Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 273 A Dangerous Girl Appears!
Zhou Chao and Yin Liang kept cleaning up Lin Yi's operative field with saline and aspirators, while the anesthetist was watching the ECG monitor without looking sideways, always paying attention to the patient's signs.

Lin Yi is like a statue, maintaining a fixed posture and skillfully removing the remaining blood clots.

An hour later, Lin Yi finally raised his head and stretched his stiff body.

"It's finished cleaning! I'm exhausted."

Everyone else followed Lin Yi's words and breathed a sigh of relief, except for the anesthetist who was watching the ECG monitor.

"how so?"

The anesthetist's voice immediately tensed up the nerves of the people in the operating room, and everyone's eyes were on the anesthetist.

"What's wrong?"

Lin Yi asked.

The anesthetist's lips were trembling.

"The extracorporeal circulation system is malfunctioning..."

"what?"

Lin Yi couldn't believe what he heard.

In heart surgery, failure of the extracorporeal circulatory system means that the patient is about to die.

"How long does it take to restart extracorporeal circulation?"

Lin Yi turned his head and asked the anesthesiologist loudly.

"Probably...about...an hour..."

The anesthesiologist said tremblingly.

"Old horse, what about the patient's signs?"

Lin Yi asked again.

"The body temperature dropped sharply and the breathing was unstable. If this continues, the patient will die soon."

Lin Yi quickly put his hands into the patient's chest, then gently grasped the heart with both hands, and began to massage the heart continuously.

"OCM?"

Several people were taken aback by what Lin Yi did. Although Zhou Chao knew what Lin Yi was doing, he was still shocked by Lin Yi's decisiveness.

"What... what is Lin Yi doing?"

Yin Liang was dumbfounded.

"He's doing OCM, also called open chest compressions, on a patient."

Zhou Chao gave a professional explanation.

"Great!"

Yin Liang exclaimed again.

This is also the method that Lin Yi used before using thoracotomy combined with cardiopulmonary resuscitation. The thoracotomy and cardiopulmonary resuscitation can compress the heart more directly and effectively.

"This is too... straightforward..."

Yin Liang couldn't help but sigh with emotion.

Lin Yi tried his best to massage the patient's heart non-stop, and sweat slid down his back like rain.

Before he knew it, Lin Yi's body was drenched with sweat.

Two minutes later, Lin Yi could clearly feel the patient's heart beating again.

"The patient's blood pressure went up and their heart rate came back!"

The anesthetist who was watching the ECG monitor turned his head and shouted.

Several people breathed a sigh of relief again as the anesthetist announced that the patient had recovered.

Nurse Zhang also came up and wiped the sweat off Lin Yi's face with gauze.

"The patient came back from rescue. Now that the congestion has been cleaned up, the chest needs to be closed as soon as possible, and then transferred to the ICU."

"Take a break. After all, cardiopulmonary resuscitation takes a lot of energy. Leave the rest to me and Bajie."

Zhou Chao said.

"I'm okay, close the chest and sew it up, let me do it."

Lin Yi said to Zhou Chao.

After the operation was completed, Lin Yi and the others walked out.

When passing by in the corridor, Lin Yi suddenly saw a nurse rushing in with a little girl on her back.

The little girl was lying on the nurse's back, panting heavily, a stream of dark red blood continuously flowed out from her nostrils, staining the pure white nurse uniform red.

Obviously, this is an emergency.

Lin Yi ran over quickly, took the little girl from the nurse's back, hugged her in her arms and continued running to the consulting room.

When he just ran to the door of the consulting room, Zhou Chao was also there, and asked quickly:
"What's going on? Why is the child acting like this? Where was she found?"

Lin Yi didn't speak, he put the little girl on the treatment bed first, then he looked back at the nurse and asked:
"Nurse Liu, what happened?"

Nurse Liu was exhausted and out of breath. She squatted down and put her hands on her knees. After panting for a long time, she said slowly:

"I just saw her playing with me in a pile of medical supplies and advised her it was dangerous.

But the little girl is petite and has a big temper. It took me a lot of effort to persuade her to leave there.

But unexpectedly, within a few steps of her leaving, her figure began to shake, and then she fainted.

I found that after she fainted, her face was pale, her forehead was covered with cold sweat, and her nose was bleeding continuously.

This must be an emergency, so I quickly carried her back.

Director Zhou and Dr. Lin, please hurry up and take a look at her. "

"Didn't you see guardians like family members beside her?"

Zhou Chao asked while picking up the stethoscope.

Nurse Liu shook her head.

"Didn't see it.

She was the only one there, and she didn't see other people like family members, guardians, or friends.

And she didn't wake up all the way after she fainted, so she has no way of knowing whose family she is..."

Lin Yi put his hand on the child's forehead, and he frowned.

"No, it's so hot? This kid has a fever!"

Zhou Chao also quickly put the back of his hand on the little girl's forehead.

"This child has a high fever, and the temperature is not low. Nurse Liu, please pass me the forehead thermometer."

Nurse Liu, who had just disinfected her hands, immediately handed the forehead thermometer to Zhou Chao.

Then the measurement results of the temperature of the little patient made people feel nervous.

"41°C!"

"This child has a fever of 41°C, which is already super high! The child's temperature needs to be lowered immediately."

Zhou Chao said.

Such a high body temperature must be caused by some reason.

Generally speaking, a child's body temperature reaches 41°C, which is already the most serious ultra-high fever among fevers.

This situation requires urgent priority fever reduction treatment.

There are only two antipyretic drugs for children recommended by the World Health Organization.

One is ibuprofen and the other is acetaminophen.

There are oral dosage forms and suppositories respectively, and no intramuscular or intravenous dosage forms.

Now the little patient faints because of ultra-high fever, and cannot be given oral antipyretic drugs, so he can only choose suppositories.

Fortunately, Zhou Chao also has rich clinical experience in this regard.

Before Lin Yi said anything, Zhou Chao said to Nurse Liu decisively.

"Nurse Liu, please prepare to treat the fever with acetaminophen suppository for the little patient immediately.

At the same time, use physical methods to lower the temperature, and wipe the alcohol bath with 25% alcohol. "

After Nurse Liu listened, she immediately turned around and went out to prepare medicines.

After answering the doctor's order, Zhou Chao put the stethoscope on the small patient's precordial area and listened carefully.

After a while, Zhou Chao's expression gradually became serious.

Then he stood up straight, handed the stethoscope to Lin Yi and said.

"I feel that the heartbeat of this little patient is not normal, it seems to be paroxysmal tachycardia, please listen to it again."

Lin Yi turned to the stethoscope with a serious expression, and after listening for a while, he raised his head and said.

"I didn't feel like just a tachycardia, but a heart murmur.

Now the little patient's heart sounds are low and blunt, and the rhythm of galloping horses is like seagulls. "

Afterwards, Lin Yi listened to the little patient's lungs with a stethoscope.

"Lung rales!"

The faces of Lin Yi and Zhou Chao became more and more ugly.

"Let's take an electrocardiogram for the little patient first."

Zhou Chao said.

Then, the two of them made another electrocardiogram for the little patient.

The results of the electrocardiogram were also very serious.

Ventricular arrhythmia, atrial fibrillation suggestive of atrioventricular regurgitation, complete atrioventricular block, right bundle branch block...

These test results alone have already suggested to Lin Yi that this young patient's disease is not serious.

Lin Yi checked the little patient's mouth again.

This examination didn't matter, Lin Yi found that not only did the little patient have many caries, but also his tonsils were inflamed.

When Nurse Liu was bathing the little patient with 25% alcohol, Lin Yi discovered an abnormality again.

"Nurse Liu, please wait a moment."

After speaking, he grabbed the little patient's right hand and carefully observed her fingers.

Then, he seemed to have discovered something, and then he raised the little patient's hand for Zhou Chao to see.

"Director Zhou, please come and take a look at the fingertips of the little patient."

Zhou Chao hurried over and carefully looked at the little patient's fingertips.

At first, she didn't find anything unusual.However, following the direction of Lin Yi's finger, she finally saw it.

"Petechiae! Why are there petechiae? It doesn't look like it was injured while playing."

Lin Yi shook his head.

"The scar is certainly not the result of an inadvertent bruise caused by the young patient while playing."

Lin Yi thoughtfully observed the little patient's fingers.Suddenly, he hurriedly took off the shoe on the little patient's right foot, and then took off the sock.

Zhou Chao looked at Lin Yi's strange behavior in confusion and asked.

"What are you doing?"

"Director Zhou, come and see, this is the problem!"

Lin Yi said loudly.

Zhou Chao hurriedly walked over and fixed his eyes on the little patient's right foot.

There were many red bleeding spots on the sole of the right foot of the little patient, which were almost the same as the petechiae on the hands.

On the flexor surface of the fingers, there are also raised purple nodules.

After the two looked at each other, their expressions gradually became serious.

"The child is critically ill now..."

Zhou Chao said with a solemn expression.

"I'm afraid the child is critically ill now..."

As soon as this sentence was said, Nurse Liu on the side was startled.

"Critical illness? No way! Director Zhou, don't scare me!"

Lin Yi shook his head.

"Director Zhou is not exaggerating, this child is indeed dangerous."

"Isn't it just a super high fever? It's enough to cool her down and reduce inflammation. It's not like we haven't treated a small patient with a super high fever.

Our hospital also has rich clinical experience in this kind of small patients with super high fever, I think we can handle it with ease.

Director Zhou, this little patient should be treated soon, right? "

Nurse Liu asked with an expression of disbelief.

"Nurse Liu, this patient's condition is not the same as that of the patients we have been in contact with before. She did not have a high fever caused by an upper or lower respiratory tract infection."

"what is that?"

Nurse Liu asked.

"Probably infective endocarditis..."

Lin Yi said with a serious face.

"Infective endocarditis?"

Nurse Liu's face also turned pale.

Infective endocarditis refers to inflammation of the heart valve or ventricular wall endocardium caused by direct infection by bacteria, fungi and other microorganisms.

This disease is different from noninfectious endocarditis due to rheumatic fever, rheumatoid, systemic lupus erythematosus, etc.

The course of this type of endocarditis is quite short, and the patient can die in a few weeks to a few months.

Although in recent years, due to the widespread application of antibiotics, the mortality rate of this disease has been greatly reduced, but it is still a disease with a high fatality rate.

And the condition of this little patient is basically at an advanced stage...

However, there are no other treatments available.It's just impossible to do it under the existing medical conditions on the island.

After Zhou Chao thought for a moment, he said to Lin Yi.

"If it is really diagnosed as endocarditis disease, small patients will soon die from embolism in the brain or heart."

"Extremely high fever, red petechiae on the fingers and soles of the feet. There are also raised purple nodules on the flexor surfaces of the fingers and toes. These symptoms are completely consistent with acute endocarditis."

Lin Yi said.

Zhou Chao still didn't give up, and couldn't believe that this little patient had such a serious illness at such a young age.

"An echocardiogram is needed so that it can be confirmed immediately if it is true acute endocarditis."

Afterwards, everyone brought the girl to the ultrasound room.

The medical staff immediately placed the ultrasound probe on the little patient's chest.

Then, continuously move the ultrasound probe back and forth across the ribs, sternum, and precordial area to repeatedly probe this area.

At the same time, Lin Yi and his eyes were fixed on the color Doppler ultrasound monitor, trying to find signs of heart infection.

Not long after, Lin Yi put his finger on an area on the monitor and said.

"Our guess is correct. It is almost certain to be endocarditis?"

Zhou Chao followed his finger to the area pointed by the monitor, where Zhou Chao did see what she least wanted to see.

Vegetation of the valve and intracardiac abscess were found in that area, and the patient's valve did have regurgitation.

Through the color Doppler ultrasound, Zhou Chao and Lin Yi could clearly see the fleshy growths of about 5 mm on the mitral valve and aortic valve of the young patient's heart.

Not only that, but there is also valvular insufficiency around the valve...

The growths are like demons, constantly eating away the remaining life of the little patient.

Zhou Chao's complexion became ugly.

"Now it is indeed confirmed that the patient is endocarditis!

The question is how to treat her now?
Given that her growth had grown so large, it indicated that the patient's condition was deteriorating, and the problem was already very serious.

If it is delayed, it may lead to more serious damage to the heart valves, and even heart failure.

At least there is still a chance now. If it is really delayed until then, I think even if Hua Tuo is reborn, I am afraid that he will be powerless. "

Lin Yi thought for a while and said:

"In this situation, we must find her parents!"

"Yes!"

Zhou Chao nodded.

At this moment, the door of the consulting room was pushed open.

(End of this chapter)