If calculated based on a 30% increase in general standards, Rawls should have been in an anemic state three days ago. If this state lasted for a long time... it would be comparable to an anemic state of 100,000 hours!
"It's interesting..." Sun Lien said to himself. He wrote a bracket after the data three days ago, "already anemic."
"Then the question is why his anemia progressed so quickly." Sun Lien circled Rawls's hemoglobin level today with a pen, "Based on today's results, he is now severely anemic, right?"
Yuan Pingan nodded, "So I gave him four units of hemoglobin, which should be able to correct his anemia first."
"So... what is the cause of his anemia?" Sun Lien squinted his eyes and asked himself, "The infection itself may cause anemia, especially pneumococci. And the adverse reactions of drugs may also cause hemolytic anemia."
"Seeing as he is so thin and short, maybe he has been anemic for a long time." Yuan Pingan followed Sun Lien's train of thought and answered, "Malnutrition can also cause anemia, right?"
Long-term malnutrition, leading to chronic anemia? Sun Lien thought thoughtfully, if so, then Rawls' problem is simple. He may have been suffering from unexplained malnutrition for a long time, and therefore continued to be anemic. And anemia and nutrition
The negative effects caused his body's resistance to be low, so the cold could not heal on its own, and even turned into pneumonia.
The hospital at the training ground where pneumonia was diagnosed directly applied Chinese health data standards to black people due to carelessness, lack of experience or simply not thinking about it. This resulted in the hospital at the training ground failing to detect the anemia symptoms in Rawls in time.
As for Rawls's current problem, it may be hemolytic anemia caused by adverse drug reactions, or it may be anemia caused by the pneumonia itself, or it may even be due to some unknown reason that aggravates Rawls's ten-year illness.
Ten thousand hours of anemia symptoms. In short, the lack of experience at the training ground is certain, but this lack is not enough to cause a decisive mistake. Although the hospital at the training ground made mistakes, their mistakes were not serious.
"Then, the next question is to figure out what caused his anemia to worsen." After thinking for a while, Sun Lien put forward his own idea, "Draw blood and let the laboratory staff do a smear."
Look, at least we need to clarify the patient's anemia type first." Although Sun Lien had learned through the status bar that Rawls had "hemolytic anemia," it was unclear whether it was "intravascular hemolysis" or "extravascular hemolysis."
"I'm going to do another physical examination on him." Sun Lien looked at his watch. It was now 10:30 in the morning, and Hu Jia had been walking around Sun City alone for more than two hours. According to the original plan of the two,
According to the arrangement, Hu Jia will walk alone for about three and a half hours. He should be able to wait until around twelve o'clock for the ward rounds to end.
But planning is basically the same thing as a joke in a doctor's life. Anyway, in Sun Lien's "career", as long as it has nothing to do with the disease and treatment, there is basically no plan that can be followed as he started.
The idea and plan continued. Hu Jia was of course mentally prepared for this kind of thing. She had just sent a WeChat message. The content was probably that she was "tasting" milk tea and desserts one after another, so that Sun Lien could calm down and work hard. If
If she is too busy to make it at noon, there is no problem for her to continue her tasting tour.
How could it be okay? Sun Lien scratched his head hard. The only thing he wanted to do now was to appear next to Hu Jia, and then the two of them would spread dog food to the innocent people around them.
Young people always have an inexplicable energy. Even a tired young emergency doctor will have a burst of extraordinary energy just to spend a few more minutes with his girlfriend who is passionately in love.
No matter what your problem is, it will be solved within two hours! Sun Lien stretched his sore arms and walked towards the small conference room.
Although he thought about solving the problem in two hours, Sun Lien knew better than anyone else that to solve this patient's problem, he would probably need more than two hours. In addition to the help of the status bar, he might also need some excellent luck.
.
Unfortunately, Sun Lien's luck has never been very good.
"Hemolysis is still continuing..." Less than half an hour after arriving at the patient's bedside, he got a more troublesome piece of information. After transfusing four units of suspended red blood cells into Rawls, his hemoglobin level increased.
, but it only rose to the level of 11.2g/dl. There is a certain error between this and Yuan Pingan's initial calculation, and the main reason for the error is probably due to some reasons that caused Rawls to have hemolytic anemia before.
The relationship has not been dissolved.
"Extract the sputum and blood and do a culture to see." Sun Lien said with a frown. After all, based on Rawls' status column analysis, the biggest difference between him now and in the past ten years is probably pneumonia and the treatment of pneumonia.
Cefoperazone is injected into the body.
But the problem is that for bacterial hemolysis caused by pneumonia, the first principle is to continue to use antibiotics for antibacterial treatment. As for drug-induced hemolysis, it needs to be treated with hormones or even large doses of hormone shock.
One cause requires anti-infection, while the other cause requires suppressing the immune system. The same symptom needs to be carefully distinguished and different plans are adopted. This is why patients with pneumonia are given corticosteroids and patients with hemolysis continue to use antibiotics, which is basically the same as fire.
Adding oil makes no difference.
The culture was done to deal with possible infection in advance, but Sun Lien's second medical order was to verify the possibility of "drug-induced hemolysis."
"Check liver function, routine urine..." Sun Lien dictated the contents of the examination and began to palpate on Rawls's belly. The liver felt elastic to the touch, but the spleen was slightly swollen, but not moderately swollen.
the point.
"Huh?" Sun Lien was a little surprised by the moderately enlarged spleen. Unfortunately, Rawls' liver showed no signs of enlargement, otherwise it could have been directly diagnosed as drug-induced hemolysis.
Sun Lien was "handling" Rawls when the closed door of the emergency room was suddenly pushed open. Sun Lien was busy palpating and didn't bother to look up. He was looking down and wondering whether to give Rawls more.
An abdominal CT scan. At this moment, he heard footsteps stopping beside him.
Sun Lien looked up and saw a green military uniform and two identical stripes on his shoulders. The person walking at the front turned out to be a major general.