medical road high rise

Chapter 457 Lifesaving Medicine
Chapter 459 Lifesaving Medicine
"What's the patient's condition?" Qin Feng asked.

"I don't know yet. I was originally going to have surgery, but it ended up like this after being given anesthesia." The doctor on the side explained.

Is it like this after taking anesthesia?
"Isn't it malignant high fever?" Qin Feng's eyes widened.

Malignant hyperthermia has a very low incidence and only appears when exposed to anesthesia. It is one of the most feared hidden dangers in the anesthesiology department.

And this disease is a hereditary disease characterized by hypermetabolism. It will be triggered when the patient is exposed to certain anesthetic drugs. Non-depolarizing muscle relaxants can delay the onset.

"How is the patient's metabolism?" Qin Feng asked.

"Exceeding 20% ​​of the normal metabolic rate." said the intern monitoring on the side.

There is a simple calculation formula for the basal metabolic rate of normal people, that is, heart rate plus pulse pressure minus 111, which is the basal metabolic rate, which is generally expressed as a percentage. It is the basic level of normal metabolism.

But this patient has already reached 20%. Far from this value, the patient is undoubtedly a hypermetabolizer.

"Stop the anesthetic first, and then go find Dantrolene." Qin Feng roared.

The other doctors were still a little confused, but the doctors in the anesthesiology department quickly responded.

Dantrolene, the most serious disease that this drug targets is malignant hyperthermia!

The anesthesiologist quickly stopped the anesthetic, and then asked, "Doctor Qin, does the patient have malignant hyperthermia?"

"Probably yes." Qin Feng checked the patient's condition again. Severe convulsions, spasms, skeletal muscle stiffness, etc. are typical symptoms of malignant hyperthermia.

However, there is no way to prevent this symptom. At present, the only doctor in China who has researched on malignant hyperthermia is Kyoto Xiehe, and the largest production place of dantrolene is Xiehe.

"Have someone contact Xiehe and transfer the patient there." Qin Feng said seriously.

People went to Ruijin Hospital to look for it, but Qin Feng didn't have much hope for it. Hospitals purchase medicines according to standards. Dantrolene is expensive and has little practicality. Very few hospitals purchase it.

After the arrangements were made, Qin Feng took over the patient rescue command.

"Increase the oxygen flow first, and let the patient inhale oxygen through the mask."

"Intravenous injection of iced saline must be done to cool down."

Qin Feng sent out instructions one by one, and Qin Feng's throat was a little hoarse.

The medical staff who were yelled at didn't complain. It was an emergency to save lives. Everyone had forgotten their thoughts. The most important thing now was to save the patient.

"Come here, let's do some physical cooling. Where's the head nurse?" Qin Feng turned his head, but he didn't find the head nurse.

"Here we come, here we come." The head nurse of the emergency department hurried over and took over the nurse's command.

In some details, the head nurse is more reliable than the doctor's command, and what Qin Feng can do is to control the overall situation.

Qin Feng roared, seemingly crazy, but in fact he was extremely careful, always calmly observing the patient's ECG monitoring, as well as the patient's vital signs.

The patient's ECG initially showed a shortened QT interval, high-pointed and symmetrical T waves, and a narrow and tent-shaped base.

A change in the electrocardiogram caught Qin Feng's attention. The P wave amplitude decreased, the PR interval lengthened, and the P wave disappeared. This is a typical manifestation of hyperkalemia. Although the test has not yet appeared, with this ECG and his own Based on his experience, Qin Feng was able to confirm that the patient's blood potassium value had exceeded 8mmol/, and might even have reached a lethal level.

"Calcium gluconate static push 4g." Qin Feng shouted.

Because calcium gluconate can correct acidosis, lower blood pressure, and inhibit myocardial function, it can correct the damage caused by hyperkalemia.

"Dr. Qin, there is something wrong with this dosage. The maximum dosage is 3g!" the doctor reminded.

"The patient's P wave is gone, and the heart is in sudden arrest. You are still talking about this with me, listen to me, I will be responsible for the accident!" Qin Feng pointed to the ECG monitoring screen and roared.

Generally speaking, if there is a sudden cardiac arrest, defibrillators or external cardiac compressions will be used to rescue.

But for patients with malignant hyperthermia, the defibrillator has no effect at all, because the patient's whole body is stiff, and the chest is like a stone, and it cannot be pressed at all.

In fact, Qin Feng has a method in mind, but it is too extreme, and Qin Feng will not use it unless he has to.

The head nurse quickly arranged for the nurse to push 4g of calcium gluconate statically.

"How much is the patient's urine output now?" Qin Feng asked suddenly.

The busy medical staff on the side were stunned, and finally the anesthesiologist took a look at the urine bag.

"20ml."

"Intravenous injection of furosemide, 60mg, ensure 50-100ml/hour." Qin Feng said, "At the same time, hyperventilate."

Director Zhao heard about the situation here and rushed over. He was relieved to see Qin Feng here.

But when Qin Feng asked for the amount of medicine, his face couldn't help but tremble. Any excessive dosage would be fatal if not careful.

Fortunately, Qin Feng's majesty in the emergency department is enough, and not many people doubt him. Basically, they do what Qin Feng says.

If I want to change to a new doctor, I am afraid that I will be driven crazy by repeated questions, even if I have a good idea, I will not be able to implement it.

Fortunately, under a series of operations, the patient's body temperature dropped to 38.5°.

It's just that dantrolene is the most important thing. Ruijin Hospital does not have a stock of dantrolene, and the reason given by Xiehe is also very realistic, that is, the day lily may be cold when the patient is sent here.

The distance between Shanghai and Kyoto is still too far.

Without dantrolene, what Qin Feng is doing now is useless. Now he can only maintain it. It is time-limited. Once the patient's physical condition collapses, it will directly lead to death, and there is no chance of rescue.

"Is there a shortage of medicine now?" Director Zhao asked.

"Well, if you lack Danqu Lorraine, you can live with Danqu Lorraine, and there is no certain death." Qin Feng said.

"I'm going to make a call." Director Zhao took out his mobile phone and called the leaders of the major hospitals in Shanghai.

"There is medicine. The No. 10 Hospital of Shanghai has medicine in stock. It has been delivered, and it will arrive in about [-] minutes." Director Zhao said excitedly.

Qin Feng was also relieved to hear that there was a medicine. Sure enough, a hospital still purchased the medicine.

"Contact the ICU and get ready to receive patients." Qin Feng said.

It is necessary to notify the ICU in advance, and prepare a large amount of iced saline and related rescue drugs in advance, so as to ensure that patients can be treated in time when they are transferred.

Qin Feng looked at the patient who was still slightly twitching and trembling, and he was also relieved. If he had the medicine, he would not be afraid.

5 minute later.

A doctor wearing a dark green emergency rescue suit and a surgical gown rushed in.

"Dantrolene has arrived!"

Qin Feng was stunned for a moment, didn't he say it would take 10 minutes?
The moment he saw the dark green rescue suit clearly, Qin Feng understood that the rescue team was dispatched.

(End of this chapter)