My medical skills add experience

Chapter 23 The Terrible Counterfeit Drug

Director Lou found no useful clues after reading the medical records.

His eyes could not help but fall on the child.

"The sick child is 11 years old, with a body temperature of 39.7 degrees and a high fever. Shortness of breath, blood pressure dropped again and again, 86/54mmHg, heart rate 155/min."

Each of these basic data looks worrying.

The sick child is currently in an extremely dangerous situation. If the cause of the shock cannot be found out in time, he may die in the emergency room.

The doctor has fulfilled his duty of rescue, so he does not need to bear any responsibility.

But it can have a negative impact on the hospital's reputation.

Judging from the previous performance of the family members, the possibility of medical trouble is extremely high.

The faces of Director Lou and the attending doctor became more and more solemn, and a trace of anxiety appeared from between their brows.

"Have you done all the inspections that should be done?"

Doctors are human beings, not gods.

When experience and medical knowledge alone cannot diagnose the cause of disease, modern advanced medical equipment can only be used.

"This is the result of a blood test, as well as the films of the brain, chest and abdomen, and nothing abnormal was found."

There are many reasons for shock, such as hemorrhage in the abdominal cavity, brain tumors compressing important blood vessels and nerves, and so on.

Director Lou took the inspection list and checked it carefully, trying to find clues from it.

Sweat dripped from his forehead.

It gathers into the size of a mung bean and slides down from the forehead.But he didn't care to wipe it.

"According to the blood test results, the possibility of poisoning can basically be ruled out. Sepsis can also be ruled out. The X-rays taken can basically confirm that the sick child has no internal bleeding and no obvious brain damage. No, I have to ask the family members. How does the clinic treat it?"

Director Lou has rich experience, and there are problems with the medicines used in the clinic.

Of course, this is just suspicion.

"I have already asked, and the family members bought Ganmaoling Capsules for the child to take. Besides, following the doctor's advice in the clinic, the child was given plenty of boiled water, and no other treatment was done."

The receiving doctors are experienced and experienced, and the receiving procedures are also very rigorous.

Everything that should be asked clearly has been asked clearly.

Medication is fine.

"Small clinics like to give patients infusions the most. Are you sure you haven't given infusions to children?"

"The family said no."

Sometimes the words of family members may not be credible.

"Did you check the child's arm, arm?"

"After careful inspection, no needle marks left by the infusion were found."

This time it was a middle-aged doctor with dark skin and a thin figure who answered the question.This person looked very serious at first glance, because of frowning for a long time, a deep Sichuan-shaped line formed between his eyebrows.

His eyes are like knives, the sharpness pierces people's hearts.

"Doctor Xu has checked it himself, and there must be nothing wrong, so I don't need to read it again. The condition of this sick child is critical, so we can't delay any longer. Contact the internal medicine department and ask them to send a doctor over for consultation."

Director Lou made a decisive decision and decided to ask a doctor from the Department of Internal Medicine for consultation.

Internal medicine is called the mother of medicine. It is the definition of disease, etiology, pathogenic mechanism, epidemiology, natural history, symptoms, signs, laboratory diagnosis, differential diagnosis of imaging examination, pathological diagnosis, treatment, and prognosis. very professional.

When encountering this kind of shock whose cause cannot be found, I am afraid that only an internal medicine doctor can give a more professional diagnosis opinion.

"I have already called to request someone from my heart to come over for consultation, and explained that the patient's situation is urgent. I hope they can send a chief doctor over."

The nurse next to him whispered.

Director Lou was silent for two seconds, "How long have you been calling?"

"It's almost 15 minutes."

The nurse puffed out her cheeks and muttered.

The doctors in the internal medicine department have always been aloof and a little airy, so they are not easy to please.

The status of the emergency department is not as good as that of the internal medicine department, so it is okay to ask once or twice occasionally.The number of invitations is too many, and people are very impatient.

"Hush again."

Director Lou also knows that internal medicine doctors are hard to find.

It's just that human life is at stake, and the hospital has this mechanism.The emergency department was initially just an emergency diversion platform. When encountering such uncertain patients, you have the right to ask any doctor in the department for consultation.

Each department shall not refuse.

"Forget it, I'll call Director Tan!" Director Lou was worried that the nurse's reminder would be useless, so he simply put down his old face and called Director Tan in the internal medicine department himself.

Director Tan did not refuse, and promised to urge his heart to send a doctor over immediately.

Zhou Can practiced in Tuya Hospital for one year, and has rotated in several important departments.

He could feel some of the mutual disdain between departments.

Internal medicine is one of the two most powerful departments in the hospital. Almost all critically ill patients, as well as various cancers, leukemia, etc., need support from internal medicine.About [-]% of the medicines prescribed by pharmacies come from internal medicine.

Whether it is medical status or ability to absorb money, internal medicine is a well-deserved leader.

Cardiology is the ace department of internal medicine.

Ask the doctor in your heart to go to the emergency department, it's normal for people to put on airs.

The inner doctor is notoriously arrogant, after all.

Maybe I also want to use this method to gently remind the emergency department not to move around, and ask them to go to the emergency department if there is something serious, everyone is very busy.

Time passed in a minute and a second.

Zhou Can stared at the sick child who was still in shock.

His face was pale, but there were two sickly flushes on both sides of his cheeks due to high fever, no sweat, and his fingertips were cyanotic... These symptoms always seemed familiar.Should have seen it in a book.

It's just that I have read too many books, and I can't remember them for a while.

"Ask the family members, maybe you can gain something."

Zhou Can walked outside.

At this time, no one cared about him as a junior trainee.Director Lou just turned his head and glanced at him, then continued to study the blood test sheet.

Colds are prone to viral myocarditis and may also lead to shock.

It's just that it rarely happens to children.

Both filming and blood tests showed normal results.

Basically can be ruled out.

Zhou Can left the emergency room and went straight to his family members.

"May I ask who are Zhu Wenwen's parents?"

"I am the child's mother. Doctor, how is my son?"

"It's being rescued, and the situation is not optimistic. Has Zhu Wenwen been living with you recently?"

"That's right! My son is so good, I never thought that a cold would be so serious, woo woo..."

Zhu Wenwen's mother burst into tears as she spoke.

"Listen to me, the hospital is doing its best to rescue them. If you can provide some important information, it may be of great help to the rescue work."

Zhou Can patiently communicated with the family members.

"If you want to know what's going on, just ask, and I will definitely cooperate."

She looked at Zhou Can with tears in her eyes, and the only thing she could count on now was the doctor.

"After Zhu Wenwen caught a cold, are you sure he didn't get injections and infusions at the clinic?"

"Definitely not."

"Just took Ganmaoling Capsules?"

"Yes. I feed my son myself."

"How many pills did you eat in total?"

"Four pills. I took two pills last night, and took another two pills this morning. I took it strictly according to the instructions. It said, take two pills at a time, three times a day."

"Did you bring the rest of the medicine?"

"I brought it with me. I was worried that I would continue to take medicine for my son when I got to the hospital. I brought them all."

She dug out a small plastic bag from her bag, which contained a box of medicine.

After Zhou Can took it, he took it out to check.

On the box it says Ganmaoling Capsules, specially designed to treat headaches, stuffy nose, and runny nose...

No, why is it different from the pack of Ganmaoling capsules in the hospital pharmacy?

Look again, good guy, it turned out to be a counterfeit brand.

These years, pharmaceutical companies have also learned to ride the heat.

They will package similar drugs produced by themselves into well-known drugs in the market.

For example, the well-known 999 Ganmaoling Capsules.

This pharmaceutical company removed the three nines and hit the edge.

The manufacturer's information is all true.It's a drug company name I've never heard of.

Zhou Can is most concerned about the ingredients of the medicine.

All drugs on the market must undergo multiple reviews by the regulatory authorities.This cannot be faked.

Drug ingredients must also be truthfully declared.

"Tricornus bitter, wild chrysanthemum, caffeine, acetaminophen, chlorpheniramine maleate, mint leaves, talcum powder as an excipient."

The ingredients are exactly the same as 999 Ganmaoling Capsules.

I have to admire the copycat capabilities of these small pharmaceutical companies.

Take out the medicine inside, there are twelve pills in one version, only eight pills are left.

Explain that the child's mother did not lie.

The sick child took four pills.

In fact, the dosage above it is customized for adults. For children under 12, the dosage should be halved.

However, many parents worry that too little dosage will not work, and they usually choose to let their children take the dosage of adults.

Usually, there should also be a paper manual inside.

After Zhou Can took out the capsule, he checked and found a folded white instruction manual inside the box.

The above content is basically the same as the description on the box.

Ordinary consumers often don't bother to look at it.

Only professional medical personnel can see some different information from the instructions inside.

"This medicine contains a powerful ingredient called paracetamol, which provides fast pain relief and allows you to recover."

Just such a sentence similar to a slogan attracted Zhou Can's great attention.

What is potent?
Only increasing the dose can produce a stronger effect.

What is paracetamol?Ordinary people don't know it, but Zhou Can knows it very well.Acetaminophen and paracetamol are the same drug.

This also means that the acetaminophen content in this box of Shanzhai Ganmao Capsules is likely to far exceed that of the genuine 999 Ganmaoling Capsules.

In order to seize market share, small pharmaceutical companies increase key drug ingredients and enhance drug efficacy, which is a common trick.

As for the safety of patients, the unscrupulous bosses don't care.

As long as it doesn't kill people and cause serious consequences such as disability, then it's fine.

"I know that the sick child is likely to be allergic to paracetamol or overdose, which leads to shock and is critically ill."

Zhou Can's heart brightened.

No wonder I always feel that the symptoms of sick children seem familiar, and I have seen similar descriptions in a medical book in the library before.

I didn't expect to encounter a case today.

[Pathological diagnosis experience value +1. 】

Experience points arrive on time.

It appears that the cause of the sick child's shock was an overdose of acetaminophen.

"This time, there is no need to ask the emperors from the cardiology department."

Zhou Can is now a doctor in the emergency department, and honor and disgrace are bound together with the emergency department.

He is very happy to help the emergency department.

"Thank you for your valuable information. This box of medicine is not genuine. I'll take it to test the ingredients of the medicine first." Zhou Can explained a few words to his family members and returned to the emergency room excitedly.

After entering the door, he found that the 'emperor' of the cardiology department had finally arrived.

Is a 35-year-old young doctor.

Judging by the situation, it should have just arrived.

The condition of the sick child is being checked.

Being so young, he must not be the chief physician.The heart probably sent a random doctor over on an errand.

"If you have a cold, you need to ask the doctor in your heart for consultation. Don't you emergency doctors usually read books?"

This person had a cold face, he didn't find out the cause of the disease, instead he first taunted the doctor in the emergency department.

The doctors in the emergency department were all full of anger and dared not speak out.Now that you need help from others, you must be patient.

"Judging from symptoms, heart rate, blood pressure, blood oxygen and other indicators, the patient's shock state is not particularly serious. It will not be life-threatening for the time being. Show me the blood test report."

The bossy tone made people feel uncomfortable.

It is not appropriate for Director Lou to hand over the inspection report in person.Especially in this person's tone of commanding servants.

Just imagine, is it appropriate for the emperor of a country to deliver documents to the courtiers of the other country like a servant?

Although the status of the emergency department is low, it is not so humble.

Zhou Can is preparing to step forward to be the delivery person.

Unexpectedly, the nurse girl took the lead.

She naturally took the inspection report from Director Lou and handed it over.

"Doctor He, this is the blood test report of the sick child."

After the other party takes it, check it carefully.No valuable information seems to be found.

"Have you ever filmed it?"

"I took color Doppler ultrasound and CT, and found no problem."

Handed over the film too.

Dr. He checked each one carefully, but still found nothing.

In fact, doctors in the Department of Cardiology can't be too mythical, basic medicine, everyone's level is not much different.

If you look at a film, you won't even look at the results of a blood test, and you won't be able to stay in Tuya Hospital.

"Doctor He, have you found out the problem?" Director Lou asked.

Now he is most concerned about how to save the patient.

"Don't worry, the patient's situation is a bit complicated, I have to think about it again." Dr. He's tone was too high just now, he put himself on the top, and couldn't get off.I can only hold on.

"Hehe, even Dr. He in his heart has to think hard to diagnose the cause. It seems that this cold is not simple!"

A simmering emergency doctor fired.

I don't know how to ridicule, just irony.

After all, when Dr. He first came in, he choked on them very arrogantly. Even if you have a cold, you have to ask the doctor in your heart for consultation. Has the doctor in the emergency department not read the book?

"I'm not saying it's difficult, it's just that it's a bit complicated, and the diagnosis needs to be more rigorous." Dr. He is still stubborn.

(End of this chapter)