Chapter 1738： Fall and shock that is in front

"What is it?" Zheng Ren asked.

“There was a female student who fell down when she went down the stairs.” Su Yun’s expression was a little weird, but the speed of speech was very fast. “I came to the hospital and found that the right lower lung pneumonia was accompanied by a large amount of fluid in the right chest.”

"In the face of Fang Lin?" Zheng Ren asked.

When Su Yun dripped the car, he glanced at Zheng Ren and asked, "Have I told you to fall down the stairs?"

"..."

"Cranial brain injury, left tibiofibular fracture with gas accumulation, traumatic shock, occipital ... This is not important." Su Yundao, "Fang Lin went to the consultation, I feel wrong, give me a call."

"How do you think about it?"

"A lot of pleural effusion, a 19-year-old girl, what would you consider?" Su Yun asked.

"The first impression of tuberculous pleurisy is this." Zheng Rendao "But if you consider falling, it also causes a fracture of the left tibia, traumatic shock, and can not rule out that she fell because of shock."

"Shock, with a lot of pleural effusion, I think so too." Su Yundao.

"Look at it and say it again." Zheng Ren tweeted the situation of this patient, and his hands unconsciously returned to the state of watching the film.

"Boss, if you keep this state on the road, it looks very handsome, silly handsome and handsome." Su Yundao.

"Shock, pleural effusion... If it doesn't matter? Just a simple pleural effusion?" Zheng Ren did not pay attention to what he said, but said from his own voice.

"If that's the case, it's simple."

"Right, Fang Lin looked at the patient, how did he consider it?"

"The patient's left tibiofibular fracture is accompanied by gas accumulation, but the patient's right calf has a large area of ​​bruise. He feels like a blood vessel embolism." Su Yundao.

"Well, Fang Lin is good." Zheng Rendao, "The chest can consider the thrombus at a glance, it should be uncommon. The patient may be a pulmonary embolism... Maybe... wrong, it should be a pulmonary embolism!"

"Boss, pulmonary embolism, very common is good!" Su Yunyi said "only this patient is more special, so Fang Lin called the echocardiogram, and gave me a call to consult."

"I think Fang Lin's diagnosis is based on it." Zheng Ren outlined the patient's condition in his mind, saying that "the strangest thing is that young students will have a lot of pleural effusion, which is rare. Down, coma, it is very common."

"Well, plus the bruises on my legs, I think Fang Lin’s logic is the same."

"Yes." Zheng Rendao "Nothing, after the inspection, it is estimated that we have not returned to the hospital, there is a certain diagnosis. Maybe even thrombolytic drugs have been used..."

Said, Zheng Ren stunned.

Cerebral hemorrhage, thrombolysis, these two treatments are completely different.

If low molecular weight heparin sodium plus warfarin is used for thrombolytic therapy, will there be a large amount of bleeding in the left tibiofibular fracture? Finally lead to brain sputum?

But if it is not treated, it is a blood clot, it is fatal!

"When is the car coming?" Zheng Ren asked.

"3 minutes."

"You told Xiao Feng, hurry to the hospital." Zheng Ren's tone immediately rushed.

Su Yun stunned.

"Fang Lin, are you around the patient?"

“Call reminder! Echocardiography will do it right away!” Zheng Ren’s voice is very loud. “If you find any problems, immediately go to the hospital for consultation, vascular department, and circulatory medicine.”

"I think it may be a pulmonary embolism, accompanied by syncope, the situation is very urgent. Can not use a large number of anticoagulants, need emergency evacuation." Zheng Rendao.

The account of the account is explained, Zheng Ren hangs up the phone.

Su Yun also finished the phone call. He looked at Zheng Ren’s quick expression and asked, “Boss, will it be a big surprise?”

"Fang Lin's intuition is correct!" Zheng Ren said firmly that "the left tibia fracture is difficult to cause a large area of ​​bruise on the right calf, which is caused by vein embolism of the lower extremity."

"So young..."

"Contraceptives may cause venous thrombosis in the lower extremities." Zheng Rendao "Hurry up and go back, you and Fang Lin keep in touch."

Said, a car with a double flash stopped at the side of the road, while Su Yun's cell phone rang.

Su Yun glanced at the license plate number and walked over.

On the train, Zheng Ren’s ear rang the “叮咚” task prompt tone.

[Emergency tasks are misdiagnosed.

Task content Many times, people's eyes will be placed on the "main" symptoms, especially bleeding. But the inner disease is more serious and even fatal. Please promptly rescue a patient with pulmonary embolism.

The mission time is 3 hours.

The mission reward experience value is 10000 points and the skill point is 1000 points. 】

Hey... Zheng Ren hasn’t seen such a meager task for a long time.

However, the biggest significance of this task is to affirm the guess. Whether it is Zheng Ren, Su Yun or Fang Lin's guess is correct.

It is a pulmonary embolism! Instead of a fracture of the tibia and a buildup of gas.

The so-called traumatic shock is also a wrong diagnosis. It is because of the appearance of pulmonary embolism that the symptoms of shock appear. Trauma, that is the future.

Various embolic detachments of the systemic circulation obstruct the clinical pathophysiological syndrome of pulmonary circulatory disorders caused by the pulmonary artery and its branches.

The most common embolism of pulmonary embolism is thrombosis, and pulmonary embolism caused by thrombosis is also called pulmonary thromboembolism.

The patient suddenly developed unexplained collapse, pale, cold sweat, difficulty breathing, chest pain, cough, etc., and symptoms of cerebral hypoxia such as extreme anxiety, burnout, nausea, convulsions and coma.

A transient brain hypoxia leads to a coma, and there will be a fall.

The large amount of effusion in the right thoracic cavity suggests that the right pulmonary artery is blocked, which is an acute pulmonary embolism.

Now the patient's oxygen saturation...

Zheng Ren thought, simply enter the system space directly, click to buy surgery training time.

The operating room of the system rose from the ground, and Zheng Ren went straight in.

The experimental body is lying on the operating table honestly, diagnosis - pulmonary embolism, deep venous thrombosis of the lower extremities and so on.

Compared to pulmonary embolism, other diagnoses are really not enough.

Zheng Ren took a look at the ECG monitoring of the experimental body, blood oxygen saturation 85, which is a very dangerous value.

Surgery, there is no other way, Zheng Ren took a deep breath and began to take the embolectomy.

In general, after deep vein thrombosis, the blood flow to the right atrium and then to the right ventricle, and then to the pulmonary artery, which will block the branches of the pulmonary artery or the larger pulmonary artery.

This is a form.

There is also a small embolism of the lower extremity that continually falls off, resulting in continuous embolization of the pulmonary arterioles, which eventually leads to a large embolism.

Another reason is that the embolus formed by the right heart system falls off and flows to the pulmonary artery, leading to pulmonary embolism, such as congenital heart disease leading to enlargement of the right atrium to form a thrombus, shedding, and the like.

The patient in front of the eye is caused by deep vein thrombosis of the lower extremities.

Zheng Ren still has considerable confidence in taking the bolt.

However, he was stunned after taking the catheter through the inferior vena cava to the right atrium and right ventricle.

.