bookpower Chapter 554
Chapter 554
It's really a hammer.
Zhao Jiajia took illness as an excuse to see Lin Feng, but he didn't expect to really see the disease.
A simple cough of chest pain led to the diagnosis of a dangerous pneumothorax.
This may be a kind of luck.
Zhao Jiajia and her friends came to the X-ray room, because the emergency department did not have to queue too long, so the results were quickly obtained.
· Chest X-ray: extremely low density gas shadow in the pleural space of the right lung, accompanied by varying degrees of compression and collapse changes in the right lung tissue.
Compression degree 90%!
"It's really a pneumothorax!!"
Zhao Jiajia couldn't help but be afraid in her heart.
Fortunately, the pneumothorax is not serious, if she does not come to the hospital on a whim this time, I am afraid that she will keep delaying, and finally find the pneumothorax, I am afraid that it will be dangerous at that time.
Zhao Jiajia returned to Lin Feng's consultation room, waited for a patient to finish seeing, and squeezed in.
"Doctor Lin, the chest x-ray was taken... It's a pneumothorax..."
"I'll see... The situation is not very serious..."
Lin Feng nodded.
Sure, it's a pneumothorax.
Then the question arises:
What are the causes of pneumothorax?
Primary (can't find the cause)?
Or is it secondary (the cause can be found)? Lung disease, leading to perforation, gas running to the diaphragm ...
Or special pneumothorax: Yue menstruation, pregnancy, trauma (car accident, etc.), spontaneous elderly ...
Let's get rid of the simpler ones first...
First of all: exclude pregnancy pneumothorax, because this patient Jiajia is still a student, and the possibility of pregnancy is very low.
And then there is: Yue meridian pneumothorax.
Lin Feng: "Did you have a painful cough before?" "
Zhao Jiajia: "Yes, yes, yes... But it will get better soon..."
Lin Feng: "Did you appear during the Yue Jing?" "
Zhao Jiajia: "Ah............ This one...... I want to think..."
Zhao Jiajia thought about it, and felt really close to Yue Jing, as if every time he coughed chest pain, it was when Yue Jing came.
This time, too.
The day before yesterday came Yue Jing.
"It seems to be..."
"That didn't run, it should be Yue Jing pneumothorax..."
The detailed pathogenesis of Yue menstrual pneumothorax is not fully understood, but it is only known to be related to endometriosis (that is, the endometrium runs to the chest) and diaphragm holes, resulting in spontaneous pneumothorax with repeated attacks of the Yue menstrual cycle.
"This disease ... No other tests for the time being, I'll prescribe you some cough medicine... If the next pneumothorax cough does not occur within 72 hours before and after Yue menstruation, come to the hospital again to check if it is another cause..."
"In addition, your disease, whether it is playing games with your boyfriend or being pregnant, it will be a bit troublesome... You go back and look it up. "
Lin Feng didn't say carefully,
Emergency, hurry!
End of diagnosis,
Zhao Jiajia left the consultation room a little lost in soul.
She was also glad that she found pneumothorax early and could be effectively treated, but she did not expect it to be Yue menstrual pneumothorax.
This disease, she happened to be in the last class teacher said that this special case, more troublesome disease, will affect the future.
......
Just after diagnosing this patient,
Preparing for the next patient,
The front desk nurse came to find Lin Feng.
"Doctor Lin, the 120 ambulance is still 1 minute to go here, it's an old man, unconscious..."
Lin Feng: "Well..."
rise
Go to the emergency department and wait.
Soon the ambulance arrived.
The patient is an elderly family with an estimated age of more than eighty
Coma state...
Eye pupils to light: no problem, sensitive reflexes
Lin Feng asked while pushing the cart to the rescue room.
"What's going on?"
The grandson of the family replied in a panic: "At noon today, the old man had a banquet with someone, and then returned home to take a nap, and then he couldn't wake up no matter how he screamed..."
Lin Feng: "Did you drink?" "
Family grandson: "Didn't drink ... My dad can't drink, he will have a serious allergy..."
Lin Feng: "Do you have any medical history?" Three highs..."
Family grandchildren: "Diabetes, high blood pressure..."
Lin Feng: "Do you take medicine regularly?" "
The family members and grandchildren nodded repeatedly: "Yes, there are ... My dad is still very afraid of death, and he takes medicine very regularly...! "
Lin Feng was surprised.
He was just wondering if it was a cerebral thrombosis caused by high blood pressure or high blood sugar caused by diabetes.
As a result, medication is regular.
"How much lunch is there?"
"This is not clear... But it seems that my dad said that he should have eaten a lot..."
Lin Feng nodded,
Ate a lot of meals,
Could it be ketoacidosis caused by diabetic hyperglycemia, or hyperosmolar coma?
"Xiao Ai, blood glucose meter, take a blood sugar test for him..."
Soon, little Eza made a finger.
The blood sugar is out.
・The blood sugar is only 1.1mmo/l!
Lin Feng: "........."
A little surprised.
Lin Feng thought it was high blood sugar, but he didn't expect it to be low blood sugar.
That's weird!
Diabetics, generally high blood sugar, almost impossible to hypoglycemia!
Very weird!
"It should be a coma caused by hypoglycemia..."
"Push him a high sugar (50% high concentration glucose), 40ml..."
Lin Feng still quickly gave medical advice.
"Yes!"
Next
Just wait.
High sugar is very sticky, pushing the syringe is still a little difficult, after a few pushes you are tired.
After high sugar enters the bloodstream, it becomes blood sugar, then travels all the way down the vein to the heart, and then circulates the aorta to transport it to the whole body, supplying the whole body with energy consumption.
More than 10 minutes later...
The patient's old man woke up slowly.
"I... Where is this? "
Looking around, he looked confused.
The grandson immediately hugged his father happily.
......
Lin Feng left the consultation room.
Just now, this elderly patient should be a coma caused by low blood sugar.
But
Why do diabetics have low blood sugar?
There is only one answer!
The old man injected an overdose of insulin!
Elderly people, dizziness, overdose when injecting insulin is also possible.
......
At this point,
Outside the emergency department,
Several family members, pushing an old lady with crooked corners of her mouth, probably in her 90s, consciously walked into the emergency department.
With a ventilator.
"Who will help us pick up the old lady..."
The nurse picked up and asked about the condition.
"My mom has a cerebral hemorrhage, respiratory failure, severe pneumonia, and her condition has recurred, so I want to see a doctor..."
The nurse listened, so serious?
Subconsciously look for Lin Feng.
Lin Feng was helping a child look at the giant colon at this time (the colon is too large to pull out), and then the family pushed the old lady and walked in.
。
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