The flat cart pushed a middle-aged and elderly male patient straight to the emergency room like a wild dog that had lost its stiffness.
Zheng Ren glanced at the system panel on the upper right side of his field of vision.
What a strange diagnosis.
Traumatic brain injury, ketoacidosis!
These two diagnoses, brain trauma are not important at all in Zheng Ren's eyes.
Not even a subarachnoid hemorrhage, would Zheng Ren care
Traumatic brain injuries are similar to concussions discussed ten years ago, except that there is no longer a diagnosis of concussion.
Patients with no organic disease, but transient dizziness, headache, nausea, vomiting and other symptoms due to a head impact are collectively called brain trauma.
Because there is no organic disease, it has become the perfect disease to blackmail people for injuries caused by fights or car accidents.
None of this matters, what is fatal is ketoacidosis.
Pathophysiologically speaking, ketone bodies are intermediate metabolites produced by the breakdown of fat into fatty acids in the liver.
Under normal circumstances, the body produces a small amount of ketone bodies, which are transported to the heart, kidneys, skeletal muscles and other tissues with the blood and used as an energy source. The concentration of ketone bodies in the blood is very low, generally no more than 1.0 mg/dl, and it is also found in the urine. Ketones are not detectable.
In severe diabetics, ketone bodies can be measured in urine. No matter how serious it is, when ketone bodies accumulate too much in the blood, it can cause the blood to become acidic and cause acidosis, which is called ketoacidosis.
Zheng Ren watched the nurses busy, putting the patient on ECG monitoring, leaving an intravenous channel in place, and waiting for the doctor's next instructions.
He came close to the patient and smelled it, smelling like rotten apples. Now Zheng Ren knew in his mind that he must be suffering from ketoacidosis.
"Test your blood sugar." Zheng Ren said, "Call the endocrinologist immediately and ask the hospital manager for consultation."
The nurse was a little surprised. The patient's head was covered with a bandage and there was obvious head trauma. Why did Mr. Zheng ask for an endocrinology consultation
However, the strict hierarchy between superiors and subordinates in the hospital prevented them from expressing their opinions during rescue operations, but chose to obey.
"Patient's family!" Zheng Ren shouted.
An eighteen or nineteen-year-old boy was following the 120 ambulance. He came to Zheng Ren eagerly, "Doctor, is it dangerous?"
At the same time, hurried footsteps came from the corridor.
Under normal circumstances, the 120 ambulance allows one family member to come up and help take care of the patient. Of course, the rules vary from place to place, and this is the case in Haicheng.
Other family members can take a taxi or drive to follow the 120 ambulance to the hospital.
Zheng Ren was a little unhappy when he saw that he was a young man.
The adults in this family are really big-hearted. The age of the patient he saw was probably in his sixties, and the child might be his grandson or grandson.
What do adults do for food? How could they let a teenager follow them in the car
"Where are your parents?" Zheng Ren asked.
"..." The young man was startled for a moment, and then said: "At work."
"Are there any adults coming?" Zheng Ren asked.
"Aunt Zhao and Uncle Li are both following."
This is more difficult to deal with, and Zheng Ren is a little difficult to deal with.
The patient's fatal diagnosis was ketoacidosis, and he could die at any time. But the immediate family members of the head of the family are not here...
"Then it's up to you. Who are you as a patient?"
"I'm his neighbor."
"..." Zheng Ren was dumbfounded, what kind of messy relationship is this
"Mr. Zheng, the patient's fingertip blood sugar is 54.2mmol/l." The nurse said with admiration.
This extreme blood sugar level is rarely encountered even in the emergency department. Maybe there will be more endocrinologists
This also proves the critical condition of the patient.
Zheng Ren doesn't know how to deal with ketoacidosis. It's not that I don't know how to do it, but at least it's not professional.
"10u insulin subcutaneous injection, 500 saline. Blood gas analysis, ions." Zheng Ren said immediately.
Low-dose insulin to correct hyperglycemia, plus fluid replenishment, to correct body fluid loss and ion disorders, are the focus of initial treatment.
There is only so much Zheng Ren can do.
The endocrinology department is not far from the emergency building. It is estimated that in a few minutes, blood gas and arterial blood may not be able to be collected, and the patient will have to be referred to endocrinology for specialist treatment.
At this time, two middle-aged people, a man and a woman, ran in, panting.
"Doctor, how is Uncle Wang?"
Zheng Ren glanced at them and asked, "It's very dangerous. Have the patient's immediate family members been notified?"
"He has no immediate family, he is just one person. We are all neighbors," the man said.
Well…
Zheng Ren is in trouble.
But it seems that this man is quite popular. The relationship between neighbors is so cold nowadays. If it were a little worse, he would be found dead when he dies at home.
"The patient's blood sugar is extremely high. He is now diagnosed with ketoacidosis, which is very dangerous. He will be admitted to the endocrinology department for treatment soon." Zheng Ren looked seriously at the three people who were present to send the patient, trying to see in their eyes There are some clues.
"Whether he can be saved or not, it's hard to say." Zheng Ren said, "Who will pay the hospitalization fee later."
"Doctor, do your best. Don't worry about the hospitalization fee. I'll pay it later." The man said.
"Brother Li, your family is not well-off and your child is still young, so I'll do it," the woman said.
Zheng Ren was a little surprised.
In hospitals and emergency rooms, we are used to seeing indifferent people. It is really rare for a widowed and lonely old man like this to have people competing to pay his hospitalization fees.
The young man who came at the beginning said firmly: "Uncle, aunt, don't argue, I'll pay it first. When we were in the car, I called my dad. He was rushing back, and he asked me to hand over the money first. Paid it. I still have the New Year’s money, so it’s okay.”
While they were arguing, a deputy director of the Department of Endocrinology rushed over.
Feng Qing, in his forties, is not tall, looks very simple and honest, and has a slight stutter in his speech.
Zheng Ren knew Feng Qing, because general surgery involves operations on elderly patients, and most of the preoperative evaluations require endocrinology consultation.
Chronic diagnosis consultation is under the charge of deputy director Feng Qing. Emergency consultations are handled by the hospital chief.
I don’t know why he came here today.
"Director Feng, the patient's blood sugar is above 50, and he is considered to have ketoacidosis." Zheng Ren ignored the disputes between several neighbors and introduced the condition to Director Feng: "I have given a small dose of insulin subcutaneously and checked the blood gas. and ions.”
"Okay." Feng Qing didn't talk much. Because he had a stuttering problem, he basically used one or two words to express his words.
"Admit it to the hospital?" Zheng Ren respectfully asked Feng Qing for his opinion.
"Okay." Feng Qing said as he began to examine his body.
The patient has problems with light reflection, and his condition has reached a certain level.
"Head CT, should I do it now or go back?" Zheng Ren asked.
"Kao... I don't think it's a head... trauma. It should be caused by ketosis... and I'll be admitted to the hospital." Feng Qing said "simply".