Chapter 1492

They only exchanged two words in a low voice, but they didn't go on.

It's a mess around. Who knows if there are patients' families. And just listening to 120 emergency doctors, there is no way to judge the specific situation at that time.

It's all speculation. You can't count. But be self righteous and preach it. If it is heard by the patient's family, the following doctors are afraid of trouble.

Don't get into trouble. It's the most basic.

Fortunately, the patient has woken up and has nothing to worry about.

Zhou Litao called the patient's family to ask about the situation. Zheng Ren listened for 2 minutes and asked, "what medicine did the patient take last night?"

"Er..." the patient's family was stunned and tried to think.

"Boss Zheng, what do you suspect?"

Zheng Renjian's family went to the luggage to find the medicine box, and whispered, "patients with hyperthyroidism generally have a fast heart rate. Oral propranolol can reduce the heart rate. It is recommended in major guidelines that it can inhibit the transformation from T4 to T3 and is the first choice.

But large doses β Receptor blockers can weaken the effect of catecholamines, inhibit hepatic glycogen decomposition, reduce hepatic glucose output and gluconeogenesis, inhibit fatty acids, reduce the level of glucagon in blood and reduce blood glucose production. "

In other words, if you eat too much of this drug, it will lead to the reduction of blood sugar.

"I see." Zhou Litao said immediately.

In fact, as soon as Zheng Ren started, Zhou Litao thought of this.

After all, I'm not an endocrinologist, right β Zhou Litao is not very familiar with the fact that receptor blockers can lead to hypoglycemia.

But if Zheng Ren is absent, he probably won't miss it. Zheng Ren reminded the direction and accelerated the process of asking for medical history.

Sure enough, the family came with propranolol's kit.

Because the patient's condition is not serious and his activities are normal, he has no family to accompany him. This morning, the clinical people said that the patient's heart rate was fast last night, and there was no significant remission 30 minutes after oral medication, so they added the dose again.

When Zhou Litao saw that there was nothing wrong with the patient, he asked the emergency physician to write a list and stay in the emergency hospital for observation.

Watch for a while.

It's just hyperthyroidism, but I can't get into the hospital.

After busy, Zhou Litao asked Zheng Ren to go to his duty room.

"Boss Zheng, your eyes are so bright. Have you done endocrinology?" Zhou Litao took out a box of Ziyun and was despised by Su Yun.

"No, I met a similar patient in Xiangjiang a while ago, but it was not hyperthyroidism." Zheng Ren said perfunctorily.

Su Yun glanced at Zheng Ren. His answer was too careless.

Hypoglycemia refers to the symptoms and signs including the decrease of glucose concentration in the blood, which eventually leads to the impairment of brain function.

The clinical manifestations range from behavior change, fatigue and insanity to epilepsy and loss of consciousness, that is, functional brain failure.

Therefore, many patients with hypoglycemia are often misdiagnosed as epilepsy or even depression and mania.

Qin Lu's illness and mania were related to hypoglycemia, but he seemed to see it at a glance.

This product is sneaky. It looks really unpleasant.

Unfortunately, I can't catch up with him. I really want to find a chance to treat him well. Su Yun smokes and thinks of it in his heart.

"By the way, Mr. Zhou, how do you judge low blood sugar?" Zheng Ren asked.

"When the patient comes, I feel something wrong." Zhou Litao said with a smile, "if you want to sleep with the nurse on duty, you don't bring your sister in the ward. It's so direct in front of others. There must be a problem."

"Well, yes." Su Yun said: "I have met a patient before. He had a car accident, multiple rib fractures on both sides, hemopneumothorax on both sides, lung rupture, traumatic wet lung and head injury. He was in ICU with a tube inserted and assisted by a ventilator for 3 days. Later, he pulled out the tube. What do you guess?"

Zheng Ren smiled and didn't speak.

Zhou Litao asked suspiciously, "no, it has something to do with nurses."

"He took the hand of the head nurse of ICU and said he would go to drink flower wine together in the evening." Su Yun laughed.

"And then?" Zhou Litao has a lot of thoughts about gossip.

Being the chief inpatient in the emergency department and listening to gossip is like having fun in pain.

"Later, his condition was slightly stable and he was expelled from the ICU." Su Yun smiled.

The condition is different, but the symptoms are similar.

"Boss Zheng, what's the matter with the patients in Xiangjiang?"

"The pancreas has a feeding artery with plaque, and the intermittent flow rate changes lead to abnormal insulin secretion. He is a little higher than these two patients. He is not nonsense, but something he has experienced." Zheng Ren briefly described Qin Lu's illness.

"Tut tut." Zhou Litao secretly wrote down the cases Zheng Ren said.

Although you may not encounter similar patients in your life, if you have a shadow and impression in your heart, you will at least reduce the probability of misdiagnosis and missed diagnosis.

"President Zhou, if the patient is not hypoglycemic, what are you going to check?" Zheng Ren continued to ask.

"Patients with hyperthyroidism have mental symptoms, which may generally be electrolyte disorder, pre hyperthyroidism crisis, hypoglycemia, or autoimmune encephalitis. It is most convenient to check blood glucose, and the symptoms of sleeping patients are also like. If not, check them one by one."

Zhou Litao has a solid foundation. Just after Zheng Ren finished asking, he said casually.

Zheng Ren thought, 912 is profound. An inpatient in the emergency department is so powerful.

It is difficult for doctors in other departments except glandular surgery and endocrinology to know the details of hyperthyroidism.

The role of specialty is here, but the good things have disadvantages. The more you study a certain direction, the less you will understand the diseases of other departments.

"Boss Zheng, you are really omnipotent." Zhou Litao smiled and said, "do I have any attention to this patient?"

"Nothing, you see." Zheng Ren said with a smile, "after two days of observation, let's go to the specialist clinic. You can solve the hypoglycemia in an emergency department. By the way, tell the patients that they can't take the medicine casually."

"Yes, it's terrible to eat as much as you want." Zhou Litao said, "boss Zheng, a patient of Gaucher's disease, when are you going to have the operation live?"

"I don't know. If there's no problem, the sooner the better." Zheng Rendao.

"I've seen your live operation. It's good." Zhou Litao was a little envious.

No one wants to be in the emergency department if he can go to surgery or be a surgeon.

But when he made a mistake, he became eternal hate. He was young and ignorant, so he was cheated to the emergency department.

Today's children are better than each other. There are not many people engaged in the medical industry after graduation, let alone emergency treatment.

The more Zhou Litao thought about it, the more he felt that his future was gloomy.

How nice it would be to be like boss Zheng.

These are still tolerable. The key is that boss Zheng has a high level and a girlfriend!

If you have a girlfriend, you can give it to him when you have an operation

Alas... Zhou Litao sighed.

Zheng Ren and Su Yun were about to leave when they suddenly heard a series of hurried footsteps in the corridor.