Auto chess in the operating room

Chapter 41 Your Rehydration Solution Is Wrong

"It does not make sense!"

Tang Lou put down the phone and received a WeChat friend request:
The two are just right, please add you as a friend, note: Cheng Sisi.

Tanglou immediately clicked through. Cheng Sisi's avatar was a four-frame avatar of the Wangfu band.

Tanglou did not expect that Cheng Sisi would also like the Wangfu band. In the most popular variety show "Summer of the Band" recently, besides Mr. Turtle and Hedgehog, Tanglou's favorite was Xiao Wangfu.

Some people think Wangfu Band is very childish, and the lyrics are very simple, but Tang Lou likes the cheerful, optimistic, uplifting, silly, but very cute they always give.

Whenever Tang Lou was unhappy, he would listen to Wangfu and soon healed.

Tang Lou sent a smiling emoji + hello.

After a while, the other side sent a location, and then just replied with three words: See you soon
Tanglou looked at the time and saw that it was almost three o'clock in the afternoon, so he clicked on the location: Hecheng City No. [-] Hospital. After checking the time, it was about half an hour's drive away.

I just clicked on the Didi software. There are not many cars in the town. It took more than ten minutes for Tang Lou to get in the car.

I took out my phone, clicked on two chachas, and replied: I will arrive at about 45:[-].

It took a long time to receive a reply, which was very cold: good.

Soon Tang Lou came to Hecheng No. [-] Hospital, which is the only tertiary general hospital in Hecheng.

In comparison, the county hospital where Tang Lou is located is only a first-class hospital, with a total of less than [-] beds. When doctors from the county hospital come to communicate, there will always be the embarrassment of Grandma Liu entering the Grand View Garden.

Looking at the No. 250 Hospital with a site of nearly [-] mu, it is impossible not to be envious, so Tang Lou took the time to catch up on the main road.

The entire campus comes in from the north gate, and all the way from Building [-] to Building [-] are the eye-catching emergency building, several inpatient departments, and the outpatient hall.

Tang Lou walked to the second inpatient department according to the location guide, and took out his mobile phone: I arrived at the second inpatient department, after that?
After a while, I received a voice message. It should be very busy and I don't have time to type.

After Tang Lou opened it, he heard a familiar refreshing female voice.

The two are just right: I'm on duty now and can't leave. Come up by yourself. It's on the far right side of the third floor, duty room 3301.

Tang Lou took the elevator all the way up and walked in the corridor. The corridor of the inpatient department of the First Hospital is much brighter than that of the County Hospital. You can faintly see a few wards with the doors open for ventilation, and you can see various patients in different conditions.

Cheng Sisi's duty room is at the end of the corridor.

"Boom boom boom!"

Tang Lou knocked on the door, and soon a girl with a ponytail came out. Seeing the handsome and tall Tang Lou, she looked her up and down.

Showing a reasonable expression, he said inwardly: "Good old Cheng, you are using public affairs for personal gain. Do you think you can impress your precious daughter with a handsome face? It's far behind. What this girl likes is talent."

Being scrutinized by a beautiful woman would make a normal boy blush, but a handsome guy like Tang Lou is used to it.

Looking at Cheng Sisi generously, he smirked professionally: "Cheng Sisi?"

"Well," Cheng Sisi was slightly surprised when she felt Tanglou's calm gaze. After all, she was also very good-looking, a top student, and had long legs. It was surprising that she could be so calm under her gaze. It's also rare to say, "I've printed out the information you want. Come in with me."

Cheng Sisi turned around. Although she was wearing a white coat, she could still see her slender figure clearly. Since she was a doctor, she didn't have that kind of random perfume on her body, but gave off a clean and pure aura.

Cheng Sisi walked to the desk. There was a stack of printed A4 papers spread out on it. After thinking for a while, Cheng Sisi cleared out a paper bag and packed the materials in it. Medical tape sealed the opening.

Picking it up and comparing it: "It won't fall out like this, here, here you are."

"Thank you." Although Tang Lou met Cheng Sisi for the first time, he was very grateful for the kindness of others, and took it with both hands.

The two noticed each other's hands at the same time.

Cheng Sisi's hands are as good-looking as Tang Lou's, straight and long, it's a pity not to use them for surgery!
"Well, my dad praised you, I hope you won't let him down in the training camp."

Cheng Sisi said candidly, and then looked at the time: "I'm going to do rounds, so that's it, see you at the training camp."

"Well, see you at the training camp." Tang Lou didn't intend to strike up a conversation any longer, Society smiled and walked out of the duty room.

Immediately afterwards, Cheng Sisi also picked up the folder and walked towards the ward with long legs.

"Tap Tap!"

Suddenly in the corridor, there was a rush of footsteps from the front room, and a little nurse ran over and shouted to Cheng Sisi while running: "Dr. Cheng, the 40-bed patient needs rehydration. Come take a look and decide on a rehydration plan."

"Rehydration plan?"

Cheng Sisi frowned. Rehydration is to replenish the amount of fluid lost by patients, such as fever, vomiting and diarrhea, various fistulas, gastrointestinal decompression, etc., as much fluid as is lost must be replenished.

Of course, rehydration is not just a simple supplement of normal saline, but also potassium, calcium, amino acids, etc. In short, it is a brain-burning thing that requires accurate calculations.

"Okay, take me to have a look."

Although Cheng Sisi is a top student, she is an intern after all. She has only learned about rehydration in class and knows the normal value.

"In fact, it is based on the standard value and adjusted to this value."

Cheng Sisi comforted herself, then followed the little nurse to bed 40.

"Replenishing fluid? As expected of the No. [-] hospital, it can meet all kinds of situations."

Tang Lou was also very interested, and it was the first time he encountered a case of rehydration. As a doctor, his instinct was to follow suit.

Cheng Sisi naturally noticed Tang Lou, and looked at him in surprise: "Aren't you going back?"

"Doctor Xiao Cheng, you know that I am also a medical student, and this is the first time I have encountered a case of rehydration, so I want to see and see, don't mind."

Tang Lou asked sincerely.

"Well, let's go. Then you just watch." Although it was Cheng Sisi's first time, she must not lose her momentum in her own territory, and acted like a big sister, leading her little brother from the countryside to see the world.

The patient was a 40-year-old uncle who had just undergone laparoscopic radical gastrectomy for distal gastric cancer. He lost body fluid during the operation. He underwent subhepatic drainage not long ago, so he urgently needed to replenish body fluid.

"Patient records."

Cheng Sisi's face was a little solemn. The patient's condition was a bit complicated. The little nurse took the medical record and Cheng Sisi looked at it carefully.

On the other side, Tang Lou also glanced over:
[Patient: Zhou Zhou, male, 63 years old

Symptoms: Preoperative prophylactic antibiotics 100ml, intraoperative rehydration 1100ml, intraoperative fluid loss: about 300ml, postoperative body temperature rise, body temperature 39.5 ℃, 350ml of light bloody fluid in subhepatic drainage, 800ml of light yellow urine in indwelling catheter

Diagnosis: The patient urgently needs rehydration, and the plan is as follows:
液体量为 48ｘ80+[(39.5-37)ｘ4ｘ80+350+300]2-100-1100 = 3365 ml；

补钠{[(142-120)ｘ80ｘ0.6]17}3 = 21（g）；
Potassium supplement Moderate potassium deficiency supplement 10 g;

The daily requirement of glucose is 160 g;

Amino acid 96 g;

Triglycerides 56 g.

Requires 1 10 ml trace element injection
Special attention: 1. If the body temperature is higher than 37°C, add 3~5ml/Kg for every degree of increase. 2. Supplement according to 1/2 of the lost amount on the first day, otherwise the patient's heart will not be able to bear it. 】

After Cheng Sisi returned the case to the nurse, she began to calculate on the ward round paper. After 5 minutes, she finally came up with the answer, but some of it was not very sure.

Looking at the plan on the paper, when he was hesitating whether to press this, a magnetic voice came from his ear, calm and sure:

"Dr. Xiaocheng, your plan is wrong. The patient will not be able to bear the rehydration!"

(End of this chapter)