bookpower Chapter 517
Chapter 517
Li Xing, a doctor next to him, explained to Lin Feng: "When this mother sent her son, she didn't say AIDS, Xiao Zheng collected blood for the patient, only did basic protection, and then accidentally got some blood... Later, the laboratory department called the child with AIDS, Xiao Zheng was scared and stupid on the spot, the director was very angry, and grabbing this family was a scolding..."
At this point,
The live broadcast assistant followed out early and broadcast the cause of the matter live.
Barrage is everywhere.
"I'll go, it's so ruthless! AIDS is not said! "
"Well scolded!"
"It's so selfish, in case it's really infected, the nurse will be ruined for the rest of her life!"
"That patient's mother is also too ignorant!"
"It's also excusable..."
"Love a fart!"
"I'm a doctor, if I encounter this, I'm afraid I'll be scared and stupid, and I guess I'll be nervous for a while in the future..."
"This is too serious!"
With the director's scolding, the young mother not only did not feel sorry, but was full of anger.
And then cursed and grinned again...
Originally, the family members of the patients around her were quite sympathetic to her, but when they saw her being so arrogant and unreasonable, they accused her one after another.
Most of the family members of the surrounding patients are aunts, and the scolding skills are very powerful, it can be said that they are masters, and they sprayed the young mother until the whole person was cracked.
......
Lin Feng shook his head and comforted nurse Xiao Zheng.
"It's okay, get a blocking needle as soon as possible, it should be able to effectively block ..."
“......"
Xiao Zheng, who was usually very active, barely squeezed a smile out of Lin Feng's face.
Lin Feng patted her shoulder.
In fact, I am a little dissatisfied with the policy things.
Lin Feng heard something before:
An AIDS woman went to a marriage test with her boyfriend and tested for AIDS.
And then what?
The hospital where the marriage was conducted did not inform the man, only the woman.
Not long after, the East Window incident happened, and the man who had married and become a husband found out that he had AIDS, and then learned that his wife had AIDS a long time ago.
Immediately took the marriage examination hospital and his wife to court.
It's quite a big deal.
In fact, in the past, the marriage examination was to inform the man, but there was a very sensational thing in the society, which led to the above policy, which could not be informed, but could only inform the parties themselves.
That's.
In short, many people are uncomfortable with this.
......
This thing,
It brings a "windy" atmosphere to the entire emergency department.
All the doctors and nurses became serious.
Even soon the hospital issued a notice, requiring all departments in the hospital to conduct self-inspections and must strictly follow the regulations for occupational protection. Then there was another wail from the departments.
midday
When Lin Feng went to the canteen to eat, many medical staff were talking about it.
Most healthcare workers are very averse to this kind of concealment.
At this moment,
Another colleague in the emergency department, Dr. Chen Dong from the blood group, sat in front of Lin Feng.
"Ah Feng..."
"Brother Chen, what's wrong?"
"We have a patient here, a little unsure, do you have time later?" Come over and palm your eyes? "
Lin Feng suddenly became interested.
"Well..."
The cases that stripped away always fascinated Lin Feng.
The two quickly finished their meals and then returned to the emergency department.
on the road
Dr. Chen Dong gave Lin Feng a detailed account of the patient's condition.
Female, Zhang Guifen, 60 years old,
Recurrent fever for several weeks for unknown reasons, while complaining of systemic bone headache
Admitted to hospital 2 days ago
Dr. Chen Dong said: "Because the whole body bone headache is a special disease, so at the beginning we all thought that it was a blood, rheumatic and immune disease, and then we went to this aspect to investigate..."
Yes, in general, recurrent fever, polyarticular pain, is to be alert to blood, rheumatic diseases.
But this patient is special.
After a series of targeted tests, blood diseases are not supported, and leukemia, lymphoma, myeloma and other diseases are excluded.
"We also drew blood for bacterial culture, and the results are not yet available."
"Then, this morning, the director came to make rounds, and then a new problem was discovered..."
"What problem?"
"The patient has a murmur on auscultation of the heart, and a systolic murmur is heard in the mitral valve..."
"This brings us to a deeper heart problem, and we're going to send the patient to cardiac surgery... I just happened to see you, you are the most powerful cardiologist in our emergency department, so I subconsciously looked for you to see if you could solve it, so that I didn't have to send it out of my heart..."
After all, this relates to departmental performance indicators.
If you can not give it away, you will not give it away...
Lin Feng nodded: "I'll take a look..."
At this time,
Came to the ward.
Then I saw the patient Zhang Guifen, a middle-aged and elderly woman, and her husband and son.
Seeing Lin Feng waiting to come in, her husband and son quickly stood up.
"Doctor..."
Dr. Chen Dong pointed to Lin Feng: "You should know Dr. Lin Feng, he is a better extracardiac doctor in our hospital, now he will help you see..."
The husband quickly looked at Lin Feng gratefully.
At this point,
The patient wears an oxygen mask and breathes a little more rapidly than usual
Blood pressure: 100/65 (if vasopressors are used)
Blood oxygen: 93 (when a non-invasive ventilator is used)
Breathe in: 35
Heart rate: 128
Lin Feng took the stethoscope and listened to the heart and lungs of the patient Zhang Guifen.
Listen,
The heart really had a murmur.
With experience, Lin Feng felt that there were problems with the mitral and tricuspid valves...
Listen to the lungs again,
There are crackles, I don't know if it's pneumonia, or blood from the heart ...
"Go push a lottery..."
Lin Feng ordered.
Lin Feng's B ultrasound, emergency first!
Boot
The probe is aimed at the chest heart.
Soon, Lin Feng passed the ultrasound and found that the patient had moderate mitral valve insufficiency, and other valves also had lesions.
And - valve vegetations!
Normal heart valves should be clean, there should not be any vegetations, if there are vegetations, it means that the valve is rotten or infected, and the vegetations may be bacterial masses.
If there is an infection, there will naturally be recurrent fever.
This may be the reason why the patient has repeated fevers.
Heart valve infection – > recurrent fever!
The valve is like the door and window of the four chambers of the heart, when the door and window are broken and cannot be closed tightly, the heart cannot pump blood normally.
So it leads to low blood pressure.
In order to supply blood to the whole body, the heart needs to increase its power, which can easily cause heart failure.
Infer infective endocarditis – > reduced pumping efficiency – low blood pressure > > effort to pump blood – > too hard to cause acute heart failure...
Acute heart failure, there will be obvious breathing difficulties, the heart function at this time is very poor, can not pump blood well, resulting in blood accumulation in the pulmonary circulation, excess blood will enter the alveoli, causing pulmonary edema, the presence of pulmonary edema, will seriously affect the patient's oxygen intake capacity, so she will lack oxygen, will be shortness of breath, wheezing.
Acute heart failure - > pulmonary edema - crackles + tachypnea in > patients
The inference is very reasonable and smooth!
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ps: End today.
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