Chapter 439： Old patient with good karma

The flat car pushed a middle-aged man, like a wild dog, and ran straight to the emergency room.

Zheng Ren glanced at the system panel at the top right of the field of view.

A strange diagnosis.

Brain trauma, ketoacidosis!

These two diagnoses, in the eyes of Zheng Ren, brain trauma is not important at all.

Even a subarachnoid hemorrhage, Zheng Ren will care?

Brain trauma is similar to the concussion that was said ten years ago, but there is no diagnosis of concussion.

The patient has no organic lesions, but the general symptoms of dizziness, headache, nausea, vomiting, etc. due to head impact are collectively referred to as brain trauma.

Because there is no organic disease, it has become the best deaf person in fighting and fighting accidents.

This is not important, it is ketoacidosis.

Pathophysiologically, ketone bodies are intermediate metabolites of fatty acids in the liver that are broken down into fatty acids.

Under normal circumstances, the body produces a small amount of ketone bodies, which are used as energy sources as the blood is transported to tissues such as the heart, kidneys, and skeletal muscles. The concentration of ketones in the blood is very low, generally not exceeding 10 mg/dl, and in the urine. The ketone body was not detected.

In severe diabetic patients, ketone bodies can be measured in the urine. Seriously, when the ketone body accumulates too much in the blood, the blood can become sour and cause acidosis, which is called ketoacidosis.

Zheng Ren watched the nurse busy, gave the patient an ECG monitoring, left the venous access, and waited for the doctor's next instructions.

He got together and smelled the smell of a rotten apple. This time Zheng Ren has a number in his heart, it should be ketoacidosis no doubt.

"Measure a blood sugar." Zheng Rendao "call the endocrine immediately, find a hospitalization to come to the clinic."

The nurse was a little surprised. The patient had a bandage on his head and obvious head trauma. How did Zheng always ask for endocrine consultation?

However, the poor grades between the hospital's superiors and subordinates, so that they did not express their opinions during the rescue, but chose to obey.

"Patient family!" Zheng Ren shouted.

120 ambulance followed a 10-year-old boy, he eagerly came to Zheng Ren, "Doctor, is it dangerous?"

At the same time, there was a rush of footsteps in the corridor.

In general, 120 ambulances allow a family member to come and help to look after the patient. Of course, the rules vary from place to place, and Haicheng is like this.

Other family members can take a taxi or drive to the hospital with a 120 ambulance.

Zheng Renjian is a young man and some are not happy.

This adult is really a big heart. He looks at the patient's age, probably in his sixties, and the child may be his grandson or grandson.

What adults are doing, how can a teenager be in the car?

"What about your parents?" Zheng Ren asked.

"..." The young man stunned and immediately said "is at work."

"Is there an adult?" Zheng Ren asked.

"Zhao Wei and Li Shu are all following."

This is more difficult to deal with, and Zheng Ren is somewhat difficult to handle.

The diagnosis of the patient's life is ketoacidosis, which can die at any time. But the immediate family members of the family's principal are not...

"That's still you coming. Who are you patient?"

"I am his neighbor."

"..." Zheng Ren is stupid, what is this messy relationship?

"Zheng Zong, the patient's fingertips blood sugar 542ol / l." The nurse said with admiration.

This extreme blood sugar level is rarely encountered even in the emergency department. Maybe the endocrinology department will be a little more?

This also proves the critical condition of the patient's condition from the side.

Ketoacidosis, Zheng Ren can not be disposed of. It is not completely impossible, but at least it is not professional.

"10u insulin subcutaneous injection, 500 normal saline. Blood gas analysis, ions." Zheng Ren said immediately.

Small doses of insulin to correct high blood sugar, plus rehydration, correction fluid loss and ion disorder, is the focus of the beginning of treatment.

There are only so many Zheng Ren can do.

The endocrinology department is not far from the emergency building. It is estimated that there will be a few more minutes. The arterial blood of blood gas may not be collected, and it has to be pushed to the endocrine for specialist treatment.

At this time, two middle-aged men, one man and one woman, ran in and panted.

"Doctor, how is Wang Shu?"

Zheng Ren glanced at them and asked, "It is very dangerous. Did the immediate family members of the patient inform me?"

"He has no immediate family members, just one person, we are all neighbors," the man said.

Uh……

Zheng Ren is in trouble.

But it seems that this man's popularity is still good. The current neighborhood relationship is indifferent. If it is a little bit worse, if you die at home, people will be discovered if they are rotten.

"The patient's blood sugar is particularly high. Now the diagnosis is ketoacidosis, which is very dangerous. I will go to the endocrinology hospital for treatment." Zheng Ren seriously looked at the three people who were present at the scene and wanted to see them in their eyes. A little bit of a clue.

"Can you save it? It's hard to say." Zheng Rendao "Who will pay the hospitalization fee for a while."

"Doctor try your best. Don't worry about the hospitalization fee, I will pay it later." The man said.

"Li Ge, your family is not affluent, the child is still small, or I am coming." Woman said.

Zheng Ren is a little surprised.

In the hospital, in the emergency department, I am used to the indifference of people. It is really rare for such an elderly person who is so lonely and lonely to fight for hospitalization.

The youngest boy who came at the beginning said firmly, "Uncle, hey, don't fight, I will pay first. When I was in the car, I called my dad. He is going back. He asked me to pay the money first. I still have a lucky money, nothing."

This side is arguing that a deputy director of the endocrinology department has come over.

Feng Qing, in his forties, is not tall, his length is very thick, and his speech is a bit stuttering.

Zheng Ren knows Feng Qing. Because general surgery involves surgery for elderly patients, most of the time requires endocrinology consultation.

The slow consultation was conducted by Feng Qing, deputy director. The emergency consultation is the responsibility of the hospital.

I don't know how he ran over today.

"Director Feng, patients with blood sugar above 50, consider ketoacidosis." Zheng Ren did not pay attention to the dispute between several neighbors, and then introduced the condition to Director Feng "has given a small dose of insulin subcutaneous injection, check the blood gas and ion."

"Good." Feng Qing did not talk much, because there was a problem with stuttering, so he basically said one or two words.

"Receipt of the hospital?" Zheng Ren respected the opinions of Feng Qing.

"Good." Feng Qing said, while starting to check the body.

The patient has problems with light reflection, and the condition has reached a certain level.

"Head ct, do you still do it now?" Zheng Ren asked.

"Testing ... consider not the head outside ... ... the problem of trauma, should be caused by ketosis ... income hospital." Feng Qing " simply" said.

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