bookpower Chapter 267
Chapter 267
Because it's an expedited queue,
Therefore, the examination of "single-fiber electromyogram" is completed quickly!
Outcome:
Myasthenia gravis, positive!
"Phew~~~~"
"It's really myasthenia gravis!"
"Dr. Lin is awesome!!"
All the nurses breathed a sigh of relief, and then looked at Lin Feng's handsome face with adoring eyes.
That's awesome!
Peak loop turn!
The dust has settled!
"How's it going, Dr. Lin?"
The patient's husband was outside the door of the examination room, saw Lin Feng pushing his wife out of the flat car, quickly walked over, and asked.
Lin Feng smiled: "Good news, it's myasthenia gravis, not rabies!"
When the patient's husband heard this, he immediately cried with joy!
I feel that at this moment, the gray world has become glorious!
Since it has been determined to be "myasthenia gravis".
Then the next step is symptomatic treatment.
The medicine prescribed by Lin Feng is "pyrididoxine bromide".
"Pyridostigmine bromide": indicated for myasthenia gravis, functional flatulence and urinary retention after surgery.
This drug can reawaken the neuromuscular junction work, restoring muscle strength.
In addition, some glucocorticoids and immunoglobulins are prescribed.
Because the onset of many patients with myasthenia gravis is related to immune abnormalities, and hormones are the strongest immunosuppressants, hormone shock therapy is also effective, even efficient.
Take all the medicine,
The next thing is to wait.
However, the patient has passed out at this time, and it is necessary to wait for the patient's attributes to see the results.
At this time, it was already 5 o'clock in the morning...
......
8：30，
Lin Feng began to hand over the doctor's shift,
Soon, the news spread throughout the emergency department.
"Hydrophobia? Not rabies? Is it myasthenia gravis?"
"Dr. Lin is amazing!"
"If I had me, I'm afraid I would have been diagnosed directly with rabies." "
"I learned, in the future, hydrophobia, I have to consider myasthenia gravis. "
9：00......
The handover is complete.
Lin Feng was about to go home to rest...
"Dr. Lin... The patient is awake!"
"Which patient?"
"Muscle weakness that patient..."
"Awake?!"
Lin Feng was overjoyed, ran back quickly, and ran into the ward.
I saw the husband holding the patient's wife, crying.
"I'm so afraid you'll just leave... scared me to death..."
And the wife tiger touched her husband's head.
After seeing Lin Feng walk in, the female patient quickly thanked her.
"Thank you, Dr. Lin. "
Lin Feng saw the patient's big bright eyes, full of spirit!
Compared with last night's eyes and eyelids, it was a world of difference.
Lin Fengxin breathed a sigh of relief.
"Congratulations!"
"Thank you Dr. Lin, if it weren't for you, I might not have survived. "
"It's all duty, you're welcome. "
That afternoon...
The patient's respiratory weakness has completely improved, and he successfully removed the ventilator and removed the endotracheal intubation.
At this time, the patient's parents and in-laws all came from abroad.
Seeing that her daughter/daughter-in-law had recovered, her heart breathed a sigh of relief and was full of gratitude to the attending doctor, Lin Feng.
(ps: The attending doctor and the attending physician are not the same concept, usually the attending physician is the attending physician, which is a professional title.) ）
(ps: Taking Lin Feng as an example, Lin Feng is currently a regular training doctor, after three years of rotation (more than two years have been completed), he began to work as a "resident doctor" in the emergency department, and after two years of residency, (it seemed that he had to go to the countryside for a year before, but now he seems to be not used), he can evaluate the "attending physician". ）
That night...
Lin Feng continued to work the night shift, at this time the patient had basically recovered to a healthy level, and he could be discharged and leave the hospital early tomorrow morning.
For the patient's family, it was a thrilling escape.
......
That evening, 23:30
Lin Feng returned to the hospital,
Continue the night shift tonight.
24:00 handover, almost 24:15 after handing over...
Today I don't know why,
There were five or six patients sitting in the emergency room.
A fever, a cold, a diarrhea ...
"Huh..."
Lin Feng found that the fourth patient, a young woman, had a red rash on her face.
Lin Feng's application suddenly became serious!
"You, come first..."
Lin Feng pointed at her and said.
Other patients in line were dissatisfied.
"Doctor Lin, we came first, you can't let her cut the queue." "
"Yes, in the middle of the night, we are all sick. "
Lin Feng shook his head: "His illness is more urgent... Wait a little longer, if you can't stand it, look for me again. "
......
Lin Feng brought the patient with a red rash into the consultation room.
Patient, female, 28 years old
Lin Feng looked serious: "What's going on on your face?"
The female patient panicked at this time: "Stung by bees... Dr. Lin, you must help me, I don't want to disfigure!"
Lin Feng glanced at it and didn't recognize what kind of bee it was, after all, he was not biological.
However, if you get so many rashes after being stung, the condition is not usually serious.
Lin Feng: "In addition to the face, is there any other place?"
The female patient nodded repeatedly: "Yes, yes, the whole body is itchy!"
Lin Feng pointed inside the curtain: "Go in, I want to see..."
The female patient also trusts Lin Feng, and she does not suffer a loss when she is seen by such a beautiful Dr. Lin.
The two walked inside the curtain and closed it, covering their gaze.
"Lift your clothes and I'll see..."
The female patient obediently lifted her clothes...
Hiss~~~~~
Lin Feng gasped!
I saw that the front and back of this young female patient, except for the part of the chest that was covered, all other places were rashed, dense, red, and not a piece was intact!
Lin Feng was shocked all of a sudden.
This allergy, too serious, right?
Will there be anaphylactic shock?
Bee venom mainly contains formic acid, neurotoxins and histamine, which can cause hemolysis and bleeding, and has an inhibitory effect on the central nervous system, so it will cause allergic reactions in some stingers.
Lin Feng asked urgently:
"Do you have it on your legs too?"
"Yes!"
"Besides itching, are there any other uncomfortable feelings?"
"Nope!"
"Really? Breathe?"
"Breathing, a little stuffy... Doctor, is my face, this skin still saved?"
It is a woman's nature to love beauty,
She was really afraid that she would be disfigured!
"It should be fine... Go, go to the rescue room!"
Lin Feng looked at such a serious allergy!
May cause two diseases:
Anaphylactic shock!
• Laryngeal edema causes dyspnea and suffocation. (Written in Chapter 93)
"Huh? Rescue?"
The female patient was shocked all of a sudden!
I was just stung by a bee, is it that serious?
However, seeing that Lin Feng's face was not right, he also realized that the situation was critical, and quickly followed Lin Feng to the rescue room.
Lin Feng explained as he walked.
"Your allergy is too severe now, it may cause anaphylactic shock, laryngeal edema and suffocation, the front should be anti-shock, and the back one should be urgently intubated or tracheostomy..."
Shock, intubation, tracheostomy?"
Female patient, this moment is really panicked!
Suddenly......
The female patient felt her throat itchy and couldn't help but scratch ...
"What's wrong?"
"I... Here..." As she spoke, she found that her voice became gradually blurred, and her words were not so clear.
It was as if my throat was blocked by something!
At this moment, the female patient began to fear.
She reflexively gulped and breathed desperately, desperately taking oxygen!
"What's wrong?"
Lin Feng saw that the patient was holding his neck and looked a little frightened.
His face changed.
"Not good! Laryngeal edema!"
just right
Not far away was a vacant flat car.
Lin Feng quickly ran over and pushed the flat car back.
"Quick, lie down!"
Hold her and lie down in the flat car.
Quickly put the female patient in the side position to facilitate breathing.
Then shouted: "Xiao Ai, immediately prepare to intubate the oxygen tube, and the "tracheostomy bag"!
At this time, intern Wang Zirui heard the movement and quickly ran over.
"Wang Zirui, come and help!"
"Yes!"
The two worked together, pushing the flat car and rushing to the rescue room.
Other doctors and nurses were also drawn in.
......
Quickly push into the rescue room.
At this time, the patient was completely speechless, pinching his neck and breathing desperately.
That's because allergies cause hyperemia and edema of the mucous membranes, which quickly block the airways.
"Nasal tubes..."
Lin Feng's first reaction was to supply oxygen first, and then try nasal cannula intubation.
I tried several times, but I found that it was blocked and couldn't put it in!
At this time, although the patient breathed heavily, it was useless, making a throat sound, and his face had become purple.
You can die of respiratory failure at any time!
The disease progressed too fast, which surprised Lin Feng a little!
Tear open the patient's upper collar,
I saw that the female patient's suprasternum fossa, supraclavicular fossa, and intercostal space appeared obvious depressions in three places.
Three concave signs!
This is inspiratory dyspnea due to upper airway edema obstruction.
The only options now are:
"Tracheostomy!"
Lin Feng said quickly: "Tracheostomy bag!"
This is just a minor operation for Lin Feng.
Hands and feet are numb.
Incision, intubation, placement, suturing...
Come to an end
The journey takes less than 1 minute...
More importantly, when the tracheostomy was opened, Lin Feng did not forget to give orders.
"Pick out the stinger with a needle or syringe!"
"Link ECG monitor..."
"May be shocked, first build a venous channel, right arm!"
"The adrenaline ... Promethazine..."
A few nurses, interns busy together...
When the ECG monitor is connected, the patient shows low blood pressure, fast heart rate...
"There is already shock!"
"Rehydrate now!"
With epinephrine, oxygen, intravenous fluid expansion, anti-anaphylactic shock rehydration... A series of corresponding treatments...
10 minutes later...
The patient opened his eyes from the stupor.
Blood pressure also returned to normal, breathing became smooth, and shock ended.
Lin Feng breathed a sigh of relief.
This patient was lucky to come to the hospital in time and treated it in time without serious consequences.
Whether it is shock or suffocation, it is easy to cause death.
Therefore, Lin Feng saved her life.
After re-suturing the trachea and handing her over to the doctor in the emergency internal medicine department, Lin Feng continued to return to the consultation room to see others.
The other patients were still dissatisfied with Lin Feng cutting the queue for that patient just now, but now they knew that because of Lin Feng's timely rescue, the patient's life was saved, and they were embarrassed to blame Lin Feng again.
"Doctor Lin, I was wrong, I shouldn't have blamed you just now..."
"yes, I'm sorry. "
Apologize.
Lin Feng smiled and waved his hand: "Just understand each other..."
At this time, a patient asked curiously:
"Doctor Lin, was it so badly stung by a bee?"
In the hearts of many people, being stung by a bee is just a trifle ...
Lin Feng shook his head: "The toxicity of bees is very weak compared to humans, and after being stung, there will generally only be local redness and swelling... However, some people will be special, if there is a large number of rashes, nausea and vomiting, panic and breathlessness, incontinence and other problems, indicating that the allergy is very serious, you must immediately seek medical attention!"
"Be sure to be nearby, don't deliberately go to a big hospital, otherwise it may be too late..."
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