"Don't talk nonsense. But the rat poison you mentioned is really possible." Zheng Ren followed Su Yun's words, "Rat's IQ is not low. If they die after eating rat poison, it is said that they will not touch similar things around them again. "
Lin Ge silently watched Zheng Ren and Su Yunzai discussing their condition. There was some nonsense, but this nonsense was necessary.
It was obvious that these two young men had no idea, and were grasping some nihilistic possibilities bit by bit through dialogue.
"Well, the replacement products are all preparations with relatively mild medicinal properties and can eventually induce internal bleeding." Su Yun continued to explain the point of view of the preparations.
This situation is really similar to the progression of Chen Zehui's condition.
I had symptoms of bleeding gums 8 days ago. I can’t say exactly when they first appeared.
I went to the district hospital for a checkup two days ago and no problem was found. Now, in just over 40 hours, my hemoglobin has dropped to 5.5g.
The most important thing is that after the patient fainted, his condition continued to erupt since he was sent to the 912 emergency department. It is shocking!
These evidences point directly to some kind of chemical agent. According to Su Yun, it should be a chemical agent used to poison rats.
"It takes effect slowly... it explodes..." Zheng Ren muttered in a low voice.
"The poisonous rat poisons of the first generation anticoagulants such as diphacin sodium salt and leprofen are quite effective and have a relatively mild effect. When I was in the laboratory, there were wild rats bullying my white mice, so I used leprofen to treat them. They administered the medicine." Su Yun said proudly.
"It's rarely used now."
"Well, not too much now. Because raticide has a weakness, the final drug effect is not strong enough, so wild rats are quite destructive before they die."
"Do you feel that this patient was poisoned by second-generation hemolytic rat poison?" Zheng Ren followed Su Yun's words and spoke faster and faster.
The more I think about it, the more reasonable it becomes.
If it was just a guess before, now Zheng Ren is 90% sure of the patient's condition.
Counting from the first symptom that the patient could ask about - bleeding gums, to the test results two days ago, to the sudden outbreak today, until the patient who was still struggling suddenly suffered from hypovolemic shock and massive hemoptysis.
Any of these pieces of evidence taken individually are bland and have no direction.
But put it all together, Zheng Ren can be sure that Su Yun's suggestion is correct.
"Is it bromadiolone?" Zheng Ren thought of several case reports on bromadiolone poisoning. The situation described there was very similar to the situation of the patient in front of him.
"I think so." Su Yun said: "It has the characteristics of not easily alarming rodents and easy to annihilate them. It also has the outstanding advantage of strong acute toxicity. A single dose can effectively control all kinds of rodents.
At the same time, it can also effectively kill pest rats that are resistant to first-generation anticoagulants. It is moderately toxic to fish, aquatic insects and other aquatic organisms. "
"You put it that way, I think it's bromadiolone." Zheng Ren said: "Then I suggest diagnostic treatment. Intramuscular injection of vitamin K1, the dosage can be slightly larger."
"What if it doesn't work?" Su Yun asked without thinking.
When the situation is urgent, someone always has to play the most annoying role when discussing the condition - to raise objections.
"It depends on fate. Anyway, vitamin K1 can promote coagulation. Even if the patient is not bromadiolone poisoned, intramuscular injection of vitamin K1 will only have benefits and no harm." Zheng Ren recalled the side effects of the drug and said casually.
"Go and talk to the hospital manager for diagnostic treatment." Zheng Ren smiled dryly and didn't mind. If rare side effects of vitamin K1 really occur, or even fatal reactions...
Forget it, when taking medicine, you must not think about things that are one in a hundred thousand or one in a million.
Once you think this way, you can't use any medicine and just wait to die.
The current social atmosphere and the responsibilities of doctors have turned such a fallacy into reality. Doctors can only...
Zheng Ren really didn't want to think about these unhappy things.
After intramuscular injection of vitamin K1, it takes 3-6 hours to take effect.
If the patient is poisoned by bromadiolone as he and Su Yun said in their analysis, vitamin K1 is a specific drug.
Intramuscular injection is too slow to be absorbed, so give it intravenously. Otherwise, a two-pronged approach is possible.
If the judgment is wrong and it is not bromadiolone poisoning, then the only option is to perform hemofiltration and then talk about the rest.
Zheng Ren and Su Yun ran in quickly. As for Lin Ge... Zheng Ren ignored him for the time being.
Lin Ge was not surprised. He had to go to the emergency room, and it sounded like he was poisoned by rat poison. It was strange that Boss Zheng had time to say a few words to himself about this kind of thing.
Zheng Ren knew that he was coerced by Su Yun's thinking, but logically, Su Yun's statement was correct, so Zheng Ren did not object because he wanted to.
Yes, just execute it.
Running fast, I almost bumped into a nurse who came to collect blood.
"Give vitamin K1!" Zheng Ren said directly after entering the ICU.
"Huh?" The resident was stunned for a moment.
"I just made a brief analysis and thought it might be caused by bromadiolone poisoning!" Zheng Rendao: "10mg injected intramuscularly, 80mg put into the pot!"
As he spoke, Zheng Ren's voice began to get louder.
This is a unique state during rescue.
There is nothing to fault about the dosage of this drug. For the patient's weight, medication should be administered at 5 mg/kg, which is relatively standard.
The drug takes 3-6 hours to take effect. Intravenous administration can take a shorter time, but it’s hard to say how long it will take. Zheng Ren simply didn't leave and helped keep an eye on the patient in the ICU.
Watching the vitamin K1 being injected intramuscularly, and the remaining 8 vitamin K1 tubes entering the drip pot, Zheng Ren turned up the speed and entered the vein almost in one breath.
I hope it gets better. Zheng Ren has seen another diagnosis added to the patient's system panel - upper gastrointestinal bleeding.
After the surgery today, I had lunch and went back to 912. I wanted to see Zhou Litao, but I didn't expect to meet such a patient.
Lin Ge also started talking.
The hospitalization deposit is advanced in the name of the medical office. This money will probably never be returned, so it is more practical for the medical office to intervene.
Then there is communication with the patient’s immediate family, etc.
One hour and 35 minutes later, Zheng Ren found no new diagnoses on the system panel.
Under the action of three groups of hemostatic drugs, the patient showed no signs of continued bleeding.
The patient's blood pressure is rising steadily, and the subcutaneous congestion is relatively stable and does not continue to spread.
The diagnostic treatment seems to be correct, it should be bromadiolone poisoning!
It's just that it took so long that it's probably difficult to verify the exact location of the poisoning and what he ate.
Zheng Ren's feelings are more intuitive than others.
After the patient's system panel was given intramuscular and intravenous vitamin K1, the color gradually became darker for more than 10 minutes, and then it stopped deepening and began to lighten.
This is what works.
Zheng Ren didn't really feel relieved until his blood pressure stabilized.
"Mr. Wu, vitamin K1 should be given for a longer period of time." Zheng Ren finally warned: "The half-life of bromadiolone is 16-19 days. We must always use vitamin K1 to antagonize it to prevent the disease from recurring."
"I know!" the ICU resident replied exhausted.