I'm really an intern

Chapter 261 Shocking White Lung

When the mouse clicks down, a new page pops up.

But it's just a page, and the picture of the previous page still stays inside.

The speed of the computer in the ICU ward is extremely slow, which is said to be due to the problem of line occupation.

But after staying here for two days, Zhang Tianyang calmly waited for the picture to load.

Beside, the ICU director has reached an agreement with the attending doctor.

Because he wanted to make things difficult for Zhang Tianyang, he had already visited the director's ward round yesterday, so today he only checked the new patients who arrived yesterday and the patients who were seriously ill and dying.

Others, wait for the attending doctor to take the little doctors to check.

While waiting for the picture, Zhang Tianyang distractedly listened to the mutterings of the two. By the way, he glanced at the little yellow chicken who was obviously much more lively in the next bed.

After getting rid of the negative psychology, this guy started staring at the best-looking little nurse in the ICU ward!

He moved his feet, and moved ten centimeters sideways with the computer, just in the middle of the sight of the little yellow chicken man.

Do good deeds every day, Amitabha!

After a full half-minute delay, the picture was refreshed in front of his eyes little by little.

Zhang Tianyang glanced casually, but after only one glance, his brows frowned.

The little nurse who had just been scolded by the head nurse passed behind him sullenly, raised her head to take a look, and then froze for a moment.

Although the little nurse is not a medical student and has not been in the clinic for a long time, she has seen a lot of various films.

One piece of black and one piece of white, although I can't understand the details, but I can get a general idea.

But now, never-before-seen images appear in front of my eyes.

She recognized that this picture should be of the patient's lungs, because the outline was still there.

Other people's lungs are black, with some white in the middle, at most one black and one white.

When discussing, the doctors will say that the white part is exudation, this white part is the standing position, and the black part next to it is normal.

But in this film, the lungs on both sides turned white, not black at all.

She spoke subconsciously.

"Is this overexposure?"

After all, no matter how serious the infection was in the past, there was no one that was completely white!

"No."

Zhang Tianyang's face has darkened.

"This is White Lung."

Zhang Tianyang let out a foul breath, and began to call the attending doctor and the director of the ICU.

"Teacher! Director! Please take a look. Yesterday's lung CT of Bed 69 came out."

The attending physician and the director of the ICU quickly responded and walked over quickly.

After two days of getting along, they probably also had a certain understanding of Zhang Tianyang.

Xiao Zhang, a little classmate, is still very capable and mentally strong.

Quite a bit of the meaning that Mount Tai collapsed in front of it without changing its color.

Therefore, Zhang Tianyang's gloomy face and low tone gave them a bad feeling.

"Let's take a look, the image just came out."

Zhang Tianyang took the initiative to give up his position.

In addition to the attending doctor and the ICU director, two little fans and little girls also spontaneously gathered together. Song Changkong wandered around at some point, poking his head to wait and see.

Then, a group of white coats fell silent.

On the film, the patient's lungs were completely white.

All white on both sides.

It is mixed with the white of upper limb muscles and other tissues, regardless of each other.

Let them be in a trance for a while.

It seems that this film is not a CT that can clearly see various organs in the body, but a stroke machine.

Outline the outline of the human body, and then fill it all with white.

After reacting for half a minute, the attending doctor suddenly trembled and subconsciously spoke.

"I rely on!"

Nobody bothered that he was swearing.

Because they may have said a lot in their hearts.

"White lung!"

As the chief physician of a lower-level hospital, Song Changkong has seen a lot of lung films over the years, but he has to admit it.

"This is the first time I have seen such an image outside of a textbook."

The two little fans who were lucky enough to witness history looked at the shocked attending doctor, at the sighing Song Changkong, and at the frowning ICU director, cautiously daring to speak.

Not long after I entered the clinic, I encountered a patient with "white lung". I don't know whether it was luck or misfortune.

The movement here quickly attracted the attention of the surrounding white coats, and they touched one or two, wanting to take a casual look.

As a result, when they saw it, they froze in place together.

Seeing that all the white coats were in shock, the only little nurse next to him who was not sure about the situation turned her eyes to Zhang Tianyang for help in a daze.

"What kind of disease is white lung?"

Zhang Tianyang paused, sighed, and briefly introduced the key points.

"White lung does not refer to a specific disease, but refers to the appearance of the lungs of patients with severe pneumonia on X-rays or CT films.

Now, like this, the whole lung is white.

The most common cause of white lung is infection, followed by diffuse alveolar hemorrhage syndrome and acute respiratory distress syndrome (ARDS). "

Hearing Zhang Tianyang explaining to the little nurse, the white coats all came to their senses.

The director of the ICU continued Zhang Tianyang's words, not knowing whether he was explaining to the little nurse or the little doctor present.

"White lung not only indicates severe infection of the patient's whole lung, but also often accompanied by sepsis, septic shock, coagulation dysfunction, etc."

"So, patients with white lung have a very high mortality rate."

The voice fell, and the surrounding was quiet.

After the slight gaffe just now, the attending doctor's face is now full of dignity.

This was the first white lung patient he encountered in his medical career.

The other little doctors were also aware of the seriousness of the problem, each quietly controlling their breathing, not daring to speak or attract attention.

But involuntarily, their eyes fell on Zhang Tianyang.

This patient seems to belong to this junior brother.

so miserable

Zhang Tianyang, who was once again in the center of everyone's focus, did not have such a tragic consciousness as himself.

He naturally followed the path that everyone gave way to him, walked in again, and stood next to the director of the ICU.

The director of ICU glanced at him and asked cautiously, "What do you think?"

Zhang Tianyang paused and spoke.

"The first is the diagnosis. The patient has an acute onset. At the beginning, he only showed rapid breathing, and soon he became progressively aggravated dyspnea. When he was sent up, his lips and fingertips were cyanotic, accompanied by symptoms of extreme anxiety and changes in consciousness. Auxiliary Ventilation did not significantly improve the patient's symptoms.

I think it is possible to add 'respiratory distress syndrome' and the diagnosis of respiratory failure to the patient. "

Zhang Tianyang's analysis was reasonable, and the director of the ICU nodded in agreement.

"Then comes the diagnosis. According to the patient's medical history and the results of the emergency department examination two days ago, the infection index rose rapidly, and the bacterial infection was serious. At the same time, we must be alert to the possibility of multiple bacterial and fungal infections."

While talking, he clicked on the doctor's order entry interface, "I think we can do a few more sputum cultures for him."

"OK."

The icu director continued to nod.

"Then there is treatment. The anti-infective drugs are still in the current regimen, and protective lung ventilation strategies are carried out at the same time, such as low tidal volume, low airway pressure, and control of excessive respiratory rate."

Paused, he didn't see any rebuttal from the ICU director, so he continued.

"Secondly, if the patient's symptoms continue to progress, I think high-dose gamma globulin pulse therapy and bedside continuous blood purification can be considered. Try to avoid multiple organ failure."

"There are also airway management, respiratory support treatment, nutritional support and nursing treatment, psychological counseling"

Under the watchful eyes of everyone, Zhang Tianyang talked a lot.

As he spoke, he entered new medical orders on the screen.

The director of the ICU listened carefully the whole time, and didn't even say a single rebuttal.

The onlookers in white coats were a little shocked when they saw such a scene.

But thinking about Zhang Tianyang's performance two days ago, he felt quite normal.

Only the attending doctor was secretly startled while listening.

With his qualifications in attending, it was also the first time he encountered a patient with white lung.

He believed that Zhang Tianyang must have encountered it for the first time after only a few months of internship experience.

But when he panicked subconsciously, Zhang Tianyang was calm and calm, and gave a clear idea, diagnosis and treatment process.

The point is, it makes sense.

He took a deep look at Zhang Tianyang, and then slowly put away the little pride left in his heart.

Ten minutes later, Zhang Tianyang finished his babbling explanation.

The director of the ICU frowned for the first time after 10 minutes.

He patted Zhang Tianyang on the shoulder.

"Good job!"

(End of this chapter)