Chapter 324 Weird recurring fever!

"The patient I mentioned to you just now is the old man's daughter." Director Jiang explained.

Xu Qiu nodded to the woman as a greeting.

"I feel relieved now that Dr. Xu is here. My father can be saved!"

The woman breathed a long sigh of relief. At this moment, she felt relieved.

She followed the two men, step by step, sometimes fast and sometimes slow, her throat moved a few times, and she was about to say something but stopped.

Xu Qiu glanced at him and said, "What's the matter?"

"Doctor Xu, I... I just gave birth to a child in our hospital last month..."

"Congratulations."

"No, no, I mean, she was sleeping a few days ago, so I took a magnifying glass and found a short golden hair under her armpit. Is that okay?"

Xu Qiu shook his head, "No big deal."

"Also, there is a very small mole on her arm, which can only be seen with a magnifying glass. Do you think it will get worse? Is it possible to be cancer?"

"Don't worry too much."

"But when I looked with a magnifying glass, there was a thin blood thread on her eyelid. What should I do?"

Xu Qiu was silent for a few seconds, "Throw away your magnifying glass."

...

When he arrived at the door of the ICU, Director Jiang's face turned red.

He almost laughed out loud.

To be honest, the doctor's advice to throw away the magnifying glass is indeed the best treatment for the mother's excessive anxiety...

It's just funny no matter how you listen to it.

The key is that Xu Qiu was not joking, but gave this treatment plan seriously and with reason.

"The patient's condition is like this, and this is a more detailed examination report..."

Director Jiang took the case sent by the nurse and passed it to Xu Qiu with both hands.

Xu Qiu looked through it while walking.

The patient's name is Tao Changhan, and he is 66 years old this year.

At first, he was weak and had a poor appetite, and the first doctor to see him was a gastroenterologist.

After a long examination, it was not chronic gastritis, heart failure, or abnormal liver function, which are common causes of illness in the elderly.

Later, a CT scan was done and pneumonia was found. He was transferred to the respiratory surgery department and diagnosed.

Typical pneumonia is cough, sputum, and fever, but Tao Changhan happened to be atypical pneumonia.

At first, the family thought it was just indigestion, so they went to the pharmacy to get some digestive drugs.

It was not until later that it didn't work that they came to Linhai First Hospital, and then they found that it was actually pneumonia.

The price of wasting precious treatment time was that the old man's pneumonia progressed to severe pneumonia.

On the day of admission, the old man's condition worsened acutely, with rapid breathing and extreme hypoxia. In the end, he even used a ventilator and almost went into shock.

After stabilizing a little, the respiratory department immediately transferred the patient to the ICU.

There are two things to be thankful for during the transfer process.

First, the old man came to the ICU smoothly. Here, as long as he has money, he will not die easily.

Second, the family members did not entangle "He was fine at home, why did he get worse when he came to the hospital."

"Doctor Xu, my father is okay, he should not be in danger of life, right?" The woman turned her attention back at this time.

"The mortality rate of severe pneumonia in the elderly over 65 years old is about 40%."

"Ah?!"

The woman's pupils contracted instantly, and she felt as if her neck was being strangled and she had difficulty breathing.

"But don't worry, the ICU has dealt with many cases of severe pneumonia. Among the severe cases, his is still relatively mild, and there is still hope." Xu Qiu comforted.

Sure enough, the patient's mood immediately rose a lot.

Excellent doctors can often control the balance between "unrealistic expectations" and "groundless panic", and easily grasp the mentality of patients and their families.

Director Jiang nodded.

Neither letting the family members have too high expectations nor scaring them is the art of communication that many doctors have to learn for a lifetime.

And Xu Qiu has already mastered it.

…

After reading the case, Xu Qiu finally understood why Director Jiang made a special trip to block him at the door.

This patient had a very good treatment effect in the first 72 hours after entering the ICU.

Clinically, many doctors have summarized many golden times.

For example, Huang Jia's rescue time for acute infarction was two hours.

Cerebral infarction is 3 to 4.5 hours.

The golden time for cardiac arrest is four minutes, tracheal foreign body is 4 to 10 minutes, and the golden time for finger amputation in hand surgery is six hours.

There is also a golden 72 hours after surgery.

This is the time when postoperative complications are most likely to occur. As long as you get through the first three days, the chances of subsequent infection and bleeding will be much smaller, and basically the operation will be safely passed.

And severe pneumonia here in the ICU also has a golden three days.

The treatment effect is good in three days, and it can be quickly controlled.

As long as there is no recurrence, the probability of patient recovery is greater than 80%.

After three days of treatment, Tao Changhan used broad-spectrum antibiotics, his infection index decreased, his consciousness became clearer, and the chest X-ray sent by the imaging department also showed that his pneumonia had improved.

But the problem arose. In the next five or six days, as all the indicators of the old man were significantly improved, and everyone was waiting for him to be transferred from the ICU to the general ward, Tao Changhan began to have repeated fevers!

Upon examination, the pneumonia did not worsen, and it was still improving compared to before.

In addition, the patient's fever was not high, only between 37.9 and 38.3.

However, this temperature is fatal for an old man lying in the ICU with a trachea.

Tao Changhan's spirit was visibly weakened. Although various indicators were reporting good news, the patient's actual performance was not optimistic.

Director Jiang said with a headache: "We have also used antipyretics in the past few days.

This fever is also strange.

After taking the medicine, the temperature immediately dropped, and the patient's spirit and energy returned immediately.

As soon as the medicine was stopped, the temperature rose again, and the patient's consciousness began to blur."

The doctor in charge said: "On the fourth day, we were planning to take him offline, but he started to have a fever and his respiratory indicators dropped again. I had to reconnect him quickly."

"What about the physical examination?"

"We checked all of them. No abnormalities were found in the chest, abdomen, lower limbs, central nervous system, urinary system, skin, pupils, face, etc."

The ICU is different from other departments.

For example, in the respiratory department, one doctor is responsible for more than a dozen patients, and there are only one or two nurses on duty at night in a ward.

Critical care is different. Take Linhai First Hospital as an example. The ratio of ICU doctors to beds is 0.8:1.

Assuming there are ten beds and ten patients, there must be at least eight doctors. Basically, the number of doctors and patients is matched, with a one-to-one special care.

Therefore, ICU doctors often have a more detailed understanding of patients and can recite medical records by heart.

"Yes."

Xu Qiu nodded.

After arriving in the ward, he conducted another examination.

Indeed, as the attending doctor said, there are no abnormal manifestations worth paying attention to in the places that can be seen by the naked eye and the places that can be touched by the examination.

Things like increased spinal curvature and atrophy of intervertebral discs are all degenerative diseases of the elderly, commonly known as old age, and have no diagnostic significance.

"What's the problem..." Xu Qiu glanced at the old man with the tube inserted and thought.