I Can See Health: Chapter 39 Stuck in phlegm!
Chapter 39 Stuck in phlegm!
It is humility for all rights to be Lu Chen.
But after this little episode, everyone had a good first impression of Lu Chen.
Department is actually a small society. There may be many dirty things among the leaders, but the doctors at the lower level are often very harmonious, and everyone appreciates people with strong abilities.
At this moment, Liu Mei suddenly walked into the ward quickly, her face full of anxiety.
"Doctor Sun, the patient in bed 10 is sick again, go and see him!"
10 beds again!
Lu Chen frowned.
This patient has suffered from heart failure once this morning, is he suffering from heart failure again now?
Sun Guoguo immediately stopped the ward round when he heard the words, and led the crowd to the 10th hospital bed.
Sure enough, it was the same as the situation in the morning.
The patient was sitting on the bed, gasping for breath, his face was pale, and his eyes had no expression.
As soon as he approached the hospital bed, Lu Chen could hear the sound of phlegm coming from the patient's throat.
The sound of phlegm is very obvious, and it can be imagined that the bronchi of the patient are all thick and sticky phlegm.
This is mainly due to pulmonary edema caused by heart failure, causing lung infection.
Lu Chen glanced at the ECG monitor beside the bed.
The blood pressure saturation is only 85%, the breathing reaches 42 beats/min, the heart rate is 125 beats/min, the blood pressure is not very high, only 140/76mmHg.
But at this time, a drop in blood pressure is not a good thing!
If the blood pressure drops too much, even if it is not less than 90/60mmHg, it also indicates the failure of the patient's heart pump function, which is often referred to as cardiogenic shock.
If a patient with heart failure can't maintain blood pressure, then the patient will be hard to save!
"Heart failure has committed again! Liu Mei, immediately push two furosemide and **** phlegm to the patient at the same time!"
Sun Guoguo immediately ordered.
"receive."
Liu Mei has a serious expression, has prepared the furosemide injection, and pushes it directly into the patient's indwelling needle.
At the same time, another nurse quickly brought a sputum suction device, ready to **** sputum from the patient.
When a person is awake, it is very uncomfortable to **** phlegm.
However, the patient's current volume of sputum is too much to be coughed out, and it is completely blocked in the trachea, which will not only reduce the oxygen saturation, but also risk suffocation at any time.
"Junior Sister Jiang, please contact the CCU (Cardiac Intensive Care Unit) on the fourth floor, we may have patients to be transferred!"
Sun Guoguo said to Jiang Qingyan beside him.
Jiang Qingyan nodded and ran out of the ward immediately.
The patient's family, the old woman, was holding Sun Guoguo's hand at this time.
"Dr. Sun, we don't go to CCU, we are poor families, we don't have much money, and my son can't earn a lot of money by working outside, so he can't go to CCU!"
The old woman grabbed Sun Guoguo tightly, like she was holding on to the last straw.
"I used to treat you well with Dr. Sun every time. We will treat it here. If we don't transfer it out, we must not transfer it to CCU. It is 10,000 yuan a day there, and we can't afford it!"
Sun Guoguo sighed and said helplessly: "Mother-in-law, this time the situation is different. Dad's oxygen saturation is only 85%."
"If you don't use a ventilator, there is a risk of suffocation at any time, or even sudden death, but our ordinary ward does not have a ventilator, so we have to go to the CCU!"
The old woman shook her head desperately, an old face full of wrinkles, full of sadness and despair.
"Doctor Sun, even if this old lady begs you, we really have no money!"
Sun Guoguo pursed her lips and sighed slightly in her heart.
"Doctor Qu, you go to contact the patient's son, who is critically ill on the phone! And it is recommended that he be transferred to CCU for treatment."
"it is good!"
Dr. Qu, as a senior doctor in charge, is better at communicating with patients. It is right to leave things like reporting critical illnesses and communicating their illnesses to her.
At this time, the nurse has finished sucking phlegm.
"Dr. Sun, the patient's phlegm is deep in the bronchus, and I can only **** out a little of the phlegm from the throat."
"Suck it again, if it doesn't work, forget it!" Sun Guoguo continued.
The sputum of the elderly is very viscous, and after several diuretics have been pushed, the sputum is even more viscous.
Looking at the ECG monitor beside the bed, the blood oxygen saturation has been hovering around 85%.
The blood oxygen saturation of normal people should be above 96%, and if it is lower than this index, it is necessary to consider whether there is organic disease.
It can’t go on like this!
Sun Guoguo was a little anxious. If the ventilator is not used immediately, the patient's condition is likely to get worse and worse.
When the patient has too much sputum, the effect of the non-invasive ventilator is not good, and it may be necessary to go directly to the invasive ventilator.
"Liu Mei, push another half cydilan and one more gasp!"
"receive."
Cedilan is a cardiac acupuncture and can be used as appropriate when diuretics and vasodilators are ineffective in treating heart failure.
The use of cedilan starts with half a stick each time.
"Dr. Sun, the sputum cannot be sucked out, and the patient feels very uncomfortable when he is awake." Another nurse said.
"Then don't **** for now." Sun Guoguo said, "Put the sputum suction device beside the bed, don't take it away, keep it ready for use."
"it is good."
The nurse nodded, and at the same time cleaned up the used suction tube and replaced it with a clean suction tube for use.
At this time, the training doctor Qu Yao returned to the ward and whispered beside Sun Guoguo: "Dr. Sun, I have communicated with the family by phone. His son understands the condition, but refuses to be transferred to the CCU."
Sun Guoguo frowned.
This is true, there is no dutiful son in front of the bed for a long time!
"I'll call CCU, Junior Sister Ke, you can borrow a simple non-invasive ventilator from them." Sun Guoguo turned around and said to Ke Yue.
"Okay, Senior Sister."
There is no ventilator in the general ward of the Department of Cardiology, only in the intensive care unit.
Ke Yue received Sun Guoguo's instructions and immediately went to the CCU on the 4th floor to borrow a non-invasive ventilator.
"Dong Hao, go and print the informed consent and critical illness notice for refusing to be transferred to CCU."
"receive."
Even if it is an old patient, even if the two old people are very good, there is still some communication.
Any medical behavior or examination that is refused by patients and their family members needs to be repeatedly informed of their risks and signed an informed consent form!
This is the most important way for doctors to protect themselves!
Because Lu Chen had just entered the department and was not very familiar with the affairs of the department, Sun Guoguo did not send him any work.
…
After about five minutes of medication.
The patient's symptoms of dyspnea did not improve in any way.
At this moment, Lu Chen suddenly noticed that on the ECG monitor, the patient's blood oxygen saturation suddenly dropped from 85% to 80%, and after a second it jumped to 76%!
Lu Chen immediately felt that something was wrong!
When looked at the patient on the bed, he found that the old man rolled his eyes upwards, his throat seemed to be blocked by something, and his breathing suddenly became extremely difficult.
"Oops, it's stuck with phlegm!"
Lu Chen was shocked.
Sun Guoguo, who was on the side, also noticed something wrong with the patient at the first time, and she immediately shouted loudly.
"Liu Mei, **** phlegm!"
At the same time, Lu Chen immediately ran to the bedside and assisted Liu Mei to open the patient's mouth.
(end of this chapter)