"Boss, look at how much trouble you have caused people." Su Yun said contemptuously.
"I always feel that there is something wrong with the patient." Zheng Ren couldn't explain the system diagnosis of Big Pig Hoof, so he could only prevaricate.
"It's too far-fetched." Su Yundao said, "The patient's symptoms are excessive phlegm, blocking the airway, causing hypoxia. Please tell me how you consider the suspicion of foreign bodies."
"You also saw the behavior of the patient's family when we were eating skewers." Zheng Rendao, "It was obviously an accident. My feeling is that the old man was fine when he left the stall, but he developed convulsions and bloodshed a few hours later. The family members were caught off guard when the oxygen saturation dropped.”
"Uh... It seems so, but don't you think it's the patient's family's problem?" Su Yun looked at Zheng Ren doubtfully and said, "You seem to have guessed something."
Zheng Ren shrugged his shoulders, shook his head and said, "If there is something wrong, it's a doctor's intuition. Just go in and take a look. It's not troublesome. By the way, you can suck out all the accumulated phlegm."
Su Yun accepted Zheng Ren's explanation. Although he was eating late night snacks and singing songs, it was a bit strange to suddenly run to the ICU for bronchoscopy and bronchoalveolar lavage.
Soon, the hospital resident in the ICU prepared the equipment for bronchoscopy. Zheng Ren came to the patient, found a suitable angle, and started to lower the tube.
When the patient is under anesthesia, if an ordinary bronchoscope is used, there will be a feeling of suffocation, which is quite bad.
Zheng Ren held the lens of the bronchoscope in his left hand and watched carefully while using his right hand to slowly insert the fiber tube into the patient's airway.
There was indeed a lot of phlegm, but Zheng Ren didn't pay much attention to the phlegm in the upper respiratory tract, which was the part that could be sucked out.
Pass the tube into the right main bronchus and slowly suck out the sputum as you go. Zheng Ren carefully observed the airway and patiently suctioned the sputum.
It seemed that the problem was not here. After checking the right airway, Zheng Ren sent the tube to the left side.
Just about 5cm into the left main bronchus, Zheng Ren saw two skeleton structures stuck on the tracheal wall.
"Grabbing forceps." Zheng Ren said in a deep voice.
"What did you see!" Su Yun hated the damn bronchoscope at this time because it had no screen and only the operator could see what was going on inside.
The boss wanted to grab forceps, which meant he saw a foreign body in the trachea. But there is a foreign body... This is illogical. The patient does not behave as if the airway is blocked.
Just as he was thinking about it, Zheng Ren stepped away from the camera and said, "Take a look."
Su Yun immediately came over.
Two drug skeletons appeared in front of him.
"I'm going to... pay homage to Xintong's drug skeleton!" Su Yun immediately said in surprise.
"Huh? How do you know you are a new fellow? Do you have any research on this?" Zheng Ren was stunned for a moment.
"Last time I saw Director Lin explaining this matter to a family member of a patient who had objections at the medical office. I bought a box when I went back and studied it carefully. It was the skeleton pattern of imported medicine. It turned out that the medicine was stuck! "
The ICU resident always installed the grasping forceps and other instruments and handed them to Zheng Ren.
Zheng Ren slowly sent it in, firmly grasped a drug skeleton and took it out. This operation is not difficult, at least not for Zheng Ren.
The second drug skeleton was also taken out, but Zheng Ren did not finish the inspection. Now that you have started suctioning under direct vision, suction more, so that the patient's recovery period can be shortened a lot.
Ten minutes later, Zheng Ren took out the fiber tube and said with a smile, "It's okay. The sputum sucked out is about 80ml, which is quite a lot."
"Boss Zheng, how did you know there was a foreign object?" The ICU resident manager asked doubtfully as she still hadn't calmed down yet.
"Because of the patient's symptoms." Zheng Ren started to talk nonsense. Anyway, he just solved the problem. How could he judge and tell her the truth
"The patient suffered from spasms, convulsions, and acute hypoxia at the beginning. Later he recovered, but the amount of sputum was very large. This cannot explain the sudden symptoms. I thought it might be that there was obstruction at the beginning, and then he gradually recovered, but Because of the existence of obstruction and irritation, only the skeleton cumulative sustained-release dosage form can perfectly explain it."
"Complete obstruction, and then the drug is absorbed by the body, but there is still irritation. The increase in phlegm caused by the stimulation is also a side reason." Zheng Ren added another sentence, wanting to make it clearer.
After knowing the answer, it became much easier to make inferences. Zheng Ren expressed his thoughts and stunned the patients in the ICU.
Even Su Yun felt that what his boss said made sense.
"Brother Yun, what is this? A toy for patients to play with?" A young nurse asked after seeing the shell of the drug skeleton of Baixintong that was taken out.
"No, it's the skeleton shell of nifedipine controlled-release tablets."
"..." The little nurse was startled.
"Baixintong consists of a film-coated tablet and an expandable hydrogel layer... This gel layer contains polyethylene oxide and hydroxypropyl methylcellulose. After the latter is eroded, it penetrates through membrane-regulated push-pull The pump principle can release nifedipine at an approximately constant rate within 24 hours, allowing the drug to be released at a zero-order rate?"
"Here, look, there's still some medicine on it that hasn't been released. This one is a little less. I guess the boss took some of it with him when he was operating."
"Baixin looks like this?!"
"Yeah, many people don't know. A while ago, someone at the medical office complained that the medicine prescribed by the doctor was fake. I think that means that I might want the hospital to pay a hundred or eighty thousand yuan. Finally, Director Lin After explaining, he ran away." Su Yun and the little nurse started chatting very familiarly.
Zheng Ren looked at Su Yun helplessly, how will he live in the future? Do you want to see Chang Yue's dark face every day
Get married as soon as possible and leave these two guys alone. Seeing Chang Yue's unhappy look every day, Zheng Ren felt that he was not well.
"What other medicines does the patient take?" Su Yun said, suddenly asking the ICU resident.
"And Daiwen and Luo De."
"Both of them can be absorbed, so they are invisible." Su Yun said following the context, "The patient has a history of cerebral infarction, has been bedridden all year round, and has a certain degree of swallowing dysfunction? Mainly because of long-term bedridden, if not properly cared for, it is easy to cause errors. suck?"
"Try to go offline in three hours." Zheng Ren said with a smile, "If everything goes well, I think I can be transferred out of the ICU tomorrow."
"Okay, okay." The hospital manager of the ICU said repeatedly, "Boss Zheng, will you explain it to the patient's family or shall I do it?"
Boss Zheng and Brother Yun came right after the patient was brought over. They probably knew each other. The hospital resident in the ICU asked this question, and he was also thinking about not overstepping his boundaries.
"You go ahead, we're going home." Zheng Ren said.
"Okay." The hospital resident in the ICU found a disposable container for sputum culture, put on gloves the drug skeleton of Baixintong into the container, and prepared to take it to the patient's family to see.