Chapter 107 More serious than expected (July 2, 1/1)
Although the prompts on the status bar are very simple, the patient's condition is not "simple". Sun Lien concludes at a glance that the young Katu people who have taken ibuprofen are in very bad condition.
At first glance, his condition looked a bit like epilepsy. He suddenly started to have an illness, was confused, foamed at the mouth, and convulsed all over his body. These are all classic symptoms of epilepsy. Although there is no horn arch retraction, it can be concluded that it is epilepsy based on these four characteristics alone.
But he has other problems.
Although the patient is black, Sun Lien remembers it very clearly - when he was treated for a few hours ago, Mangten's lips were still bloody. Now... his lips are bruised and even darker than his skin. At the same time, Sun Lien saw the symptoms at first sight, and sweating all over his body.
It seems that it is not so much an epilepsy, but rather a heart and lung problem. Combined with the "sinus rhythm speed" in the status bar, the first diagnosis that came to Sun Lien's mind was "motor fainting".
Motility syncope is a type of syncope that may be induced by a variety of reasons, including vascular decompression, gravity shock, orthostatic hypotension, paroxysmal weakness, primary consciousness, etc. However, most motor syncopes last very short, usually ranging from a few seconds to dozens of seconds. Manten's syncope obviously has exceeded this time limit - this means that his syncope is likely to indicate more serious consequences.
The medical team now carries limited diagnostic equipment, and the results of blood pressure and heart rate will soon come out - blood pressure 132/62mmHg, heart rate 130 beats/min, breathing 24 beats/min.
Fortunately, they also brought an electrocardiogram this time, and the quick examination results were quite straightforward and clear - sinus rhythm was rapid and there were towering T waves.
The patient's V2-5 lead T wave has obvious "tent-like" characteristics, and the peak of the T wave becomes sharp, and the ascending limbs and descending limbs are symmetrical. This is a significant electrocardiogram characteristic of hyperkalemia.
"What was he doing before he fainted?" Sun Lien called Felipe to translate and quickly asked about his medical history. Having this hyperkalemia electrocardiogram characteristic means that although the patient currently has hyperkalemia, the high time is not long. If it is severe hyperkalemia, as the blood potassium continues to rise, the patient's T waves, P waves and QRS voltages will continue to drop - instead, it will not show such an obvious and typical "tent-like" electrocardiogram.
"They are training and preparing to participate in the London Marathon next April." Felipe quickly translated the opponent's answer and added, "Monten is the main player. He was conducting his eighth 1,000-meter sprint training today before he fainted."
Sun Lien frowned and looked at Munden, who was still twitching. His condition was really not good. And the problem was very difficult - hyperkalemia has a great possibility of acute myocardial injury, thereby reducing the heart's blood loss function. But this is not consistent with his heart rate and blood pressure. Now this season is the most intense training, and there are certainly the possibility of heatstroke, but the symptoms of heatstroke should be hypokalemia, which is not consistent with the electrocardiogram.
"Have he had dinner today?" Sun Lien looked at Mangten's thin long-distance runner's body and suddenly had a guess, "When will I have dinner?"
"I ate this morning...I ate a piece of chicken breast," Felipe translated. "He has recently had a high body fat rate, so the coach arranged a fat loss plan for him."
"A little high? How much is that? How long has he been taking a fat-loss meal?" Sun Lien looked at the lean young man and it was hard to believe that his body fat rate was actually high.
"11%, their coach's requirement is that the body fat rate must be reduced to 9% in April," Felipe said. "This recipe for eating only one piece of chicken breast in the morning has lasted about five days."
Sun Lien did not continue to ask questions, but took out the blood sugar meter and blood sugar test strips from his medicine box. After picking a little blood from Manteng's fingertips, he quickly got an important parameter from this small instrument.
"The blood sugar content of random fingers is 2.4mmol/L." Sun Lien looked at the data, muttered a few words in a low voice, then stood up, flipped through the medicine box brought by the medical team for a while, then raised his voice and asked, "Teacher Liu, have we brought 50 sugar?"
"Where is this?" Liu Tangchun took out glucose from a bag, "Is it severe hypoglycemia?"
"It's only 2.4, it's strange if you don't get dizzy." Sun Lien took the plastic bottle containing 50% glucose concentration, skillfully pulled out a syringe, and drew 40ml of liquid from it. "I'll give him some sugar first to see what it is."
40 ml of a 50% concentration glucose solution was slowly pushed into Manteng's venous blood vessels. After completing the static push, Liu Tangchun handed over another bag of 10% glucose and started intravenous drip maintenance.
Everyone, including the medical staff, looked nervously at Manten, who was twitching on the ground. After about twenty minutes, his breathing frequency slightly decreased a little. After almost half of the first bag of 10% glucose input, the young man opened his eyes.
All the locals cheered, and only an elderly woman was kneeling beside Munden, covering her mouth and crying. This was his mother, a widow who was only 37 years old but looked at least in her 50s.
Seeing the patient gradually awakening, Sun Lien was quite happy at first. However, the status bar seemed to be a Chinese cat hiding in a dark corner, waiting to push the objects on the table to the ground, jumping out to show off a wave of presence.
The "unconsciousness" on Manteng's head had just disappeared, and then it added a "irritable" state.
At the same time, Manteng's breathing is still rapid, and the breathing frequency of a normal person is about 16 to 18 times per minute. When he is in a coma, Manteng's breathing frequency is as high as 27 times per minute, and now he is about 25 times per minute after he wakes up. At the same time, his lips are pale and he makes two dry retching from time to time.
What's even worse is that his lower limb muscle tremors still did not improve at all. His heart rate also remained at 140 beats/min.
Liu Tangchun frowned, and Sun Lien fell into deep thought together.
"We can't check blood here, there is no equipment." Liu Tangchun broke the calm first. He told Felipe, "This patient's condition is quite serious. He should not only faint because of hypoglycemia - there may be other serious symptoms, but the specific problem cannot be determined. It is necessary to go to the camp for further examination to clarify."
Felipe translated Munten's mother, and then Sun Lien continued to add, "The treatment process may take a long time - we now initially suspect that his kidneys may be damaged and his heart may be damaged, but the specific situation depends on the test results."
Sun Lien is not talking about running trains to scare people. Just by relying on the towering T waves on the electrocardiogram and the "tent shape" he can confirm that the patient is currently suffering from hyperkalemia. It is likely that due to a lot of exercise, muscle damage was caused - perhaps even rhabdomyolysis.
Hypoglycemia encephalopathy leads to motor syncope and rhabdomyolysis, which is Sun Lien's diagnosis.
Chapter completed!