When doctors have a simulated operating room

The more you eat, the more you eat.

Amoxicillin belongs to penicillin, which is the most common antibiotic, or in layman's terms, an anti-inflammatory drug.

In addition to the disorder of intestinal flora, the main reason for diarrhea and diarrhoea is bacterial infection, and most of them have both.

Bacterial infection can indeed be treated by taking anti-inflammatory drugs or transfusing anti-inflammatory drugs.

But it is definitely not like this old lady who takes medicine every time she has a stomachache, and it is easy for the body to tolerate it after taking it for a long time.

Tolerance means that the body has developed drug resistance.

Under normal circumstances, diarrhea and enteritis can indeed be treated with penicillin, but because you often take this medicine, the pathogenic bacteria in your body are not sensitive to this medicine and have developed drug resistance.

Then it will be difficult for you to use penicillin to treat enteritis and diarrhea caused by infection in the later stage.

Zhang Yi looked at the old man and said earnestly:

"Uncle, you must not eat leftovers in the future. Even if those leftovers are placed in the refrigerator, they will breed bacteria and some nitrites.

Bacteria breeding is prone to gastroenteritis, and nitrites are prone to cancer if eaten too much.

Look at your wife now. Didn't she take amoxicillin again because she had a stomachache last night?

As a result, you see, it has no effect now, right?

Is it still so serious after taking the medicine?

Hey! Taking this kind of medicine for a long time is not good for the body. Her body may have tolerated amoxicillin.

We have to change to another medicine to see if the other medicine can work."

"Ah? What works? I... I don't quite understand this, doctor."

The old man is also in his seventies, and there is indeed a generation gap in communication with Zhang Yi.

Just at this time, the ambulance stopped and arrived at the hospital.

Zhang Yi said to the old man as he got off the car:

"Where are your son and daughter? Contact them. The old lady's condition is more serious than ordinary diarrhea. Ask them to come over and let the doctor communicate with them, okay?"

The old man nodded repeatedly:

"Okay, okay, I'll call right away."

Soon, the old lady was sent to the emergency room.

The bag of feces that Pu Ling had just put in the room was also replaced with a measuring cup and sent to the laboratory.

In addition to blood tests for diarrhea, the most important test is stool tests.

Blood tests mainly check for elevated white blood cells and whether there is infection.

And stool tests can detect specific pathogenic bacteria.

Then blood tests also include electrolytes to see if the electrolytes are disordered. If the diarrhea is too frequent, electrolytes need to be replenished in time.

In the emergency room, fluids have been transfused.

According to Zhang Yi's suggestion, amoxicillin may have developed drug resistance, so the antibiotic was replaced with ceftriaxone sodium.

The water is sodium chloride, and severe diarrhea is basically given sodium chloride to prevent sodium deficiency.

The test results came out half an hour later.

The white blood cell count soared to 17x 10⁹/L!

Electrolytes also decreased to varying degrees.

The most outrageous thing is intestinal flora imbalance! !

There are many kinds of microorganisms parasitizing in the human intestine. Under normal circumstances, these microorganisms are a healthy ecological environment formed by checks and balances.

However, due to age factors or long-term use of antibiotics, a certain flora will be inhibited by the drug, causing another flora to multiply wildly, forming a situation of one rising and the other falling.

In this way, the checks and balances between microorganisms will fail, and diarrhea will follow.

Now, this old lady is not just suffering from diarrhea caused by intestinal infection!

Intestinal flora imbalance is also a big problem that needs to be solved.

Don't underestimate these intestinal microorganisms. When they are good, it is called win-win cooperation, and when they are not good, it can kill you.

Why do some doctors recommend eating more probiotics or drinking more yogurt for people with poor stomachs?

This is because it can properly regulate the intestinal flora and relieve the symptoms of frequent diarrhea.

Only when the diarrhea is really serious will antibiotics or infusion be given directly.

While looking at the examination form, the nurse suddenly lifted the bed sheet and exclaimed with disgust:

"Oh my, this old lady has pooped again? Did she poop unconsciously?"

The old lady was drowsy at the moment. Occasionally she could open her eyes and call for help, but she would not respond when she was called.

But she did not delay her pooping at all.

Zhang Yi walked over and saw that she was indeed pooping again, and it was watery...

Oh my god...

The emergency room was almost stinking...

Several doctors and nurses quickly tightened their masks.

Zhang Yi said to the nurse: "

Let's change her diaper. We'll put one in first and let the family buy the rest. Also, pay attention to turning her over and be careful not to get pressure sores. "

"Okay..."

The nurse nodded while trying to hold back the stench.

Fortunately, a disposable medical cotton pad was added to the bed sheet, otherwise the bed sheet and the cotton wool under the bed sheet would have to be changed.

After finishing his work, Zhang Yi handed the man over to the doctor on duty in the emergency room.

Zhang Yi was in charge of the ambulance today, and the emergency room was not under his charge.

Before leaving, Zhang Yi also reminded the duty officer to notify him if the old lady's condition did not improve.

After all, there was intestinal flora imbalance plus infection, plus penicillin resistance, plus the old lady's age.

Zhang Yi was worried that this diarrhea might not be so easy to treat.

Soon, Zhang Yi went out for another visit in the ambulance.

This time, he brought back an old man with a heart attack, and he was sent to the operating room for emergency surgery as soon as he was brought back.

As a result, just after finishing his work, he saw the doctor in the emergency room next door rushing over:

"Doctor Zhang, the old lady is still diarrhea! "

Zhang Yi frowned: "Hmm? Still having diarrhea?"

It has been almost an hour since Zhang Yi came back from his visit after the infusion.

Still having diarrhea?

"Has the ceftriaxone been infused?"

The doctor on duty nodded: "Yes, it has been infused a long time ago. ”

The anti-inflammatory drugs have been infused, but the diarrhea has not improved?!

Zhang Yi hurriedly walked to the bedside to check. The family had already bought the diapers for the old lady.

They were the regular diapers for the elderly.

But at this moment, the diaper was stained with some yellow loose stools.

It can't be called loose stools, it's just a yellow liquid.

After many diarrhea patients have defecated many times, the dry and hard substances are basically discharged. If the diarrhea is not stopped, they will continue to defecate, and at this time, they will defecate water.

At this moment, what the old lady defecates is almost in the state of water.

It's just that there is a little bit of fecal residue in the water.

"It seems that the effect of ceftriaxone sodium is not very good. Let's wait for another hour to see if she still has diarrhea. If she still has diarrhea, try levofloxacin and feed her some montmorillonite powder. ”

If the anti-inflammatory drug is not effective, change it. Zhang Yi is mentally prepared for this.

Amoxicillin can be taken for half a year. Who knows if the old lady has taken it in exchange for other drugs during this period but the old man doesn’t know?

Ah!

How confused.

“Okay! "

The doctor on duty nodded and did as he was told.

Then, Zhang Yi lowered his head and looked at the old lady again. Because she had a fever, he changed her mattress to an ice mattress.

The ice mattress is a physical cooling method currently commonly used by Union Hospital.

The mattress can automatically adjust the temperature. Patients with cold bodies after surgery can adjust the mattress temperature higher.

Patients with fever but only need physical cooling can adjust the mattress temperature lower.

The clinical effect is very good, not only in the emergency department, but also in the inpatient department.

After checking around, Zhang Yi reached out and touched the old lady's forehead again. Fortunately, the forehead was not so hot.

It means that the fever has subsided, but the diarrhea has not stopped.

At this moment, the old lady is slightly awake.

She half-opened her eyes and looked around, as if she wanted to find her family.

Zhang Yi lowered his head and said:

"Old lady, you are sick and hospitalized, and your family is outside now. "

The old lady understood and nodded slightly.

She didn't say anything, just lying on the bed looking at the ceiling, not knowing what she was thinking or whether she was fully awake.

Seeing this, Zhang Yi had to remind her again:

"Old lady, this is a hospital. If you feel uncomfortable, remember to tell our doctor, okay? You had diarrhea so badly that you almost fainted, did you know that?"

The old lady turned her head and looked at Zhang Yi and slowly uttered a few words:

"Thank you for your help."

"Well, it's not a problem. Just take good care of yourself and call a doctor if you need help. "

"Okay..."

After giving the instructions, Zhang Yi went out again.

At the door of the emergency room, there were several middle-aged and elderly people in their fifties and sixties standing next to the old man.

It looked like they were the two old sons and daughters. At this moment, their family was sitting on a bench and talking about something.

Zhang Yi glanced at them and saw that his children's faces were full of reproachful expressions.

They probably knew about eating leftovers.

It was also weird that they would cook so much food at one time and put it in the refrigerator.

And it seemed that they should be put in the fresh-keeping layer of the refrigerator. The temperature of that layer could not keep food fresh for a long time, especially for cooked food.

Any food tastes best when it is fresh.

Put it in the refrigerator

Not only will it lose its freshness after a long time, it will also affect the taste and even breed bacteria.

Even if it is taken out and heated before eating, it cannot be guaranteed that all the bacteria that grow on it can be killed.

Especially for people with low immunity, it is easy to have diarrhea like this old lady and end up in the hospital.

Zhang Yi walked by and prepared to go to work.

As a result, the old man saw Zhang Yi with sharp eyes, and quickly stood up and walked to Zhang Yi and asked:

"Doctor Zhang, how is my old lady now? Is she awake?"

"She is awake now, and the fever has subsided, but the diarrhea has not healed yet, so we need to observe her again."

Behind him, several children of the old man followed.

Among them, an aunt in a black down jacket did not ask about the old lady's condition at the beginning, but asked directly about the hospitalization fee.

"Doctor, I want to ask how much does it cost to stay in your emergency room for a day? How come I have already paid more than 3,000 yuan in such a short time?"

"It's like this. The reason why the cost of the emergency room is more expensive than other departments is that Tang Guihua's condition is more serious. You saw it when she came to the hospital. She fainted. This symptom is more dangerous at her age.

So she has to be monitored in the emergency room. Since it is monitoring, the equipment and labor are more expensive than other ordinary departments.

In addition, since she has just been admitted to the hospital, the electrocardiogram and B-ultrasound tests will add a little more cost. The cost will be reduced when she stabilizes tomorrow or the day after tomorrow."

The auntie couldn't help rolling her eyes and complaining to the ceiling:

"Huh? It's so funny. Just diarrhea makes her so weird? It makes my mother look like she is going to die. Maybe your hospital deliberately puts her in a department with high costs!"

Hearing this, the smile on Zhang Yi's face froze immediately.

? ? ?

Deliberately? ?

Haha!

I helped you treat your illness and you said I did it on purpose? ! ?

Huh!

Forget it, forget it, don't be angry! !

Pay attention to the doctor-patient relationship!

Otherwise, it will be another medical dispute.

Zhang Yi let out a long sigh and suppressed the anger in his heart.

Being a doctor is like this, often misunderstood, but also often thanked.

You can't destroy your professional ethics because of the occasional misunderstanding.

Seeing that Zhang Yi's expression was not right, the old man turned around and glared at his daughter:

"Say less, Dr. Zhang carried your mother down from the seventh floor and sent her to the hospital. What about you? What have you been doing?"

As soon as the old man opened his mouth, the old lady in the down jacket shrugged and said nothing.

The other two middle-aged men and women on the side also looked ashamed.

Turning his head, the old man smiled and said:

"I'm sorry, Doctor Zhang, she is impatient..."

"It's okay. It's not uncommon for doctors to be misunderstood. I just want to explain to you again. Although Tang Guihua was admitted to the hospital for diarrhea, she had taken antibiotics from another hospital for half a year without authorization, and her body had developed drug resistance.

Penicillin and cephalosporins are no longer effective for her. We just changed to another anti-inflammatory drug.

If this one still doesn't work, we have to change it again.

If it still doesn't work after changing it again, it means she It may have developed resistance to most drugs.

Diarrhea will not kill people, but if it is not treated in time and Tang Guihua has drug resistance, we can't guarantee what will happen next.

There was a patient who thought the food in the cafeteria was not clean, so she took a penicillin pill every day to kill bacteria, thinking that she could kill the pathogenic bacteria, but she didn't expect that her body would become drug-resistant.

In the end, an ordinary cold took her life. "

Zhang Yi's voice was not loud, but it was very heavy, and it hit the ears of these family members word by word.

Can a cold kill people? ?

Is it true? ?

Is this doctor bluffing?

Is it... trying to make it sound serious so that they spend more money? ?

Among these family members, the others showed a worried expression after hearing Zhang Yi's words.

They were all afraid that the situation would become serious and their 75-year-old mother would die.

But only the aunt in the down jacket was still half-believing and half-doubting.

Forget it, Zhang Yi doesn't care whether you believe it or not.

Anyway, I've said almost everything, good or bad, so be prepared.

After that, Zhang Yi left.

He didn't go to the emergency room today, so he had to go and prepare for the visit.

Behind him, the aunt in the down jacket put her hands in her pockets and looked at Zhang Yi's back and muttered:

"Is it so weird? Drug resistance? And it will cost lives? I'll make a phone call and ask! I don't believe it at all.

Is the stomachache really as serious as he said? "

After saying that, the woman picked up the phone and dialed a number she knew.