had died of brain herniation attacks.There are five patients left in the entire ward.

When they are in the hospital, doctors also have to face this kind of sad thing that patients keep dying.But this kind of thing where three people died in a row within a few hours is still too "exciting".Even Chen Tianyang felt an inexplicable annoyance - obviously the diagnosis was correct, and the treatment plan was also correct.But the patients died one by one, which had a great impact on the doctors.

"If I didn't do my homework before I came here, I would almost feel that Sun Li'en's diagnosis is wrong." Chen Tianyang sat in the corner, drinking a cup of cold green tea in his hand, "This is too fast to die .”

"After an acute attack, the mortality rate is extremely high and the prognosis is extremely poor... These are all things that have been written in the literature. But only after personal experience can we understand what these two 'extremes' mean." Hu Chunbo was also a little depressed. For the doctor's self-esteem, there are probably still some residues that can't see the original shape.And they were so broken that they could not be scooped up with a spoon for half an hour while kneeling on the ground.

"Being a doctor, that's it." Liu Tangchun stretched his waist, and he was exhausted after repeated chest compressions failed, "Don't think that you can save every patient. Do your best. One can save one."

"There is no effective means at all. We can't even say that we are doing our best." Chen Tianyang has a different view on this. As a surgeon, he has long been used to controlling the situation as much as possible.I can't get used to the emergency department's attitude of "doing everything you can to know your destiny". "Besides pressing on the chest for 10 to [-] minutes when their brain herniated, and breaking a few ribs by the way, we have to think of other ways?"

"How about a preventive craniotomy?" Sun Lien sat on the ground panting for a long time before raising his hand to try to speak, "The intracranial pressure of these patients rises too fast, even if mannitol is used, it can't stop the intracranial pressure Ascent. As a precautionary measure, would it be okay to remove a piece of their skull first to relieve the intracranial pressure?"

"It's not just the obstruction of cerebrospinal fluid flow in the ventricles that causes them to have elevated intracranial pressure, but also a brain-wide inflammatory response." Hu Chunbo shook his head, "Simply taking out the skull bone flap is not very effective."

"Then add hormone shock therapy. Suppress the inflammatory reaction first." Sun Lien shook his noodle-like arms, half serious and half angry, "I have to die before them!"

As the lowest professional title in the entire medical team, he is also the youngest emergency doctor.During the rescue process, Sun Li'en did his part and became the main force in the rescue.Work such as chest compressions is all done by Sun Lien.Other doctors rotate around.But I don’t know if it’s because of professional habits. Anyway, after seeing the chest compression posture of other doctors, Sun Lien got up from the ground angrily and continued to fight for a position to do compressions—their posture was too substandard.

The result of occupational diseases is that Sun Lien is currently as tired as a salted fish.If Hu Jia hadn't been cheering Sun Lien by the side, and at the same time staring at the mask on his face, Sun Lien really wanted to take off the mask and lie on the ground to sleep.

Since you can't rest completely, you can only find solutions to the problem from other angles.Sun Li'en half-lyed on the ground, and gave his own solution, "Use a large dose of hormones to control the inflammation of the whole brain, and cooperate with a craniotomy to release the intracranial pressure. Use two prongs to buy time for the amphotericin B to take effect."

"It's possible. But what is the amount of hormones? Methylprednisolone 1000mg?" Chen Tianyang shook his head, "We have no experience in shocking Americans with hormones."

Liu Tangchun raised his eyelids and glanced at Chen Tianyang, "Before you came to Africa, did you have any experience in treating black people?" He shook his waist, and said to Sun Li'en beside him, "Go and call Dr. Pascal and ask. His opinion—he is better at developing immunosuppressive regimens." Then, he turned his head and said to Chen Tianyang, "Do you have experience in opening people's heads?"

"Is it really open?" Chen Tianyang asked in surprise, "How about the procedures?"

"There was no procedure for rescue before. Humanitarian aid, just come as long as it is good for the patient." Liu Tangchun waved his hand and said, "If you are not sure how to open the skull, then call Yourong and ask her. The human head is a good hand."

·
·
·
Dr. Pascal was taken aback on the phone, "Have you discovered... more than 20 cases of primary amebic meningitis with concentrated onset?"

"More than 20 people have died. After we made a clear diagnosis and proved that the diagnosis was correct, three more patients died of brain herniation caused by increased intracranial pressure." Sun Lien sighed on the phone, "Now The situation is very urgent, and we must find a way to curb their brain-wide inflammatory response as soon as possible. Otherwise, the remaining five patients will not last long-if there is no way, I suspect that none of them may see the sun in the morning after tomorrow .”

"The systemic hormone shock is a solution." Dr. Pascal immediately began to use his brain after hearing Sun Lien's request, "Did you bring antimalarial drugs this time? I mean dihydroartemisinin."

"I have." Sun Lien replied with some confusion, "But their symptoms have nothing to do with malaria."

"Dihydroartemisinin also has a suppressive effect on the immune system." On the other end of the phone, Dr. Pascal explained, "It's better for you to take 800mg methylprednisolone directly, and then combine it with dihydroartemisinin to do the suppression plan. This combination The regimen is safer than simply using artemisinin or methylprednisolone, and it works a little faster."

After confirming that Sun Lien had written down the plan, Dr. Pascale continued, "I recommend intrathecal injection of methylprednisolone, which will have a better effect on the nervous system."

"We have already injected the patient with amphotericin B intrathecally." Sun Li'en seemed a little embarrassed, "Another 800mg of methylprednisolone... this dosage will cause accidents, right?"

"The dosage for recovery is 20mg slow injections each time, and the dosage can be increased to 40mg when fighting Sjögren's syndrome." Dr. Pascal said helplessly on the other end of the phone, "The total amount of cerebrospinal fluid in the human body is more than 100 milliliters and less than 40 milliliters." , intrathecal injection of [-]mg and then intravenous infusion."

(End of this chapter)