I Can See Health

Chapter 299: Broken atropine

Chapter 299 Breaking Atropine

Wang Xiaodong stood up immediately and ran out of the office.

Lu Chen saw this and followed closely.

Cheng Peng and Xiao Lin came to the emergency department for the first time, when did they see such a battle!

The two were stunned for a moment, and then ran out with Lu Chen's footsteps.

…

Lu Chen followed Wang Xiaodong to the emergency room of the emergency ward.

"What is the patient's condition?"

As soon as he entered the emergency room, Wang Xiaodong asked aloud.

The nurse next to the ward immediately said, "A couple each drank a bottle of dichlorvos, transferred from the hospital below!"

At this time, Lu Chen also came to the hospital bed.

At the moment, the woman's health is 36, while the man's health is 52.

In addition, there was a medical record of a local hospital by the bedside, and Lu Chen quickly took out the medical record.

All the information of the two patients also appeared in front of Lu Chen's eyes.

About an hour ago, the two patients were found unconscious at home.

There are two empty dichlorvos bottles beside them.

Dichlorvos (DDVP) is an organic compound belonging to the class of organophosphorus pesticides.

The family immediately dialed 120 and went to the local hospital for gastric lavage, tracheal intubation and ventilator-assisted ventilation, and treatment with iodine phosphine 1.5g and atropine.

The man regained consciousness after intubation, but was still agitated.

The woman suffered sudden respiratory and cardiac arrest on the way, and she recovered after giving chest compressions for about 10 minutes.

Because he needed to use blood perfusion and other treatment measures, he was transferred to the emergency department of Jinghua Second Hospital for further treatment.

…

Lu Chen immediately told Wang Xiaodong the medical history information he had learned.

Wang Xiaodong nodded, and immediately stepped forward to conduct a preliminary physical examination for the two in turn.

Both were intubated.

The man's consciousness is awake, but the woman is still in a coma.

"Nurse, immediately give the patient an emergency blood test, a routine set, in addition to blood gas analysis and cholinesterase!" Wang Xiaodong ordered.

"Received!" Gong Nannan nodded.

At this time, the man's consciousness recovered, but his mood was particularly irritable.

"Men's lungs have obvious wet rales!" Wang Xiaodong frowned, "Immediately use a long toning and atropine."

"Received, one intramuscular injection of longtonin and one intravenous bolus of atropine."

"Another intravenous access was opened, iodophosphine was hung up, and both medicinal charcoal and mannitol were used."

…

On the other hand, the situation of women is much heavier than that of men!

Not only did she not wake up, but her vital signs were extremely unstable, her heart rate was 60 beats/min, and her blood pressure was 85/54mmHg.

"Both of them have to prepare for blood perfusion!"

Although men's condition is relatively better, it cannot avoid the occurrence of delayed polyneuropathy!

Wang Xiaodong stared at the two patients with a pair of eyes, daring not to relax in the slightest!

The rescue is proceeding in an orderly manner.

…

With the assistance of Lu Chen, Wang Xiaodong's rescue process went smoothly.

This kind of rescue is not the more people the better, but too many people will affect the efficiency.

So Cheng Peng and Xiao Lin stood aside, staring blankly at Lu Chen and Wang Xiaodong's rescue.

Wang Xiaodong was their superior doctor, so he had nothing to say.

But as a newcomer to the emergency department, how could Lu Chen be so familiar with the rescue procedure?

Cheng Peng was not surprised, but Xiao Lin was very surprised.

…

At this moment, Lu Chen noticed that the female patient's heart rate was slowing down!

"Brother Wang, look at this female patient..."

Wang Xiaodong was startled and looked at the ECG monitor of the female patient.

Her heart rate went from 60 to 50, and finally to 45.

In Lu Chen's eyes, her HP is also slowly decreasing, from 36 before to 32!

Wang Xiaodong said solemnly: "Immediately give 250ml of sodium bicarbonate intravenously, and atropine 5mg intravenously!"

The effect of atropine is very fast. Basically, after the static push, the heart rate will rise.

But this female patient, after the intravenous injection of atropine, the patient's heart rate did not rise significantly!

At this time, the blood oxygen saturation of the female patient also continued to drop, only 80%!

"Ready to board!"

Wang Xiaodong immediately placed a hemofiltration catheter.

However, what no one thought was that after the female patient got on the plane, her heart rate continued to drop progressively!

"Grass, I can't keep it up!" Wang Xiaodong cursed to himself.

…

"Heart stopped!"

Lu Chen suddenly shouted, he kept paying attention to the ECG monitor by the bedside.

He was the closest to the hospital bed and immediately stepped forward to perform chest compressions.

And Wang Xiaodong kept urging the nurse: "Keep pushing atropine, keep pushing!"

Atropine 5mg, 5mg, 5mg, 5mg IV...

And Lu Chen pressed on the bedside for about ten minutes, the patient's heart rate returned to sinus, and the blood pressure rose to 101/90mmHg.

"Continue to push atropine, and then give 4g of iodophosphine to be given slowly intravenously." Wang Xiaodong instructed.

Lu Chen also breathed a sigh of relief, but a string was still tight in his heart, and he didn't dare to relax.

This female patient is not only poisoned by organophosphorus pesticides, but also has cardiac arrest!

The treatment is much more complicated than that of the male patient!

"Adjust the ventilator parameters, the Peep is increased to 7, the frequency is adjusted to 17, and the tidal volume is 550ml." Wang Xiaodong began to adjust the ventilator.

The purpose of is to increase the minute ventilation and promote the discharge of carbon dioxide, but the dead space will increase, which is not conducive to the discharge of carbon dioxide, because the exhalation time is sacrificed.

At this time, the laboratory indicators for the patient's emergency investigation came out.

Cholinesterase in both men and women was less than the minimum value, women's liver function was 1010 with astragalus, 999 with glutathione, and 11.1 in lactic acid. Other tests for men and women were normal.

Wang Xiaodong said: "Let's do it for now! There is a blood filter **** and it can be stabilized under the condition of high replacement."

At this time, the patient's blood oxygen saturation was always 100%.

Everyone present breathed a sigh of relief.

…

3 hours after the female patient was on the machine.

Blood gas analysis clock, lactate dropped to 5.0, Ph was stable at 7.17, carbon dioxide partial pressure dropped to 56!

Cholinesterase was retested every hour, all of which were less than the minimum value, and the patient’s heart rate had been stable at around 120.

A great deal!

"It feels like the patient is coming back!"

Lu Chen was standing beside the patient's bed, happy.

Suddenly, he saw that the patient's blood pressure and blood oxygen saturation could not be measured!

Lu Chen's complexion changed immediately, and he immediately auscultated the patient's lungs, and the moist rales increased.

Does the patient's heart rate not drop?

But blood pressure and blood oxygen saturation cannot be measured first?

Wang Xiaodong has also been paying attention to the changes in the patient's condition. He noticed the changes in the patient's condition at the first time, and immediately ordered.

"Norepinephrine 18mg, micro pump, 5ml first!"

is invalid!

Instruct 5mg of atropine to push statically! invalid!

Instruct 10mg atropine to push! invalid!

Instruct 5mg of atropine to push statically! invalid!

All the treatment measures are ineffective!

Improve blood gas, lactate rises to 11, carbon dioxide partial pressure rises to 90mmhg again, ph7.06!

with void, void, void.

Wang Xiaodong continued to issue doctor's orders, 2mg long-term care for tranquility!

After about 3 minutes, the patient's blood pressure can be measured!

50/30mmHg, blood oxygen saturation 100%.

Blood oxygen saturation is a normal ripple, proven to be real and effective!