When doctors have a simulated operating room

The blood potassium level is 2.8mmol/L!

It is moderate hypokalemia!

Mild hypokalemia: within 3.5-3.0.

Moderate hypokalemia: within 3.0-2.5!

Severe hypokalemia: below 2.5!

The patient's value is 2.8, but 2.8 is already a relatively dangerous value.

Potassium must be supplemented immediately!

If the diarrhea continues and drops below 2.2, then central venous catheterization can only be used to supplement potassium.

But because the blood potassium is too low, some patients may not be saved even with this method.

(Central venous catheterization is a rapid potassium infusion method, but it also has advantages and disadvantages.

The advantage is that it can quickly replenish potassium and raise the patient's blood potassium.

But the disadvantage is also for this reason. This rapid potassium supplementation method can easily cause patients to suddenly have high potassium.

Potassium ions are raised in a short period of time. If hyperkalemia occurs without timely observation, it is also easy to die suddenly.

Therefore, many doctors in small hospitals generally dare not take the risk of using this method to supplement potassium, but use more conservative arm veins to supplement.

But the arm vein is relatively slow. If some patients with severe hypokalemia are supplemented too slowly, the blood potassium will not rise and it will not have any effect, and they are also prone to sudden death.

So this potassium supplementation method still depends on the specific hospital equipment or the doctor.)

The element potassium is like a double-edged sword.

It must not be lacking. If it is lacking, you will feel weak, weak muscles, and listless. In severe cases, you will have difficulty breathing, arrhythmia, and heart failure and die.

But it can't be too high. Too high can also cause arrhythmia and sudden death.

Potassium deficiency is usually seen in too little potassium food, hyperthyroidism, or like this patient, severe diarrhea, diarrhea to collapse.

High potassium is more common in kidney problems. The kidney filtration function is low, potassium cannot be excreted and accumulates in the body, which will cause problems over time.

The doctor on duty did not dare to delay and immediately gave the patient anti-inflammatory balanced electrolyte potassium supplementation treatment!

First infuse anti-inflammatory drugs, and then immediately infuse electrolytes and potassium.

2.8mmol/L can slowly replenish potassium by controlling the drip rate through the arm vein.

Now the main thing is to observe the patient's blood potassium level and abdominal pain and diarrhea.

After waiting for several hours.

At six o'clock in the morning, the patient's condition improved a little.

After all, he is a young man with relatively good physical fitness.

At least the frequency of diarrhea has gradually decreased, and the symptoms of dyspnea have disappeared.

But the blood potassium is still at 3.1mol/L.

The blood potassium has risen a little, but it is still in a state of mild hypokalemia.

So the doctor on duty gave another potassium infusion prescription.

This time it was slowly replenished, 10% potassium chloride is 15 ml, containing about 1.5 grams of potassium, and 500 ml of 5% sugar water for intravenous drip.

The drip rate is 40 drops/minute.

The normal drip rate is generally within 40-60 drops.

The daily potassium supplement for adults is between 3-6 grams, which can be increased according to the degree of potassium deficiency.

This patient has already supplemented 3 grams with this potassium chloride. If the situation improves slightly in the future, but the blood potassium is still between 3.3-3.5, then oral potassium supplementation can be switched, such as potassium chloride sustained-release tablets.

In general, as long as the potassium deficiency is not particularly severe, doctors recommend oral potassium supplementation for mild potassium deficiency, and only choose intravenous potassium supplementation when necessary.

After receiving the doctor's order, the nurse prepared the liquid and changed the liquid for the young man. The young man looked at the large bag of transparent liquid and asked:

"Nurse... How long will I need to infuse it? I'll... I have to go to work at eight o'clock..."

The nurse glanced at him:

"Go to work? How can you go to work in this situation? You should ask for leave quickly. You still have a lot of liquid. You have diarrhea like this. You still want to go to work when it is so serious?"

The nurse shook her head and didn't understand what the young man was thinking.

After changing the liquid, the nurse continued:

"Remember, this bag of liquid must be infused slowly. It will probably take three or four hours to finish infusing it. If all the liquid is infused, you will probably go to work in the afternoon."

The young man frowned:

"Ah? I have to infuse it until the afternoon..."

He looked up at the clock on the wall of the emergency room. It was already seven o'clock.

It was bright outside and he had to go to work in an hour.

After infusing the liquid all night, the young man actually felt that his body had improved a lot.

He felt stronger.

He asked, "Nurse,

Can I tell the doctor that I don't want to infuse this bag of fluid? I feel much better now. "

The nurse said with a serious expression:

"Of course not, this is the medicine for your treatment, it is to maintain the acid-base balance of your body, otherwise you will have diarrhea and collapse, do you think you can get better just by infusing anti-inflammatory drugs?

All kinds of nutrients need to be supplemented, otherwise you can get better so quickly?

And you are not completely well yet, you still have to continue to infuse fluids, you know?

Just lie down and infuse, it won't hurt to take a day off, your own health is the most important, you know? "

After saying that, the nurse took the infusion tray and left the ward.

But after just two steps, she turned back and looked at the drip rate and said:

"You must remember, this must be infused slowly, otherwise... it will kill people! "

The nurse looked serious.

The young man had no choice but to nod.

After the nurse left, the colleague who had brought the young man to the hospital also stood up and said:

"Then Kang Yong, you just lose here. I have to go to work. I'll ask for leave for you later."

The young man lying on the bed said with embarrassment:

"Oh, it's so annoying. If I ask for leave, I'll lose my full attendance."

Full attendance is 600 yuan.

His monthly salary is barely enough to pay off his mortgage and car loan.

So 600 yuan for full attendance is just a month's food money for him.

The colleague spread his hands and said:

"Oh, what can I do? You can't work while you're sick, right? "

The young man could only sigh in silence.

Looking at the back of his colleague leaving, the young man named Kang Yong regretted it at this moment.

It's all his fault for being greedy.

The boss sent seafood to reward the employees. Kang Yong usually didn't have money to eat these, so he thought it was free anyway, so he ate more.

I didn't expect it!

I was actually hospitalized!

I don't know if I can ask the leader for compensation for this.

But if I want compensation, I'm worried about losing my job...

Alas!

It's so hard to be a social animal!

Kang Yong, lying on the bed, was still a little weak, but much better than when he first went to the hospital in the middle of the night.

After thinking about it for a long time, Kang Yong still wanted to go to work.

The main reason was that he didn't want to lose the 600 yuan full attendance bonus.

It's not appropriate to remove the needle at this time.

So Kang Yong increased the drip rate while the nurse was not paying attention.

He thought to himself, the infusion would Dead? ? I don't believe it!

I don't know if the infusion will kill people, but I will really die if I don't have money!

Mortgage, car loan...

He dared not rest for a moment!

Immediately, Kang Yong ignored the nurse's instructions and opened the liquid completely.

Tap! Tap! Tap!

Kang Yong was happy to see the transparent liquid dripping into his body quickly.

As long as this bag of liquid is quickly infused, he can directly remove the needle and go to work when the liquid is changed later.

At worst, I can continue the infusion after get off work in the evening.

Thinking of this, Kang Yong closed his eyes happily and prepared to take a nap.

...

Half an hour later, it was close to 7:45.

The nurse went to each bed of the rescued patient to check the liquid drip rate and the patient's condition.

Suddenly!

When she walked to Kang Yong's bed, she couldn't help but exclaimed!