This doctor has a system

Chapter 62. Chapter 62
The patient who made an appointment in the afternoon arrived. She was a 66-year-old lady who was pushed by her son in a wheelchair.The patient was breathing heavily.

The patient was diagnosed with lung adenocarcinoma in the provincial doctor 2 years ago, had undergone chemotherapy 6 times, and had relapsed half a year ago.

After coming to the hospital again, genetic testing showed that the epidermal growth factor receptor (EGFR) group had a sensitive mutation, and Dong Qianqian prescribed the targeted drug gefitinib for her.

One week ago, the patient began to have obvious symptoms of chest tightness and cough after catching a cold. The film was taken in the district health center, and the result indicated: bilateral pleural effusion, mainly on the left side.

No pleural effusion was found in the last hospitalization. When Dong Qianqian received the call from this patient, she immediately thought that the pleural effusion might be caused by tumor recurrence and metastasis.

The nurse inhaled oxygen for the patient, and Gao Feng carefully looked through the patient's previous two hospitalization records.

The patient had a 20-year history of hypertension and a 9-year history of coronary heart disease.

"Hello, let's take the old lady for a chest CT after the blood draw." Gao Feng communicated with the patient's son, "There is less information on the chest X-ray."

"Okay, we will listen to your arrangement." The patient's son was very compliant.

Gao Feng asked him to go to the CT room to make an appointment now, and asked Gui Peisheng to fill an oxygen bag for the old man.

After looking at the CT images on the computer, Gao Feng called the patient's son over.

"There is good news." Gao Feng told him to sit down, "It should not be the recurrence and metastasis of the tumor this time."

Gao Feng pointed to the CT on the computer and showed him, "The tumor lesions have shrunk, and some metastatic lesions in the lungs can no longer be seen, indicating that the targeted drug is still working."

"Then what's the reason for my mother this time?" The patient's son was relieved to hear that it wasn't a tumor recurrence.

"It should be heart failure induced by infection! The old lady has a history of high blood pressure and coronary heart disease. When I came here, I noticed that her lower limbs also had edema." Gao Feng said to him.

"Let's do a bedside echocardiogram later."

"Doctor, this should be better than tumor recurrence?" The patient's son asked Gao Feng before leaving.

"Yes."

Hearing Gao Feng's answer, the patient's son showed a smile on his face.

The results of blood drawing showed that the heart failure marker BNP was 9000pg/ml (normal value 100-300), and the echocardiography also showed that the left ventricular ejection fraction was only 31%.

It's quite serious. Gao Feng asked the nurse to give the patient furosemide first.Furosemide is a diuretic that takes the load off the heart while reducing fluid buildup.

"Nan Nan, come and perform a thoracic puncture on our patient." Gao Feng shouted, the patient had a relatively large amount of pleural effusion on the left side, and a tube was needed to drain it, which could quickly relieve the symptoms of chest tightness.

"Have you set your position yet?" Qi Nannan was very active, and all the things for the puncture were ready.

"It's already been positioned. I just ordered it during the bedside echocardiography." The female guide Pearson hurriedly told her.

Briefly explain the precautions to the patient.

Qi Nannan skillfully removed the puncture bag, put on gloves, disinfected, spread the drape, applied local infiltration anesthesia, punctured, inserted the guide wire, expanded the skin, placed the tube, fixed it, and connected the drainage bag.

All in one go.

Seeing the light yellow pleural effusion flow out smoothly along the catheter, Gao Feng suddenly remembered a sentence: Farewell for three days, treat each other with new eyes!
Qi Nannan, I admit that you have something, although not much.

"The operation is okay." Cheng Song stood aside and said to Gao Feng, "She really likes to do this closed chest drainage."

"It's really well done." Gao Feng praised Qi Nannan, who was a little proud.

A few people returned to the office, and just sat down for a while, a nurse ran over, "Doctor Shi, go and see bed 65, I feel uncomfortable right now."

Shi Peiyuan is a bit overwhelmed. The 65-bed patient has complicated illnesses, including hypertension, hyperlipidemia, type 2 diabetes, coronary heart disease, severe pneumonia, cerebral infarction, chronic bronchitis, and hypothyroidism. He has suffered from all possible diseases.

"Let's go and have a look!" Shi Peiyuan hurried to bed 65 with his two Gui Peisheng.

The patient on bed 65 is clutching his chest in pain, "It hurts badly!" He told Shi Peiyuan, "It's been hurting for 10 minutes, and it's going to be very severe."

The family members walked around in a hurry.

The electrocardiogram showed frequent ventricular premature beats.

"Hurry up, get him an EKG." Shi Peiyuan directed a Gui Peisheng, and then shouted to the nurse, "Hurry up and call the cardiology department for an emergency consultation!"

Gao Feng in the office suddenly received a task reminder from the system:
"Bringing back to life: Ask Dr. Gao to help save the life of Mr. Dong Jianguo in bed 65. The system will issue skill points according to the degree of completion."

Gao Feng stood up immediately, "Come on, let's go and see the 65th bed too."

The consulting doctor from the Department of Cardiology has already rushed to the department, "It should be angina pectoris, take the Shexiang Baoxin Pill sublingually, you can pump the nitroglycerin, it really can't be transferred to the CCU."

He looked at Dong Jianguo's medical records and shook his head. Why does this man suffer from all kinds of diseases? How can the doctor treat him.

If nitroglycerin on the pump can relieve the symptoms, it is estimated that the system will not issue tasks.

"Doctor Shi, I think it's okay to transfer to the CCU directly. The patient's condition is too complicated." Gao Feng didn't want to speak out, but when he thought about the patient's accident, he might feel a little bit tormented inside.

Shi Peiyuan glanced at Gao Feng dissatisfied, who do you think you are?A guy who was lucky to come in, let this speech look for a sense of presence.

"Pump glycerin first and observe." He asked the student to give a doctor's order.

The nurse quickly pumped the nitroglycerin to the patient. After more than 10 minutes, Mr. Dong Jianguo felt much better.

"It doesn't hurt like before." He said to Shi Peiyuan.

"Okay, let's continue to observe." Shi Peiyuan heaved a sigh of relief.

Everyone returned to the office in twos and threes. Gao Feng waited for another half an hour, but did not see anything new about bed 65.

But he still had an ominous premonition in his heart, and the system didn't give any more notification sounds.

"Forget it, let's do the ward rounds first," Gao Feng called to two students, preparing for the routine ward rounds before get off work.

At this moment, a nurse ran over yelling, "Doctor Shi, hurry up, bed 65 is in a coma!"

Gao Feng was shocked, it really wasn't that simple.

"Respiratory and cardiac arrest!" Shi Peiyuan was sweating, and he quickly started cardiopulmonary resuscitation for the patient.

Gao Feng stood beside him and shook his head, the movements were not good enough, the strength was not enough, and the frequency was not up to the mark.

You can't watch from the side like this, Gao Feng walked up directly, "I'll do it! You contact the CCU." He directly pulled Shi Peiyuan aside.

Shi Peiyuan was pulled aside by a great force, and almost sat down on the ground.He looked at Gao Feng angrily, and found that the other party was indeed more professional in pressing than he was.

"Damn it! I remember you," he growled inwardly.

"Push an epinephrine." Gao Feng said to the nurse.

After 3 rounds of pressing, the patient's heartbeat and breathing recovered. Gao Feng just breathed a sigh of relief when he found that the waveform on the ECG monitor had changed.

Why is this still ventricular fibrillation!
"Quick, ventricular fibrillation!" Gao Feng roared, "Defibrillator!"

　Have a great weekend everyone.

　　
　
(End of this chapter)