I can see the status bar

Chapter 706 Epic Healing (4)

A patient who fell from a building more than 40 meters high for eight hours should not have symptoms of acute alcoholism, no matter from the perspective of physics or botany.

Even though he has been used to the status bar for almost two years, Sun Lien still maintains the habit of "going through his head first" for all the prompts on the status bar.And this habit played a vital role at this moment - it only took him a few seconds to realize what happened to Zhang Junyi now.

Before falling from the building, Zhang Junyi drank a lot of wine.Even if only counting what Sun Lien saw, his drinking volume should be more than 700 milliliters.

Eight hours, for an ordinary adult, it is not too difficult for the liver to metabolize the alcohol.But Zhang Junyi's situation is completely out of line with "ordinary".

The fall injury caused him serious trauma and internal bleeding.The body's self-protection mechanism will allow the blood in other parts of his body to concentrate on the core as much as possible, giving priority to ensuring the blood supply to the lungs, heart and nervous system.

During this period of time, the digestive tract was in an almost static ischemic state. In addition, the anesthetic drugs had an inhibitory effect on smooth muscle during the operation, so his digestive tract was basically in a non-working state.

Absorption of alcohol and food stored in the gastrointestinal tract is suspended due to the mobilization of the digestive tract.The ethanol that has entered the blood system is replaced by internal bleeding and massive blood transfusion.Therefore, during the operation, only craniocerebral injury caused a certain degree of trouble to the work of anesthesiologists.Alcohol has little effect on treatment at this stage.

As the operation continued, Zhang Junyi's vital signs gradually stabilized.The large amount of plasma and blood products brought his body back to a certain level of balance.Narcotic drugs are gradually metabolized through the liver, and the operation of the digestive tract is slowly restored, which causes alcohol to enter the internal circulation through the digestive tract again.

When the ethanol content in the blood of a normal person rises, the liver will start to metabolize it rapidly.But... Zhang Junyi doesn't have this condition now.

More than 35 percent of his liver had been removed, which basically meant that his body's ability to metabolize ethanol had dropped by that much.What's worse, the rest of the liver is very busy right now.

A large amount of sodium citrate injected into Zhang Junyi’s body needs to be metabolized in the liver. The metabolites of cells damaged by trauma need to be metabolized by the liver. The drugs used by the anesthetist during the operation need to be metabolized by the liver. Even the antibiotics injected prophylactically during the treatment It is also metabolized by the liver.

Now another ethanol...that's throwing two more bales of straw on an already overwhelmed camel.Zhang Junyi's body can bear it, it's called hell.

Sun Li'en was a little confused. Although he had dealt with many seriously drunk patients in the emergency department, he was really not sure how to deal with such seriously injured patients after acute alcohol poisoning.

But this was enough for Sun Lien to warn. He pulled Wu Faxian, the director of the Department of Critical Care Medicine who was busy, from the crowd, and whispered his "discovery".Of course, in order not to shock the world too much, the reason he used was "I saw him drink a lot of wine before he fell from the building".

Director Wu looked at the patient lying on the bed covered in tubes in disbelief, and then muttered a few dirty words in a low voice.

It's not that ICU has never seen patients sent to the hospital because of drunkenness.However, such patients are generally admitted to the hospital due to cardiovascular and cerebrovascular accidents caused by drunkenness.Injured from falling from a high altitude combined with alcoholism, even Director Wu was a little dazed for a while.

Drunkenness does not cause too much direct damage to the human body, at least there is basically no damage that will lead to serious consequences immediately.It affects the patient's central nervous system, puts pressure on the digestive tract, and damages the liver in the process of metabolism.But in general, patients with acute alcoholism are generally not in immediate danger of life.The biggest risk for drunk patients is that after the central nervous system is inhibited, vomit may block the airway.

But Zhang Junyi, who is already receiving mechanical ventilation, obviously does not have this problem.Even if an opioid overdose suppressed his breathing, mechanical ventilation would keep him from suffocating himself.From director Wu's point of view, the symptoms of acute alcoholism are at best a troublesome disturbance, not enough to kill quickly.

But it is not enough to kill quickly, it does not mean that it will be as harmless to humans and animals as a two-month-old white sheep.For Zhang Junyi, whose half foot is still in the gate of hell, acute alcoholism is also a dangerous beast that can kill him.It's just that compared with other symptoms, the start-up action of this beast will be slightly slower.

"Please come to the anesthesiology department for consultation." Director Wu thought for a while and decided to ask foreign aid to help immediately.Conventional methods of dealing with drunkenness are not suitable for Zhang Junyi - naloxone is an antagonist against the inhibition of the central nervous system.It can quickly reverse the current situation of the drunken central nervous system being suppressed, but it does not help in reducing the burden on the liver.Rather, it puts even more stress on an already overwhelmed liver -- naloxone itself is metabolized and inactivated in the liver.

For the ICU, it is beneficial for Zhang Junyi to remain under anesthesia.His body has suffered too many serious traumas, if he is allowed to wake up now, that Zhang Junyi will definitely struggle continuously because of the severe pain.This kind of struggle will affect the support of his vital signs, and it will be even more fatal if two tubes are accidentally pulled out.

The treatment of acute alcoholism is generally based on symptomatic treatment and treatment to promote alcohol metabolism.The liver damage and heavy load made Zhang Junyi's body unable to tolerate the alcohol metabolism-stimulating treatment, so the only way left now is symptomatic treatment.

This is the reason why Director Wu asked the anesthesiology department for consultation - he is going to perform liver replacement therapy for Zhang Junyi, and if the situation continues to deteriorate, he may even have to undergo plasma replacement.

However, liver replacement therapy and plasma exchange will cause Zhang Junyi to quickly escape from anesthesia.This is clearly detrimental to further treatment.How to maintain a state of anesthesia while being treated, and at the same time not add more other burdens to his body.The trade-off requires not only professional knowledge, but also rich experience in vital signs maintenance.

Biochemical magicians have a wealth of experience in maintaining vital signs, but... they are not sensitive or sharp enough. The treatment in the ICU is relatively rough and direct than that in the anesthesiology department.Dialysis for renal failure, replacement for liver failure, ECMO for cardiopulmonary failure... All in all, they have rich experience in dealing with unexpected situations.But in avoiding these unexpected situations, the ICU's ability is much weaker than that of anesthesiologists.

Dr. Li Tianfeng, deputy director of the Department of Anesthesiology, arrived at the scene 3 minutes after the consultation request was sent.Then he faltered and began to guide the rescue. Seeing that the situation here had basically stabilized, Sun Lien heaved a sigh of relief and went back to the operating room floor to find Hu Jia.

While waiting for his girlfriend at the door of the operating room, Sun Lien suddenly realized that Christmas had passed.It is now December 26, 27:[-] in the morning.

When Hu Jia appeared outside the operating room, Sun Lien hugged his girlfriend with some distress, and then rubbed her head vigorously, "The patient has stabilized... Well done, thanks for your hard work."

(End of this chapter)