I Can See Health: Chapter 215 The helplessness of a small hospital
Chapter 215 The helplessness of the small hospital
Speeding up the fluid infusion is a skill that many older patients are familiar with.
The speed of the drip infusion is very adjustable, and there is a valve to adjust the speed.
Intravenous pump infusion, but not so easy to adjust.
There are many buttons on the intravenous pump, and the operation is complicated.
However, for these old patients, they are used to seeing the operation of nurses, and many people can do it.
"Turn up the pump speed?" Fan Zhiping's face turned black.
Many drugs in cardiology have strict infusion rates.
Some drugs, once infused too much in a short period of time, can cause serious side effects.
Nitroglycerin has the effect of dilating coronary arteries and reducing cardiac preload and afterload. It is routinely used in various types of angina pectoris, chronic heart failure and other diseases.
When the patient adjusts the pump speed of nitroglycerin by himself, the large dose of nitroglycerin in the body causes the blood vessels to dilate greatly, which temporarily disappears the contractility of the coronary arteries.
The intracoronary blood pressure is temporarily reduced, and the microcirculation is temporarily opened and closed, resulting in myocardial ischemia and hypoxia, which in turn induces the occurrence of malignant arrhythmia events.
At present, the most likely reason is that the patient adjusted the pump speed faster, which induced the occurrence of ventricular fibrillation.
However, this matter has to be confirmed by the nurse on duty.
…
Lu Chen came to the nurse station and found the nurse who was handling the medical order.
"His nitroglycerin pump ran out?"
When the nurse heard Lu Chen's words, her face became extremely ugly.
"I remember that the pump speed is obviously 3ml/h. It takes at least ten hours to run out! He, finished the pump in such a short time?"
"After running out, you didn't change your medicine on the way, right?" Lu Chen said in a deep voice.
"No, the medicine has never been changed!" the nurse said decisively.
It seems that the fact that the patient adjusts the pump speed privately is almost confirmed.
"He adjusted the speed himself." Lu Chen said.
"Huh? This..." The nurse shook her lips, looking like she was hesitant to speak.
"What's wrong?" Lu Chen asked in confusion.
Could it be that there are other hidden secrets in it?
"Hey, hasn't this patient been wanting to urinate all the time?" the nurse said after a pause, "I let him rest for a while, and he can get out of bed when his condition is stable. But this uncle insisted on asking for a specific time, I I just said casually, at least until the infusion pump is finished..."
The nurse on duty looked helpless.
She means that the patient should not be in a hurry. When the infusion pump is finished, he will not be able to get out of bed until tomorrow at least.
"So this is because the patient adjusted the infusion pump privately in order to get off the ground earlier?" Fan Zhiping whispered.
Lu Chen nodded: "I think Bacheng is like this, otherwise I can't explain the rapid use of this medicine."
Really solved the case!
At this time, a prompt popped up on Lu Chen's system panel.
"Congratulations, the system upgrade completion rate has increased! The current completion rate is 21%!"
After so long of hard work, Lu Chen's system completion rate has finally reached one-fifth!
The system prompt also confirmed Lu Chen's guess.
As the saying goes, a long illness becomes a doctor, but don’t think of yourself as a real doctor!
…
Back to the doctor's office.
Lu Chen told Yin Xinhua of his guess.
Yin Xinhua was silent for a long time, and adjusted the speed of the venous pump by himself?
This is too dramatic!
"I called the doctors in CCU and asked them to ask the patient's family members to help confirm it." Yin Xinhua immediately called CCU and told Dr. U of CC about Lu Chen's guess.
"The patient adjusted the pump speed of nitroglycerin by himself?" The CCU doctor on duty was surprised.
Such patients are still rare!
He hurriedly called the patient's family into the CCU.
"Mother-in-law, in the upstairs ward just now, the uncle adjusted the speed of nitroglycerin by himself?"
The mother-in-law is also a sincere person, and nodded: "He thought the medicine was too slow, so he adjusted it a little faster. He was hospitalized before, and he also adjusted it. Is there any problem?"
It's actually really fast!
The CCU doctor on duty immediately said: "Then do you know how much faster it is?"
Mother-in-law paused and frowned, "I don't know about this, but this medicine is taken very quickly and it will be over in a while. Do you... think there is a problem with this?"
"Mother-in-law, we are only suspicious for the time being, and we are not sure yet. I will ask you any questions."
The family grabbed the sleeve of the CCU doctor and said nervously, "Doctor, is my old man alright now?"
"Not very good, I haven't regained consciousness." The CCU doctor shook his head.
"Hey……"
…
Eight districts in the heart.
Got feedback from the CCU doctor, which basically confirmed the fact that the patient adjusted the pump speed privately.
Although in normal wards, nurses will visit each patient at regular intervals, but it is impossible to pay attention to the patient's status all the time.
This patient completely infused most of the nitroglycerin in half an hour.
This will definitely go wrong!
aside, Fan Zhiping couldn't help but sigh, this big hospital is really different!
Doctors are fierce, but patients are even fiercer!
…
After about half an hour.
The news was sent back from the CCU, the patient's rescue was invalid, and the clinical death was confirmed!
"The patient is gone."
Lu Chen and others sighed deeply, but they were not surprised.
When the ventricular fibrillation was not corrected in the ward, Lu Chen realized that the patient might be dying.
Sure enough, although he went to CCU to rescue him for so long, he still failed to rescue him.
"Take a warning." Yin Xinhua said solemnly, "We need to strengthen the monitoring of patients, and do a good job in the publicity and education of patients!"
Many patients rely on their own experience to do whatever they want.
This situation is the hardest to deal with!
Fan Zhiping said: "Your big hospital is fine, and many family members of patients dare not make trouble. If this kind of thing happens in our county hospital, the family members may have to bring someone to make trouble again."
In fact, patients have much more trust in doctors in large hospitals than in small hospitals!
This is why some people are reluctant to go to the local small hospital for treatment when they are sick, and they all want to go to the best tertiary hospitals for treatment.
This is also the thinking of most patients, who have a higher sense of trust in large hospitals.
But for small hospitals, they may doubt the level of doctors.
As long as there is a problem, I think the doctor must be at fault, and I like to make trouble.
Yin Xinhua frowned and said, "Why should you be afraid of these patients? If there is a problem, go to legal channels. If you need to pay, you will pay. If you shouldn't, you will not pay. Everything is subject to the court's decision!"
"Hey..." Fan Zhiping shook his head helplessly, "It's not like this in a small hospital, if someone makes trouble, if it's not particularly serious, the hospital will give some money to settle the matter in order to settle the matter. It's the hospital's fault, so pay more. , it's not the hospital's fault, so I'll pay less. But clinically, it's hard not to make mistakes!"
This is also the current status of small hospitals. Severely ill patients are afraid to be treated. Even if they have this level, they will try to push them to higher-level hospitals to avoid potential disputes.
(end of this chapter)