Quan Xiaocao was busy all night.
I just lay down in the early morning and wanted to sleep for a while, but my mind was still filled with all the details of the colonoscopy, and what Brother Yun recently said was to summarize the case reports on intestinal malformations and surgeries and send them to "New England" magazine Things to do.
Although I didn’t join Boss Zheng’s medical team, I did get two of the world’s top SCI articles. If I can pass this, it will be my third.
Of course Quan Xiaocao knew the weight, so she worked harder than usual. It’s just that I feel a little sleepy today. It’s already dawn outside. I need to take a nap. I have other things to do during the day.
But tonight she did not get the blessing of the night shift god. As soon as she lay down, the phone rang.
The nurse knocked on the door and said outside: "ICU emergency consultation, Mr. Yang has diarrhea, I want you to go and take a look first."
Quan Xiaocao is in the first-line class, and this kind of consultation should be a general matter for second-line hospitalization.
Mr. Yang said he had diarrhea, so he might as well go up and take a look.
Wearing an isolation gown and white clothes, Quan Xiaocao came to the ICU sleepily.
"What's wrong?" Quan Xiaocao asked quietly after entering.
The atmosphere in the ICU was a bit stagnant, as if something big had happened.
"The urine of the patient you sent here a few days ago turned green." A young nurse knew Quan Xiaocao and told her in a low voice, "Go to the hospital chief, you can't handle this."
Quan Xiaocao nodded quickly and cautiously stepped out to avoid being scolded by the first and second line staff in the ICU.
Arriving in the corridor, Quan Xiaocao immediately called Mr. Yang.
"Mr. Yang, the urine of the patient who underwent surgery a few days ago turned green." Quan Xiaocao lowered his voice and said.
"I didn't see it with my own eyes..."
Quan Xiaocao escaped one scolding, but had no choice but to receive another one.
However, Mr. Yang didn't say a few words, and finally said that he would come over as soon as possible.
Waiting in the corridor of the ICU, Quan Xiaocao felt a little cold and lonely.
It's almost dawn, I haven't slept all night, and I don't know how much cosmetics can repair the wrinkles on my face. Although he is still young, Quan Xiaocao feels that he has begun to look older than his high school classmates.
If I had a choice, I would definitely not engage in medical treatment. Not to mention stressful, just working the night shift is unbearable.
If there is a night shift plus one or two rescue operations, I can't even think about it. I feel bad when I think about it.
In the midst of random thoughts, Mr. Yang came in.
"Xiaocao, what's going on?" Mr. Yang asked.
Quan Xiaocao got scared all of a sudden. He just got scared, and now... life is just about being scared.
Seeing her look, and knowing a little about the situation on the phone, Mr. Yang had his own guess.
Xiaocao was probably kicked out.
Shaking his head slightly, Mr. Yang strode into the ICU.
"Mr. Yang, does the green urine found in your patient's urine bag have anything to do with the surgery?" the ICU resident asked directly.
Mr. Yang quickly came to the patient's side, his heart had shrunk into a ball.
Urine, green, his first thought was bilirubinuria!
Bilirubin can be divided into unconjugated bilirubin that is not processed by the liver and conjugated bilirubin that is formed by hepatic conjugation with glucuronic acid.
Unconjugated bilirubin is insoluble in water and cannot pass through the glomerular filter membrane when combined with proteins in the blood. Conjugated bilirubin has a small molecular weight and high solubility, and can pass through the glomerular filter membrane and be excreted in the urine as urinary bilirubin.
The presence of this kind of urine means liver failure!
Although the possibility of appearing is unlikely, Mr. Yang has seen it once before. The patient did not make it through in the end. After three days and three nights of resuscitation, he still died.
When he came to the patient's bed, Mr. Yang squatted down and looked at the urine bag carefully.
There was about 300ml of urine in the urine bag, which was light green and looked eerie. The green inside is vaguely fluorescent, like the beautiful world of the movie Avatar.
But in the movie, you can experience a kind of beauty. And the urine bag that appeared in front of him... Mr. Yang's head buzzed.
This patient is going to die!
"How long has it been here?" Mr. Yang asked.
"It just appeared 20 minutes ago." said the resident in the ICU. "It was normal before, but suddenly the color of the urine changed. I just checked the liver function, and it was supposed to be normal."
Obviously, she also considered bilirubinuria.
Just checking the liver function in the morning showed no problem, and the patient's condition continued to improve. If it weren't for his old age and respiratory function problems, he would have been taken off the machine and returned to the gastrointestinal surgery department long ago.
The ICU residents also don’t understand.
How come you, a good person, have bilirubinuria
"Is liver function checked urgently?" Mr. Yang asked.
"Well, it's an urgent check-up." The chief resident of the ICU said, "She should be back soon. I'll take a look."
After saying that, she walked back to her workstation and glanced at the computer.
"Mr. Yang!" the ICU resident shouted.
Mr. Yang stood up in confusion. He looked over anxiously, like a criminal waiting to be tried.
"The liver function is normal!" Being admitted to the ICU is not exciting. Doing this in the ICU can easily kill someone.
normal
Liver function normal? !
What's up with that green urine!
Mr. Yang started to think.
“What anti-inflammatory drugs does the patient take?”
"Twenty-four hours after the operation, the anti-inflammatory drugs were stopped." The resident in the ICU said.
The ICU at 912 is very sterile and does not require anti-inflammatory drugs at all during normal operations. This was a gastrointestinal surgery, and it only took 24 hours to give "face".
This is completely different from the ICU of Haicheng City No. 1 Hospital.
In Haicheng, if a patient does not need antibiotics for 3-5 days after being discharged, no one from top to bottom will be relieved.
The difference in technical strength is reflected in all aspects.
It doesn't mean that the surgery is done well.
Mr. Yang originally knew that antibiotics are no longer used, but green urine can also appear when large doses of certain antibiotics are used.
But now, this road is also blocked.
"Does it have anything to do with the surgery?" ICU residents always ask.
"It should be fine... ah..." Mr. Yang also began to feel unsure.
The operation was relatively successful, but the green urine in front of him was like a taunting warrior, taunting him to his heart's content.
"Have your blood calcium been checked?" Mr. Yang asked.
"The blood calcium and vitamin D have been checked. The results are a little slow, and it will probably take another hour or two."
"Have you used triamterene?"
"No."
"What about methylene blue, indigo red, creosote, and salicylic acid?" Mr. Yang asked.
"Mr. Yang, it's not like you didn't read the doctor's advice. What are your patients using these things for?" the resident of the ICU said unhappily.
It has nothing to do with the surgery. It most likely won’t be bilirubinuria, so just wait.
Mr. Yang and Quan Xiaocao observed the patient for an hour. The patient was assisted in breathing by a ventilator in a sedated state. His vital signs were stable and nothing was wrong.
Subsequently, blood calcium and vitamin D returned and no abnormalities were found.
The two residents were dumbfounded.
There is no other way, just report it layer by layer and find a second-tier professor to check it out.