There is no need to be too normal to be a doctor

Chapter 144 Emergencies
This was the first time Chen Gong encountered such a thing.

He stood there for a while, breathing heavily and feeling a little unwilling.

Good guy!
Where are you here to see a doctor?
You are clearly here to kill your relatives for justice!
Okay?

But... Chen Gong has no way to influence the other party's thoughts. It is illegal to buy or sell by force, let alone forced medical treatment!
This woman's attitude really puzzled Chen Gong.

This is your son, okay?

Even if it is the elimination method, do you still need to check it?

Besides, whether it is a serum iron SI test or an abdominal X-ray, they are very cheap and can be done for as little as 80 yuan.

Although Chen Gong was not 100% sure that the other party must have iron poisoning.

However, when it comes to clinical diagnosis, no one is a fairy, okay?

No one can say that it can be diagnosed at once and that the diagnosis is 100% confirmed.

Therefore, the logic of modern medical diagnosis and treatment is still a process of elimination and contraction of judgment.

"Team Leader Chen, please... don't be angry." Wu Xueyu couldn't help but say something.

Yang Hui nodded and laughed at himself: "Yes, this is the situation here..."

Chen Gong was a little disappointed when he heard this.

The establishment of a doctor-patient relationship starts with trust.

If there is not enough trust, it will be difficult to proceed with the next step of treatment.

No matter how capable you are, in the final analysis, if people don't want to believe it, there is nothing you can do.

Having said this, Chen Gong looked at the test report on the computer screen and began to think deeply.

He felt that he had made no diagnosis and treatment error.

Judging from the patient's current symptoms and laboratory test results, it is likely to be iron poisoning.

Thinking of this, Chen Gong hesitated, picked up the other party's registered phone number, and sent a message.

Although this woman is said to be arrogant and unreasonable,... the child is innocent.

This is a two-year-old child. If it delays the optimal treatment period and causes serious complications, it will be more than worth the gain.

When Yang Hui and Wu Xueyu saw Chen Gong's actions, they couldn't help but said to Chen Gong:
"Team Leader Chen, you are really a good doctor!"

"But... I think it's a pity that you come here!"

"However, I have a question. You are so sure that the patient is suffering from iron poisoning. What if it is not... what should I do?"

"You have also seen that the family members are so cruel..."

Chen Gong glanced at Wu Xueyu, smiled, shook his head and said, "It's just a mistake!"

"But it doesn't matter if you are wrong, the most you can do is scold me."

"I even hope I'm wrong."

"But it's a pity...ah..."

Chen Gong shook his head, stood up and returned to the office.

Sitting on the chair, Chen Gong pondered for a long time. It was undeniable that patients had a crisis of trust in the hospital and doctors.

It is very dangerous for this situation to continue to develop.

what can we do about it?

Chen Gong was a little worried.

He is just a team leader, how should he solve the problem at hand?

……

……

That night, Chen Gong ushered in the first serious night shift in her life.

Although I had experienced this before when I followed Zhao Xi.

However, there is still a big gap between dealing with emergency patients independently and dealing with surgical patients.

At around seven o'clock in the evening, Chen Gong was busy dealing with several trauma patients and had not had time to eat.

When I returned to the office, I saw Wu Xueyu walking in with a lunch box in his hand.

After seeing Chen Gong, Wu Xueyu smiled awkwardly:

"Team Leader Chen, my mother sent me some dumplings. I couldn't eat them by myself. I thought you were too busy to eat, so I sent them to you."

When Chen Gong saw this, he immediately laughed: "You're welcome, I can just order takeout. It's not necessary to go all the way."

Wu Xueyu scratched his head: "No...actually...I want to work the night shift with you."

"I can learn more."

"I know, Team Leader Chen, you are really capable. I have a surgical background and am actually... quite nervous in the emergency department."

"Today's patient, to be honest...who would have thought that he was suffering from iron poisoning?"

"I checked this afternoon and it seems that the patient's condition is exactly as you predicted."

"so……"

"I want to follow you and learn more, otherwise... I'll end up doing emergency medicine in the future and not understand anything."

"Don't give other patients bad treatment."

Chen Gong heard this and looked at the young man in front of him who was about the same age as Qin Ge but was extremely humble and studious, and couldn't help but feel good about him.

"Okay, then it's hard for you."

"Ha ha……"

While talking, Chen Gong sat on a chair. Wu Xueyu took a pair of disposable chopsticks and handed them to Chen Gong. He smiled and picked up a book to read.

"Emergency Surgery."

Although this book is the 2014 version, Chen Gong knows that the version is already far behind.

It can only be said that the pace of innovation in domestic emergency medicine is too slow.

In other words, not only domestic but also international emergency surgery, although it has only been patched up in recent years, it is still difficult to have too many reforms.

Thinking of this, Chen Gong took out his notebook and handed it to Wu Xueyu.

“These are some of my own emergency surgical experiences, which I compiled based on the guidelines and the latest surgical and emergency medicine cases.”

"If you are interested, take a good look, maybe it can be of some help to you."

Hearing Chen Gong's words, Wu Xueyu took the book with excited hands, his eyes a little more excited.

"Thank you, Team Leader Chen!"

"Thank you!"

"hey-hey."

After finishing speaking, Wu Xueyu picked up the notebook, walked aside, and began to read it carefully without disturbing Chen Gong.

Chen Gong ate the dumplings without taking it seriously.

only……

At about nine o'clock in the evening, suddenly a rushing sound sounded outside the door.

"Quick, quick!"

"faster!"

"Help, doctor, is anyone there?"

Hearing the noise outside, Wu Xueyu quickly stood up and ran outside.

When Chen Gong saw this, he followed him out quickly.

In the middle of the night, it was obvious that something unexpected had happened.

After coming out, I saw the nurse pushing out a hospital bed with a child on it, followed by two adults and an old lady.

When Chen Gong saw this, he naturally recognized it.

Isn't this the little boy who came today?

Are you really sick?

After coming in, the old lady was sweating profusely. When she saw Chen Gong, tears streamed down her eyes.

"Doctor, Dr. Chen!"

"Save the doll."

"As you said, the child slept until now this afternoon. When he woke up, he started vomiting, and there was blood in it!"

"And he passed out."

"We sent it to the Provincial People's Hospital and had to check it out for a long time. The doctor there couldn't find the cause at all."

"That's when I thought of the message you sent me."

"No, send the child over quickly."

"Just like what you said, the child is really in a coma!"

"Please, save the child."

Chen Gong heard the sound and quickly said to Wu Xueyu: "Xiao Wu, send the child to the custody room."

"Get on the monitor, check some blood pressure, and temperature."

"Let's check the serum iron by the way."

"hurry up!"

After all, Wu Xueyu was young and walked quickly. He quickly pushed the child and walked towards the intensive care unit.

Don't dare to delay in the slightest.

to be frank!
Wu Xueyu's admiration for Chen Gong at this time was simply to the extreme.

In the evening, the two of them chatted about the patient's condition, and Team Leader Chen estimated that if the child got sick, it would probably be around nine o'clock!
Wu Xueyu didn't take it seriously at that time.

After all...he felt that this was a bit too mysterious.

How can any doctor predict the disease so accurately?
None of Wu Xueyu’s master’s tutors could do this.

How old is Team Leader Chen?

How can it be?

However, at this moment, when he saw the patient's condition, Wu Xueyu was truly shocked.

At around nine o'clock, the symptoms were exactly the same, and he fell into coma.

At this moment, Wu Xueyu dared not stop.

Because according to Chen Gong's prediction, this disease will last for more than 12 hours.

The disease will develop more rapidly.

By then, leukocytosis, coma, and even delayed shock will occur.

Here, Chen Gong was not idle either. He called over a little nurse and asked them to help the family members go through the procedures.

The person on duty at the nursing station tonight is the old nurse He Ling.

He Ling was transferred from the emergency department of the original cancer hospital and has good abilities.

In other words, this personnel transfer is a bit special.

There are many nurses transferred, most of them are young and middle-aged professionals. After their clinical training, their skills are very proficient in handling various clinical matters.

but!

In comparison, the level of doctors is a bit underwhelming.

Except for a few pillars who are indeed at the deputy director level, most of the young and middle-aged doctors performed poorly.

Therefore, the nurses these days even look down upon these doctors.

Fortunately, He Ling and the others worked very cooperatively.

Everyone still showed some respect for Chen Gong, the young team leader who had just arrived.

Soon, preparations began to be coordinated.

He Ling also quickly followed Wu Xueyu towards the emergency room.

Chen Gong, on the other hand, was not in a hurry, but began to prepare medicine.

Although the serum iron has not been detected yet,... Chen Gong estimated that the patient's condition was similar to what he had guessed.

Therefore, the medicine Chen Gong needs to prepare is rather special.

It’s really not always possible to find a hospital.

So, Chen Gong found the patient’s family and the child’s father.

"Go and buy two kilograms of eggs and a carton of milk right now."

"Hurry up, hurry up."

Hearing Chen Gong's words, the man was stunned for a moment, then nodded quickly: "Okay, I'll go now!"

"By the way...Dr. Chen, please don't...don't mind."

"My wife... oh... I'm so offended today."

"I'm really sorry."

"We are also very anxious today."

"actually……"

Chen Gong waved his hand: "Go quickly!"

The woman also glanced at Chen Gong sheepishly at this time, not to mention how embarrassed and guilty she was.

Chen Gong didn't mind, but got up and walked towards the doctor's office.

Prescribe medicine immediately.

For patients with this kind of iron poisoning, "iron removal" related operations must be carried out in a timely manner.

Iron supplements are absorbed slowly.

A process that takes 24-48 hours to manage in the intestines.

The patient absorbed it around 12 o'clock this morning. As a result, there is still the possibility of inducing vomiting and gastric lavage within [-] hours.

but!

Regarding the preparation of this iron gastric lavage solution, Chen Gong had his own ideas.

At this time... the child's mother walked in, looking uneasy.

After coming in, he quickly said to Chen Gong:

"Dr. Chen, I'm so sorry!"

"I apologize to you."

"I'm really too angry and anxious today, so...it's a bit presumptuous to speak to you."

"Because before, my husband came to your hospital because of a stomachache. As a result, he did a lot of tests, but no results came out."

"I...I just have some ideas about your hospital."

"I know it's my fault that has had a bad influence on you."

"Sorry, please forgive me."

"Of course...you don't have to forgive me. I hope you can save the child."

Chen Gong did not say anything, but nodded and said:

"Since you are a nutritionist, you should know that acidic fruits cannot be cooked in an iron pot, right?"

"There are some chemical reactions that occur that produce low-iron compounds."

"After long-term use, this compound will be absorbed by the body and cause symptoms of iron poisoning."

Hearing Chen Gong's words, the woman lowered her head in embarrassment and kept admitting her mistakes.

After Chen Gong finished prescribing the medicine, he turned to look at the woman and said:

"All right!"

"These things don't matter. I don't mind what you think about our hospital."

"But I hope you can learn to respect people."

After saying that, Chen Gong stood up and walked towards the emergency room.

At this time, in the rescue room.

After Wu Xueyu took the child's temperature, he exclaimed!
"Body temperature: 38.5!"

"Blood pressure: 68/40 mm!"

"I rely on!"

Nurse He Ling was busy at this time. She was startled by Wu Xueyu's voice and frowned slightly: "Doctor Wu, what are you doing?"

"You're making such a fuss, can't you keep calm?"

Nurse He Ling was a little disappointed. To be honest, after arriving here, He Ling really couldn't say anything about the level of doctors here.

Because...it's too ordinary!

Or did you see an excellent doctor at your original hospital?
After arriving here, He Ling was speechless when she saw the quality of these emergency doctors.

Seeing Wu Xueyu's fuss at this time, he couldn't help but sigh.

Wu Xueyu then said:
"no no!"

"Sister He, you misunderstood."

"Team Leader Chen is really awesome!"

He Ling was slightly startled: "Chen Gong? What does it have to do with him?"

Wu Xueyu then explained what happened today and then said something.

"When we were eating and chatting just now, Team Leader Chen predicted that the patient would get sick at about nine o'clock, and would show symptoms of hypotension and shock."

"The blood pressure will not exceed 70/40 mmHg." "And even the body temperature can be predicted accurately!"

"It's just amazing!"

"Team Leader Chen is so awesome!"

Wu Xueyu was really frightened.

Chen Gong's level has far exceeded Wu Xueyu's ability.

He really couldn't imagine why Chen Gong could predict even these things?
He Ling was completely stunned when she heard Wu Xueyu's words.

She looked at Wu Xueyu with slight surprise and couldn't help but said: "Really or not?"

"Don't lie to me!"

"When I was in the emergency department of the cancer hospital, I saw some experts, but... I have never heard of such a person."

"how is this possible?"

Wu Xueyu said excitedly: "Really!"

"I'm not lying!"

At this time, the door opened and Chen Gong walked in from outside.

After hearing Wu Xueyu's words, I couldn't help but ask: "What kind of lie?"

Wu Xueyu saw this and said quickly: "Team Leader Chen, it's exactly as you expected!"

"Blood pressure, heart rate, temperature!"

"Basically the same!"

"How did you do it?"

Hearing this, Chen Gong couldn't help but smile and shook his head.

All of this naturally comes down to the surgery performed on Ma Shu.

Chen Gong was very involved at the time, and the operation was extremely difficult.

and so!
After Chen Gong completed the operation, he received a special reward.

"Poisoning Medicine: lv6!"

Poisoning medicine at the academic leader level.

Similarly, it was this skill that solidified Chen Gong's idea of ​​coming to the emergency room.

Although poisoning medicine has developed in recent years,... on a global scale, there is a lack of an absolutely representative academic leader.

Although more and more people have paid attention to it in recent years,...so far, only one academician has been born in the field of poisoning medicine in China.

Moreover, even in many emergency medicine medicines, gastric lavage solutions for poisoning rescue have not been updated yet.

Chen Gong heard this and smiled: "Okay, what's so praiseworthy about this?"

"This is the law of disease development."

"Just like when you have a cold, how high your fever will be and when the temperature will rise... the same principle."

"After iron poisoning, there is actually a very predictable development process."

"Generally, about 12 hours after oral iron poisoning, hypoglycemia and metabolic acidosis occur due to cell damage caused by iron.

Therefore, at this time, there will usually be fever, but this fever is very stable and will basically remain in the range of 38.5 degrees Celsius.

At the same time, leukocytosis and coma will also begin to occur.

And if it is a child, it is delayed shock! "

"Just remember this thing!"

After finishing speaking, Chen Gong read all the patient's physical signs, as well as the electrocardiogram and blood pressure indicators.

Wei Wei pondered.

He Ling looked at Chen Gong with a little surprise.

She didn't expect that Chen Gong, at such a young age, could achieve such a level?
This is somewhat unbelievable!
After hesitating for a moment, He Ling looked at Chen Gong and asked:

"Dr. Chen, can you make another prediction?"

"Let me see it too!"

Chen Gong glanced at He Ling and knew what the other person was thinking.

However, he didn't mind, after all... with the cooperation of the nurse, the work would be easier to carry out in the future.

I couldn't help but smile: "If my prediction is not wrong, the child's serum iron will be as high as about 89.5 μmol/L (500 μg/dl), which will not be too high."

As soon as these words came out, He Ling rolled her eyes.

"How could this have been predicted?"

Chen Gong did not explain.

Because if the serum iron concentration is too high at this time, the bleeding volume will increase again, instead of the current performance.

Soon!
The nurse sent the test sheets.

"Dr. Chen, the test results are out!"

"The patient's serum iron concentration is 90!"

When Chen Gong heard this, he didn't pay attention, but continued to prepare the medicine in his hand.

He Ling and Wu Xueyu were completely confused.

Did he really guess it? !

This……

For a moment, He Ling looked at Chen Gong with a bit of shock.

Now, after hearing Chen Gong's words, He Ling gave up completely.

She knew that she must have met an expert!
At this time, the family members outside started knocking on the door. After the nurse came in, she looked at Chen Gong and said awkwardly:
"Director Chen...the patient...the family members sent eggs and milk..."

Chen Gong was stunned: "Bring it in?"

The nurse couldn't laugh or cry: "I can't take it!"

"The other party bought a lot!"

Chen Gong was stunned for a moment. When he came out and took a look, he was immediately dumbfounded.

There were four or five cartons of milk in front of him, as well as two baskets of free-range eggs.

This is like a gift, placed at the door of the ward.

Chen Gong immediately rolled his eyes: "Why did you buy so many of these?"

Man: “You asked me to buy it!”

"I'm thinking of buying more."

Chen Gong was speechless: "..."

He uses these things... could it be for eating?
He quickly asked the nurse to let the patient's family take it away, but he only brought in a few eggs and bottles of milk.

Wu Xueyu looked at Chen Gong: "Team Leader Chen, are you... preparing the medicine yourself?"

Chen Gong nodded.

"Ok!"

"Generally, the rescue of poisoned patients is mainly divided into two major steps."

"The first step is emergency treatment."

"The second step is drug treatment."

"Emergency treatment is also divided into several steps."

"First, prevent absorption, but the method should be selected according to different toxicities. The patient is iron poisoned. A large amount of egg white and milk can promote the formation of ferritin complex from free iron, which can prevent absorption."

"Second, induce vomiting. Actively, the tongue depressor stimulates the epiglottis, throat, etc. to make the patient spit out the iron as much as possible. But this needs to be done while the patient is conscious."

"Third, gastric lavage."

After speaking, Chen Gong took out the medicine and handed it to He Ling: "Head nurse, this is the medicine I prepared. You can do the gastric lavage."

"Xiao Wu, please remember this plan. You can use it in the future for iron poisoning."

"Gastric lavage with 2% sodium bicarbonate solution can turn ferrous sulfate into less corrosive ferrous carbonate."

"Fourth, catharsis: use sodium sulfate for catharsis."

"The last step, and the most critical, is intravenous perfusion therapy: it supports tissue perfusion, corrects severe acidosis and shock, prevents liver and kidney function damage, and promotes iron excretion. Hemodialysis can be used for severe poisoning."

These are not guides, nor do they appear in guides.

In European and American countries, emergency treatment is actually not as good as in China.

why?
This involves regional differences.

Because the Chinese are so awesome.

Dare to eat anything.

Therefore, this leads to the fact that the Chinese people’s experience in poisoning is far ahead in the world.

May I ask which one is the best for detoxification?
Yunnan, China is great!
No way, we are really far ahead in detoxification.

Of course, hospitals not only in Yunnan but also in Fujian are not bad either.

Therefore, poisoning medicine in China is much more complete than that in foreign countries.

……

Here, He Ling is very cooperative with Chen Gong.

With the child in hand, treatment and gastric lavage were quickly started.

This step-by-step operation is hearty.

Chen Gong also saw the role of excellent emergency nurses.

If doctors are the brain center, nurses are the execution power.

No matter what plan your doctor gives, a nurse still needs to implement it.

This is the value and significance of the existence of excellent nurses.

So don't underestimate nurses, emergency nurses... they really shouldn't be underestimated. In many cases, they are even better than doctors.

A skilled and experienced emergency nurse is fully capable of dealing with many emergencies in the emergency room.

quickly!

After patients take deferoxamine, the excretion of iron in the body is accelerated to reduce serum iron levels.

About an hour later, the child on the bed woke up.

He Ling and Wu Xueyu laughed excitedly when they saw this.

There is nothing more fulfilling than this.

Seeing this, Chen Gong waved his hand to Wu Xueyu: "Go and notify the patient's family."

"The patient is awake."

"Don't worry."

Wu Xueyu heard the sound and ran outside happily.

Young people can't hold anything in their hearts. If they have any good things, they are anxious to share them.

Seeing this, He Ling couldn't help but give Chen Gong a thumbs up.

"Dr. Chen, you are so amazing!"

"But... you are not at all mature and stable as you should be at this age."

Chen Gong waved his hand: "I look young."

To be honest, no one in the department knows how old Chen Gong is.

This has become a mystery.

After learning that the child was getting better, the family was overjoyed and extremely happy.

After Chen Gong came out, he just waved his hand and returned to the office.

The pile of things sent by the patient's family members was also placed at the nurse's station.

Don't take anything away.

The child still needs to continue to be observed and eliminate iron, so he will definitely stay for observation tonight.

But there is no need to continue to stay in the intensive care unit.

Sent to the observation ward to wait.

……

……

the next day.

When the shift ends early.

Jiao Liming walked into the office and was about to start handover.

Suddenly a woman came in from the door, holding a banner in her hand.

"Dr. Chen, thank you so much!"

In everyone's surprise, Chen Gong finally received the first banner in his life.

Hanging on the wall of the office.

So far, the Third Emergency Department has successfully broken the pennant shortage and won the first pennant since the establishment of the department.

When Jiao Liming saw this, he was naturally overjoyed.

On the day of handover, Chen Gong naturally received a lot of praise.

After get off work, Chen Gong was about to go home.

Jiao Liming smiled and patted Chen Gong on the shoulder, smiling slightly: "Chen Gong, good job!"

"You've given us a good start!"

Chen Gong smiled slightly: "Take your time!"

Jiao Liming heard the sound and nodded excitedly.

Why doesn't he want to build a great cause here?

For a moment, I was full of confidence.

However, Chen Gong was preparing to leave.

suddenly!

A crisp phone rang.

Over at the nurse's station, a nurse ran over anxiously after answering the phone.

"Director Jiao, it's not good!"

"An accident occurred at the West Valley Mine."

"The higher ups asked us to send a car over immediately!"

Hearing this, Jiao Liming's expression changed.

He quickly returned to the office and said to everyone:

"An accident occurred in the West Valley Mining Area. A person in charge came and followed the car immediately."

"Whose class is today?"

Hearing Jiao Liming's words, everyone's expressions changed immediately.

Accident in mining area...

This is no small matter, right?
A 40-year-old middle-aged man stood up: "My class!"

When Jiao Liming saw the other party, he frowned immediately.

Because the person on duty today is the head of the emergency internal medicine department and the team leader Gu Haichang.

Gu Haichang is an emergency medicine specialist and has been Jiao Liming's right-hand man since he arrived.

but……

The other party also had some difficulties with this kind of traumatic accident.

At this time, Jiao Liming shifted his sight to the leader of the second group.

"Director Qian, are you going?"

Qian Jianhua stood up, coughed, and seemed ready to say something.

But Chen Gong said directly to Wu Xueyu.

"Xiao Wu!"

"Pack up your things and get ready to go."

After finishing speaking, Chen Gong nodded to Jiao Liming: "Director Jiao, let me go!"

After saying that, Chen Gong stood up and put on the white coat he had just taken off without saying anything, and walked outside with Xiao Wu.

At this time, He Ling was preparing to get off work after handing over her shift.

Seeing this, Chen Gong called directly: "Sister He, would you like to go out with us?"

He Ling couldn't help but nodded and put on her hat: "Okay!"

While I was talking, the ambulance was already at the door.

Chen Gong and the others quickly got into the car and rushed towards the mining area.

……

ps: Remember, you must not cook acidic foods or fruits in iron pots. There are really many cases of this in life.

The purpose of medical novels is also to popularize science, hoping to serve as a warning.

(End of this chapter)