In the seventh room, everyone is overshadowed by the glory of the tenement building. The rankings are updated:

The first tenement house 6+9+8+8+10+10+10=61

Second place Yang Ming 10+9+8+10+7+8+8=60

Third place Li Yundi 9+8+9+8+8+9+8=59

Fourth place Cheng Sisi 9+8+9+8+8+7+8=57

Fifth place dish talk 8+8+7+7+8+7+8=53

Sixth place Lu Rong 8+8+6+7+6+8+7=50

Seventh place Yunzhou 7+7+7+6+7+6+7=47

...

In addition to Tanglou, Yunzhou, which is also a county-level hospital, is also amazing. Although it does not have a high score, it is firmly ranked among the top eight.

"This little girl from Yunzhou is pretty good. She has a solid foundation. Our military hospital wants her."

Diao Xiwen stated directly that after all, the emergency training camp is to identify and select the most promising young doctors for various hospitals.

Over the years, only those who enter the top three have the opportunity to enter the first city hospital for further study, and those who follow are selected by each city-level hospital.

Although Yunzhou is not as dazzling as Tanglou, being able to enter a military hospital for further study is already a huge career leap for an intern in a county hospital!

Among the eliminated contestants, Wu Qian looked extremely ugly. Her score was shamefully fixed at 34, and Yunzhou was already preparing for the assessment of the eighth room.

As for Tanglou, she was already numb, after all, Yang Ming's face was trampled under his feet.

"The eighth room, what kind of response will Yang Ming give?"

Everyone was talking a lot, and amid great expectations, the eighth ward was opened!

In the preparation room, for the first time, Yang Ming could only wait behind him.

He clasped his hands together and sat on a stool with his feet and toes off the ground, his head half lowered. No one knew what he was thinking.

Tanglou shook his clothes and glanced at Cheng Sisi: "I'm going."

After Tanglou entered the ward, the familiar scene was simulated again, and a short short film was projected on one wall.

In the screen:

A man in his 50s and his son were hiking in the wild together. When they climbed to the mountainside, they fainted and fell to the ground.

The patient's son had learned some simple cardiopulmonary resuscitation. When the medical staff arrived, he had already performed cardiopulmonary resuscitation for 5 minutes.

Next, the screen switched to the emergency room.

The assistant doctor began to read the patient's case:

"The patient's heart rhythm was ventricular fibrillation (VF), and a total of 8 defibrillations were performed before spontaneous circulation recovery. The patient had a history of hypertension and type 2 diabetes, which were controlled by medication. He had a history of smoking for many years and did not have a family with sudden cardiac death.

history."

After the simulation in the previous seven rooms, Tanglou was already familiar with the first aid process. He stretched out his hand, and the assistant doctor handed over the physical examination information.

Patient vital signs:

Body temperature 37.5°C, blood pressure 105/55, heart rate 95, regular.

The patient was intubated, ventilated and sedated with fentanyl and propofol.

Physical examination revealed normal heart sounds and clear respiratory sounds bilaterally.

GCS rating 3/15.

Hb14.6, WCC 15.3, PLT 275, cr95.

Arterial blood gas: ph7.15 pO2 22.5, pCO24, HCO3 20, lactate 7.5.

...

At the end of the physical examination information is a chest X-ray and electrocardiogram of the patient.

Tanglou looked at it carefully.

"For the first question, please discuss the meaning of a GCS score of 3/15 and the necessary responses."

Tanglou started the discussion with an understatement: GCS score, also called Glasgow Coma Score.

The total score is 15 points, including the following three items:

Opening eyes, language and movement have 4 points, 5 points and 6 points respectively.

Each project is divided into several levels:

If you can open your eyes voluntarily, the score is 4 points, if you open your eyes with voice stimulation, 3 points, if you open your eyes with pain stimulation, 2 points, and if you don't open your eyes, 1 point.

5 points for normal language, 4 points for confused language, 3 points for inappropriate wording, 2 points for unintelligible sounds, and 1 point for no language.

6 points for being able to follow instructions, 5 points for being able to localize pain, 4 points for flexing the limbs in response to painful stimulation, 3 points for abnormal flexion due to pain, 2 points for stretching the limbs after painful stimulation, and 1 point for no response to pain.

The above three scores are added together to form the total Glasgow Coma Scale score.

The highest score on the Glasgow Coma Scale is 15, indicating clear consciousness.

12 to 14 is classified as mild disturbance of consciousness.

9 to 11 are classified as moderate disturbance of consciousness.

A score below 8 is considered coma.

The patient's score is only 3 points, which means he is obviously in a coma, so he should be intubated and mechanically ventilated immediately.

"The answer to the first question is completely correct. +3 points"

"Second question, please use the materials provided in the scenario rationally and implement targeted treatment for the patient."

After the assistant doctor finished speaking, he completely handed over the space in the middle of the room to the tenement building.

In the center of the room is a patient wearing mountaineering clothing, and on the table to his left is a bag of white crystals. In the cabinet to the patient's right, there is a hint of cold air.

Tanglou continued to observe and found a washbasin and a towel under the hospital bed.

Tanglou walked over and opened the cabinet. A chill hit him, and it turned out to be a bag of crushed ice cubes.

There is a mercury thermometer on the table of another cabinet.

After thinking about it for a while, Tanglou naturally understood the intention of the items in the scene, but he still needed to further confirm his conjecture.

"Assistant physician, conduct further blood tests, including arterial blood gases and renal function."

"Okay, Doctor Tang."

"You, check the electrocardiogram again and look for cardiac ischemia..."

"You, bedside ultrasound, looking for the presence of pulmonary embolism, assessing ventricular function, water load..."

Tanglou issued clear instructions and simultaneously began to use the items in the scene.

"Come, come here and help me bring the basin over."

Tanglou himself poured the crushed ice cubes from the cupboard into it.

"Saline solution..."

...

...

While the tenement building was busy, some interns in the review room were a little confused.

"What is he doing?"

"I don't know, but it looks very powerful."

"Make a glass of Ice Cream? Wake the patient up."

"No, no, actually, he just wants to do an ice bucket challenge."

"I think maybe he wanted to tell everyone that the patient was cold."

"..."

While the eliminated contestants in the back row were showing off their cleverness, the directors in the front row were different, with approving looks on their faces.

As the saying goes, laymen watch the excitement, while insiders watch the door.

Niu Bolin directly told the purpose of the tenement building to the students in the back row:

"This patient obviously has an initial shock-induced out-of-hospital arrest, or OHCA. For such patients, we should cool down to prevent secondary brain damage. This is called therapeutic hypothermia."

"If conditions permit, the ice blanket machine cooling method is naturally the best choice. However, in the background, it is obvious that the patient was hiking in a remote mountainous area, and the hospital he was sent to must have extremely poor conditions. So how to carry out cold therapy?"

"Under harsh operating conditions, first aid is the most test of an emergency physician's ability and level. For example, Tanglou is currently using the simplest but also practical cold and wet compresses."

...

...

After the other medical staff completed all the examinations required by Tanglou, Tanglou simultaneously prepared the ice water in the basin and used the towels as treatment towels...

"First remove all the patient's clothes, then soak the treatment towel in cold water, wring it dry, preferably without dripping, apply it on the patient's body, change it every 3-5 minutes... Monitor body temperature at any time and control it at 32-32
Chapter completed!