Chapter 328 When did the emergency department dare to admit patients? Xu Qiu dared!

At 11 o'clock in the evening, three hours after taking the medicine, Tao Changhan's temperature was completely stable.

This scene also shocked the doctors in the ICU.

A box of medicine that costs a few dollars has a better cooling effect than special antipyretics!

Before that, the intensive care unit was helpless.

At first, they gave moxifloxacin for anti-infection treatment, and the body temperature rose and fell repeatedly.

Later, it was upgraded to panipenem, which was effective but still not ideal.

Later, vancomycin, cold compresses, oral diclofenac, intramuscular injection of aminbarbital and other measures had little effect. Once the medicine was stopped, the temperature immediately rose again. In the end, the patient's heart rate rose instead, and the hypoxia became more serious.

In desperation, the ICU considered experimental drug withdrawal.

Who would have thought that it was a small naproxen that broke the deadlock?

…

The next day, the patient's spirit improved a lot compared to last night.

On the third and fourth days, there was no fever again, and Tao Changhan finally got off the ventilator smoothly, seeing the hope of recovery.

On the fourth night, after the evaluation, the tracheal tube was removed, and he was finally able to speak.

Tao Changhan held it in for a long time and scolded his daughter: "Can you say less?"

The second sentence: "Tell your aunt Zhang, aunt Wang, and aunt Liu not to come to see me, and refuse visits."

Tao said, "Do you mean Aunt You can?"

"..."

Tao Changhan exhaled a few times: "You go too."

After that, no matter how his daughter provoked him, he didn't say a word.

"If it was before, he would at least quarrel with me until the next morning. It turned out that he had mutism." Tao commented that today she could scold her father better, although it was a bit unfair.

The morning after the extubation, after a strict evaluation in the ICU, it was confirmed that the old man could be transferred out of the intensive care unit.

However, Director Jiang hesitated about which department to send him to.

He called Xu Qiu, and after a brief chat, he asked, "Respiratory Department or Neurosurgery?"

Xu Qiu: "Emergency Department."

If this answer came from other doctors, it would be ridiculous.

The emergency department has always been a transit station for patients. It only dares to send people away. When will it accept people?

But the emergency department of Linhai First Hospital is a special case. No department dares to snatch patients from Xu Qiu's territory...

"Received, but this patient's tumor is probably hard to find. I guess we need to follow up." Director Jiang shook his head and sighed.

The tumor index is not high. Even if it is a tumor, it must be in the early stage.

Imaging can see people clearly, but it is still limited to tiny lesions, and the detection rate is extremely low.

Even with the most advanced AI automatic recognition system, it is difficult to detect abnormal lesions.

Before, Tao Changhan was still a little feverish.

Now he is not feverish anymore. It is not too much to say "close follow-up" until the tumor grows to the extent that it can be detected by imaging examination.

Clinically, many people have lung nodules or small chocolate cysts, and doctors recommend follow-up.

As for why the problem is not dealt with in the early stage, the reason is also very simple.

Real clinical practice is not to kill every abnormality, but to haggle like the aunt in the vegetable market.

To put it bluntly, it is still the relationship between cost and benefit.

For Yan Ziqiang, a tumor that is extremely difficult to find in imaging, no one can tell whether the quality of life after surgery, radiotherapy and chemotherapy is better, or palliative treatment is more beneficial.

Once the expected difference in efficacy is not large, it is unnecessary and not in line with the principle of "maximizing patient benefits" to open the skull at great risk.

What's more, even if the skull is opened, whether the tumor can be found is another matter.

In the complex cranial cavity, it is obvious which is easier to find a sesame seed attached to the brain tissue or a cavity, and which is easier to find an egg in the skull after it grows up.

In addition, there are two other reasons.

First, the old man's metabolism is very slow, and this intracranial tumor may not continue to develop or recur.

Second, he has just been transferred out of the ICU, and his physical condition and other aspects are not suitable for tumor treatment. If you must focus on this small tumor, the risk is too high.

The industry's recognized leader, the Daxia Academy of Medical Sciences Cancer Hospital, as the strongest tumor hospital in the Union Medical College, treats patients like Yan Ziqiang, probably because he occupies the already tight medical resources, does not know how to check, let alone surgery.

…

After Yan Ziqiang was transferred to the emergency department, Xu Qiu gave a special medical order and asked the nursing department to take extra care.

Mainly beware of related diseases of the central nervous system, such as headaches, vomiting, vision-related problems, and diabetes insipidus caused by hypothalamic invasion, monitor urine volume, etc.

If it were another doctor, he would definitely say "examination is meaningless" and send him off.

But Xu Qiu is different.

He needs to make a decision between early surgery and letting him go. At this time, he has to figure out how much impact this tumor has on the patient and what kind of tumor it might be.

Benign tumors that are well differentiated and grow slowly, such as pituitary tumors, meningiomas, and embryonic residual tumors, are harmless.

However, if it is a primary malignant brain tumor, then a different treatment plan may be required.

A few days later, Xu Qiu's case spread throughout the hospital, and naproxen became a popular drug.

"It's outrageous. How can naproxen be used like this?"

"I just checked CNKI. Most papers on naproxen are in the industrial field, such as sewage treatment degradation and synthesis of rare earth-naproxen complexes.

Even if you search specifically in the clinical medicine section, naproxen is mostly used for anti-inflammatory and analgesic purposes for diseases such as arthritis!"

"If I hadn't specifically searched for the two keywords naproxen and cancer fever, I would never have thought that it could be associated with cancer fever!"

"That's because you don't know. Cancer fever is the strength of the oncology department. They usually identify it, and they must have naproxen as a solution."

...

At this time.

The doctors in the oncology department looked at the large group of Linhai First Hospital and silently chose to shut up.

In fact, even in the oncology department, they don't encounter many cancer fevers.

Those who can be sent to the oncology department are basically confirmed to have tumors.

Either surgical resection or various radiotherapy and chemotherapy treatments, the tumor itself is no longer protected, so how much cancer fever is there?

In addition.

The diagnostic criteria for cancer fever are very strict, with a total of six items. Finally, other causes of fever such as infection need to be excluded before confirmation, which is an exclusionary diagnosis.

That is, it is impossible to make a direct diagnosis. Cancer fever can only be considered after all possible causes of fever are excluded.

For most patients with malignant tumors, the culprit of fever is infection, and fever caused by the tumor itself is very rare.

Therefore, the practice of the oncology department is actually quite rough.