world famous doctor

Chapter 4 Intravenous Thrombolysis
Zhou Chen opened his mouth, but he didn't have a chance to speak, and was interrupted by Shen Meng:

"If the old lady is taking anticoagulant drugs recently, or in the past three weeks, she has a history of urinary system bleeding and other trauma, or a history of myocardial infarction, diabetes, heart, liver and kidney insufficiency, has received heparin therapy, mental illness, major Arterial dissection, intracranial hemorrhage, these contraindications of intravenous thrombolysis, if you rush to intravenous thrombolysis, it will only accelerate the death of the patient."

"Now is not the time to memorize the schoolbag. What you just did were just general first aid measures, but I used special first aid measures, which could save lives." Zhou Chen retorted.

"Be firm in your beliefs and get praise +35," the system prompted.

No matter how urgent the situation was, Zhou Chen was still able to maintain extreme confidence and calmness on the surface.

Of course, this is also due to the "famous doctor system" bound today.

But to be honest, he still felt a little guilty in his heart, and he didn't know if he had chosen the right medicine.

Taking a step back, the small circle of the system flickered in his mind for four years before it was successfully loaded. It was hard to say whether it was reliable or not.

Shen Meng turned her head and looked into the distance, her face looked very anxious.

The ambulance was still nowhere to be seen.

An enthusiastic person drove over in a car and suggested, "Why don't I put the old lady in the car, and it will be faster for me to send her to the hospital now."

However, this proposal was immediately rejected by the wife who was sitting in the co-pilot.

The wife of this enthusiastic person is also a doctor, but she is an irresponsible pediatrician who also has a certain understanding of cerebral infarction.

She persuaded her husband: "For this critically ill patient, any inadvertent movement during the handling process may aggravate the patient's condition. We have to wait for a professional emergency doctor to check the patient's vital signs, oxygen saturation, etc. , heart monitor, etc. to make an accurate assessment, and then carry out rescue measures and take them away from the scene."

In fact, behind such high-sounding rhetoric, it was just an excuse for her to sit idly by and be indifferent.

After hearing this, the husband nodded and felt that it made sense, so he drove away again.

Everyone thinks that more things are worse than less things.

Zhou Chen's heart was filled with a sense of urgency.

The golden window period of thrombolytic therapy is only 4-6 hours, beyond which there is no way to perform thrombolysis.

In case of traffic jam on the road, God knows when the ambulance will arrive.

Zhou Chen took out urokinase, and regardless of the objections of everyone present, he started intravenous thrombolytic therapy for the patient on such a street without any conditions.

Just as Shen Meng and the others were about to step forward to stop them, Zhou Chen said loudly: "You all don't need to talk anymore, each of you does the work and the other is responsible. If something really happens to this old lady, I, Zhou Chen, will be responsible for it alone!"

In this case, no one dared to say anything more.

Too much intervention will only make the scene more chaotic.

What's more, everyone wants to protect themselves, and no one wants to take a life on themselves for no reason.

As a classmate, Shen Meng knew Zhou Chen's character quite well. If he got stubborn, ten bulls wouldn't be able to pull him back.

Shen Meng's tone softened a little.

She said meaningfully: "Zhou Chen, you have to think about it. If you rashly give the patient high-risk thrombolytic therapy and save the patient, nothing will happen to you. At most, the patient's family will give you a word or two of thanks. If the real patient has any contraindications or any omissions, it will be a medical malpractice..."

Zhou Chen could tell that this sentence was due to Shen Meng's concern for his classmates.

In fact, intravenous thrombolysis itself is not a difficult medical method, but thrombolysis has many uncertain factors and risks that people cannot control.

Thrombolytic drugs have been developed for decades. There are three generations of thrombolytic drugs in clinical practice, and urokinase thrombolytic agent (UK) is only the first generation of thrombolytic drugs.

In many years of clinical trials, after patients received urokinase treatment, there were many adverse reactions and bleeding phenomena, and there were many different controversies in the selection of dosage.

Therefore, some hospitals no longer use urokinase clinically.

In contrast, using the third-generation new thrombolytic agent, reteplase, which has the advantages of long half-life, strong thrombolytic effect, and small side effects, is actually a better choice.

Reteplase not only has a significant therapeutic effect, but also has a lower probability of bleeding and other adverse reactions than urokinase.

No wonder, Zhou Chen's "Likes" were not enough, that's why he couldn't make the best choice.

Zhou Chen used intravenous infusion. After establishing two intravenous accesses, he mixed 100 million U of urokinase into 250 mL of normal saline, and controlled the infusion time for 30 to 45 minutes to perform intravenous thrombolysis for the old lady.

Zhou Chen's gaze never left the old lady's body.

He has been meticulously observing the changes in her vital signs from beginning to end, Zhou Chen can perceive even a slight change.

Zhou Chen was steadfast in his belief, and he murmured from time to time:

"System, this time I will give you all my wealth. I trust you so much, you must not cheat me."

It is natural for Zhou Chen to have such concerns, after all, it is the first time in his life to "deal with" the system.

The emotions of the people around became tense.

There are also some people who are purely here to join in the fun, looking like they have nothing to do with themselves and hang on high.

Some voices of discussion reached Zhou Chen's ears.

"I said, is this young man a doctor from some hospital? It doesn't look like it."

"I recognize him, he is a handyman in the Baojitang Traditional Chinese Medicine Center."

"What? Chinese medicine center? I'm still a handyman, isn't this a joke about life?"

Some people laughed, some people sang a different tune.

Of course, there are also praises.

"At a young age, you know what you can't do, but you can be so responsible and responsible. It's awesome for future generations."

Finally, I heard a voice of affirmation. Although I was still a bit pessimistic about myself, it was enough to make Zhou Chen feel deeply relieved.

"Get praise from others, like +25"

Can other people's praise also make you praise?

Zhou Chen smiled heartily.

10 minute later.

The ambulance rushed to the scene with its siren honking, and several emergency doctors got out of the car to check the condition of the old lady, and then nodded.

"Well, yes, the first aid measures are well done."

Zhou Chen stood up and put on a smiling face: "Oh, I'm just doing my best."

Another doctor praised me.

Like it?

Come to the bowl soon?
Zhou Chen rolled his eyes and looked at the sky at an elevation angle of 45°.

"I think this bandaging technique is quite professional. What's the matter? Have you learned it?" While several other medical staff were loading the patient into the ambulance, the emergency doctor chatted with Zhou Chen.

Zhou Chen looked embarrassed.

It was Shen Meng who was praised by the other party for a long time.

He scratched his head: "Oh, I didn't bandage it, I just gave her intravenous thrombolysis."

Hearing about intravenous thrombolysis, the emergency doctor's expression changed instantly.

After a pause, the emergency doctor said solemnly: "What? Are you giving this patient thrombolytic therapy on the street?"

"Yes."

Zhou Chen replied casually that he didn't think there was anything wrong.

As long as it can save lives, don't be limited by any venue, let alone any method of treatment.

The emergency doctor obviously thought this was incredible, and he didn't expect Zhou Chen to answer so lightly and so naturally.

"Do you know that without a comprehensive understanding of the patient's physical condition and without the signature and consent of the patient's family, it is not possible to give the patient thrombolytic therapy without permission. You have to take a big risk." The emergency doctor said with deep concern.

The other doctor who came with him was not so polite, and held Zhou Chen accountable for a while.

"You young man, why are you so sloppy?"

Unexpectedly, Zhou Chen accidentally said something out of his mouth: "There has never been any kind of medical treatment that is 100% risk-free in this world."

"Don't be afraid of authority, refute with reason, get praise +30"

(End of this chapter)