bookpower Chapter 387
Chapter 387
"Huh??"
The doctors around were shocked all of a sudden!
Suck laundry detergent?
Pothead?
Everyone looked at the patient Wang Chen with strange eyes.
Wang Chen wanted to quibble, but when he wanted to speak, he faced the eyes of the doctors one by one, and finally smiled bitterly.
"That's right..."
His face was full of regret and shame.
"I didn't want to, I was instigated by a few friends at that time, and then I tried it, but I couldn't get rid of it..."
At this moment,
There was an uproar throughout the ward.
One by one, the doctors of respiratory medicine were very angry.
One of the doctors cursed angrily.
"Why didn't you say it earlier!"
"Don't you know that this will delay the condition?"
On the one hand, it is angry with the patient's concealment, and on the other hand, it causes the entire department to toss blindly and waste precious time.
The patient Wang Chen said weakly: "I dare not let my family know, otherwise my wife, son, and parents will be very worried, and this has nothing to do with my illness, you don't know and will not affect anything." "
Lin Feng shook his head: "No, on the contrary, the impact is very large!" "
"If you have sucking laundry detergent, then consider infectious "endocarditis" ..."
Principle: The main key to the pathogenesis of endocarditis is bacterial infection. Due to long-term intravenous puncture and injection of drugs (patient Wang Chen's elbow socket injection addiction), washing powder is easy to cause bacterial infection because of the lack of necessary skin disinfection treatment and the use of injection equipment that is not hurried.
Bacteria enter the bloodstream through the puncture site, and then multiply at the site of heart damage and degeneration, forming vegetations, and eventually causing "endocarditis".
And endocarditis, it will cause fever!
However, endocarditis generally has a 'heart murmur', but the patient in front of him does not, probably because the vegetation is not large enough to be heard.
"Let's do a heart ultrasound..."
Cardiac ultrasound, you must be able to clearly see whether the heart has vegetations.
Because the patient's condition was stable, Lin Feng greeted the imaging department and cut in line.
The results of the inspection were issued on the spot:
Cardiac ultrasound: mitral and tricuspid valves have vegetations. Vegetations have been found in heart valves, most likely bacterial clumps of intimal infection.
Obviously, this is exactly endocarditis infection!
Really murderer, found it!
Next
Three steps at the same time:
Bacterial culture to confirm what bacteria cause growths
Rotate antibiotics to see what works... When the bacterial culture results come out, you can prescribe the right medicine, but there is a point, half of the bacteria in the vegetation are difficult to kill, if it is serious, at least 2 months to take the drug.
If the vegetation is too serious, it is necessary for cardiac surgery to do open surgery, chest opening, dissection, and remove the vegetation, so as not to let the vegetation grow rapidly... After this trip, I'm afraid 200,000 can't stop ...
But
None of this needs to be worried about by Lin Feng.
Respiratory medicine can do it.
Not long after Lin Feng returned to the emergency department, he heard gossip from the doctor of the respiratory medicine department: The patient Wang Chen's smoking of washing powder was known by his wife and children, and I heard that it cost nearly 500,000 yuan because of washing powder... The patient's wife wants to make a fuss divorce on the spot...
After Lin Feng listened, he did not sympathize with this patient at all.
"If you know this, why bother?"
Absorbing laundry detergent is not stained in itself!
......
Lin Feng returned to the emergency department,
Continue to receive medical treatment,
The first patient was a 3-year-old boy.
Held by my mother,
Blushing, comatose in consciousness.
An ice antipyretic patch is also attached to the forehead.
The mother was anxious and begged: "Doctor, my baby is 40 degrees, I must help him reduce his fever..."
Lin Feng: "Have you taken your temperature?" "
Usually the nurse's station will start taking your temperature.
Mom is anxious: "Measured, 40.8 degrees..."
Lin Feng: "How long has the fever been?" "
Mom: "It started yesterday afternoon..."
Lin Feng: "That is, less than 24 hours... Did you take antipyretic medicine halfway? What medicine? How is the effect? "
"After eating, the medicine is Merrill Lynch, take it once in 6 hours, and then retreat after eating, but after 4 hours, it starts to burn again..."
Merrill Lynch is a commonly used antipyretic drug like ibuprofen.
Lin Feng nodded: "Okay, continue to take fever-reducing medicine, and then go to draw blood and check urine..."
At this time, the mother cried and said: "Doctor Lin, it's nearly 41 degrees, the fever used to be more than 38 degrees at most, but now it's directly more than 40 degrees, doctor, will my baby burn out his brain?" "
Lin Feng shook his head: "Don't worry, it's generally difficult..."
Then it was explained.
"The so-called burned brain should actually be the invasion and infection of bacteria and viruses, or the lack of oxygen in the brain..."
The higher the fever, the heavier the infection, which is easy to cause brain inflammation, and inflammation will naturally make the 'bad brain'... (highest probability)
At the same time, fever will cause a large amount of oxygen in the body to be consumed (fever is the oxidation reaction in the organism, which is the body's self-protection response against pathogens), causing hypoxia in the brain... (Low probability)
Brain cells may be damaged during high fever... But this part, in fact, the probability is very low, almost more than 42 degrees.
Lin Feng looked at the antipyretic patch on the little boy's forehead and couldn't help but remind.
"This antipyretic sticker, in fact, is useless, just psychological comfort..."
"Huh? No way? Isn't propaganda very useful? "
Lin Feng shook his head: "This kind of cooling is not as effective as fever-reducing medicine." "
For the record:
Inside the antipyretic treatment guide, there are no antipyretic stickers!
Medical organizations around the world believe that in most cases it is more convenient to cool down drugs, and warm water rubbing baths can be given priority when children are intolerant or allergic to fever-reducing drugs.
The two classes of drugs recognized as classics are: "ibuprofen" and "acetaminophen (Merrill Lynch)".
And
The main purpose of using fever-reducing drugs is also to relieve your child's pain, not purely to reduce fever.
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ps: That's it for today... First......
Now write a case, you have to check a lot of information ... Difficult......