Medical ethics is a very elusive thing. Generally speaking, once a doctor's behavior is understood as "arrogance, arrogance, indifference, greed", he will be directly labeled as "having no medical ethics", and then he will be criticized by the general public.
Doctors will basically not use "no medical ethics" to comment on their colleagues. After all, morality should be kept deep in the heart to restrain oneself. Taking it out and throwing it in other people's faces all day long, no matter how good the original intention is,
The taste will change.
Chen Tianyang said that Sun Lien had no medical ethics, which was a misunderstanding. And Zhou Jun said that Chen Tianyang had no medical ethics. This... was probably a deliberate revenge.
Chen Tianyang, who was scolded, said angrily, "In order to guide Sun Lien in writing that lousy thesis, I didn't have a good sleep for three days. I must have slept on the plane! What doctor has nothing to do and starts observing the surrounding passengers as soon as he gets on the plane?
of?"
"Me." Zhou Jun pointed to himself, then lowered his head to touch the phone. "I don't even have the habit of observing physical signs. Are you a surgeon?"
Emergency doctors are not considered internal medicine or surgery. Strictly speaking, they may be closer to a combination of general practitioners, critical care medicine, anesthesiology and orthopedics.
Because of the diversity of work, emergency doctors can follow surgeons or physicians at will. This is probably one of the few benefits that emergency doctors can get in a job that is so busy every day.
Chen Tianyang, who was hacked, was speechless. His retort was stuck in his throat and he could not get up or down. After a while, Chen Tianyang took a long breath and sighed, "There is a full-time flight attendant in the business class.
, she may have observed the condition of the previous patient. Why don't you call and ask."
Zhou Jun took the phone away from his face and said angrily to Chen Tianyang, "Keep your voice down, I'm asking the flight attendant about the situation."
The flight attendant's answer was not helpful. There was nothing strange about the passengers she saw. No shivering, no coughing, no headaches, no forcing themselves to sit up straight, nothing, everything was normal. In fact, the whole business class behaved
The most abnormal one was Chen Tianyang. He had obvious sleep apnea syndrome. He could hear clearly without speaking in the cabin. After a deafening snoring, he had to hold his breath for a long time before finally exhaling.
He held his breath for so long that the flight attendant girl was worried that Chen Tianyang might suffocate herself to death.
"No useful news." The ambulance had already arrived on the highway and started running at top speed again. Zhou Jun sat aside and didn't pay attention to the shaking of the car body. He readjusted the inhaled oxygen content on the ventilator.
, the pure oxygen in the previous emergency was adjusted to an oxygen concentration of 90%, and then he made a call again. "Is it the imaging department? I am Zhou Jun from the emergency department. We will send a critically ill patient in about eight minutes.
Go to the hospital, leave a CT scanner, and then ask Director Zhao Hua from the Department of Nuclear Medicine to watch the film."
Before the patient developed pulmonary edema, he did not have high blood pressure, infection, or forced sitting or left heart failure. In other words, this patient suddenly developed acute pulmonary edema without any signs about two hours ago. Although acute pulmonary edema
Edema may progress quickly, but there are always signs before it.
Acute pulmonary edema caused by other symptoms? Zhou Jun frowned and asked Chen Tianyang, "Is there a loss of pressure in the plane?"
"Loss of pressure? What pressure loss?" Chen Tianyang was confused when asked.
Zhou Jun sighed and changed the question, "Did the respirator fall off the plane? It's the respirator with a tube attached and a yellow plastic mask on it."
"It's fallen." Chen Tianyang nodded.
Zhou Jun's frown deepened. Rapid loss of pressure at high altitude may cause severe pulmonary edema in some patients. This sequence of reasoning is consistent with the patient's condition and Chen Tianyang's testimony. However, Zhou Jun still feels that something may not be right.
.
He looked at the lively Chen Tianyang, and then asked, "When did the respiratory mask fall off on the plane? Was it before the turbulence and vibration of the plane, or after the vibration? When the mask fell off, did the flight attendant tell you to wear a mask...
"He sighed, "Forget it, just sit still and I'll make a call to ask."
Zhou Jun looked at Chen Tianyang and thought of a very critical question. If the patient's acute pulmonary edema was caused by loss of pressure at high altitude, why did Chen Tianyang seem to be fine? The patient was a middle-aged man in his thirties and almost forty years old.
Men, it seems, are definitely in better physical condition than Chen Tianyang, a fat man. If he had acute pulmonary edema caused by loss of pressure at high altitude, then Chen Tianyang should be at least somewhat unwell.
However, considering that Chen Tianyang didn't even know what loss of pressure meant, it was obvious that his testimony was not necessarily reliable. Zhou Jun had seen on the news that sometimes, the oxygen mask on the plane might fall due to violent vibrations of the fuselage.
The quickest way to determine whether a patient's acute pulmonary edema is caused by decompression is to ask the flight attendant.
"The oxygen mask fell after the plane shook violently, and there was no instruction from the cabin, right?" Zhou Jun got the answer he needed, but this answer did not reveal the root cause of the patient's acute pulmonary edema.
Diagnosing clues just becomes a little more difficult.
Pulmonary edema is not caused by loss of pressure.
"We've arrived at the hospital." While Zhou Jun was meditating, the ambulance rushed onto the main road of Ningyuan City's Quiet Zone with its siren blaring. About four hundred meters away, the sign of Ningyuan City's Fourth Central Hospital shone brightly.
"The injured male, anonymous, about thirty-five years old, highly suspected of cervical vertebra fracture, unexplained acute pulmonary edema, unconsciousness, coma score 9." Zhou Jun quickly conveyed his examination results and preliminary results to the doctor who came to pick up the car.
Diagnosis. "Send to the CT room immediately. Is Director Zhao here?"
"125 ml of 20% mannitol, hang up immediately!" The doctor who came to pick up the car was Cao Yanhua. While he asked the nurse to go back to the emergency room to get the medicine, he said to Zhou Jun, "The imaging department just called and Director Zhao is already here."
Another advantage of the emergency ambulance transfer in your own hospital is that you don’t have to rush to move the patient from the emergency transfer bed to the hospital gurney. The Fourth Central Hospital’s emergency vehicle fleet has left two ambulances as backup for the corresponding 120 emergency center dispatch.
strength, so you don’t have to worry about pressing the bed.
By the time a group of people rushed to the door of the imaging department pushing the emergency transfer bed, mannitol had already been hung beside the bed. A group of strong male nurses pulled the sheets on the emergency transfer bed with their hands, and then gently lifted the patient
Moved to CT machine.
"Scan the cervical spine, chest cavity, and add a lumbar spine." Zhou Jun spoke out the request quickly. When the CT machine started running, he suddenly added, "After scanning the chest cavity, don't rush to check the lumbar spine.
Let’s get a brain CT scan.”
The CT results come out very quickly. Without Director Zhao Hua reading the scans, Zhou Jun can see that the patient currently has cervical dislocation at C5 and C6, and there are uneven cloud-like shadows scattered in both lungs. These two points proved to Zhou Jun
Regarding the diagnosis of the patient's "cervical spine damage" and "acute pulmonary edema". However, the cause of the acute pulmonary edema is still unclear. Chest CT confirmed that the patient had mild left ventricular hypertrophy, but no infection in the lungs, which can rule out cardiogenic pulmonary disease.
Edema and infectious pulmonary edema.
Zhou Jun's frown deepened. He already had a rough guess, but this guess still needed to be confirmed by CT examination results.
"Go and ask Vice President Liu to come over." The brain CT scan was about to begin. Zhou Jun turned to Cao Yanhua and said, "Ask him to come over immediately. This patient may be in some trouble."