Li Songzhao was indeed ill. Without Sun Li'en's need to say anything, the two big men turned Li Songzhao over and laid him flat on the ground. They used a portable cardiopulmonary monitor to monitor Li Songzhao's heart rate and did an electrocardiogram at the same time. The results were as expected.
The sharp and symmetrical inversion of the T wave indicates acute right ventricular dilation and is a typical electrocardiographic change of pulmonary embolism.
Big Han A ran out of the Internet cafe to pull the first aid bed, while Sun Lien asked for two pairs of latex gloves from Big Han B. After making sure that the gloves were on and not damaged, Sun Lien carefully took off Li Songzhao's shoes. There was a strong smell of
The fishy smell hit his nose. The socks on his feet that were supposed to be white were wet, and strange cyan and yellow liquid soaking marks were revealed on the edges of his toes. Apart from these two socks, which had been worn for an unknown period of time, Li Songzhao's feet were directly exposed.
In the air.
Starting from the toe of Li Songzhao's right foot, there was an ulcer about five centimeters by three centimeters. Smelly pus was slowly flowing out of the ulcer.
The big man B glanced at Li Songzhao's feet and said curiously, "It really looks like he has a diabetic foot. How did you tell that? You couldn't be lying next to his feet and smelling it, right?"
"Such a strong smell, anyone with a long nose can definitely smell it." Sun Lien took off his latex gloves, took two steps back, looked at Li Songzhao's feet, shook his head and sighed, "With this level of diabetic foot... you can only
Amputated."
Li Songzhao's foot injury was serious, but it was not the top priority right now. The big man A rushed in pushing the emergency bed, and there was an oxygen tube on the bed. The two big men worked together to transfer Li Songzhao to the bed, skillfully
He fastened an oxygen mask on his face. The oxygen flux was turned on to the maximum. Then the big man B took out a bottle of heparin sodium from the medicine box. After dissolving it with the sodium chloride injection in the small bottle, he was ready.
Prick the vein in the middle of Li Songzhao's elbow.
After cutting open the clothes with scissors, the big man B was dumbfounded, "This..." He looked at the gray skin on Li Songzhao's arm, "What's wrong with this?"
Sun Lien glanced at it and instructed, "It's just that I haven't taken a shower for a long time. Wipe it with the alcohol cotton ball." He picked up the mineral water that he had not yet opened the bottle and handed it over, "Wash off the dirt first.
Then wipe with a cotton ball."
The alcohol cotton balls distributed by pre-hospital first aid should actually be called alcohol wipes. The advantage is that each piece is packaged independently, which is very convenient to use and carry. But this is the inconvenience if a large amount of alcohol wipes are needed.
For wiping with a ball, a non-woven cloth soaked in alcohol would not work at all. Sun Lien saw the wipes that the big men took out, and then asked them to take a bath on the spot to remove the dirt.
Disinfection is necessary in such an emergency, not because the doctors have any mysophobia. It is simply because Li Songzhao's body is so dirty. It is so dirty that Sun Lien is worried that the needle will be blocked. Compared with his hands, his elbows are usually too dirty.
It doesn't come into much contact with other things, and the dirt will not be "patched". Instead, pieces will fall off naturally, and then the moisture removed by the body's heat and pores will stick to the body. Big man B uses a piece of gauze and
Sun Lien wiped a whole bottle of mineral water for several minutes before barely scraping out a piece of real skin. Then he used an alcohol wipe to disinfect it, and then injected a tube of heparin sodium into Li Songzhao's vein.
"Get in the car and send it to the nearest place." Two big men pushed the first-aid patient into the car and dragged Sun Lien up. "You reported 120, and you are a doctor. At least come with us, and those in the hospital's emergency department
It would be good for the doctors to hand over the situation."
Sun Lien was dragged into the car just like that. Unfortunately, the overnight computer he spent 30 yuan to open lasted for less than an hour. The Internet cafe owner looked at Li Songzhao's pair of socks with an angry look on his face. It seemed that he should not
I will refund Sun Lien's money.
"Send him to the nearest..." After getting into the ambulance, the big man A patted the driver's seat and said to the driver, "Brother Wang, send Xiehe."
"Concorde, right?" The driver looked young, and for some reason he was called "brother" by the pre-hospital emergency doctor who looked to be in his late 40s, but his response was still very decisive. "No problem!"
After pressing the accelerator twice, the driver suddenly lifted the clutch and quickly and randomly kicked the accelerator down. The heavy ambulance even tended to raise its head slightly, and then there was a harsh sound of tires scraping the ground.
Although the ambulance accelerated very quickly, there was not too much shaking inside the car. Although it was already late at night, there were still many vehicles on the streets of Beijing. They were walking left and right in the traffic, but in just three minutes, they were shouting.
The howling ambulance drove along Dongdan North Street and entered the entrance of the emergency hall of Union Hospital.
"What was just predicted is acute pulmonary embolism, combined with diabetic foot." While jumping out of the ambulance as fast as flying, the big man A shouted to the doctors and nurses rushing out of the emergency hall, "It has already been treated with high concentrations.
He was given oxygen and 7,000 units of heparin sodium was injected intravenously."
Sun Lien also jumped out of the car and helped push the bed towards the emergency room. The big man A pointed at Sun Lien and said, "This is the doctor who called the ambulance. He saw that there was something wrong with this man. When we arrived at the scene
, the patient suddenly stood up and was very excited. Then he suddenly fell down holding his chest."
The doctor who treated the patient looked at Sun Lien in surprise, "Whose student are you? I've never seen you."
"Uh..." Sun Lien was stunned, and then he realized that the other party probably thought that he was a doctor of Xiehe University. "I came to Beijing from Ningyuan on a business trip."
"From the Fourth Central Hospital?" The other party immediately called Sun Lien's unit, "I heard Director Zhu mentioned that your hospital is a major emergency center, right?"
While they were talking here, the nurses nearby had quickly guided the emergency bed to an empty bed. Several people worked together to lift Li Songzhao to the bed. Then they began to attach electrodes to his body.
At this time, the electrode patch encountered unprecedented difficulties. The patch either could not be adhered at all, or there was no electrical signal response at all. This made the nurses at Xiehe very anxious. Seeing this person become so dirty
With this look, the nurses could only hold a 500 ml bottle of physiological saline each, and began to wipe off the thick layer of dirt on Li Songzhao's body with gauze. The black water flowed down his body, and the sour smell was almost...
It filled the entire emergency room. After a while, the nurses finally wiped out a few necessary clean areas on his body. Then they reluctantly attached the electrode patches.
While the nurses were scrubbing Li Songzhao, the doctor who was talking to Sun Lien performed a B-ultrasound and confirmed that there was indeed a thrombus in the deep veins of Li Songzhao's lower limbs. However, the specific size needed to be confirmed through imaging examinations. Taking into account the pre-hospital emergency treatment, Li Songzhao had already been injected
After taking heparin for anticoagulation, the first priority now should be to solve his pulmonary embolism.
Li Songzhao's symptoms of pulmonary embolism are very typical, and there is no difficulty in diagnosis. Dyspnea, syncope, tachypnea, wheezing, tachycardia, and jugular vein distention. These are very typical symptoms of acute pulmonary embolism.
.However, how big the embolism area is can only be known after CT pulmonary artery angiography.
The doctor who spoke to Sun Lien introduced himself, "My name is Yuan Pingan, and I am the chief resident here. Do you know Professor Liu Pingchuan?"
Sun Lien stretched out his hand and shook it, "My name is Sun Lien. Professor Liu is now the vice president of our college."
"Are you Sun Li'en?" Yuan Pingan grinned, "I saw a post about you in Liuxiang Garden." He paused and asked curiously, "Professor Liu's students are really in the same treatment room as you.
team?"
Sun Lien nodded helplessly, "Although there were many unavoidable circumstances, the fact is that it is true."
Yuan Pingan and Sun Lien shook hands a little more forcefully, "I have listened to Professor Liu's class before. I originally wanted to study in Professor Liu's research group when I was taking the Ph.D. exam, but I didn't expect that Professor Liu was poached by your Fourth Central Hospital.
.”
Sun Lien suddenly felt a little chill in his back.
"I studied neurosurgery as a graduate student. I originally thought that the research direction during the graduate period would coincide with Professor Liu's direction..." Yuan Pingan shook hands with more force, "I didn't expect that two days before my interview, Professor Liu was actually
You dug away." He gritted his teeth and looked at Sun Lien with a very "kind" look, "In the end, I was reluctantly accepted by Professor Zhu from the emergency medicine department."
Yuan Ping'an's own level will definitely not be bad if he can be admitted to the Union Medical College. But a former neurosurgeon finally became the chief resident of the emergency department. The story that happened in the middle is probably full of blood and tears besides the ups and downs. Sun Lien
I looked at the doctor shaking hands with some sympathy, but I didn't know what to say to comfort him.
The emergency department can dominate the operation of the entire hospital. This kind of thing can only happen in a hospital with a large emergency model. As the pinnacle of Chinese medicine, although the emergency department of Union Medical College is also very powerful, it is not as good as their neurosurgery and cardiology departments.
Surgery has high value. Yuan Pingan, who originally came to be a doctor of surgical medicine at Peking Union Medical College, suddenly became a doctor of emergency medicine at Peking Union Medical College. You can imagine the psychological gap.
"Doctor Yuan!" The nurse next to her rescued Sun Lien in time, "The patient's blood oxygen saturation is dropping!"
The cardiopulmonary monitor next to Li Songzhao was beeping, and his blood oxygen saturation was always less than 90%. During the ten minutes when Yuan Pingan and Sun Lien shook hands and did basic examinations, Li Songzhao's blood oxygen saturation
The degree has dropped to 87% and is still gradually declining.
"Is the oxygen concentration at the highest level?" Yuan Pingan let go of Sun Lien's hand and turned to see the situation. While watching the cardiopulmonary monitor, he adjusted the support plan. "How much heparin sodium was given before the hospital?"
"Seven thousand units." Sun Lien replied promptly, "Except for heparin sodium, no other drug treatment was given."
"Another two thousand units." Yuan Pingan frowned, "What is his current coagulation time?"
"Prothrombin time (pt) is 17 seconds." The nurse has received the test results. "The INR is estimated to be 1.6, which is not enough time."
"It shouldn't be." Yuan Pingan's brows furrowed even deeper, "Please ask the hematology department for consultation. This patient may be insensitive to heparin."