socalfunplaces Chapter 529
Chapter 529
"Give me a flashlight..."
Lin Feng put on gloves, held a flashlight, and opened the patient's pupils...
"Huh..."
"No reflection of light!"
Dr. Liu Fei was shocked.
The pupil's reflection on light disappears, which is a very dangerous signal!
These are patients who are more critically ill or dying, and they will have such signs.
This change occurs because the nerves that control the pupil are innervated or stimulated.
"Did you do a head CT?"
"Done, no big problem, just a little lacunar cerebral infarction..."
Lin Feng groaned.
Lacunar cerebral infarction is a mild condition that is not sufficient to support unresponsive pupils.
Dr. Liu Fei: "By the way, there is another point, the patient has atrial fibrillation..."
Atrial fibrillation, (not ventricular fibrillation)
Then be careful with blood clots.
Atrial fibrillation, local blood is easy to form turbulence, easy to coagulate to form thrombus, once the thrombus falls off, it may cause cerebral infarction.
(At this time, the patient is sent for 3 hours, if it is a cerebral infarction, edema has not yet appeared, then brain CT can not be found, only when edema appears, CT will come out.) ）
"What is the cause of shortness of breath?"
"Chest x-ray, lung fluid immersion, should be pneumonia, why there is pneumonia, it is not clear ... However, the blood routine came out, and the white blood cells were not very high, so the pneumonia was not serious, and it should not be a coma caused by it..."
(There are also a small number of patients with serious infections whose white blood cells are not high, which may be related to the patient's poor immunity, and the white blood cells cannot respond.) ）
"What about blood sugar?"
Low blood sugar, energy can not supply the whole body, will be weak, severe cases will be coma.
Especially the elderly with diabetes, the nerves are not sensitive, maybe you have not found that it is hypoglycemia, people are in a coma.
"Blood sugar is okay too... Tested, normal..."
At this time, Liu Fei said:
"By the way, the patient is a little anemia, hemoglobin is only 89g/L..."
Lin Feng: "Have you found out what is the cause and why is it anemic?" "
Liu Fei shook his head: "No..."
Lin Feng scratched his head.
Too much trouble.
There are many problems, but suddenly there is no way to find the real cause.
At this moment,
The patient's body shook a few times and coughed...
And then a minute passed,
The patient's blood oxygen unconsciously began to fall.
Lin Feng looked at this blood oxygen, it was almost 92%, this is still the case of oxygen.
"No, intubate..."
The ventilator pushed over...
Anaesthesia......
Intubate......
One plug!
See what's wrong!
Lin Feng's face didn't know whether to smile or bitterly.
"No, this liquid is not the liquid of pneumonia, it is gastric juice and food scraps!"
This is aspiration!
It must have been in a coma, and the gastric juice refluxed down the throat, then into the airway, all the way down to the lungs.
So
Why the blood cells are not very high in the blood routine is different from the patient's shortness of breath pneumonia.
The answer is coma aspiration!
"Attractor..."
Constantly suck out all the fluid in your lungs.
Then Mari plugged in the oxygen tube.
A few minutes later,
Blood oxygen begins to rise continuously.
The ventilator gradually smoothed down, and the overall vital signs stabilized.
Saved his life for the time being.
Lin Feng breathed a sigh of relief.
Gastric juice inhaled into the lungs, it is likely to block the respiratory tract at once, may cause suffocation, and severe death.
And the patient does not, which is a kind of luck.
However, this gastric juice runs to the lungs, which is troublesome, because the gastric juice is acidic and can damage the fragile bronchi and even other things in the lungs.
And there are many bacteria in gastric juice, and these bacteria will bring a large bacterial infection to the lungs.
It is estimated that now that the blood routine is checked, the white blood cells must have been greatly improved.
Next, to avoid another aspiration,
Lin Feng immediately stretched out the gastric tube into the stomach and sucked out the gastric juice and waste residue inside.
"Let's do a deep vein puncture..."
At this time, the patient's condition is more complicated, or just in case, there is a deep vein puncture, and the speed of what to do will be much faster.
Originally, Lin Feng still wanted to do an MRI.
As mentioned earlier, brain CT cannot detect cerebral infarction before edema, but MRi can.
Lin Feng originally wanted to use MRI to check for cerebral infarction.
But now, the patient has not been able to get rid of the ventilator, naturally can not enter the MRI machine, the strong magnetic force will directly flatten hundreds of thousands of ventilators.
......
So far here,
Still no cause can be found.
Lin Feng took advantage of the patient's support on a ventilator, and his vital signs were quite stable, except for the rescue room.
Find the patient's son and find out the situation.
Maybe there is something that Lin Feng did not find.
"Has your dad eaten anything lately?" Food poisoning, drug poisoning and so on. "
The son shook his head repeatedly: "No... My dad didn't take any medicine, and as for what he eats with us, there is no problem..."
Lin Feng: "Think again..."
The son recalled...
"Drinking, does it count?"
"Count... But how much did you drink?! "
"Baijiu, two pot heads, about 50 degrees... Seven or eight bottles..."
Lin Feng: ".................."
Son: "Recently, my father didn't know why, he was in a very bad mood, and then he drank a lot of wine, drank all meals, and didn't eat much..."
Lin Feng: "Is the coma a coma soon after drinking, or is it a coma after a long time?" "
Son: "It's been two or three hours..."
Lin Feng groaned.
Alcoholism was excluded.
Because the patients with alcohol poisoning are acute, the acute will be drunk and coma, but the patient did not drink alcohol before the coma.
suddenly
A disease appeared in Lin Feng's mind!
Wernicke encephalopathy!!
"Your dad... Drink a lot? "
"Yes, we are Northeasterners, and drinking is the norm..."
When Lin Feng heard it, he felt more like it.
"Wernicke encephalopathy": is a common metabolic encephalopathy of chronic alcohol poisoning, which is an emergency caused by thiamine deficiency.
This disease often appears in people who drink excessively for a long time, and this kind of people have neurological dysfunction because of long-term excessive drinking, which can be manifested as sudden coma, ataxia and so on.
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PS: End of update.