Doctor of Healing

Chapter 371 Addison's Sudden Death

"What's the situation?" Lu Gang was in a daze for a long time, and finally asked in doubt.

Meng Qingfei sighed deeply.

Ji Xiang's performance was more sophisticated than that of an experienced emergency doctor, especially the last step when he jumped up, kneeled and sat on the patient's abdomen, and performed chest heart compressions with both hands. Meng Qingfei looked like a slippery veteran All were ignited.

But the question immediately came to Meng Qingfei, what is the patient's condition!
"Director Lu, you haven't diagnosed yet?" Meng Qingfei asked cautiously.

Lu Gang shook his head, indicating that he did not know.

He wanted to follow along to have a look, but as soon as he raised his leg, he stopped again, staring blankly at the end of the empty corridor in the distance, at a loss for what to do.

"Doctor Meng, do you know the patient's condition?" Lu Gang asked.

When he was free, Meng Qingfei told Lu Gang about the patient's condition.

A middle-aged man took a large amount of toilet water orally, and developed symptoms such as nausea, vomiting, and abdominal pain half an hour after oral administration.

Everything is proved to be caused by toilet water, as long as the gastric lavage is enough, and there is no abnormality in the physical examination.

Similar patients are common.

wrong!

A shooting star flashed across Meng Qingfei's mind, tearing up the shady scene.

"The patient's body temperature is high! His body is red and hot!" Meng Qingfei said in a deep voice.

He remembered a sentence that the emergency physician said casually, so it was so!

"Body temperature...irritability..." Lu Gang murmured to himself in confusion.

"Director Lu, I still remember..." Meng Qingfei only said one thing at the beginning, and Lu Gang continued, "Three years ago, there was an emergency in the gastrointestinal surgery department."

"Correct!"

That was a past event three years ago.

A patient with abdominal pain came to the emergency department, with a body temperature above 40 degrees Celsius, nausea and vomiting accompanied by tenderness, but no rebound tenderness.

Considering it was an acute abdomen, the gastrointestinal surgery department did not know what the diagnosis was, because the abdominal pain was getting worse and worse, so he could only do an exploratory laparotomy after explaining to the patient's family.

result!

After opening the stomach, there was nothing wrong with it. I stroked the intestines to make sure there was no strangulated ileus and other internal organs were fine.

Ask for a consultation on the stage. Since it has already been opened, let all the departments take a look at it at this time, so as not to be unclear after going down.

The last problem was solved by Lu Gang - the patient diagnosed adrenal crisis.After symptomatic treatment, the patient's condition improved and he was finally discharged smoothly.

That "medical accident" was due to insufficient technical level, and the communication between the gastroenterology department and the patient's family was smooth, and the family did not pursue responsibility, so the matter was peaceful.

Meng Qingfei and Lu Gang thought of this at the same time.

The patient has fever, rapid heart rate, and irritability.

The digestive system also has anorexia, nausea, and vomiting, which are often early symptoms.

right!And blood pressure! !

Meng Qingfei and Lu Gang thought at the same time that the patient's heart rate was rising and blood pressure was falling at the same time. When the patient was finally pushed away, the patient's high pressure had reached about 85mm.

Drinking toilet water will not lead to hemorrhagic shock. The shock manifestations of increased heart rate and decreased blood pressure, together with other symptoms, are more and more consistent with the diagnosis of adrenal crisis.

"I know!" Lu Gang clenched his right hand into a fist, and slammed it on the palm of his left hand with a slap.

"It's Addison's disease!" Meng Qingfei said at the same time.

"Yes, it's Addison's disease. The sudden death just now was Addison's sudden death!"

The two looked at each other and smiled, as if they had solved an extremely difficult math problem.

But in an instant, both of them were a little embarrassed.

This is not an exam, but clinical emergency first aid.An afterthought diagnosis is meaningless to the patient. Ji Xiang just immediately defibrillated, performed chest compressions, and contacted the ICU bed in advance. These are the keys to solving the problem.

If there is no Jixiang, not to mention whether the correct answer can be obtained, even if there is a correct diagnosis of Addison's sudden death, the patient is probably hopeless.

Meng Qingfei smiled embarrassingly, "Xiaoji is really amazing."

Lu Gang was still a little unconvinced, but the successive blows in the past few months made him feel a little lonely.

The only strand of hair on the top of his head was hanging down, listless.

The bald head has lost its glossy light and is gray.

Lu Gang pondered for a few seconds, and said bitterly, "I came late this time, and the patient had a problem just after arriving in the emergency room. Next time, definitely!"

Meng Qingfei glanced at Lu Gang in surprise, he knew that Lu Gang was competitive and wanted to compete with Ji Xiang.

Does it make sense?

Lu Gang's actions made no sense at all.

"Director Lu, forget it." Meng Qingfei smiled and said, "Take a break, take a rest, my whole body seems to be aching right now."

This is a side reaction after stress, and Lu Gang also understands it.

"Wait a minute, I'll make an appointment for a B-ultrasound." Lu Gang said, "Since it's an adrenal crisis, there must be something wrong with the adrenal glands. Xiaoji, he may not know."

With that said, Lu Gang took out his mobile phone and made a call.

"Icu?"

There was a loud noise on the other side of the phone, apparently in the emergency department.

Lu Gang understands that this is not a good time to be long-winded, so he wants to make a long story short.

"The patient just sent, I think it is an adrenal crisis, immediately call the bedside B-ultrasound."

"Director Lu, the B-ultrasound is being done. The patient... oh, oh, the patient's right adrenal gland has calcification, and adrenal tuberculosis is considered." The doctor in the ICU replied.

Obviously, he was watching the rescue while answering the phone.

"Then hurry up." Lu Gang hangs up the phone in a sense of loss.

Lu Gang knew very well that the critical strength of the Second Affiliated Hospital was second to none in the province, but when a patient with an inexplicable cardiac arrest was sent, they could immediately discover the adrenal crisis...

Ahem, a figure appeared in Lu Gang's heart.

No way, if the rescue is timely, it can be explained by Ji Xiang's youth and quick response.

However, adrenal crisis is extremely rare in clinical practice, and it will be misdiagnosed every time it occurs.Every misdiagnosis will most likely lead to the death of the patient in the end.

Few family members in China agree to autopsy, so patients who die inexplicably have no diagnosis, which in turn leads to lack of experience of clinicians.

It was also because of the incident three years ago that Lu had established a general understanding of adrenal crisis just now, so he and Meng Qingfei were the first...the second to give a diagnosis.

What about Jixiang?
Where did his diagnosis come from!

Where does his clinical experience come from!
Lu Gang coiled his bald head, and the drooping hair became more and more listless.

"Xiaoji really diagnosed it? This is too fast." Meng Qingfei was a little surprised.

Although Lu Gang didn't speak, his expression said everything.

Ji Xiang got the correct diagnosis in the blink of an eye, and the emergency treatment was successful.

What the hell, Meng Qingfei cursed in his heart.

For a patient who suffered cardiac arrest after drinking toilet water, Ji Xiang actually judged the adrenal crisis while rescuing him, which can only be done with deep clinical experience.

(End of this chapter)