Back in 2002 as a doctor

"Why are you in the hospital?" Zhou Congwen asked.

"Don't mention it." Boss Chunxiao took out a cigarette, knowing that Zhou Congwen smoked ganoderma lucidum, he was not polite, so he gave Lu Tiancheng one, lighted it, and said, "An old man from a friend's family has no energy. He has visited the hospital many times. It's a potassium deficiency."

"Have you made it up?" Zhou Congwen asked.

"It's been replenished." Boss Chunxiao said, "It's good to replenish potassium every time. After going home for a few days, I have no energy. I can't straighten my back, my whole body is sore, and my arms and legs are about to break."

"How's your blood sugar?" Zhou Congwen asked.

Lu Tiancheng smiled. He knew that Zhou Congwen's first suspicion was hypokalemia caused by high blood sugar.

It was indeed an old doctor. Boss Chunxiao had just mentioned something at the beginning. Zhou Congwen had his own judgment, and he directly asked about high-probability events, so he was definitely not guessing.

"Blood sugar... seems to be okay. Every time the doctor writes a lot of orders, checks and checks, and finally says potassium deficiency, which is not reliable at all."

Boss Chunxiao babbled.

"How is it now?" Zhou Congwen asked.

"We're going to have an examination and wait for the results." Boss Chunxiao said, "I'm not far away here. Every time a friend has something to do, he will come to me."

"You know a lot of people in the Third Hospital." Zhou Congwen said with a smile, not in a hurry.

"Doctor Zhou, you're doing well in the provincial capital." Boss Chunxiao said with a smile.

"Fortunately."

"Why are you coming back this time?"

"Academician Chu performs surgery on the people of the group company, and I will come back to take a look."

Boss Chunxiao gave a thumbs up, "Excellent!"

Zhou Congwen smiled slightly.

Chatting with Boss Chunxiao, Zhou Congwen is still very relaxed, and he is very interested in Boss Chunxiao.

After saying a few words, after smoking a cigarette, Zhou Congwen stood up and patted his butt, "Go, go and see if the result is out."

Chapter 1263 Stay away from the emergency room and cherish life

"Get up!"

In the corridor of the emergency department, the roar of the emergency doctor echoed.

After Zhou Congwen heard about the random secretion of various hormones, he became excited before seeing the patient, and then entered the fatigue of a sage.

What the hell, it would be great if there was no emergency department in the world, Zhou Congwen thought to himself.

Just listening to the sound, I walked around, I really don't know why Shen Lang is so obsessed with this place.

"What are you yelling at!" The patient's family members were also anxious. After being yelled at, they became more irritable and directly yelled back.

"Hypokalemia, people will die at any time, get out of the way!" The emergency doctor pushed the patient's family members away with his shoulder and rushed in.

Zhou Congwen made no secret of his exhaustion and sighed deeply.

Stay away from emergency and cherish life.

"Professor Zhou, isn't it too messy?" Lu Tiancheng smiled when he heard Zhou Congwen sigh, "I have been to the emergency department three times, each time for half a year. The best night I slept from 10 o'clock until dawn."

"Just once." Zhou Congwen asked sharply.

"Well, I found the reason why the patient didn't come that time. I tried everything, and I felt that I was very lucky that day."

Of course, once in a while, this will definitely not be the norm.

"Why do you believe in fate like buying a lottery ticket?" Boss Chunxiao asked.

"If you don't believe in fate, you have to pray every day on duty that you will be less likely to come to the emergency department today, and the patients in the ward will be quiet. If you can sleep well, you have to burn incense when you go back." Zhou Congwen said helplessly.

When I came to the emergency room, the emergency doctor was instructing the nurse to supplement the patient with potassium.

Zhou Congwen came to the emergency doctor, "Brother Qiang, are you busy?"

The emergency doctor Wang Qiang turned around and saw that it was Zhou Congwen, he was startled for a moment, and then a look of surprise appeared on his face.

"Wait a minute, Xiao Zhou, I'm giving potassium supplements to the patient." Wang Qiang said hastily.

Although he wanted to chat with Zhou Congwen for a while, the patient's blood potassium level was very low, and he could tell which was mild and which was severe.

"The test is back? Let me take a look." Zhou Congwen took the test form from Wang Qiang and glanced at it.

There are not many test results in the urgent investigation, only a few items, which are shocking.

Serum potassium was 1.5, Be 14.32, which proved alkalosis; blood sugar was relatively normal, and lactic acid was 3.4 higher.

A little strange, Zhou Congwen looked at the test sheet, and then at the patient lying on the bed humming.

"Doctor Zhou, why do you think this old man is in pain all over?" Boss Chun Xiao asked.

"The pain is muscle spasm pain caused by low potassium, which is the most likely cause of high lactic acid. It also reminds one thing that the patient has rhabdomyolysis caused by low potassium, which requires rapid correction of hypokalemia." Zhou Congwen said .

"Correction, correction, correction every time I come, it's not good at all!" A family member of a patient nagged beside him.

"How do you talk?" Boss Chun Xiao turned his head. Seeing that it was an old man, he didn't say much, but kicked a young boy who happened to be standing next to him on the ass.

"Why are you kicking me, Brother Chunxiao?"

"Tell the family to talk less. You are in the hospital and listen to the doctor. If you have the ability, don't come to the hospital. Treat yourself at home." Boss Chunxiao scolded, "When you come to the hospital, you are begging the doctor to see a doctor, and at the same time chatting Noisy, something is wrong."

If the emergency doctor in white had said this, a fight would have started at that time.

But Chang Chunxiao's boss said that the family could only go back and persuade the angry old people.

"Doctor Zhou, continue talking." Boss Chunxiao said.

Zhou Congwen looked funny, but he couldn't say anything more about this kind of thing from a doctor's point of view, so he continued, "Alkalosis is still a critical level, which proves that the patient's fluid volume is insufficient recently, and it is very likely that he has used diuretics. .”

"Ask the patient if he has diabetes and what medicine he has taken recently."

Boss Chunxiao went to ask about it, and when he came back, he received it from Zhou Congwen, "I do have diabetes, and I recently ate Andalose."

Andalose, also called dapagliflozin, is a new drug, and Zhou Congwen doesn't remember when it entered the clinic.Zhou Congwen was a little surprised that the family would eat it so soon.

"Alkalosis aggravates hypokalemia, and the cause of the acute phase is alkalosis." Zhou Congwen said a word without thinking, and then quietly looked at Dr. Wang Qiang in the emergency department to direct the rescue.

Boss Chunxiao said a few more words, but Zhou Congwen acted as if he didn't hear him, so Boss Chunxiao shut his mouth.

40ml potassium chloride oral solution orally, 500 ml saline + 15ml potassium chloride intravenously.

Because it is an emergency department, and there is no micropump in the whole hospital, it is natural not to use a deep vein catheter, and then directly enter the superior vena cava, and pump potassium chloride inward.

If the potassium ion is too high, it can also cause all kinds of problems, too much.

Potassium supplementation is to quickly supplement to a safe concentration when the patient can tolerate it.

The safe concentration is not the normal concentration, but the concentration at which the clinical symptoms are relieved, such as the relief of muscle weakness and soreness, that is, the relief of rhabdomyolysis.

Oral potassium chloride solution is preferred, because veins stimulate blood vessels, and potassium chloride sustained-release tablets will lead to excessive local concentration, damage the gastric mucosa, and cause bleeding.

Wang Qiang's rescue measures were relatively safe. Zhou Congwen put his hands on the patient's ECG monitor after seeing the nurse put on the drip.

"Cough cough cough~" the patient coughed.

"Slow down, the IV finally got in." The nurse hurriedly held down the patient's hand, for fear of rolling the needle.

"My back hurts." The patient said while coughing.

"My whole body hurts, I know, and I will feel better after taking the medicine." Dr. Wang Qiang from the emergency department saw that the patient's vital signs were stable, and turned to ask the family members, "Didn't I tell you to go to the provincial capital to see what's going on? Did you go?" ?”

"I didn't go." A patient's family member said confidently, "I went to draw blood and test, but I can't tell what's wrong."

"That's right, a group of quack doctors know how to treat headaches and feet."

"That's right, today's doctors don't know how to see a doctor without equipment. It's better to be a doctor in the early years. You can know what the disease is at a glance."

"What are you talking about?" Boss Chunxiao was upset again, "I caught so many traditional Chinese medicines, and it's useless to eat them. Why didn't I see you nagging."

"..." The patient's family members were stunned.

"If you have the ability to send someone to the genius doctor you mentioned, see if they accept it."

"..."

Zhou Congwen scratched his head, suddenly remembered something, and pulled Boss Chunxiao to leave.

"Boss Chunxiao, what did you say about taking traditional Chinese medicine?"

After leaving the emergency room, Zhou Congwen asked.

"Isn't this the old man's cough? I told him to come to the hospital. They insisted on finding a doctor to get the medicine." Boss Chunxiao said, "Eating it is helpful, but it doesn't remove the root."

"Okay, commit again, commit again, go back and forth, toss."

Chapter 1264 I'm an Honest Man

Lu Tiancheng thought about it, and generally people under the guise of genius doctors prescribe medicine randomly, mainly starch, because they don't want to have any accidents.

There are countless excuses for prescribing medicine, but if you eat a dead person, you will face tremendous pressure from the patient's family.

As long as there are no dead people, people who have no effect and come to the door are rare animals.Generally speaking, the family members of the patients who go to see a miracle doctor have the attitude of treating a dead horse as a living horse doctor.

Moreover, the patient's condition is hypokalemia, alkalosis, and many toxic Chinese herbal medicines can cause liver and kidney damage.

Looking at it this way, it shouldn't be the serious consequences caused by the so-called "miracle doctor".

He also knew that Zhou Congwen was asking about the medical history on the sidelines, and he didn't take it too seriously.

"Is the prescription in there?" Zhou Congwen asked.

"Hey." Boss Chunxiao said with a smile, "generally people don't give it. It's a baby. It's a single pass. It's just pointing at this thing to cheat money. It's impossible to give it. Just say it, Dr. Zhou, we The Northeast used to be a wild land, so there is no inheritance of traditional Chinese medicine."

Zhou Congwen was smoking a cigarette, his eyes narrowed.

"Doctor Zhou, what are you thinking?" Boss Chunxiao asked.

"I'm thinking, it's really possible that it came from taking traditional Chinese medicine." Zhou Congwen said lightly.

"..." Boss Chunxiao scratched his head, "Doctor Zhou, seems to have had it for many years, and his family is very familiar with that Chinese medicine practitioner."

"Can you ask about the actual situation?" Zhou Congwen glanced at Boss Chunxiao and gave him a smile.

"This..." Boss Chunxiao scratched his head at Zhou Congwen's "unreasonable request", but only hesitated for a moment, then nodded, "Then I'll find some guys to try."

"Don't worry, there are still some inspections that haven't come out." Zhou Congwen smiled, "Boss Chunxiao, what are you going to do?"

"I'm an honest person." Boss Chun Xiao said proudly.

Lu Tiancheng was silent.

He had never seen an honest person who would say that about himself.

This Boss Chun Xiao did look quite ordinary, but when he said this, he was also very responsible, and he did not have the arrogance and arrogance of a rascal, similar to Teddy barking at people without confidence.

But by connecting the preceding and following sentences, Lu Tiancheng knew that the boss Chunxiao must be holding back his energy and preparing to harm someone.

Who did Zhou Congwen know, Lu Tiancheng thought to himself.

"Recently, I met a few people who are wandering around." Boss Chunxiao said, "You know, Doctor Zhou."

"Oh?"

"Isn't this close to your third hospital? If someone dies, if you want to hire someone to cry, you will contact them. Crying for the grave, you know."

"Well, I know. But in the hospital, it's rare."

"Business is not very good, there is no meal." Boss Chunxiao said, "I think they are pitiful, so I will give them a meal and send them away after a while."

"you prepare……"

"Let's just say that the medicine prescribed by that genius doctor killed people." Boss Chunxiao laughed.

Zhou Congwen couldn't laugh or cry.

Lu Tiancheng looked at Boss Chunxiao with surprised eyes. What he said was very simple, but there were all kinds of twists and turns in it.

"Okay, I'll trouble you then." Zhou Congwen said lightly, "As soon as possible, I may be leaving tomorrow."

"Doctor Zhou, you are really busy." Boss Chunxiao said with emotion.

"I'll go to 912 next year. Boss Chunxiao, by the way, have you bought a house in the capital?"

Zhou Congwen asked.