On the evening of the 20th, Gu Lin's "relatives" came. Chen Xia finally got a truce for a week, so she fell asleep early.

In the early morning, the phone in the living room rang desperately, and the ring is ringing~~~~~~~~~~

Chen Xia opened her eyes, jumped out of the bed, and ran outside to answer the phone without putting on her clothes.

Anyone who has been a doctor knows that when the phone rings in the middle of the night, there is definitely something wrong, and things will not be small. It often means that a patient in the department has a major problem or that major casualties occur in society.

Even if Chen Xia was a salted fish in his previous life, he just refused to work extra overtime. He still did his job well and never refused to give up on emergency surgery in the middle of the night.

This is not only a problem of medical ethics, but also... If Mrs. Yin knows that, she must be beaten to death...

"Hey, I'm Chen Xia, where are you?"

"Chen Laoshi, hurry up, the chickenpox patient suddenly fainted and was in shock and was rescued."

The phone call was from Wu Shaochen. The poor little doctor really lived and ate and lived in the emergency room 24 hours a day, staring at the patient. Whenever there was any situation, he immediately called and called.

"Okay, I'll be here soon. You should notify the doctor on duty in the internal medicine department immediately and ask Director Du to come if necessary."

After Chen Xia hung up the phone, she hurried to the room to change her clothes. Gu Lin was lying on the bed with a big word. The ringing of the phone did not wake her up, and this girl was not a pity for being a sleeping god.

Chen Xia covered her with a quilt and tiptoed away.

When he arrived at the emergency department, Director Du had just arrived.

As soon as the family saw several attending doctors arrive, they immediately knelt on the ground and cried loudly, "Doctor, help, what's wrong with my husband?"

Director Du and Chen Xia did not care about their families and urged repeatedly: "Wu Shaochen, report on the condition quickly."

"Director, Chen Laoshi, the patient said he wanted to get a bowel movement at around 2:20 in the morning, but suddenly fainted after coming out of the toilet. At that time, he was cold sweat all over, indifferent to his mind, and shortness of breathing.

At that time, I took a test and my body temperature was normal, my heart rate was 180, and BP105/80. I immediately gave the mask to inhale oxygen and opened two intravenous channels to replenish fluid to prevent shock.

Now the patient is confused and can't respond to his breathing, has a rapid breathing, and is wet and cold all over. His face mask is inhaled with pure oxygen. He urgently checked his blood oxygen saturation by 80%, his blood pressure is 65/53, and his heart rate is 163.

The whole body was covered with pectoris and blood was exposed to chickenpox. There was no miscellaneous diagnosis of the heart and lungs, abdominal distension, liver and spleen under the ribs, and intestinal rumbling sounds were not heard for two minutes."

Why did you suddenly get shocked?

Chen Xia was full of questions. This was really deadly. The previous diagnosis was not clear, but now the condition suddenly worsened.

The diagnosis cannot be confirmed and the cause cannot be found. Now we can only treat the symptoms according to the symptoms. This is a problem that can treat the symptoms but not the root cause for emergency treatment.

Director Du quickly said: "Take blood quickly, and immediately test biochemical and blood qi analysis, blood routine, urine routine, coagulation function, D2. Continue anti-shock treatment, Chen Xia, immediately ask the whole hospital for a large consultation, this patient is not simple."

Chen Xia knew that the patient was in shock, had pectoris and ecchymosis in the skin and mucosa, and was particularly flaky necrosis. This was either spreading intravascular coagulation or subcutaneous bleeding caused by severe liver disease.

No matter which case it is, it is enough to be fatal. The key is that the diagnosis is unclear. If the cause cannot be removed, any treatment will be ineffective and the patient's condition is progressing too quickly.

Chen Xia immediately called the dean Gu Wei, and then called the insider to the bosses of various departments one by one.

In less than 15 minutes, President Gu, Deputy Director Yang Jingye, Director of Respiratory Department Feng Runguang, Director of Cardiology and Vascular Department Yu Chuncheng, Director of the Department of Surgery Qiu Fangjue, Director of Gastroenterology Department Xuan Yongda, Director of Infectious Diseases Department Ren Yuanfei, and Director of the Medical Department Qian Jun all arrived.

The hospital-wide consultation has begun.

When Chen Xia reported on his condition, the emergency examination reports were also released one by one.

Chen Xia looked at the report sheet and couldn't help but take a breath, swallowed, and read out the value on the report sheet:

"The patient's blood is routine, with 25 white blood cells, 90% neutrophils, 73 platelet counts, 4.9 red blood cells, and 151 hemoglobin.

Blood biochemistry: 5309, 6721, total bilirubin 28.4, creatinine 402, urea nitrogen 15, uric acid 640, glucose and blood lipids are normal, creatine kinase 760, lactate dehydrogenase determination 8378, ?Clean creatine kinase-MB isoenzyme 180, amylase 402.

The D dimer is greater than 20,000, the plasma prothrombin time is greater than 240 seconds, and the blood coagulation time is greater than 240 seconds, all exceeding the maximum measured value."

When everyone heard Chen Xia’s emergency test report, they took a breath of air conditioning. A thought flashed through everyone’s mind was: “This patient is helpless, and all the indicators are seriously exceeding the standard.”

President Gu asked with a stern face: "Xuan Yongda, Qiu Fangjie, Ren Yuanfei, Du Guobiao, you either participate in the treatment throughout the whole process, or you attended the consultation before, let me tell you what you think.

Xuan Yongda's first answer was also not very good-looking:

"The patient currently seems to have severe explosive hepatitis and is in an acute liver failure state, but why does the patient have no jaundice? One of the clinical characteristics of acute liver failure is that jaundice deepens. This patient has been ill for 4 days and has no signs at all, such as jaundice, liver percussion, etc., so I misdiagnosed before, and I reviewed it."

President Gu waved his hand: "Now is not the time to review, and the request to save people, what do you think about Du Guobiao?"

Director Du thought for a while and said slowly:

"The pathophysiology of acute liver failure is mainly a disorder of synthesis of coagulation factors, while DIC is hyperfibrinolytic, so it shows that platelet progression decreases and fibronectin progression decreases.

When this patient's condition changed in the early morning of this morning, the D-dimer was significantly increased, but the jaundice was not obvious, and it was manifested as circulatory failure, which obviously supported diffuse intravascular coagulation and did not support acute liver failure."

Qiu Fangjue then added:

"The patient's shock should be caused by infection, that is, sepsis. Since it was not taken seriously before, sepsis was not diagnosed and treated in time, further worsening into severe sepsis.

Later, septic shock occurred, and now there are disseminated intravascular coagulation and multiple organ failure. As for where the infection is located, I think it will be acute severe pancreatitis?"

Yu Chuncheng made his fourth speech: "The D dimer in the patient is significantly increased, especially when the liver enzymes are not that high at the beginning, the increase is difficult to explain by infection.

Moreover, the patient has not found a tumor in his youth. Such a high clinical increase requires consideration of embolism. Combined with the patient's admission symptoms, abdominal pain, and the main complaint of stopping defecation, mesenteric artery embolism needs to be considered."

Vice President Yang was a little dissatisfied: "You have been consulting and exams. After a long time, I still don't know what exactly caused the patient to look like now? It's simply a dereliction of duty!"
Chapter completed!