I Can See Health

Everyone thought that Lu Chen was being modest.

However, after this small episode, everyone had a good first impression of Lu Chen.

The department is actually a small society. There may be a lot of dirty things among the leaders, but doctors at the lower levels are often very harmonious, and everyone appreciates people with strong abilities.

At this moment, Liu Mei suddenly walked into the ward quickly, with a look of anxiety on her face.

"Dr. Sun, the patient in bed 10 is sick again. Go and see him quickly!"

Another 10 beds!

Lu Chen frowned.

This patient had already suffered from heart failure this morning. Could it be that he is suffering from heart failure again now?

Upon hearing this, Sun Guoguo immediately stopped the ward rounds and led everyone to bed No. 10.

Sure enough, the situation was exactly the same as in the morning.

The patient was sitting on the bed, breathing heavily, his face was pale, and his eyes were lifeless.

Just as he approached the hospital bed, Lu Chen could hear the sound of phlegm coming from the patient's throat.

The sputum sound is very obvious, and it can be imagined that the patient's bronchial tubes are all filled with thick sticky phlegm.

This is mainly caused by heart failure leading to pulmonary edema, which causes lung infection.

Lu Chen glanced at the electrocardiogram monitor next to the bed.

The blood pressure saturation is only 85%, the breathing reaches 42 times/min, the heart rate is 125 beats/min, and the blood pressure is not very high, only 140/76mmHg.

But at this time, lowering blood pressure is not a good thing!

If the blood pressure drops too much, even if it is not less than 90/60mmHg, it indicates the failure of the patient's heart pump function, which is often referred to as cardiogenic shock.

If a patient with heart failure cannot maintain blood pressure, then this patient is hopeless!

"Heart failure has occurred again! Liu Mei, immediately push two doses of furosemide and suction the patient's sputum at the same time!"

Sun Guoguo immediately ordered.

"receive."

Liu Mei looked serious. She had already prepared the furosemide injection and pushed it directly into the patient's indwelling needle.

At the same time, another nurse quickly brought a sputum suction device and prepared to suction the patient's sputum.

Suctioning phlegm is very uncomfortable when a person is awake.

However, the patient currently has too much sputum and cannot cough it out. It is completely blocked in the trachea, which not only reduces the oxygen saturation, but also risks suffocation at any time.

"Junior sister Jiang, please contact the CCU (cardiology intensive care unit) on the fourth floor. We may have patients who need to be transferred!"

Sun Guoguo said to Jiang Qingyan who was standing aside.

Jiang Qingyan nodded and immediately ran out of the ward.

The patient's family member on the side, the old woman, held Sun Guoguo's hand at this time.

"Dr. Sun, we don't want to go to CCU. We are a poor family and don't have much money. Our son can't make much money while working in other places, so we can't go to CCU!"

The old woman clung to Sun Guoguo tightly, as if grasping the last straw.

"Every time I was treated well by Dr. Sun, we will treat him here. If he is not transferred out, he must not be transferred to CCU. It costs 10,000 yuan a day. We can't afford the treatment!"

Sun Guoguo sighed and said helplessly: "Mother-in-law, the situation is different this time. Daddy's oxygen saturation is only 85%."

"If you don't need a ventilator, there is always a risk of suffocation or even sudden death. But we don't have a ventilator in the general ward, so we have to go to the CCU!"

The old woman shook her head desperately, her wrinkled old face full of sadness and despair.

"Dr. Sun, even if I, an old woman, beg you, we really have no money!"

Sun Guoguo pursed her lips and sighed slightly in her heart.

"Dr. Qu, please contact the patient's son and tell him on the phone that he is critically ill! He also recommends that he be transferred to CCU for treatment."

"good!"

As a senior attending physician, Dr. Qu is better at communicating with patients. It is right to leave matters such as reporting critical illness and communicating about the condition to her.

By this time, the nurse had finished suctioning the sputum.

"Dr. Sun, the patient's phlegm is deep in the bronchus. I can only suck out a little bit of the phlegm from the throat."

"Suck it again, if it doesn't work, forget it!" Sun Guoguo continued.

The phlegm of the elderly is already very thick, and after taking several diuretics, the phlegm becomes even thicker.

I looked at the electrocardiogram monitor beside the bed and saw that the blood oxygen saturation had been hovering around 85%.

A normal person's blood oxygen saturation should be above 96%. If it is lower than this index, it is necessary to consider whether there is an organic disease.

This can't go on like this!

Sun Guoguo was a little worried. If the ventilator was not used immediately, the patient's condition was likely to get worse.

When the patient has too much sputum, the effect of the non-invasive ventilator is not good, and the patient may have to go directly to the invasive ventilator.

"Liu Mei, give me half a bottle of Cidilan and a bottle of Chuanding!"

"receive."

Cedilan is a cardiotonic shot and can be used as appropriate when diuretic and vasodilator drugs are not effective in treating heart failure.

When using cedilan, start with half a stick every time.

"Dr. Sun, the phlegm cannot be suctioned out, and the patient feels very uncomfortable when he is awake." Another nurse said.

"Then let's stop suctioning for now." Sun Guoguo said, "Just put the suction device next to the bed. Don't take it away. It will be ready for use at any time."

"good."

The nurse nodded and at the same time cleaned out the used suction tube and replaced it with a clean suction tube for later use.

At this time, Qu Yao, a training doctor, returned to the ward and whispered beside Sun Guoguo: "Dr. Sun, I have contacted the family on the phone. His son understands the condition, but refuses to be transferred to CCU."

Sun Guoguo frowned.

This is really true, there is no filial son in bed for a long time!

"I'll call the CCU. UU Reading www.uukaｎshu.net Junior Sister Ke, go and borrow a simple non-invasive ventilator from them." Sun Guoguo turned to Ke Yue and said.

"Okay, senior sister."

There are no ventilators in the general cardiology ward, only in the intensive care unit.

After receiving Sun Guoguo's instructions, Ke Yue immediately ran to the CCU on the fourth floor to borrow a non-invasive ventilator.

"Dong Hao, go and print out the informed consent form and critical illness notification form refusing to be transferred to CCU."

"receive."

Even if it is an old patient, even if the two old people are very good, there still needs to be communication.

Any medical actions and examinations that patients and their families refuse must be repeatedly informed of the risks and they must sign an informed consent form!

This is the most important way for doctors to protect themselves!

Because Lu Chen had just joined the department and was not familiar with the affairs of the department, Sun Guoguo did not assign him any work.

…

About five minutes after taking the medicine.

The patient's dyspnea symptoms showed no improvement.

At this moment, Lu Chen suddenly noticed that on the ECG monitor, the patient's blood oxygen saturation suddenly dropped from 85% to 80%, and then jumped to 76% one second later!

Lu Chen immediately felt that something was wrong!

When he looked at the patient on the bed, he saw that the old man's eyes were rolling upwards, his throat seemed to be blocked by something, and breathing suddenly became extremely difficult.

"Oops, it's stuck in phlegm!"

Lu Chen was shocked.

Sun Guoguo on the side also immediately noticed something was wrong with the patient, and she immediately shouted loudly.

"Liu Mei, suck the phlegm!"

At the same time, Lu Chen immediately ran to the bedside and helped Liu Mei open the patient's mouth.