bookpower Chapter 377
Chapter 377
Lin Feng held the patient's baby and ran wildly all the way,
10 minutes later...
Arrived at ICU!!
The family members of the patients outside the ICU were taken aback.
The door opens.
"Doctor Lin!" The nurse waited early.
"Quick, meridian channels, salt water, and glucose!"
When Lin Feng rushed in, he quickly instructed the nurse.
"Don't worry, knowing it's septic shock, we're ready!"
The husband and wife took the opportunity to follow in.
Nurse Mari connected the ECG monitor...
At a glance,
・Heart rate 190!
Low blood pressure (unlike hemorrhagic shock, septic shock has normal or low blood pressure, but it is not very low)
Blood oxygen saturation: 94%!
Shallow breathing, low heart sounds, thin pulse...
Didn't run,
Absolutely shock!
Hurry up to give the patient oxygen, direct pure oxygen flow...
At the same time, the meridian channel, rehydration...
Lin Feng was busy on the side,
ICU doctor: "Dr. Lin, what's the situation?" "
Lin Feng shook his head: "It's not clear, but the CRP exploded, and the reason must be infection..."
shock
Naturally, it is necessary to catheterize so that the amount of urine can be recorded.
Left a catheterization directly for the baby!
As a result, the moment I inserted it, I saw the "turbid" urine flowing out!
"Urinary tract infection!"
"So it is!!"
Lin Feng and ICU doctors, when they saw this situation, they immediately understood.
"Quick, send for a urine routine check... By the way, do a urine culture and see what it is..."
ICU inspections are also prioritized for cutting the queue.
......
Half an hour later,
The baby's urine routine results are out:
Urinalysis: white blood cells 3+!
As soon as this result came out, Lin Feng and ICU doctors were surprised.
"So serious!"
"The infection is terrible!"
Three plus white blood cells, indicating a more serious urinary tract infection, may also be due to aseptic inflammation caused by bladder mucosal lesions.
Waited another half an hour,
Urine culture results come out:
Culture result: a large amount of Escherichia coli!
Really fierce, it's out!
The main reason why the baby's high fever does not go away is urinary tract infection, and ascending leads to pyelonephritis, and leads to septic shock, which is almost life-threatening!
Fortunately, the routine operation of catheterization found abnormalities in urine at the first time.
Otherwise, it is difficult to do a urine routine (it is difficult for ordinary children to get urine), and the condition will continue to be delayed.
Now that the infection of "Escherichia coli" has been identified,
Symptomatic treatment!
Direct targeting of antibiotics, infusions.
The intramuscular injection is too slow, and the patient's condition is a little serious, so it is directly infusion.
With hydration, pruritus, antibiotic anti-urinary tract infection therapy,
After 2 hours,
The baby's condition has finally stabilized!
Next, further examination is needed to see why it causes a urinary tract infection.
It took another day, several checks,
Finally found the reason,
"Vesicoureteral reflux"!
This means: the urine in the bladder refluxes into the ureters, renal pelvis or kidneys!
In general, the path of urine is from the kidneys-ureters-bladder, in one direction.
And then
Urine itself, shedding cells, minerals, etc., are all nutrients that bacteria need...
After reflux into the kidneys, it is naturally easy to cause large-scale outbreaks and growth of bacteria.
Causes pyelonephritis, and then leads to fever, repeated high fever that does not subside...
It is easy to cause kidney failure!
"Dr. Lin, why is the baby regurgitating?"
The couple was relieved to see that the baby had eased up, but they couldn't help but be curious.
Lin Feng: "It may be congenital, such as urinary system insufficiency, or it may be acquired, such as infection or something... These need to be carefully examined..."
......
This patient is Lin Feng's last patient in pediatrics.
The following week, Lin Feng went to gynecology training.
Gynecologic male doctor?
Lin Feng suddenly became the most popular doctor among gynecological patients.
......
Another week later,
Gynecological training is over.
This represents that Lin Feng has officially completed the rotation of various departments in the three years of regular training.
Next, 2 years of specialist (emergency) work,
So 3+2 ends,
Then go to the countryside once (it seems to have been canceled), wait for the end of the countryside, wait for approval, and then you can officially become an attending doctor!
......
A new day,
Emergency Department,
"Wow, Dr. Lin is back~~~~"
"I haven't seen you for two weeks, and I'm not used to Dr. Lin's absence!"
"Without Dr. Lin, this handsome guy, I have been in a bad mood at work these two weeks..."
One by one, the nurses warmly welcomed Lin Feng's return.
Other Pu Ugly doctors: "..........................."
paralysis
Flip table(╯‵□)╯(┻━┻!
Lin Feng, can you not come back?
At this moment,
"Bell Bell ~~~~~"
Lin Feng's mobile phone rang.
"Hey..."
"Doctor Lin Feng? I'm Zhang Wei from the Department of Obstetrics and Gynecology..."
Lin Feng was shocked.
Zhang Wei, the director of the Department of Obstetrics and Gynecology, is in her 50s, a big man in the field of obstetrics and gynecology.
"Hello Director Zhang, is there something wrong?"
"That's right, Dr. Lin, there is a relatively special patient here in our obstetrics and gynecology department, and we need to do a more special operation, the difficulty is very high, no one has done it, I want to see if you can do it..."
now
Lin Feng's name of 'firefighter' and 'hand of the devil's claw' spread throughout the entire Harmony Hospital.
Wherever it doesn't work, you can't help but think of Lin Feng.
And Lin Feng happened to be in the obstetrics and gynecology department a few months ago, rescuing a pregnant woman who lost more than 10,000 milliliters of blood, and everyone in the obstetrics and gynecology department knew and praised.
Lin Feng was polite: "Director Zhang, you said..."
Zhang Wei: "That's right, there is a pregnant woman who is pregnant with twins, but this twin is a little special, twin blood transfusion syndrome, sister "snatched" my sister's blood, we need to do a super subtle "fetoscopic surgery"..."
Lin Feng listened quietly.
Originally
Here's what happened:
Miss Zhang, a pregnant woman, is pregnant with twins, which are "single velvet twin sheep twins".
What does that mean?
That is, one placenta, one chorionic sac and two amniotic sacs, two fetuses.
This was originally nothing.
However, it was not until 21 weeks + 2 days of pregnancy that Miss Zhang had a prenatal examination and found a big problem.
In the color ultrasound prenatal examination, in the twins,
The first fetus has growth restriction and mobility restriction due to oligohydramnios.
In the second fetus, there is an increase in amniotic fluid.
This is a type of "twin transfusion syndrome".
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ps: There are too many things today, only two more, sorry ~~
。