Chapter Four Hundred and Thirty: The Invisible Blade
After Liu Boli became the dean, the entire hospital was very active in taking action. In addition, Hu Fengyun, as the secretary, was very supportive of Liu Boli's many initiatives.
The hospital quickly established a facial paralysis rehabilitation center outpatient clinic, and the encephalology department, acupuncture and other departments actively cooperated with the work.
However, what surprised Bai Ye was that Liu Boli did not transfer him there. Instead, he asked Wang Wenliang and the deputy chief physician of the acupuncture department to be jointly responsible for things there.
Since the 24 beds on the 14th floor are used for facial paralysis rehabilitation, Bai Ye no longer needs to go to the 14th floor in a short period of time.
Because seven or eight doctors still have to work, we can’t let them have three or five patients alone, right?
So Bai Ye went with the flow and decided to go to the fifteenth floor, which is a mental health department full of magic and weirdness. After the facial paralysis rehabilitation center is officially established, he will return to the fourteenth floor. After all, cerebrovascular disease is still the main disease in the encephalology department.
And there are still many things that need to be mastered about this disease.
In fact, this is also called the anxiety and depression department! Or the insomnia department.
Originally, the 14th and 15th floors were used for the treatment of cerebrovascular diseases, but later it was discovered that there were more and more patients with anxiety and depression, and the number of people with insomnia had gradually increased, so this insomnia department was launched.
Patients in this department are generally restless!
This was Bai Ye's first feeling when he arrived on the fifteenth floor. Many patients with anxiety and depression did not want to go to Western Hospital for treatment.
Because if you go there, you just need to take psychotropic drugs. If you can’t take one, you can take two, or if you can’t take two, you can’t take three. If you can’t take one, switch to another…
Medication maintenance is the main treatment method, and the side effects of this treatment are very intuitive and obvious.
If I don’t talk about anything else, let’s just talk about insomnia.
At present, modern medicine has basically no particularly effective treatment for insomnia, and the main ones are various sleeping pills.
From benzodiazepines such as clonazepam, diazepam, lorazepam tablets, alprazolam to non-benzodiazepines such as zopiclone tablets, eszopiclone tablets, etc.
However, no matter which drug they are, they all bind to the benzodiazepine receptor with high affinity and specificity in the brain, including the cortex, dense limbic system, brain, brainstem, spinal cord, and central inhibition.
The sex transmitter-aminobutyric acid (Gaba) GABAA receptor binding mechanism experiment proves that benzodiazepines can enhance the synaptic inhibitory effect of GABAergic neurotransmission function.
After Bai Ye came to the fifteenth floor, he was not as casual as the fourteenth floor. Instead, he was assigned to a teacher, Chang Lili.
In other words, she was Wang Wenliang's little crush who came to the fourteenth floor every day, but she was easily captured because of Bai Ye's mangosteen.
Bai Ye was not officially in the specialty department on the fifteenth floor, but came over temporarily to get acquainted with the common illnesses in this department.
During the morning rounds on the fifteenth floor, Bai Ye felt the most terrifying thing!
"Dr. Chang, the new patient in bed 12 took a box of 20 tablets of Alprazolam one night, and now he feels very lethargic!"
Chang Lili, who was talking to Bai Ye about the precautions, suddenly felt confused when she heard this and hurriedly walked towards the twelve beds.
Bai Ye also followed Chang Lili anxiously and ran towards the ward.
After entering, I found a nearly sixty-year-old woman lying there, moaning and groaning, not even having the strength to open her eyes.
Chang Lili hurried over, clamped the blood oxygen saturation monitor on her finger, then took out the stethoscope and started auscultating the lungs.
About a minute later, Chang Lili looked at the woman's blood oxygen saturation monitor, which read: blood oxygen saturation 93%, heart rate 45 beats/minute.
The breathing sound was very slow. Bai Ye observed it and estimated that it was only about fifteen times!
At this time, Chang Lili asked the nurse: "What is the patient's morning blood pressure?"
The nurse took the medical record and said: "The blood pressure in the morning is 100/60mmhg, and the blood pressure before going to bed is 150/95mmhg."
Chang Lili pondered for a moment: "Put the patient on ECG monitoring and focus on observing the heart rate and blood pressure. If the heart rate is lower than 40 and the high pressure is lower than 80, notify me."
After saying that, Chang Lili took Bai Ye out of the ward and continued her rounds.
Chang Lili breathed a sigh of relief and said to Bai Ye: "These patients in our department are more troublesome, so sleeping pills and other psychotropic prescription drugs are all given by the nurse, who distribute the drugs every night. This patient was hospitalized just last night, and the drugs are not available yet."
There was no time to deal with it, so something like this happened all of a sudden. You must not talk nonsense to the patients in the department in the future, because... because they may take your joke as evidence and take you to court!"
Bai Ye nodded. Normally, when Chang Lili came to the fourteenth floor, she was a very open-minded, enthusiastic and sunny girl, but at this moment, she looked very depressed, and her whole face was tense.
Bai Ye asked: "Is it okay for this patient to take so many sleeping pills? Doesn't he need gastric lavage?"
Chang Lili shook her head: "There is no need for the moment. The patient took the medicine last night, and alprazolam is absorbed quickly. At this time, gastric lavage is no longer helpful. It can only mess with people, and the patient is at this time
The heart rate is very slow and the blood pressure is also very low. Now the patient’s vital signs should be monitored to ensure that there is no life-threatening danger.”
Seeing that Bai Ye was a little nervous, Chang Lili smiled and said, "Don't be afraid. The maximum daily dosage of alprazolam is 10 mg. The content of one tablet of alprazolam is 0.4 mg. After taking a box of 20 tablets, it will be enough."
Even though I took a total of 8mg, it did not exceed the maximum dosage.”
"However, this kind of anti-anxiety sedative-hypnotic drug has a strong inhibitory effect on the central nervous system, so it can easily cause slow breathing, slowed heart rate, lowered blood pressure, etc. Since it has been eight hours since taking the medicine, the peak value of the drug has not been reached.
It has passed, so the danger is no longer great. Today we will wait for the drug to metabolize and monitor the ECG for the next ten hours, just in case. I will give her medical instructions later, a bottle of amino acid nutrient solution, um... flumazenil injection
The liquid can effectively inhibit the toxicity of benzodiazepines. In this case, you can get one as directed by your doctor, just in case!"
"Alprazolam is highly toxic to the liver, so...if the patient's liver function is rechecked when he is discharged from the hospital, there won't be any reaction for a while. That's it, prepare the case and start the ward rounds!"
After saying that, Chang Lili walked towards the hospital bed like a general!
Bai Ye stared at Chang Lili in explanation, his eyes full of shock!
This is a powerful woman, both physically and mentally. A patient who has taken a box of sleeping pills looks calm and relaxed in front of her as if it were a common occurrence.
Moreover, being able to master the dosage of drugs so skillfully, clearly knowing the various adverse reactions of drugs, and taking comprehensive consideration measures are the basic skills of a physician!
Ordinary yet great!
There is no amazing surgical operation like that of a doctor in the surgical department, but only the proficiency in various drugs, the processing and analysis of clinical diseases, and the comprehensive judgment of the patient's condition, so as to arrive at the most effective treatment method!
From the perspective of surgery, there is no problem that cannot be solved with one knife.
Internal medicine, however, needs to make a comprehensive judgment on the patient.
This is the professional ethics and quality of an ordinary doctor.
Ordinary yet great.
Bai Ye couldn't help but ask: "Sister Chang, why are you so calm?"
Chang Lili smiled: "I have been in Puze for three years. I have seen three successful suicides and dozens of failed suicides. I can't even remember them. Taking a box of sleeping pills is ordinary. I have seen the most.
I took two hundred sleeping pills..."
When Bai Ye heard this, his eyes widened: "Two hundred pills? Is this... too exaggerated? You can't hold two hundred pills in one hand, right?"
Chang Lili nodded: "Actually... the patient didn't know how many pills she had taken. We only found out after we found out. Because she was anxious, manic, and had severe insomnia, she took three or four pills at a time.
I couldn't sleep and kept eating... so I ate more than two hundred pills in one night."
Bai Ye felt a little scared when he thought about that scene: "Then... doesn't she know that eating it will kill people?"
Chang Lili shook her head: "At that time, there were so many things on my mind, and maybe all I could think about was falling asleep. Isn't that uncomfortable?"
Bai Ye was silent: "Those who committed suicide...aren't they afraid of death?"
Chang Lili sighed: "I have seen nearly a hundred suicides, and the success rate is less than 3%. Do you know why?"
Bai Ye shook his head.
Chang Lili stared at Bai Ye and said: "Because of their survival instinct, they don't want to die, so they can be saved. Do you know? Everyone in the face of life and death instinctively wants to survive. Death may be because of just
A momentary thought, or even just a momentary thought, during our rescue process, the most common thing said by all patients is: I don’t want to die, doctor save me!”
Bai Ye was silent.
Chang Lili only had eight patients, all of whom suffered from insomnia, anxiety and depression, but Bai Ye felt that these seven or eight patients were more troublesome than Wang Wenliang's more than twenty patients.
The mental illness treated in traditional Chinese medicine may be milder than in Western hospitals. Most of the patients are patients who can control themselves and are not those mentally ill patients on TV.
Chang Lili returned to the doctor's office and said to Bai Ye while giving medical instructions: "Among the eight people, three have experienced suicide, and six have had suicidal tendencies and thoughts..."
This surprised Bai Ye!
Because during the ward rounds just now, Bai Ye clearly felt that these people were normal, answered fluently, and were very polite in their speech and behavior.
However, when the disease came, Bai Ye couldn't understand how uncomfortable it was to make them commit suicide.
How do diseases such as anxiety and depression gradually destroy people's will and create a death-seeking mentality?
At this moment, Bai Ye suddenly felt an impulse deep in his heart!
He really wanted to find out what was the reason that led to such a result?
Because every living person has no problems with various physiological and biochemical tests, and the indicators are all normal, but this is it, but they want to commit suicide?
What is the reason?
At this moment, Bai Ye's heart was full of curious desire to explore.
He really wanted to figure it out.
Because if you say that it is due to physical reasons or diseases caused by some reason, these have brought danger to your life, it is easy to say, but a healthy and living life, but inexplicably wants to leave life, this
What kind of torture and pain required them to make such a choice!
The invisible blade is the most deadly.
Perhaps it is these invisible knives that harvest life!