Sun Lien walked to the hospital in the morning, and it was another day that was no different from usual. He arrived at the emergency room early in the morning, and after handing over to his colleagues who worked the evening shift last night, the next step was the less urgent consultation time. On the left and right were Sun Lien, who was working the shift.
I prefer that there are continuous patients to see so that it won't be too boring.
However, the weather turned out to be unsatisfactory. It seemed to be because it had snowed for several consecutive days, and it seemed to be because today was a working day. The ninth clinic responsible for complex diseases was not open all morning. The emergency room was still busy, but other
Most of the patients go directly to the outpatient clinic. Those who need emergency treatment go directly to the emergency room, and it is basically not Sun Lien's turn to deal with it.
After sitting in the ninth clinic for two hours, Sun Lien put down his cell phone, which still had 45% of the battery in his hand. No, he had to find something to do for himself.
So, this person is born to be a bitch. He is usually very busy, crying and shouting that he wants to die. But when there is really nothing to do, he still has to find something for himself to do. Otherwise,
What can I say, men are all big hooves, right?
Strictly speaking, doctors who are on call cannot fool around. But it seems that the chance of the ninth clinic being opened today is not very high. In addition, there are telephones posted on the door, and doctors in several surrounding clinics are communicating with each other through air.
After that, Sun Lien's job of finding trouble for himself became more logical.
Sun Lien, who was looking for trouble, was wearing a white coat, with his hands behind his back. His upper body was naturally hunched a little, and then he swung a pair of black sneakers on his feet and walked towards the rescue hall with a steady and small stride.
Just the right speed for a walk after a meal.
If you want to watch the excitement, you have to go to the emergency room. If you want to secretly observe and remember the stories between people, you can go to the infusion room. If you just want to chat with people, go to the inpatient department.
If you go shopping and catch two patients smoking illegally on the rooftop or balcony, they can tell you four or five hours of their life experiences.
The hospital is actually a large story box, and those patients are the beginnings of one wonderful novel after another. And for most of them, the stories are far from ending when they should be. Sun Lien had this habit when he was an intern.
, he likes to look at these patients and guess their stories.
Always remind yourself that what you are treating is a living "person". Sun Lien has always felt that this is very important.
"You are simply not human!" Sun Lien strolled to the infusion area. In response to national requirements, the outpatient clinics of the Fourth Hospital had long canceled outpatient infusions. Patients need to go to secondary hospitals or community hospitals for infusion treatment. However, the situation in the emergency department is still a little different. Rescue
Of course, patients receiving hundreds of beds in the room can receive infusion treatment, and patients diverted from the emergency outpatient department can also receive infusion treatment in the observation area. Of course, this is not the point. The point is that this high-level comment that Sun Lien heard
The angry curse came from a young male nurse.
The male nurse was wearing a light blue male nurse uniform and was holding a bag of intravenous infusion fluid covered with a black plastic bag in his hand. His eyes were wide open and he pointed a trembling finger at the head of an old lady in her sixties.
Nose, "What are you going to do?! Do you know this can kill people?!"
Sun Lien was shocked when he heard this. He loosened his hands behind his back, straightened his slightly hunched back, and walked quickly, "What's wrong?"
"Doctor Sun." The male nurse recognized Sun Lien. When he saw Sun Lien coming over, his voice trembled, "She...she..." She waited for a long time, but still didn't say what happened.
"This old lady is probably a little confused." The middle-aged woman sitting next to her receiving the infusion shook her head and told Sun Lien what happened.
The story itself is actually quite simple. The old lady was admitted to the hospital this morning because of difficulty breathing, coughing, stomachache and poor mental state. After a preliminary examination of the old lady, the emergency department determined that she had difficulty breathing due to senile bronchial asthma. Therefore, the old lady was prescribed a prescription.
A treatment prescription of 2ml (0.25g) of aminophylline injection intravenously and 2ml (0.2g) of cimetidine (0.2g) each with 200ml of 5% glucose intravenous infusion was issued.
The male nurse was holding a bottle of levofloxacin in her hand.
"When I checked the patient's name, she actually agreed!" The male nurse finally calmed down from her fear and anger. "I asked her three times in total, and the three times it was not her name, she agreed!
It’s not that I have some impression that this old lady has used aminophylline, so I hooked up this bottle of levofloxacin to her!"
The old lady probably knew that she almost caused a big trouble by blindly agreeing without understanding, but she still just said harshly, "I was the third person to receive the infusion before, and I thought it would be my turn with your third bottle..."
"
Only then did Sun Lien realize why the male nurse was so nervous.
Aminophylline is an antiasthmatic drug that has been used clinically for many years, and is also the most widely used classic drug for asthma. However, the effective therapeutic concentration of aminophylline is very low, and individual plasma concentrations vary greatly. It is a
For drugs with a relatively narrow "therapeutic window", blood drug concentration testing is required to ensure that the drug level in the patient's body is not too high to cause adverse reactions, or too low to achieve therapeutic effects.
As for cimetidine, it is a commonly used combination drug with aminophylline in clinical practice. This H2 receptor anti-caking agent can inhibit gastric acid secretion and prevent or alleviate peptic tract ulcers in asthma patients when using aminophylline.
It will destroy the gastric mucosal barrier and stimulate gastric acid secretion, and asthma patients often suffer from peptic tract ulcers. On this basis, cimetidine is often used as a necessary supplement to aminophylline in the treatment of asthma.
However, when cimetidine and aminophylline are dissolved in 5% glucose solution at the same time, the compatibility stability time is only four hours, so it cannot be safely used in clinical practice. Therefore, cimetidine can only be administered after the aminophylline infusion is completed.
Infusion therapy with imitidine.
The bottle of levofloxacin covered by a black plastic bag belongs to the fluoroquinolone antibiotics. Like macrolide antibiotics, when used in combination with aminophylline, it will cause theophylline clearance rate to decrease, thereby increasing theophylline's clearance rate.
serum concentration.
As mentioned just now, if the male nurse had mistakenly administered levofloxacin to this old lady, the theophylline concentration level in her serum would not have suddenly increased, but would have remained at a level for a long period of time.
At a relatively high level. After she completes the infusion and walks out of the hospital, she may have serious side effects or even be poisoned due to the high blood concentration of theophylline. The consequences are simply unimaginable.
"Okay, okay... forget it's okay." In this situation, the medical staff can't kick the patient vigorously to relieve his anger. In desperation, Sun Lien could only pat the male nurse on the shoulder and said, "Come on.
Be careful. When you encounter an older patient who may not be able to hear well, ask them to take a look at the registration slip. It is always more reassuring than verbal verification."