This doctor has a system

Chapter 57. Patient with many disasters

"Come on!" A private car drove directly to the gate of the emergency department, and a man in black jumped out of the car.

It seems that there are critical patients, otherwise the security guards wouldn't let people drive the car here.

"What's wrong?" A nurse hurried out.

"My mother suddenly fell into a coma today." The man in black was sweating anxiously, "When I got home, she was lying on the ground, unable to scream."

The nurse hurried to level the car, and several people lifted the old lady up together.

"Quick, blood sugar, blood pressure, electrocardiogram!"

"Prick a needle first, use 0.9% sodium chloride injection."

"The monitoring also went up to give the patient oxygen."

Dr. Ma Liang issued a bunch of oral doctor's orders with a bang.

"Does your mother have any illness?"

"The blood sugar is high, and I'm taking hypoglycemic medicine." The man wiped the sweat from his brow, "I've caught a cold these days, and I'm still taking 999 cold medicine."

"Is your blood pressure high?"

"Not high, my mother usually has low blood pressure, and often drinks these medicines like Shengmaiyin." The man thought for a while and said.

"Blood sugar 34mmol/L." The nurse who measured the blood sugar yelled at Ma Liang: "The blood pressure is very high, 180/94mmHg, and the heart rate is 121 beats/minute."

"Blood sugar is so high?" Ma Liang looked at the man in black, "Did your mother not take hypoglycemic drugs these days?"

"I don't know." The man in black looked anxious, "I'll be back at night in these two days."

"The breath smells like rotten apples." Ma Liang conducted a careful physical examination on the old man, "It should be ketoacidosis, check a blood gas analysis!"

The results of the blood gas analysis came out soon, and the pH value was 7.25, which strongly supported Ma Liang's judgment.

"Contact the Department of Endocrinology and ask them to send a doctor over to take a look."

Ma Liang called the man in black over, "Your mother's condition should be ketoacidosis caused by high blood sugar, and the condition is quite serious."

"The endocrinologist will take a look at it in a while. If they are willing to accept it, we will go to the endocrine ward. If they think it is too heavy, we will go to the intensive care unit first."

The man in black had no idea at all, "Okay, okay, doctor, please make arrangements for us."

"First, give 10 units of regular insulin a subcutaneous injection." Ma Liang said to the nurse on the side.

"Please make a clear diagnosis for this dying old man. After completing the task, you can get 3 skill points." The system's voice rang.

Gao Feng was stunned for a moment, there was something else going on.

The performance of the patient is indeed very consistent with the performance of diabetic ketoacidosis. Is it hyperosmolar non-ketotic diabetic coma?
"No, the patient's exhalation smells of rotten apples, and most of them are found in ketosis. And the pH value is low, and the pH value of hyperosmolar non-ketotic diabetic coma is generally normal." Gao Feng quickly transferred the internal medicine to the system. This chapter has been turned over.

Both diseases can make patients coma, and the vast majority of patients will have a drop in blood pressure.

"This patient's blood pressure is obviously on the high side, 180/94mmHg, which is a bit abnormal." Gao Feng held his chin and suddenly got an idea, "Isn't it due to a cerebrovascular accident?"

"Where is the patient?" Zhao Hui, an endocrinologist, rushed to the emergency room.

Ma Liang hurriedly introduced the patient's current situation to Zhao Hui, "Doctor Zhao, do you think it should be taken in for you, or go to the severe disease?"

"Go ahead, there is still a bed in the emergency room opposite the nurse's station." Zhao Hui thought for a while.

"Ms. Ma, why don't you get a head CT scan." Gao Feng hurriedly said, "According to the procedure, a head CT scan is a must for comatose patients."

Ma Liang was stunned for a moment, "That's also good."

Zhao Hui was a little dissatisfied and said: "Is that necessary? This is obviously a coma caused by ketosis, why waste time, the most important thing is to go to the ward and get the medicine!"

"Ms. Zhao, this patient had always had low blood pressure, but now his blood pressure is on the high side. I think it may be combined with a cerebrovascular accident." Gao Feng explained.

To be honest, if there is no reminder from the system, Gao Feng will not suggest a head CT scan.
"If you want to check it, you can check it." Zhao Hui was a little annoyed, "It's a waste of effort!"

For a moment Ma Liang was a little embarrassed, but he still believed in Gao Feng, "Let's make one! Don't be afraid of [-], just in case, it won't take long."

"Hi, is the imaging department? I'm in the emergency department. We have a patient who needs a head CT. It's urgent, so I'll push it over right away." Hu Jiaran called without Ma Liang's instructions.

Ma Liang quickly opened the order, and Hao Mengpei and the nurse went to level the car.

"What do you do?" Zhao Hui said to Gao Feng, "Look at your badge, are you trained?"

"Yes, Teacher Zhao."

"Are all the current Gui Peisheng so assertive? Doctor Ma, are you all listening to Gui Peisheng now?" Zhao Hui sarcastically said.

Ma Liang frowned, "Listen to whoever is right."

Zhao Hui said angrily: "You mean what I said is wrong? A regular trainee has a higher level than me?"

How could Dr. Zhao get angry so easily? Ma Liang was very upset, but he didn't speak any more.

Gao Feng glanced at Zhao Hui, but said nothing.

Seeing Ma Liang "conciliating", Zhao Hui felt a little better, "I will humiliate you again when the result comes out."

"Ding ding ding" Ma Liang's cell phone rang, "Hello?"

"Mr. Ma, the teacher in the imaging department said it was a cerebral hemorrhage." Before Hu Jiaran finished speaking, the diagnostician in the imaging department snatched the phone and said, "This patient has to give you a critical report. The amount of bleeding is quite large. Into the brain!"

"What?" Ma Liang was in a cold sweat.

"Teacher Ma, what should we do? Let's push the patient back first?" Hu Jiaran asked.

"Don't push it back, push it directly to the Neurosurgery Intensive Care Unit. You wait, I'll go right away. Gao Feng, you watch the door here!" Ma Liang rushed to the imaging department anxiously.

"You helped the patient clarify the diagnosis and gained 3 skill points." The system issued the reward in time.

Zhao Hui from the endocrinology department felt very, very embarrassed.

Fortunately, this patient had a head CT scan according to the procedure, otherwise Zhao Hui would be sent directly to the ward, and after a few hours, Zhao Hui would immediately break out in cold sweat.

"Well, I'll go back first, you can tell Dr. Ma later." Zhao Hui said something to Gao Feng, turned around and left.

More than 20 minutes later, Ma Liang and other talents came back.

"Gao Feng, you are amazing!" Hao Mengpei said to Gao Feng admiringly.

"Brother Feng Niu! Save the patient from the fire and water!" Hu Jiaran flattered everyone in public.

Ma Liang was a little unhappy. He had been in the emergency department for a long time, and he still made such a low-level mistake, and almost missed the diagnosis.

"From now on, those who are comatose should get head CT first!" He reminded himself fiercely in his heart.

Gao Feng opened the patient's head CT on the computer, "The amount of bleeding is a bit heavy! Need an emergency operation? I'm afraid the prognosis is also very poor."

"Yes." Ma Liang said solemnly, "The doctor who is seriously ill may not be able to wake up."

"Ah?" Hao Mengpei was a little disappointed, "I thought I found it in time and the recovery would be fine."

(End of this chapter)