I'm really an intern

Chapter 150 Death Comes Knocking

"Come on, sit down."

Zhang Tianyang stood up involuntarily and helped the patient sit down.

The new patient is an old man. According to the data, he is 65 years old.

Looking at people, Zhang Tianyang feels that he is 75 years old.

With the support of his wife, the old man half-bent and walked in tremblingly.

But at the moment when he saw the old man, Zhang Tianyang felt a serious illness.

This is not the metaphysics of a magic stick popping up from the corner of the Taoist temple and clasping his hands together and saying, "This benefactor, your seal is black."

It's a kind of intuition produced subconsciously after seeing many patients with various illnesses, mild or severe, in the hospital all the year round.

Just like many doctors stare at someone occupationally when walking on the street, and feel that the other person is sick no matter how they look at it.

In fact, there are traces to follow.

Many details showed the old man's critical condition.

When he raised his head slightly, Zhang Tianyang could see that his wrinkled face was covered with tiny drops of sweat.

His arms exposed to the air showed the skin color of a normal old man, some were darkened, and there were many brown age spots.

But his face was pale, and his wrinkles were much deeper than usual because of the pain.

The old man was still holding his stomach when he was supported by one left and one right to sit down.

It was another patient with abdominal pain, so painful that his face was pale and he was sweating coldly.

"shock."

This word, which was mentioned countless times just now, reappeared in Zhang Tianyang's mind.

Is there another one?

"I have a stomachache and diarrhea. I may have eaten expired mung bean cake."

Before Zhang Tianyang asked carefully, the old man took the initiative to explain his main complaint.

The last little brother had kidney stones, and this old man had diarrhea, both of which are generally not serious, but can be fatal when serious.

"When did you start having diarrhea? What does the stool look like? Describe the color and shape. How many times have you been there since the beginning?"

Zhang Tianyang quickly chose a direction for further consultation.

The patient's complaints were clear, with epigastric pain and recurrent watery diarrhea that had begun seven hours earlier.

This is actually a very common complaint in the emergency department.

After all, the temperature in Guangdong Province is relatively high, and the recipes are extensive, and there are many restaurants of various sizes around the Oriental Hospital.

In the past two days alone, Zhang Tianyang has dealt with many patients with diarrhea as the main symptom.

For example, the first aunt who received a doctor today also complained of diarrhea.

At that time, Zhang Tianyang prescribed some medicine and let her go.

But this old man was different.

First of all, his basic conditions don't look good.

Coupled with the obvious "acute face", pale skin, and cold sweat, it is enough to be listed as a key observation object.

Zhang Tianyang spoke quickly, and quickly and briefly asked about the medical history.

"Is there any nausea and vomiting?"

"Did you have any dizziness and headache?"

"Do you have a fever?"

"Do you have any chest pain?"

"Is there any weakness in the limbs?"

"Is there any history of hyperglycemia and hypertension in the past?"

"Any drug allergies?"

His heart has long been disturbed. According to his judgment, this patient has a serious problem in all likelihood.

But the medical history that should be asked still needs to be asked. Only when the medical history is clear can the cause of the disease be found more quickly and accurately, and the cause of the disease can be treated.

"How much blood pressure did you take at the nurse just now?"

After glancing at the medical records handed over by the patient, Zhang Tianyang jumped up from his seat in an instant.

It said in black and white, "Blood pressure 84/46mmHg".

This old man is in shock now!

"Brother! Here comes a patient with seven hours of diarrhea and shock! Blood pressure has dropped to 84/46!"

Dr. Chen was explaining the condition to the patients, when he heard the words, he immediately jumped up.

"Take the emergency room!"

"it is good!"

"Help! Call the nurse in the emergency room to set up an IV!"

The white meat shield accepted the task under Zhang Tianyang's signal, and ran to the emergency room to notify the doctor automatically, and at the same time rushed back with the nurse who had just been pulled over by him.

And Zhang Tianyang and Dr. Chen, two white coats, put the old man on the treatment bed to lie down, and gave him a physical examination.

The family member who came with the old man was an old lady, who had been showing anxiety all the time, and finally couldn't help it at this time.

"Can I get some anti-inflammatory drugs?"

"If the bacterial diarrhea is caused by unclean food, antibiotics must be given."

Zhang Tianyang carried out the physical examination seriously and quickly, and casually replied to the family members.

"And now his blood pressure has dropped, and he is already in a state of shock. He has to go to the emergency room for immediate treatment and observation."

As he answered, his mind turned sharply.

There are many causes of diarrhea. Although the old man is likely to have bacterial diarrhea, other causes cannot be completely ruled out.

Specifically, it still depends on the blood picture and whether the infection index has risen.

From the perspective of blood pressure, the shock is real.

But what exactly caused the shock?

do not know!

Is it possible that the simple blood volume reduction caused by repeated diarrhea?

Are there any accompanying electrolyte disturbances?

Could it be that the bacteria in the food entered the blood, causing the shock of the infection focus?

do not know!

But it's all possible!

The specific cause of the disease must be checked for blood and can only be judged after the results come out.

The most important thing now is to treat the symptoms first, relieve the hypovolemia state, and closely monitor the vital signs of the patient.

There is a string in my heart that is stretched tightly.

Although the old man seemed to be able to talk and walk, he was already in shock.

Coupled with his history of hypertension and diabetes in the past 20 years, his basic condition is not good.

What Zhang Tianyang is most afraid of is that on the basis of the secondary shock, he will develop a more serious disease!

For example, electrolyte imbalances caused by diarrhea can induce serious cardiovascular events.

If that time really comes, it's up to you whether you can be saved or not!

The white meat shield has already rushed back with the nurse in the emergency room with a full set of equipment.

Zhang Tianyang immediately stepped aside and helped the nurse to expose the patient's upper limb veins.

"Quickly, establish a vein for him!"

"Quick infusion of saline, rehydration immediately!"

After seven hours of diarrhea, God knows how much water the old man has pulled out. Now the total circulating blood in his body is definitely reduced.

Fill up the water first, and then talk about other things.

Dr. Chen stayed in the consulting room to greet the patients, while Zhang Tianyang slipped and jumped out.

The emergency room has already said hello, and the bed has been vacated, and now he has to find a way to send the patient in.

Soon, he found the flat car he wanted, and hurried back to the door of the consulting room with a bang.

"Let the patient lie down! Push him into the emergency room for monitoring now! I'll take an EKG for him right away!"

Zhang Tianyang yelled at the consulting room.

"That nurse, help me to draw blood! The six items of liver and kidney function, six items of infection, and two items of myocardial enzymes are drawn! The doctor's order will come later!"

All medical workers are on the alert, ready to go.

Everything is ready, just waiting for the patient to go to bed.

But after a urging, the old man was still sitting on the treatment bed in the innermost part of the consulting room, clutching his stomach to himself, without moving a muscle.

The old lady who came with him frowned and stopped Zhang Tianyang who was about to carry the old man into the car.

"Doctor, don't bother."

She spoke not fast, but with persistence, and a little impatience and distrust.

"We just broke our stomachs after eating, and the transfusion will be fine, no inspection."

As if afraid that some white coats might not hear clearly, the old lady repeated it again.

"We're not sick, it's just that our stomachs are ruined."

Finished!

　I had surgery today, and the things I encountered became more and more magical () I am so black...

　　

　

(End of this chapter)