Auto chess in the operating room

Chapter 10 Nitrite Poisoning
Sure enough, upon hearing Tang Lou's words, Xu Lanlan's pretty face blushed suddenly, and even the roots of her ears were frost-like, very cute.

Tang Lou couldn't help being stunned.

"Irregularity." Xu Lanlan looked at Tang Lou's handsome face, feeling ashamed and angry, and even a little bit of joy in her heart.

"Oh, I won't tell you anymore. I'm here to find Dr. Li on an urgent matter."

Only then did Xu Lanlan think of something serious.

"Is Dr. Li not in the ward? I'm looking for him too."

"Then what to do, I didn't answer the call." Xu Lanlan stamped her feet anxiously.

"What's wrong, maybe I can help you?"

Tang Lou said seriously.

"You? You're an intern." Xu Lanlan looked at Tang Lou, and thought of the picture he gave Director Shen that day, her eyes lit up, "It may be true, then you come with me, and I will talk to you while walking!"

"Okay." Tang Lou hurriedly walked towards the emergency ward with Xu Lanlan.

"A male patient came here just now. Today, I invited the girl I like to eat hot pot with pickled vegetables and fish in the dormitory. She refused to confess, and the girl left with an excuse after eating a few mouthfuls."

"The patient was depressed. He called a friend over for a drink. The friend arrived about an hour ago and found that the patient was lying on his side on the bed, confused, reeking of alcohol, shortness of breath, and a lot of vomit on the ground without coffee."

Xu Lanlan introduced the patient's situation while walking.

"Acute alcoholism?"

"It's not that simple. The test sheet should come out in a while. Dr. Li should have come to look at the test sheet at this time. I don't know why he disappeared and couldn't be contacted. So the head nurse was so anxious that I came to look for it. he."

Xu Lanlan was very helpless. Dr. Li was already in his forties, and his behavior was like a monk hitting the clock for a day, so his reputation in the department was not very good.

This time the chain dropped again at a critical moment.

Tang Lou nodded, rejoicing in his heart that only the lazy resident had the chance to show himself. It seems that there is great hope for his small goal to be achieved!
The two quickly ran to the ward.

"Sister Zhang, I'm back." Xu Lanlan waved to the head nurse Zhang Nannan.

"Xiao Xu is back, huh? Where's Dr. Li?" Zhang Nannan's skin is a little dark in her forties, but her face is still pretty. Her long hair has just been permed and is curly, very foreign.

"Dr. Li is not in the office, but I have invited Dr. Xiao Tang over." Xu Lanlan pointed to Tang Lou beside her.

Looking at Tang Lou's youthful facial features is pleasing to the eye, but he is too young.

Zhang Nan frowned: "Doctor Xiao Tang? When did a doctor Xiao Tang come to the hospital?"

"Ahem, sister Zhang, I'm a new intern, and I was assigned to the emergency department today." Tang Lou's tone was also a little weak.

"Nonsense, you bring an intern here, who will be responsible for any problems? Xiao Xu, do you really have any brains?" Zhang Nannan scolded, and then looked at Tang Lou, "An intern doesn't go to the office to stay, what is it? .”

"This emergency department is getting more and more unreliable. Li Fan is a guy who can't be contacted at work, and here comes another young boy." Zhang Nannan took out his mobile phone and contacted Li Fan while scolding.

"Sorry, the user you dialed was not answered"

"Xiao Xu, take this here to take care of the patients, and I'll go rescue the soldiers." Zhang Nannan ordered sternly.

"And you, little guy, take it with me honestly, and the doctor who brought you will come and lead him later."

Can be assigned to the emergency department, what else is good?Zhang Nannan has already seen through these things.

Looking at the back of the head nurse in a hurry, Xu Lanlan stuck out her tongue, and explained to Tang Lou in a low voice: "Sister Zhang, you have a knife mouth and a bean curd heart, and it's all my fault that you were scolded together."

"It's okay. After all, not every intern is as good as me. Show me the test sheet."

Tang Lou walked towards the patient's bed, and saw a man lying on the bed, still in a coma.

"Here, here is the test report that just came out."

Tang Lou looked at the basic information:
Wu Weibing, male, 38 years old, was sent to the emergency department by 1 due to confusion, nausea, vomiting and shortness of breath for 120 hour.

120 on-site blood glucose 6.8mol/l, does not rule out the patient's acute alcoholism.

Pretentiously, he continued to look through the basic information. Tang Lou used the diagnostic technique (one star, 3), and saw a medical certificate in front of him:

[Patient: Wu Weibing, male, 38 years old

symptom:

Blood pressure 96 / 44 mmHg, R30 beats/min, P 118 beats/min, SPO2 90%.

She was lethargic, and could open her eyes when she breathed out; she was speechless; her lips and fingertips were red; her pupils were equal in size and round, with a diameter of about 2.5 mm, and her light reflex was sluggish.

The neck is soft; the breath sounds of both lungs are coarse without rales.The heart rate was 118 beats/min, regular rhythm, no murmur.

Blood routine: carboxyhemoglobin concentration 31%, the rest normal

Urine routine: nitrite was obviously high, and the rest was normal

Diagnosis and Treatment:
Carboxyhemoglobin increased significantly, carbon monoxide poisoning, emergency hyperbaric oxygen therapy for 1 hour
Pay special attention (general diagnosis is easy to ignore):

Nitrite is obviously high, acute nitrite poisoning, quickly with 1% methylene blue 1 ~ 2 mg/KG + 50% glucose solution 40 mL intravenous injection within 15 minutes, and vitamin C 4 g added 10 % glucose 1000 mL in intravenous infusion. 】

"Doctor Xiao Tang, did you see anything?" Xu Lanlan asked expectantly, it was Tang Lou who looked so handsome just now focusing on the checklist.

"Ah, of course."

Tang Lou was interrupted by Xu Lanlan, returned to reality from the system diagnosis, and said very calmly: "The patient is poisoned by carbon monoxide and poisoned by eating nitrite by mistake. As long as the hyperbaric oxygen therapy is 1 hour, and the injection of 1% nitrous Intravenous injection of methyl blue 1-2 mg/KG + 50% glucose solution in 40 mL was completed within 15 minutes, and vitamin C 4 g added in 10% glucose 1000 mL was intravenously infused."

Listening to Tang Lou Balabala's pile of professional vocabulary, Xu Lanlan was stunned.

At first I thought Tang Lou was joking, but as a professional nurse, I naturally understand the accuracy of these reagents. Nitrite poisoning is not common in the emergency department, so the drug configuration for this case is something that even old doctors can understand. It depends on the computer system to prepare.

Tang Lou actually said it so casually?
"Are you really an intern?" Xu Lanlan stared at Tang Lou beautifully, trying to see through him.

"I encountered this kind of case in a case class before, and I had to memorize the answer for a long time!" Tang Lou also blushed a little, and could only make nonsense.

"Tanglou, you graduated from 211. You are really good. You must have been a top student in the past, and your head was full of cases. Like when I was studying, I only had Korean dramas and boy groups in my head. You should go to the city or a tertiary hospital."

Xu Lanlan looked at Tang Lou with some admiration, and what she admired most was this gentle and handsome doctor with high IQ.

"Doctor Li, hurry up, the examination has come out."

At this time, Zhang Nannan hurried over with a middle-aged doctor.

Li Fan is in his forties, with small eyes, a flat nose, and a somewhat round face. At first glance, he looks like a fat man with a big heart.

Trotting, a general's belly was dangling, panting.

"Sister Zhang, Dr. Li, Dr. Xiao Tang has read the test sheet just now, and the patient is..."

Zhang Nannan stopped Xu Lanlan with sharp eyes: "What nonsense, Xiao Tang, you and Xu Lanlan stand side by side."

It was the first time for Li Fan to see Tang Lou, and he was a little envious when he saw his slender figure and handsome face.

"Sure enough, you are a good-looking talent. No wonder Director Shen specially took care of me to take you well."

"You will follow me in the future. The cases in the emergency department are more complicated, but don't worry, as long as it is related to sutures, I will arrange for you to operate the surgery for minor cases."

Li Fan thought about Shen Jun's ten thousand exhortations, although he didn't take it seriously, but one more thing is worse than one less thing, since the director said it, then he will do it.

"Well, thank you, Dr. Li. I have seen this patient."

Tang Lou was going to tell Li Fan about his diagnosis.

Li Fan smiled kindly, took the checklist from Xu Lanlan, and ignored Tang Lou's suggestion.

(End of this chapter)