When doctors have a simulated operating room

The symptoms of nausea, vomiting, coma, and convulsions are indeed symptoms of hypokalemia. But has it never happened before? "He shouldn't have such low blood potassium suddenly. Did he take any medicine that can cause hypokalemia before he fell to the ground and convulsed?" Zhang Yi thought for a while and asked again. The classmates shook their heads with doubts: "No... He hasn't had a cold recently, and he didn't take medicine. And the meal we had at noon was also a normal Chinese meal, which was tofu, cauliflower, spinach, chicken legs, and rice." No random medicine, and normal meals. This made Zhang Yi a little confused. "Does he like to drink?"

The students shook their heads again: "We have so much homework every day, how can we have time to drink? If we drink, we can't do experiments the next day."

"Okay, then you wait outside for a while, I will notify you if there is any situation inside."

After that, Zhang Yi took the phone number given by the teacher and called Qin Fang's parents.

The phone rang only once before an anxious voice came from the other side.

"Hello??!"

"Hello, I am Zhang Yi, a doctor at Union Hospital. Are you Qin Fang's father?"

"Yes, yes! I am his father. Doctor, how is my son now? Is he okay??!"

The voice of the middle-aged father on the other end of the phone was trembling.

"Don't worry, the situation was really bad just now, he almost died, but he was rescued for the time being. He is in a coma and has not yet woken up.

I called you just to ask, has Qin Fang ever had symptoms similar to this time of hypokalemia, or coma and convulsions?"

"What?!? He almost died?!?"

"Yes, hypokalemia as low as 0.9 is a very dangerous situation. Has he had it before?"

"No, my son has been very healthy since he was a child. He went for a comprehensive physical examination during the summer vacation after graduating from high school. He said that he wanted to be a doctor in the future, and he had to make sure whether he was a healthy person before going to college. Oh my God! My son is usually fine! I don't know why he suddenly had to go to the hospital for rescue... Doctor! You must save my son. When I arrive at Union Hospital, I will kneel down to you and give you red envelopes. I only have this one son, please save him!"

Qin Fang's father was a little emotional.

Of course, Zhang Yi could understand.

He is the only son in the family, and his parents are also old.

He was suddenly sent to the hospital for emergency treatment and almost died.

This would be uncomfortable for anyone.

"No, no, no, we will definitely undergo emergency treatment, and we have already given him potassium and fluid supplements. As long as potassium is infused, the blood potassium in the body will recover. Don't be too anxious, just come to the hospital as soon as possible."

After hanging up the phone, Zhang Yi sighed slightly.

He didn't get anything from his parents.

Everyone said that Qin Fang was a very healthy person.

And he had a comprehensive physical examination during the summer vacation after graduating from high school.

It was only three years ago.

Could it be that his body has changed during the three years of college?

Half an hour later, Zhang Yi went to the emergency room to check on Qin Fang again.

He was still not awake, and the indicators on the ECG monitor had returned to the critical point of normal values.

Wang Yufei saw Zhang Yi coming over, patted his shoulder and said:

"Don't worry too much, just replenish potassium for hypokalemia, and you will probably wake up at night."

Zhang Yi nodded.

But he still felt a little strange in his heart.

He couldn't tell why he felt this strange.

Just...doctor's intuition? Sixth sense?

In short, Qin Fang was not conscious for a while, and he was always worried and couldn't let go.

After thinking about it, Zhang Yi asked the nurse to draw blood again and send it to the laboratory for examination.

To see if there is any endocrine disease or other drug components in the blood.

Then he called for a bedside color Doppler ultrasound to see if the kidneys are normal.

Generally speaking, abnormal kidney urination may also cause the body to lose potassium ions too quickly, leading to hypokalemia.

But after looking around, he found that there was no problem with the kidneys.

Even Zhang Yi himself didn't find anything wrong.

Is it congenital hypokalemia?

It's just that it hasn't been found before?

Zhang Yi, who couldn't find the cause, could only temporarily consider it as congenital.

"Let's just leave it at that for now. Once the blood potassium level comes back up, the patient will be fine. Don't be so nervous."

Wang Yufei comforted Zhang Yi.

At this moment, the nurse suddenly said cautiously:

"Doctor Zhang, why do I feel that Qin Fang's heart rate has... become faster again?"

Everyone looked over and found that the heart rate was 87 beats per minute just now, but it became 98 beats per minute in a few minutes.

Suddenly, Zhang Yi's heart was alarmed!

The heart rate went from fast to tachycardia and then to abnormal in the blink of an eye.

Everyone was also worried that the patient would have arrhythmia again, and hurriedly brought the defibrillator to the bedside.

At this time, the relief on Wang Yufei's face disappeared, replaced by confusion:

"What's going on? Didn't he just rescue him? And he is still taking potassium, why is his heart rate still accelerating?"

The question in Wang Yufei's heart is also the question in Zhang Yi's heart.

Zhang Yi frowned slightly and told the nurse:

"Xiao He, first do a blood gas analysis and biochemistry test to see how much the blood potassium level has risen after half an hour of supplementation, and then add a tube of biochemistry to the laboratory."

"Okay!"

Bedside blood gas analyzer and biochemical test can help critical patients rescue in critical moments.

But the value may be slightly different from the result measured by the laboratory in the laboratory.

So it is only used in clinical cases in critical situations.

In non-essential situations, blood is usually drawn and sent to the laboratory for examination.

Soon, the blood potassium concentration on the biochemical detector showed: 0.9mmol/L.

"What?! How come it hasn't moved at all after half an hour of supplementation?"

"It's impossible, how can it rise so slowly?"

The doctors and nurses who saw this value were stunned.

It has been more than half an hour since the potassium was supplemented. According to the drip rate, it should be within 1.5-2.0 in more than half an hour.

How can the potassium not be supplemented in half a day? ?

Immediately, Zhang Yi concluded that Qin Fang had hypokalemia!

This guy must have taken other drugs that can cause hypokalemia before he fainted!

Otherwise it wouldn't be so strange!

"Watch the patient, I'll go out and ask his classmates and teachers."

"Okay!"

Outside the emergency room.

Zhang Yi looked at the students and the teacher and asked them seriously:

"I want to ask, do you have a good relationship with Qin Fang in school?"

Several students nodded: "Yes, we are roommates."

"Then how are your grades? Especially in pharmacology and biochemistry."

"It's okay, we are all above average."

The teacher on the side also responded: "Indeed, these students have good grades, what's wrong, Doctor Zhang? Why did you suddenly ask about pharmacology and biochemistry?"

Zhang Yi's eyes were slightly cold, and he glanced at them before speaking lightly:

"Because... one of the key points of these two subjects is that some drugs can inhibit potassium ions in the human body."