Chapter 1737 Fall and Shock Are in Front (Leader LUCKY Bread Tree Plus 2)

"What's the matter?" Zheng Ren asked.

"There is a female student who fell while going down the stairs." Su Yun's expression was a little weird, but he spoke very fast, "Come to the hospital for examination, and found that the lower right lung pneumonia is accompanied by a large amount of fluid in the right pleural cavity."

"In Fang Lin's side?" Zheng Ren asked.

Su Yun glanced at Zheng Ren as he dropped the car, and asked, "Did I tell you that you fell while going down the stairs?"

"..."

"Cranial brain injury, left temporal bone fracture with gas accumulation, traumatic shock, occiput... This is not important." Su Yundao, "Fang Lin went to the consultation and felt something was wrong, give me a call for consultation."

"How did you think about it?"

"A lot of pleural effusion, a 19-year-old girl, what would you consider?" Su Yun asked.

"Tuberculosis pleurisy, the first impression is this." Zheng Ren said: "But if you consider the fall, which also caused a fracture of the left temporal bone and traumatic shock, it cannot be ruled out that she fell because of shock."

"Shock, accompanied by a large amount of pleural effusion, I also think so." Su Yun said.

"Take a look and then talk." Zheng Ren pondered the patient's condition, and his hands unconsciously returned to the state they were in when watching the movie.

"Boss, if you maintain this state on the road, you will look very handsome, stupid and handsome." Su Yun said.

"Shock, pleural effusion... What if it doesn't matter? Just pure pleural effusion?" Zheng Ren ignored what he said, but whispered to himself.

"If that's the case, it's easy."

"By the way, Fang Lin saw the patient, what did he think about it?"

"The patient's left temporal bone fracture was accompanied by gas accumulation, but the patient's right calf had a large area of ​​bruising, which he felt like a vascular embolism." Su Yundao.

"Well, Fang Lin is not bad." Zheng Ren said, "It should be uncommon for a thoracic department to consider thrombosis at a glance. The patient may have pulmonary embolism...maybe...no, it should be pulmonary embolism!"

"Boss, pulmonary embolism is very common, okay!" Su Yun said contemptuously: "It's just that this patient's situation is special, so Fang Lin called me for a consultation while calling for an echocardiogram."

"I think Fang Lin's diagnosis is well-founded." Zheng Ren outlined the patient's situation in his mind and said, "The strangest thing is that young students will have a lot of pleural effusion, which is rare. Falls, coma, and falls are common."

"Well, with the bruises on his legs, I think Fang Lin's logical process is the same."

"Yes." Zheng Ren said: "It's okay, after the examination, it is estimated that we have not returned to the hospital before we have confirmed the diagnosis. Maybe even the thrombolytic drugs have been used..."

Saying that, Zheng Ren was startled.

Intracerebral hemorrhage, thrombolysis, these two treatments are completely different.

If low molecular weight heparin sodium plus warfarin is used for thrombolysis, will there be massive bleeding from left temporal bone fracture? Eventually lead to brain herniation?

But if left untreated, blood clots alone can be fatal!

"When will the car arrive?" Zheng Ren asked.

"3 minutes."

"Tell Xiao Feng to go to the hospital quickly." Zheng Ren's tone immediately became anxious.

Su Yun was startled.

"Fang Lin, are you with the patient?"

"Call to urge! Do an echocardiogram right away!" Zheng Ren spoke in a loud voice, "If there is any problem, consult the whole hospital immediately, including the Department of Vascular Medicine and the Department of Cardiology."

"I think it may be pulmonary embolism, accompanied by syncope, and the situation is very urgent. Anticoagulants cannot be used in large quantities, and emergency thrombectomy is required." Zheng Rendao.

Everything that should be explained has been explained, and Zheng Ren hung up the phone.

Su Yun also finished the phone call. He saw Zheng Ren's hurried expression and asked, "Boss, will you make a fuss?"

"Fang Lin's intuition is right!" Zheng Ren said firmly: "The fracture of the left temporal bone is difficult to cause a large area of ​​bruising on the right calf, which is caused by venous thrombosis in the lower extremity."

"So young..."

"Contraceptive pills may cause venous thrombosis in the lower extremities." Zheng Ren said: "Go back quickly, you and Fang Lin keep in touch."

Saying that, a car stopped not far from the road with double flashes, and at the same time Su Yun's cell phone rang.

Su Yun glanced at the license plate number and walked over.

When he got in the car, Zheng Ren heard the task prompt tone of "Ding Dong".

[Urgent Task: Misdiagnosis.

Mission content: Many times, people's attention will be on the "main" disease, especially bleeding. But the underlying disease is more serious, even fatal. Please rescue a patient with pulmonary embolism in time.

Task time: 3 hours.

Mission reward: 10,000 experience points and 1,000 skill points. 】

Uh... Zheng Ren hasn't seen such a meager quest for a long time.

However, the appearance of this task, the biggest significance is to affirm the guess just now. Whether it was Zheng Ren, Su Yun or Fang Lin's guesses, they were all right.

It's a pulmonary embolism! rather than a temporal bone fracture complicated by gas accumulation.

So-called traumatic shock, is also a misdiagnosis. Symptoms of shock occurred because of a pulmonary embolism. Trauma, that comes later.

Various emboli from the systemic circulation block the pulmonary artery and its branches, causing a clinicopathophysiological syndrome of pulmonary circulation disorders.

The most common form of pulmonary embolism is a thrombus, and pulmonary embolism caused by a thrombus is also called pulmonary thromboembolism.

The patient suddenly developed unexplained collapse, pale complexion, cold sweat, dyspnea, chest pain, cough, etc., and had symptoms of cerebral hypoxia such as extreme anxiety, fatigue, nausea, convulsions and coma.

Transient cerebral hypoxia, leading to coma, will cause a fall.

A large amount of fluid in the right pleural cavity indicates that the right pulmonary artery is blocked, which is an acute pulmonary embolism.

The patient's oxygen saturation is now...

Zheng Ren thought about it, and simply entered the system space and clicked to buy surgery training time.

The operating room of the system rose from the ground, and Zheng Ren went in directly.

The experimental subjects lay on the operating table honestly, and diagnosed - pulmonary embolism, deep vein thrombosis in both lower extremities, etc.

Relative to pulmonary embolism, other diagnoses are really under-mentioned.

Zheng Ren glanced at the ECG monitor of the subject, the blood oxygen saturation was 85%, which was a very dangerous value.

Let's do the surgery, there is no other way, Zheng Ren took a deep breath and started the thrombectomy.

Generally speaking, after the deep vein thrombosis falls off, it flows with the blood flow to the right atrium, then to the right ventricle, and then to the pulmonary artery, which will block the branch of the pulmonary artery or the larger pulmonary artery.

It's a form.

In addition, the small emboli of the lower extremities continue to fall off, resulting in continuous embolism of the small pulmonary arteries, and finally leading to large emboli.

Another reason is that the emboli formed by the right heart system fall off and flow to the pulmonary artery, leading to pulmonary embolism.

The patient in front of me was caused by deep vein thrombosis in the lower extremities.

Zheng Ren still has quite a bit of confidence in the thrombectomy.

However... After the thrombectomy catheter was passed through the inferior vena cava to the right atrium and right ventricle, he was stunned.