When doctors have a simulated operating room

The reason is that the body is not as good as the body.

Inhibit potassium ions? ?

Zhang Yi said this, even a fool could understand what he meant.

Pharmacology and biochemistry can teach medical students the most basic clinical pharmacological reactions.

For example, you can no longer take cephalosporins after drinking Huoxiang Zhengqi Liquid.

Because cephalosporins will inhibit the metabolism of ethanol in Huoxiang Zhengqi Liquid, causing ethanol accumulation, and in severe cases can also induce acute liver damage or ethanol poisoning.

For example, broad-spectrum cold medicines, antipyretics and painkillers cannot be taken at the same time, because these medicines contain an ingredient called "acetaminophen".

Taking them at the same time will cause an overdose of acetaminophen in the body, causing acute liver damage or even liver failure.

Another example is potassium.

It is impossible for medical students not to know the importance of potassium.

So when learning this chapter, the teacher will definitely focus on explaining what drugs will react chemically with potassium ions.

For example, the antipsychotic drugs risperidone and quetiapine, the side effect of this drug is abnormal glucose metabolism, which will allow potassium ions outside the cell to enter the cell, leading to hypokalemia.

Another example is the commonly used diuretics in clinical practice, furosemide, bumetanide, mannitol, etc. The function of diuretics is to help the body excrete a large amount of sodium ions to relieve peripheral vascular pressure and lower blood pressure.

But at the same time, it can also take away a large amount of potassium ions.

Therefore, when supplementing potassium, you must closely observe whether the patient's urine volume is normal.

There is also a four-character saying in clinical practice, called "see urine and supplement potassium."

These four words are basically engraved in the bones of every medical student.

Before supplementing potassium, you must ensure that the patient's urination function is normal, and the minimum urine volume must be >500mL/24h or 30-40 mL/h to supplement potassium.

Patients with low urine output are prone to potassium ion accumulation, causing hyperkalemia.

High urine output is not good either. Just after replenishing it, the urine is all discharged again in a short while.

But the strange thing about Qin Fang is that his urine output is within the normal range, but potassium cannot be replenished.

This is obviously not ordinary hypokalemia.

According to the current situation, the possibility of congenital hypokalemia is a bit small.

Unless it is an extremely rare genetic disease.

But Zhang Yi has never seen such rare genetic diseases that cannot be replenished with potassium.

Of course, there is another possibility that he secretly took some medicine and prepared to commit suicide by hypokalemia.

Otherwise, it was done by someone around him.

Thinking of this, Zhang Yi looked at the people in front of him calmly.

That's not right.

It shouldn't be, right?

These are all students and teachers.

Well... maybe Qin Fang wanted to commit suicide himself?

During the few minutes when several students were surprised, Zhang Yi had already imagined a lot in his mind.

The teacher seemed to understand what Zhang Yi meant, and she asked:

"Doctor Zhang, according to you... Qin Fang didn't take some medicine to commit suicide because he knew the pharmacological reaction?"

Zhang Yi did not deny it, and nodded:

"It is very likely. We can't replenish potassium now. After half a day of transfusion, the blood potassium is still 0.9, and it is very likely that there will be secondary ventricular fibrillation."

"Ah?! What... What should I do? He is a good person... Oh my!"

When the teacher heard it, a deep regret flashed across her face.

The expressions on the faces of several students next to her were also very disappointed.

They were all worried that Qin Fang really died like this.

"But... No, Qin Fang will not commit suicide. He is heartless every day. How can such a high-profile and cheerful person suddenly commit suicide?"

A classmate suddenly said.

"You mean Qin Fang has a good personality? He can't commit suicide?"

"Yes, Qin Fang is usually carefree and says whatever he wants. How could he commit suicide? Is it depression? But it's hard for him to be depressed."

The classmates told Zhang Yi everything they knew.

Now, Zhang Yi couldn't help but really start to doubt the people around him.

At this moment, the nurse suddenly ran out and shouted to Zhang Yi:

"Doctor Zhang, come in and take a look. The patient named Qin Fang has a heart rate of 140!"

"140?!"

As he said that, Zhang Yi quickly walked into the emergency room.

Outside the door, the classmates and teachers couldn't help but get nervous.

It's really strange.

How could this happen out of the blue!

The teacher turned around and looked at the classmates and asked:

"Before he fainted, what did he eat and drink besides lunch?

What did he do?"

Several students thought for a while and shook their heads: "We don't know about this, we just had a meal together in the cafeteria, and then... he seemed to smoke a cigarette?"

Smoking?

Smoking should be okay, right??

At this time, a male student wearing glasses next to him suddenly said:

"I remember that he seemed to drink water, but that water was from his own cup."

"Water? !"

"Yes, I remember seeing him drinking it when he finished smoking and sat on the edge of the bed before lunch break. After drinking it, he started playing games. When I was half asleep, I vaguely heard Qin Fang whimpering. I opened my eyes and found that he was lying on the ground twitching. "

The teacher frowned when she heard this.

Water?

Is it possible that Qin Fang wanted to commit suicide?

Did someone poison the water??

If it was really poisoning, then the severity of this incident would be amplified.

It is not something that she, a teacher, can handle.

After thinking about it, she quickly sent a message to the school leaders.

And in the emergency room.

As soon as Zhang Yi came in, he found that the heart rate on the ECG monitor had soared to 150 beats/minute.

"Have the results of the emergency blood potassium test come out? Call the laboratory department to urge them!"

"Okay, I'll go get it right away!"

Zhang Yi needs a more accurate blood potassium value from the laboratory.

If it is confirmed that potassium has not been replenished, then the infusion is no longer of any use.

The only way to save people is to change to a desperate method.

Soon, the nurse who called hurried over: "It's out! It's still 0.9!"

"It's also 0.9 in the laboratory? ! ”

“It’s still 0.9, which means potassium really hasn’t been replenished!”

“Urine volume is normal, but potassium can’t be replenished?” Wang Yufei thought for a while and asked, “Zhang Yi, do you think it could be some drug poisoning reaction that causes potassium ions to be absorbed into the cells, so no matter how much potassium we replenish, it can’t be given outside the cells?”

Zhang Yi’s eyes sank slightly, and he made a bold decision as he looked at the increasingly shocking numbers on the ECG monitor.

“Hurry up and notify the hemodialysis room, tell them that we want to do bedside hemodialysis, and ask them to bring the machine over!”

“Hemodialysis? Do hemodialysis directly? But the cause of the disease has not been determined yet, Zhang Yi, this is too risky, and his family members haven’t arrived yet, what if something happens…”

Wang Yufei’s worries are not unreasonable.

Doctors should learn to protect themselves while treating and saving people, and not let themselves fall into controversial dangers.

But now, Zhang Yi can’t care so much!