Doctor Zhao, help!

Chapter 33 Pesticide poisoning?

After the tall girl signed the notice of critical condition, Zhao Sheng and Li Mujia devoted themselves to the treatment of the young girl.

But unfortunately, the young girl's blood pressure started to drop.

This drop in blood pressure is like a cliff.

Drop drop!
Just when Zhao Sheng and Li Mujia were concentrating on the young girl's condition and trying to find out the cause of the girl's critical condition, the life monitor rang rapidly!
After a while, Song Wei shouted: "Dr. Zhao, the heart has stopped!"

After hearing this, Zhao Sheng, who was thinking, saw a straight line on the ECG monitor at a glance.

After hearing Song Wei's words, Li Mujia immediately stepped forward and began to perform cardiopulmonary resuscitation on the young girl.

"Adrenaline, quick!"

Zhao Sheng also quickly said to Song Wei.

Song Wei took out epinephrine from the first aid cabinet, smoked one, and pushed it into the young girl.

Li Mujia was still doing chest compressions, but at this moment, the young girl's breathing was almost weak and non-existent.

Seeing this situation, Zhao Sheng quickly said to Li Mujia: "Doctor Li, you do the tracheal intubation, and I will continue the resuscitation."

"it is good."

Li Mujia also nodded resolutely. When it comes to tracheal intubation, no doctor in any department is more skilled than those in the ICU.

This is also a specialty in the art industry.

Just like pressing the fast forward button, Li Mujia completed tracheal intubation in just 1 minute, which usually takes 3 to 5 minutes.

After the tracheal intubation was completed, Li Mujia put the young girl on a ventilator for assisted ventilation.

With this quick response, Zhao Sheng continued to press for another 2 minutes, and the young girl finally recovered her spontaneous heartbeat.

Seeing the beating curve reappearing on the ECG monitor, everyone in the emergency room breathed a sigh of relief.

Only then did Zhao Sheng realize that his back was already soaked!

The two girls who were still in the rescue room did not dare to take a breath at this moment. They were completely shocked by this scene.

It was these two girls who were enjoying their youthful years, but how could they have personally experienced the horror of life and death?
Moreover, the person who was lying on the rescue bed and almost died was a colleague who worked with them.

What is the cause of the girl's death?
At this moment, the girl temporarily saved her life, but Zhao Sheng and Li Mujia were both thinking hard.

Li Mujia, who wore gold-rimmed glasses and tied up hair, looked very smart and capable. After thinking for a moment, he said to Zhao Sheng: "Doctor Zhao, could the patient be poisoned by something?"

"Poisoned?"

When Zhao Sheng heard this, he was immediately excited.

Abdominal pain, vomiting, diarrhea, profuse sweating, hypotension, shortness of breath, rales in the lungs, shock, and coma, but there were no abnormalities in abdominal B-ultrasound, blood tests, and electrocardiogram.

At this moment, the situation of the young girl went through Zhao Sheng's mind.

Poisoning?

Zhao Sheng instantly thought of an impossible guess!
Thinking of this, he immediately stepped forward and opened the eyelids of the unconscious girl.

When looking at the girl's pupils, Zhao Sheng was stunned.

The girl's bilateral pupils, not only did not fall into the dilated state of a normal coma, but were actually very small, like needlepoints!
The diameter of a normal person's pupil is about 2-4mm. If it is dilated during coma, it can even reach 10mm.But the pupil of the young girl Zhang Xuan at this moment is not even 1mm, it is like the tip of a needle. This shows that the pupil of the girl Zhang Xuan is extremely narrowed!
"Needle-point pupils!"

When Zhao Sheng was inspecting, Li Mujia, who was standing aside and watching, immediately blurted out!

Yes, these are pinpoint pupils!
Zhao Sheng concluded immediately.

Under what circumstances does a patient have pinpoint pupils?

Only patients who take morphine or some powerful sedatives can cause miosis.

But this young girl had no access to this drug.

There is another reason that can cause extreme pupil constriction, and that is organophosphorus poisoning!

Yes, abdominal pain, vomiting, diarrhea, profuse sweating, hypotension, shortness of breath, crackles in the lungs, shock, and coma are all symptoms that occur after organophosphorus poisoning and the transplantation of cholinesterase, which affects the peripheral nerves. M-like (muscarinic-like) performance!
All of the young girl's symptoms can be explained by organophosphate poisoning.

Sweating profusely at the beginning is not a shock, but a manifestation of increased glandular secretion caused by organophosphorus poisoning.

Blurred vision and poisoning are symptoms of poisoning.

Chills and shivering but no fever are myofibrillar fibrillations caused by organophosphorus poisoning!
All the symptoms are connected!

Organophosphorus pesticides (OPS) are the most widely used pesticides in my country.Mainly include dichlorvos, parathion (1605), phorate (3911), systemic phosphorus (1059), dimethoate, trichlorfon, malathion (4049), etc.

Acute organophosphorus pesticide poisoning (AOPP) refers to a series of injuries, mainly nervous system damage, caused by organophosphorus pesticides entering the human body in large amounts in a short period of time. Clinically, it mainly includes cholinergic excitement or crisis in patients with acute poisoning. intermediate syndrome (IMS) and delayed-onset peripheral neuropathy (OPIDPN).

After organophosphorus poisons enter the body, they quickly combine with the cholinesterase in the body to generate phosphorylated cholinesterase, which causes the cholinesterase to lose its function of hydrolyzing acetylcholine, resulting in a large accumulation of cholinergic neurotransmitters, which act on the bile gallbladder. Alkaline receptors can cause severe neurological disorders, especially respiratory dysfunction, thus affecting life activities.

Due to the M-like effect caused by parasympathetic nerve excitement, a large number of glands are secreted in the patient's respiratory tract, causing severe pulmonary edema and aggravating hypoxia. The patient may die due to respiratory failure and hypoxia.

However, a young girl who sells a house in a big city like Zhongdu and seems to live a refined life, where did she come into contact with pesticides, and how could she get organophosphorus poisoning?
Because the vast majority of organophosphorus poisoning occurs in rural areas, and they are all taken orally by suicide.

"Do you live with her?"

Thinking of this and with doubts, Zhao Sheng asked the two girls.

In a big city like Zhongdu, most young girls, especially colleagues, live in shared apartments. It is difficult for one person to afford the high rent of a house.

"Ah."

The tall girl nodded.

"Normally, does she raise any flowers and plants at home? Is she possibly exposed to pesticides? Is it dichlorvos, dimethoate, etc.?"

Zhao Sheng asked.

"No, the three of us live together. It's already very crowded and there's no room to grow flowers and plants."

The tall girl thought for a while and said.

"Think about it carefully. Has she been exposed to anything similar to pesticides in her daily life?"

Zhao Sheng asked again.

Although organophosphorus poisoning is suspected, the diagnosis must be confirmed before pralidoxime, an antidote to organophosphorus poisoning, can be used.

Otherwise, it is not organophosphorus poisoning, but the use of pralidoxime will accelerate the death of the patient.

(End of this chapter)