Facts have proved that this kind of man who is extremely cruel to himself is really cruel from the beginning to the end. Although the epidural anesthesia has been completed, it is still difficult to stop the bleeding of an unconscious patient.
How to cooperate with anesthesia.
The cystoscope entered the bladder through the broken urethra that had stopped bleeding. Through the screen, Dr. Cao saw a metal-like strip. Because of difficulty in urinating, the patient's bladder was very full, probably because of the long-term filling.
The necklace had balled up into a big ball in the patient's bladder. It was absolutely impossible to pull it out directly, and it was physically impossible.
Dr. Cao sighed and began to operate the endoscope and play a puzzle game. What is the relationship between this metal chain and the metal chain at the other end?
As time passed, epidural anesthesia was what people often call spinal anesthesia. The anesthesia process had little impact on the patient's consciousness. And this patient, whose mental state had never been very stable, began to show some signs of irritability. Fortunately,
The nurses and Dr. Cao constantly comforted the patient. Although the patient was upset, he could still lie still in bed.
"It's almost done." Forty-eight minutes later, Dr. Cao Xin finally untied the balled up necklace and slowly pulled it out of the patient's bladder.
"Then you didn't even watch the subsequent surgery and just came to me to complain?" Sun Lien asked with a smile, "Disconnection and reconnection are at least a level three surgery, right? Isn't it good to just watch?"
"I gave up the opportunity to be the first assistant to my junior brother." Dr. Cao said with a smile, "I did the cystoscopy anyway, so it's good to let my junior brother take the stage."
"I received a lot of patients today, but God bless them, none of them are serious." Sun Lien sighed, pointing to a pile of outpatient receipts on his desk, "The most serious one is the Daye I just told you about.
He was diagnosed with pneumonia and was transferred to the respiratory department."
"Are there any beds in the respiratory department?" Doctors in the hospital chatted, and the most popular topic was whether there were beds in certain departments. "Respiratory diseases are more common in winter, can they still free up beds?"
Speaking of this problem, Sun Lien also felt a bit toothache. "There is no place... I can only arrange the person to the emergency observation room first." The Department of Respiratory Medicine also felt that it was necessary for this patient to be admitted to the hospital for treatment. After all, the patient
Although he is not very old, he has a history of smoking for a long time. And because the amount of rusty sputum is relatively large, dilation of the veins in the neck can already be observed.
Although it has not reached the level of respiratory distress syndrome, the situation should not be underestimated. However, the Department of Respiratory Medicine cannot spare any beds in the inpatient department, let alone the ward. There is even a patient lying on the bed in the treatment room. Level 2
No extra beds are allowed in the corridors of the inpatient departments of the above medical units, and patients must be diverted to lower-level hospitals as much as possible. But now none of these patients can meet the discharge standards. And the number of the new patient is from the emergency department. The number of the emergency department is
You cannot refuse medical treatment.
"Then you have to worry more." Dr. Cao spread his hands and expressed helplessness, "There is a first-diagnosis responsibility system. If this patient is not transferred to the respiratory department for a day, you have to be responsible to the end."
After chatting for a while, Dr. Cao suddenly received a call.
"Ah?" He was stunned for a while, then stood up from his seat suddenly, "Have you contacted the pharmacy department?"
Sun Lien smelled something amiss from Dr. Cao's fierce movements. He also frowned and stood up.
"I know, I'll ask right away." Dr. Cao sighed, hung up the phone and started sending a WeChat message.
"Brother Cao, what's wrong?" Sun Lien asked curiously, "Do you need any help?"
"What the fuck..." Dr. Cao Xin, who had always been calm, cursed, "The patient I performed the surgery on has malignant hyperthermia!"
Sun Lien looked confused, "What?"
Malignant hyperthermia is a very serious genetic disease. It is also the only known serious disease that can cause death of patients by conventional anesthetic drugs.
As a subclinical disease, malignant hyperthermia does not have any signs or symptoms before the onset. These patients have defects in the calcium ion channels in the skeletal muscle cell membrane. When exposed to volatile inhaled anesthetics or depolarizing muscle relaxants, they can
It causes an abnormal increase in the release of calcium ions, and only at this time will malignant hyperthermia suddenly break out.
In patients with malignant hyperthermia, the skeletal muscles of the whole body will begin to contract tonicly. The contraction of the skeletal muscles of the whole body bursts out with huge energy, causing the patient's body temperature to rise uncontrollably and rapidly, and causing the patient to be in a hypermetabolic state.
The patient's body temperature will rapidly rise to about 45c to 46c, and hypercapnia will occur in a hypermetabolic state. It will also be accompanied by symptoms such as tachycardia and a sharp rise in blood pressure, profuse sweating, and increased blood potassium.
In other words, the body is trying to burn itself to death.
The trouble is that general clinical cooling methods are difficult to have a sufficient effect on malignant hyperthermia, and eventually the patient will die due to organ failure.
Since it was an idiopathic disease in the anesthesiology department, Sun Lien basically didn't know anything about it. Brother Cao, while sending messages for help in the doctor exchange groups of major hospitals, quickly explained to Sun Lien what the current situation was.
"The specific drug for treating malignant hyperthermia is dantrolene." Cao Xin didn't even have time to wipe away his sweat. He was still typing quickly. "The problem is, this drug is not only available in our hospital, but also in hospitals in the province.
"
Dantrolene is a specific drug for treating malignant hyperthermia. However, it has not been introduced, produced or even batch numbered in China.
Even if you take the green channel and buy dantrolene from abroad, it will take at least two to three years for a single drug approval to pass inspection and enter customs. And the shelf life of dantrolene is only three years. After the drug enters the country smoothly,
Dantrolene is expired and useless, which also leads to the fact that there is no reserve plan for dantrolene in domestic hospitals.
As for domestic generics, the road is even more long and difficult. After all, there were only 16 reported cases of malignant hyperthermia in 2015 and 2016. A large amount of money has been invested in generics, but they may face the embarrassing situation of being unable to recover the costs at all. As a pursuit, pharmaceutical companies
Profitable companies will certainly not touch this hot yam.
Sun Lien thought about it and suddenly remembered that Takeda Pharmaceutical was planning to acquire Shire Pharmaceutical. Isn't Shire Pharmaceutical a company that specializes in producing orphan drugs? Or...can he call Yutaka Kobayashi for help?
Without further ado, fight now.
However, Sun Lien did not know that the two companies that could produce Dantrolene were both American companies.
"President..." Xiao Linfeng's secretary quietly walked into the room and whispered something to Xiao Linfeng's ear. Xiao Linfeng is currently sitting in the conference room of Shire Pharmaceuticals in Dublin, Ireland. He is talking to Shire
Senior pharmaceutical negotiators are conducting further negotiations on the merger and acquisition deal. These damn Irish people don't know what the evil is. Faced with the merger offer of 64 billion US dollars, not only do they refuse to agree, but they actually want more during the conversation.
Something like a board seat at Takeda Pharmaceuticals.
After all, Xiao Linfeng is a businessman who is used to seeing big storms, but a transaction can only be accomplished with the consent of both parties. If one of the two parties has a bad idea, the entire transaction may completely fall apart.
Xiao Linfeng was thinking whether to throw Sun Lien out now as his trump card.
"Dantrolene?" He frowned and asked his secretary, "Does our company have this drug?"
"No." The secretary's voice was low, "It's an orphan drug produced by an American company."
Xiao Linfeng thought for a moment and suddenly said, "Bring the phone in, and let the translator come in."
The secretary turned around and left the conference room. Xiao Linfeng said to the Vice President of Shire Pharmaceuticals opposite, "Mr. Aaron, I suggest that we pause the discussion first. A helpline from China has called my phone. I would like to ask you