"Vitamins, have you checked?" Zheng Ren asked.
"Vitamins?" Su Yun was startled.
ICU, the custom of emergency rescue, does not include vitamin examination at all, unless it is a special disease.
Trauma is not a special disease.
"Vitamin b1 deficiency, I'm considering this now." Zheng Ren said: "Stop the patient's sedative for a while."
"..." Su Yun was slightly startled.
"I want to see if the patient has symptoms of oculomotor nerve palsy when he is agitated."
Paralysis of the extraocular muscles innervated by the oculomotor nerve will cause symptoms such as abnormal eye position and loss of reaction to light due to dilated pupils.
Su Yungang wanted to refute, but suddenly recalled the scene of Yang Lili's eyes trembling when she was awake.
He pondered for a few minutes, then suddenly raised his head and his eyes lit up, "Boss, I think you are right."
Director Qian and other consultation directors were stunned.
Are these two young men joking
The city is still waiting for today's condition report. They...
If Su Yun hadn't already demonstrated a level of emergency first aid that surpassed everyone in the ICU, and if Zheng Ren hadn't demonstrated extremely high surgical skills in previous emergency surgeries, he would have been spitted on.
Vitamin b1 deficiency
What a joke.
"Xiao Zheng, Xiao Su, don't be ridiculous." Director Qian's voice was deep, expressing his dissatisfaction.
"Director Qian, you're not joking." Su Yun smiled.
Zheng Ren's words cleared away the fog in front of his eyes, revealing a clear sky.
Sometimes, the difference is just a little bit. Once that layer of window paper is pierced, it actually doesn't matter looking back.
"What does the patient's symptoms have to do with vitamin B1 deficiency!" The director of the medical department said angrily: "Is it beriberi?! That's nonsense!"
"You must have studied pathophysiology." Su Yun looked around, with a mocking smile on his lips, "This vitamin deficiency is commonly known as beriberi, which is correct."
As he spoke, the smile on his lips grew stronger, and he could see the stars in the eyes of many young nurses in the ICU twinkling.
“The vitamin is also called thiamine, and after thiamine is absorbed in the intestine, it is phosphorylated by enzymes to form thiamine pyrophosphate.
Thiamine pyrophosphate is an important coenzyme in the decarboxylation reaction of pyruvate and α-ketoglutarate in the tricarboxylic acid cycle, and is also a coenzyme of erythrocyte ketol transferase. "
A series of professional terms, like thunder from the sky, emerged from the void and landed on the heads of everyone present.
Director Qian pondered, what Xiao Su said seemed to be an idea.
The director of the medical department looked ugly because... he didn't understand it at all.
His position is very important. He is responsible for the integration of various rescue links, handling medical disputes, and controlling medical quality.
But I have been away from clinical practice for so long that I have almost forgotten things like pathophysiology.
Su Yun ignored the thoughts of the big shots present and continued: "In the brain tissue and myocardial tissue with strong metabolism, sufficient vitamins must be involved in the metabolism of glucose and pyruvate, otherwise acetone will be caused due to the lack of thiamine pyrophosphate. It is difficult for acids to enter the tricarboxylic acid cycle.
A large amount of pyruvate remains in the blood, causing peripheral arterioles to dilate, peripheral resistance to decrease, venous flow to increase, and cardiac output and cardiac workload to increase. "
Huh? Finally talking about right heart output and cardiac load
The director of the medical department pretended to be thinking. At this time, he could not let anyone see that he did not understand.
But... couldn't this hateful guy put it simply
"So, I..." Su Yun's smooth tone paused for a moment, "My boss said that considering Yang Lili's agitation and psychological symptoms, they should be complications caused by vitamin B1 deficiency."
After speaking, Su Yun glanced at Zheng Ren.
"I'm right, boss."
"That's basically what I mean." Zheng Ren was not polite, and then said, "It is recommended to inject 100 mg of vitamin B1 intramuscularly, but the body absorbs intramuscular injection drugs slowly. You can try intravenous injection of 20ml normal saline + 50mg vitamin B1 at the same time as the intramuscular injection. .”
"A larger dose on the first day will be fine," Zheng Ren said.
The directors and the director of the medical department present looked at each other in confusion, but in each other's eyes, all they saw was confusion.
Although not everyone agrees with Zheng Ren and Su Yun's statement, if you want to criticize them, you have to have a reason not to.
He explained things and judgments clearly from a biochemical point of view.
Although I don’t understand it, I just think it’s awesome.
What to do
What else can be done
"Let's try it, there's no other good way." Director Qian said.
He has been in contact with Su Yun for the longest time and knows Su Yun well. Generally speaking, once Su Yun has that kind of expression on his face, it means that what he said is right.
Don't refute at this time. Even the director will be slapped in the face when faced with a well-founded medical condition.
Besides, the intake of dozens of milligrams of vitamin b1 will certainly not have a negative impact on Yang Lili's condition.
"In half an hour, stop the sedative." Zheng Ren stood up and said the last part.
"Okay, boss." Su Yun went to give the doctor's orders.
Looking at Zheng Ren's leaving figure, Director Qian felt vaguely emotional.
This is a little tiger that has grown up.
This kind of momentum is not found in senior directors who have been here for many years.
There is no absolute certainty in medical treatment. Who dares to say something so certain? Whatever you say, you will soon be slapped in the face, one slap to the left, one slap to the right, and a few slaps will turn you into a pig's head.
Director Qian has only seen this kind of temperament in a few professors from imperial and magical cities, but the First City Hospital... has never had such a person.
Su Yun gave the doctor's order, and a nurse hurriedly carried it out. Then he injected vitamin B1 intravenously and gave a muscle injection.
After checking the time, Su Yun sat down on the chair beside the bed and looked at Yang Lili intently.
Half an hour, the time the boss said should be fine. At that time, the dosage of the sedative should be reduced. It should be 2 hours later when Yang Lili's body has almost metabolized the sedative.
If it is really the oculomotor symptoms and cardiovascular symptoms caused by vitamin B1 deficiency, they will definitely be improved.
This diagnosis is really interesting.
…
At the same time, in the surgery room, the orthopedic surgery to remove the vertebral body was in progress.
"Xiao Zhou, is it true that there was an embolism yesterday?" Professor Tian from the Orthopedics Department of the Imperial Capital asked while opening the skin.
Dr. Zhou said: "The embolization takes a long time because we only have one interventional doctor here. I can't tell whether it is successful or not. But in the past, he has embolized patients with peritoneal hematoma after pelvic fractures, and the results were quite good."
"Well, there are relatively few interventional doctors, so it would be nice to have one." Professor Tian began to bluntly separate the muscle tissue, carefully avoiding a location with dense capillaries.