When two extreme situations that should be opposed to each other appear in a patient at the same time, the person who has the biggest headache must be the patient's doctor.
The specific causes of systemic disseminated intravascular coagulation vary. But in general, it is caused by the human body erroneously starting the coagulation process under various conditions. A large number of coagulation fibers and platelets are clogged in the human blood vessels.
Due to incorrect start-up, thrombi appear in blood vessels in various parts of the human body. These thrombi will affect the normal blood flow, causing tissues throughout the human body to be unable to receive enough blood, resulting in symptoms such as hypoxia.
The total amount of coagulation substances in the human body is limited. When these coagulation substances turn into thrombi in blood vessels throughout the body, there will not be enough coagulation substances in the areas that really need to stop bleeding. Therefore, the human body will tend to
Spontaneous bleeding. After all, the human body is actually a place where little things go wrong.
Our bodies are damaged all the time, and tissue cells are repairing the damage all the time. When both parties reach a balance point, the human body is healthy. However, DIC will completely overturn this delicate balance. The areas that need repair cannot be repaired.
Repair materials, while normal blood vessels are filled with blood clots that block blood flow.
For the treatment of DIC, in addition to "symptomatic treatment" and "supportive therapy", the most important tool is heparin. At the same time, it is necessary to replenish blood volume as soon as possible, maintain blood pressure, and treat the primary disease causing DIC.
The symptoms that happened to Wu Fenmei were actually very direct. The severe infection caused by avian influenza triggered coagulation. Judging from the changes in Wu Fenmei's condition, she should be in the early stage of DIC. The treatment method is obvious and straightforward. A small amount is required.
Intravenous infusion of heparin (50~100u/h) and supplement of crystalloid solution.
Liu Tangchun skillfully found the heparin from the clean room cart, but because he was wearing protective clothing, it was really difficult for Comrade Liu to dispense the medicine with hands covered with several layers of gloves. So Sun Lien became Nurse Sun without hesitation.
Although he was clumsy in preparing the medicine, it was still easier than Liu Tangchun.
"Just replace the medicine bottle!" Liu Tangchun looked at Sun Lien, who was about to give the patient another injection, and was furious. "Are you afraid that she won't bleed enough, right?" He pointed to the bottle of quick injection.
After finishing, Imipenem Cilastatin Sodium shouted. After Sun Lien put on the medicine, he kicked Sun Lien on the butt, "I'm usually very smart, why are you so clumsy now?"
Sun Lien rubbed his sore buttocks and said with a wry smile, "I've been so tired these past few days. I feel like my brain is numb."
"You can tell by the way you rush in without thinking." Liu Tangchun snorted, and Bi Tianhua, director of the Menwai Hospital's Inspection Office, intervened in time, "Old Liu, your gas tank will be empty in two minutes, come out quickly.
!”
The gas cylinder Liu Tangchun carries is not large. The carbon fiber gas cylinder with a water capacity of 1.5 liters can theoretically provide about half an hour of battery life if it is used only for breathing. However, because the gas cylinder is directly connected to the positive pressure protective suit,
The theoretical safety time left for Comrade Lao Liu was only fifteen minutes. Thirteen minutes had passed since he entered the clean room. Bi Tianhua was afraid that something might happen to Lao Liu's old bones, so he quickly called him
come out.
"They brought a total of three gas bottles, and this is the last one for me." Liu Tangchun was also a little distressed, "You might as well go out with me."
"There is still a possibility of human-to-human transmission of avian influenza." Sun Lien's answer was somewhat off-topic. "Since no matter who comes in, there is a risk, then it is better for me to keep an eye on it for a while. This can at least reduce the number of doctors exposed to the risk.
"And this mask..." He pointed to the N95 mask on his face, "The effective defense time is eight hours, which is plenty of time."
"Then be careful." Liu Tangchun understood that this was the best solution at present. "I urged the laboratory department. If the avian influenza is diagnosed, the patient should be transferred to the hospital as soon as possible. If the patient needs medication, please tell me directly.
, I will give you permission."
Sun Lien nodded. But there was a wry smile in his heart. Judging from the patient's current vital signs and condition, it was basically impossible to arrange a transfer. If she was forced to transfer, I'm afraid something would happen to her on the way.
Maybe after the patient's test results come out, her vital signs will be stable. Sun Lien thought in his heart.
In addition to the door, the communication channel between the clean room and the outside world also has a "hole" in the wall. There are plexiglass doors on both sides of the hole, which can be used to transport samples, medicines and surgical instruments. Speaking of which, there is such a thing in the rescue room.
A clean room is a bit strange. I don’t know what the designer’s mentality was when they placed a class 100 clean room here.
Sun Lien put crystalloid on Wu Fenmei. After seeing that the blood pressure did not change much, he added a dose of norepinephrine intravenously with Liu Tangchun's consent. After watching Wu Fenmei's blood pressure gradually rise from 80/45 to 95/55,
Relaxed a little.
There were no stools in the clean room. Sun Lien looked around, found a corner to lean against, and slowly sat on the ground. He was really too tired.
When he was about to fall asleep, Sun Lien suddenly opened his eyes. He stood up alertly, looked at the status bar above Wu Fenmei's head, quickly picked up a syringe, and injected it into Wu Fenmei's still slowly bleeding vein.
A tube of blood was drawn from the needle. Then the syringe was sealed and placed in the transfer hole on the wall.
"Check the kidney function urgently." Sun Lien briefly and quickly ordered Xiao Guo who was waiting outside, "Immediately ask Dr. Xu Ce from the Department of Nephrology for consultation."
Xiao Guo did not dare to delay, carefully picked up the syringe, put a plastic bag around it, and quickly turned around and rushed out of the emergency room.
Sun Lien returned to Wu Fenmei's side, and the status bar was updated with a new status, "Acute renal injury."
The kidney is a very sensitive organ. The kidneys filter waste in the body and require a large amount of blood to provide energy and oxygen. Therefore, nearly half of the patients with DIC will develop acute kidney injury (aki). The drug peramivir is
The research on the side effects and adverse reactions of new products in the human body is not yet very clear. Although the drug itself will basically be excreted by the kidneys in the form of prototype drug, no one can say whether it will increase the burden on the kidneys during the elimination process. Wu Fenmei has appeared
The acute renal injury should be caused by DIC. But Sun Lien was still a little unsure whether he should slow down the input speed of peramivir.
So he decided to call for help.
Hello? What about Zhou Ce? That bad guy Dic is causing trouble with his kidneys, come here and help!