I can see health

Chapter 313: White Whoring Skill Card
However, Lu Chen glanced at the girl standing in the middle of the consulting room.

From the outside, she didn't look uncomfortable, but her expression was a little dull and lifeless.

Lu Chen looked over her head, the girl's HP was 68.

This is definitely problematic, but the problem is not life-threatening.

"Tell me in detail how she drank mercury." Wang Xueyang asked the middle-aged man.

"Hey, it's like this..."

The middle-aged man paused and briefly talked about the whole process.

This little girl is her daughter.

When she was a child, she was always brought up by her grandparents. She has a withdrawn personality and has been prone to depression since she was 12 years old.

This time, the little girl committed suicide by drinking mercury!

At around 3 o'clock this afternoon, the girl broke fifteen thermometers by herself, then poured the mercury into a mineral water bottle, and then drank them all.

However, the girl did not experience abdominal pain, diarrhea, nausea, or vomiting after taking mercury orally.

After the middle-aged man found out, he immediately sent his daughter to the local hospital.

After completing the laboratory tests of blood routine, liver function, kidney function, and coagulation in the local hospital, no obvious abnormalities were found.

Although no abnormalities were found, the parents were still not at ease.

Now for further diagnosis and treatment, he was transferred to the Emergency Department of Jinghua Second Hospital.

"Is there anything uncomfortable about you now?" Wang Xueyang leaned in front of the girl.

The little girl frowned, looked at Wang Xueyang vigilantly, then shook her head slightly, but still did not make a sound.

Seeing this, Wang Xueyang immediately stepped forward, put the girl on the physical examination table in the consultation room, and then "drived" other patients and their family members out of the consultation room.

Lu Chen gently closed the door, and Wang Xueyang began to conduct a detailed physical examination and auscultation on the little girl.

half an hour.

After the inspection, Wang Xueyang breathed a sigh of relief. She didn't find any problems, and then said to Lu Chen: "Mercury is the only liquid metal at normal temperature, and the main way of poisoning it is through the respiratory tract in the form of vapor."

"The absorption of metallic mercury through the digestive tract is minimal, or even negligible. I have seen a case report of taking hundreds of grams of mercury orally, and the patient survived. Therefore, taking mercury orally is generally not life-threatening."

Lu Chen understood.

He has relatively little exposure to metal poisoning.

He sees organophosphorus pesticides and rat poisoning more often. As for metal poisoning, it is rare and relatively troublesome.

"By the way, doctor, this is an X-ray taken at the local hospital."

At this time, the middle-aged man took out his backpack and took out an X-ray from it.

This is a chest + full abdomen + pelvic X-ray.

Wang Xueyang picked up the X-ray and looked at it, with a look of surprise on his face.

She muttered softly.

"This mercury is almost reaching the anus!"

Lu Chen also glanced at the X-ray.

Sure enough, as Wang Xueyang said, the mercury taken by the girl's mouth went directly to the anus.

"Do you feel the swelling of the anus?" Wang Xueyang looked at the little girl again.

Lu Chen knew that Wang Xueyang was asking if he felt anal swelling.

The little girl was still shaking her head.

Wang Xueyang said to the middle-aged man on the side: "The child may need to be hospitalized in the emergency ward. Although it is not life-threatening, if a large amount of metallic mercury is taken orally, if it cannot be excreted quickly, the mercury may be oxidized into mercury ions in the intestinal tract and absorbed by the human body." Blood. Mercury absorbed through the digestive tract mainly causes digestive system symptoms and kidney damage.”

"Then where do I go to go through the formalities?" The middle-aged man immediately agreed to be hospitalized.

"I'll issue a hospital bill for you, and then go to the payment window in the lobby on the first floor to pay." Wang Xueyang said, "During the hospitalization, you must be accompanied by you 24 hours a day."

"Okay, no problem." After getting the hospital certificate, the middle-aged man took the little girl and left.

Seeing the backs of the two leaving, Wang Xueyang sighed slightly.

She said slowly to Lu Chen who was beside her: "Actually, I'm not worried about this little girl's mercury poisoning, but about her mental state. She was only 15 years old this year, and she started committing suicide. This time, if I am saved, I can't save her." There is a next time."

Lu Chen nodded slightly.

Society is developing rapidly, but many problems have also been exposed.

For example, the psychological problems of left-behind children.

Although Lu Chen has not been in the clinic for a long time, he has seen many such patients.

Before the Department of Endocrinology, he also saw a little girl with depression who was poisoned by eating "licorice tablets".

Today, I met another person who was poisoned by drinking mercury.

"Lu Chen, go and inform the doctor on duty in the emergency ward upstairs, and make sure the family members keep a close watch on the patient so as not to cause any accidents in the hospital."

"Okay, Teacher Wang." Lu Chen nodded, "The person on duty upstairs tonight happens to be a classmate I know, so I'll give him a call."

"Okay, you go to fight."

Lu Chen immediately called Cheng Peng directly.

"Fatty, a little girl with oral mercury poisoning will come to the emergency ward later."

"Ah? Mercury poisoning?" Cheng Peng said in astonishment, "This... this is really a mouthful!"

Lu Chen briefly described what happened, and Cheng Peng was also secretly shocked.

Lu Chen continued: "Fatty, the patient is a 15-year-old girl who has depression and suicidal tendencies in the past. Go and talk to the teacher on duty. Let the family members of the patient pay more attention. Be sure to accompany her 24 hours a day. The ward rounds should be strengthened to avoid another suicide.”

"Okay, tonight's night shift happens to be Senior Brother Wang Xiaodong, I'll go and tell him." Cheng Peng said, "You're doing a great job in the emergency department, so you can take fewer patients."

"Don't worry, I won't collect them indiscriminately, and I won't refuse them." Lu Chen smiled.

After hanging up the phone, Lu Chen turned to look at Wang Xueyang who was beside him.

"Teacher, I have already explained to the doctor on duty upstairs." Lu Chen said.

"Okay." Wang Xueyang nodded, "Actually, in our emergency department, the more common patients, in addition to patients with fever and abdominal pain, are those who take medicine indiscriminately, poisoned, and some suicide attempts."

Those who commit suicide successfully are dragged directly to the funeral parlor or crematorium, and have no chance to come to the hospital at all.

"Teacher, do patients with mercury poisoning need gastric lavage and catharsis?" Lu Chen asked suddenly.

Because of clinical common sense, as long as the poison enters from the digestive tract, timely gastric lavage and catharsis are required, which can reduce the absorption of toxic substances and strengthen excretion.

However, mercury is very special, almost not absorbed in the digestive tract.

Wang Xueyang paused, and then said after a long while: "Gastric lavage and catharsis both have a certain effect. However, gastric lavage with normal saline should not be used, especially in the case of mercury poisoning, because it can increase its solubility and increase absorption. Carbonic acid can be used in the early stage. After gastric lavage with sodium hydrogen and activated charcoal, milk and egg whites can be taken orally, and protein can not only protect the gastric mucosa, but also combine with mercury to prevent the absorption of mercury."

Lu Chen wondered: "For this little girl, the mercury has already reached her anus. Logically speaking, gastric lavage has almost no effect, right?"

Wang Xueyang cast admiring glances at Lu Chen.

"I have an idea. For this patient, gastric lavage may not have much effect, but catharsis is very important. We usually use mannitol catharsis and glycerin enema to promote intestinal peristalsis, and intravenous infusion of PPI to suppress acid and protect gastric mucosa. , alanyl glutamine protects the intestinal mucosal barrier, edaravone vitamin C resists oxygen free radicals, and even uses some sodium dimercaptopropanesulfonate as a mercury expulsion treatment..."

Wang Xueyang's explanation is very clear.

Lu Chen's knowledge of emergency poisoning is still not perfect.

As a senior attending doctor, Wang Xueyang has rich emergency experience.

A small number of diseases are rare in Lu Chen's view, but Wang Xueyang can also tell one or two.

At this moment, a prompt popped up on the system panel.

"Ding, I have received the knowledge of clinical toxicology."

"Congratulations, you have obtained the Emergency Toxicology Skill Card (Elementary)!"

When Lu Chen saw this reminder, he was still dazed.

The last time I got a skill card in this way was when I participated in the difficult case discussion with Li Yao.

At that time, he obtained a primary skill card of clinical thinking.

This time, unexpectedly, he got a skill card for emergency toxicology!

Lu Chen was quite surprised.

During the rotation in the cardiology department, Sun Guoguo and Li Yao also taught a lot of cardiology knowledge, but he never obtained the relevant skill cards.

Lu Chen guessed that it might be related to unfamiliar fields.

In this unfamiliar field, as long as someone else taught him the knowledge, he would be able to obtain the relevant skill cards.

However, this acquisition method should have certain limitations.

Lu Chen still can't figure out these doorways of the system for the time being, and further exploration is needed.

However, Lu Chen was very happy to be able to prostitute a primary skill card for nothing.

Because in the system mall, this emergency toxicology skill card also costs 30 thank you points.

For Lu Chen now, every bit of gratitude is very precious.

No matter how small a mosquito is, it is still meat!
……

After treating the patient with mercury poisoning, Lu Chen and Wang Xueyang continued to see the rest of the patients.

In just two hours, they saw about forty patients.

There are more patients in the emergency department, but Wang Xueyang still feels that something is different tonight.

The number of patients tonight has increased by [-]-[-]% compared to usual.

Wang Xueyang glanced at Lu Chen beside him.

Fortunately, there is this relatively reliable graduate student here. If another novice came over, with so many patients, he might be in a hurry.

"Doctor, is this the emergency internal medicine department?"

At this time, an obese middle-aged man appeared at the door of the consulting room.

Beside him was an old man about 70 years old.

"Yes." Wang Xueyang nodded.

The middle-aged man hurriedly helped the old man into the consulting room.

"Doctor, come and see my dad, he has been hiccupping for four days."

As soon as the middle-aged man finished speaking, Lu Chen and Wang Xueyang heard an "uh".

The old man's chest rose and fell slightly, and he hiccupped.

Immediately afterwards, less than three seconds.

Another uh-

The man at the side said with a bitter face, "That's it, hiccups happen every few seconds."

(End of this chapter)