When doctors have a simulated operating room

The patient was sobbing and thought for a while before answering:

"I heard him say that his hand hurt and was a little swollen last night, but my eyesight is not very good, so I can't tell if it was swollen or not.

But I can be sure that it was definitely not as serious as it is now!"

After hearing this answer, Zhang Yi had a rough guess in his mind.

He then asked:

"Did he accidentally scratch his hand yesterday or the day before yesterday?"

"Hand...hand scratch? I don't know about that..."

The family member shook his head.

There was no way, Zhang Yi had to carefully examine the patient's hand again.

From fingers to back of hand to arm, Zhang Yi looked carefully at any place with edema and blisters.

Kang Yanming saw Zhang Yi examining so seriously and walked over to ask him:

"Zhang Yi, what are you looking for?"

Zhang Yi said without raising his head:

"I want to find the cause and the pathogen."

Good fellow!

You started looking for the cause directly on the patient? ?

The two doctors on duty in the emergency room next to him were shocked.

You are quite good.

It is obviously the job of the laboratory department, why do you have to steal their work?

You found a blue-shaped fungus Marneffei and then you are addicted to looking for pathogens?

Please, big brother!

Leave some work for the laboratory department~!

They also have to get bonuses!

You do all the work, and they are left to starve? ?

Kang Yanming didn't say anything, just reminded:

"According to the current symptoms, this person is most likely suffering from septic shock. In addition to the rescue medication, I have added two amoxicillin.

Most septic shock infections are caused by Gram-positive and Gram-negative bacteria.

These two pathogens are extremely sensitive to broad-spectrum antibiotics.

The medicine has been used and rescue work is being done.

The final result depends on the patient's own immunity."

Gram-positive and Gram-negative bacteria are very sensitive to broad-spectrum antibiotics such as penicillin and cephalosporin.

Generally, taking medicine or intravenous drip after infection can cure it.

But only for patients with normal constitution.

Cancer patients, people with low immunity, and patients with AIDS cannot be guaranteed.

The patient lying on the bed has a set of fluids on both sides of his upper arms, some to expand blood volume and some to regulate acid-base balance.

On the ECG monitor, blood pressure also rose a little because of the medication.

At least the data shows that the drug is effective.

At this time, the patient's family suddenly remembered something and said to Zhang Yi:

"I suddenly remembered something!!"

Zhang Yi looked at her: "What is it?"

I remember that when we went to the seafood market to buy vegetables yesterday morning, he seemed to be choosing shrimps.

Suddenly I saw him shrink his hand and complained: Ouch, why is this shrimp still pricking my hand?

Doctor? Could it be that his hand is like this now because he was pricked by that shrimp? ! "

After the family members recalled it, the words "unbelievable" and "unbelievable" were written all over their faces!

No way...

Could it be that he got infected because he was pricked by the hand when he was choosing shrimps?!

"Pricked by the hand when choosing shrimps? ?

Is that seafood market authentic? Are the seafood in it all genuine and fresh seafood? "

The family members nodded repeatedly and said with tears in their eyes:

"Yes, it's the Dahai Seafood Market. The seafood there is the freshest nearby. Whenever we want to eat seafood, we go there to buy it. "

Zhang Yi nodded and observed the patient's arm again.

Blisters of varying sizes, edema, fever, chills, shock...

For a moment, thousands of pathogens flashed through Zhang Yi's mind...

Finally!!

The name and image of Vibrio vulnificus stopped in front of Zhang Yi!

Vibrio vulnificus, also known as marine Vibrio.

It belongs to the Gram-negative Vibrio. Vibrio vulnificus has more flagella all over its body, has strong motility, and is highly invasive after infection.

Once infected, the mortality rate of normal patients is 50%!

It also secretes pathogenic factors such as MARTX toxins, iron carriers, capsular polysaccharides, metalloproteinases, and cytolysins.

These secretions enhance its toxicity and pathogenicity.

So once infected, the disease will progress very quickly and be extremely harmful. If not treated in time, it will endanger life.

Just like the uncle in his fifties in front of him.

From last night to now,

In less than 24 hours, he was almost in shock.

If he hadn't been sent to the doctor in time to relieve the pain, I'm afraid he would have died at home now.

This pathogen is widely distributed in seawater and coastal crustaceans, and is a pathogen shared by humans and fish.

It is also an important pathogenic Vibrio of humans and aquaculture animals.

Marine organisms such as marine fish, shrimp, oysters, crabs, shellfish and whales are prone to carry this bacterium.

It can be seen not only in seawater, but also in fresh water.

After having a clue in mind, Zhang Yi combined the patient's symptoms and found that 99% of it was Vibrio vulnificus! !

"Director Kang! Don't use penicillin first! Switch to doxycycline plus ceftriaxone!"

Kang Yanming narrowed his eyes slightly.

He also heard what the family members said just now.

After combining the patient's symptoms, Kang Yanming also thought of Vibrio vulnificus.

But I didn't expect Zhang Yi to react so quickly! !

It took less than ten seconds to think of this pathogen, and even the corresponding best treatment drug was mentioned!

This shows...

Zhang Yi has a very rich knowledge reserve!

He must read books often.

Then, Kang Yanming's appreciation increased again.

"Okay! Although the laboratory department has not yet issued the results, we can trust our own judgment first in the clinic.

Li Yong, go and change the doctor's order and change the medicine.

Doxycycline plus ceftriaxone."

Li Yong looked up at Zhang Yi and Kang Yanming and nodded, and hurried back to re-order the doctor's order.

However, Zhang Yi is not excited at all about finding the pathogen.

Because the mortality rate of Vibrio vulnificus for normal patients is 50%.

What about this kind of cancer patients?

It may be as high as 70%, or even 90%! 100% is not certain!

So Zhang Yi dare not relax at all at this time.

He looked at the nurse next to him and ordered:

"Go get the drainage bag, disinfectant, cotton balls, and gauze! I want to clean the wound and drain!"

"Okay!"

The nurse also went to prepare things with a look of anxiety.

She also knew the mortality rate of Vibrio vulnificus.

If he is not rescued in time, he will be gone!

Cleaning and drainage are trivial matters. In serious cases, the hand must be amputated to save him!

On the side, the family member saw that the doctors around him suddenly became nervous, and she became more panicked.

She quickly grabbed Zhang Yi's hand and asked:

"Doctor?! What's wrong? Why are you all so nervous all of a sudden?

What disease does my husband have??

Can it be cured??

Wuwu...you must save him, doctor!"