Chapter 484: Critical! Blood oxygen saturation drops sharply!

"A real man!"

"There are not many people who can do this job. Brother, we respect you as a man!"

Several doctors who knew the inside story gave a thumbs up.

If you put yourself in someone else's shoes, they would never be able to do this.

Xu Qiu patted the man on the shoulder and said: "The patient's current situation is very unoptimistic. He may be admitted to the ICU at any time. The cost will be high, and the mortality rate is not low. Contact the patient's parents as soon as possible."

"She no longer has her parents. In her third year of junior high school, several families in her village were spraying pesticides together. As a result, the wind changed and more than a dozen people were poisoned. Her parents failed to save her... We had been together for two years by then. , I don’t want my parents to raise her, otherwise what would she become, a child bride?

So I study and make money at the same time.

I didn't ask for a penny more from my family, so I rented a small house for her by doing odd jobs, which supported her through high school, passed the entrance examination, and then went to graduate school. "

Having said this, the smile on the man's face became increasingly bitter.

It is precisely because of this that he only went to college in the end, and there was an educational gap between him and his girlfriend. In those years, he was often ridiculed by his girlfriend who was a graduate student.

Many times when we break up, the other party will use "I can like you as a college student, why don't you still stick to me" as a trump card.

Later, his girlfriend's temper suddenly improved, her personality became more well-behaved, and she became more and more obedient to him as if she had become a different person. Only then did he finally make up his mind to get married. After his parents helped him with more than one million yuan, he settled down in Linhai City. .

Now think about it carefully, they had not seen each other for nearly a year during the time when their tempers improved...

Pregnancy and induced labor may occur during this time.

The drastic change in personality was probably because she was abandoned by another man and could only hold on to him as a spare tire.

"I'm so stupid." The man laughed loudly. He felt like a clown being played around by a woman.

For a moment, there was silence in the ward.

No one thought that this man would go to this extent for his girlfriend.

Xu Qiu's expression did not change. He passively accepted all kinds of information and remained indifferent to everything that had nothing to do with his condition. After a moment, he said: "Go and sign."

…

After the man signed, Xu Qiu also gave new treatment measures.

The first is to connect the tracheal intubation to the ventilator for assisted ventilation.

The second step is routine treatment for acute severe pancreatitis. In addition, Xu Qiu also placed a nasojejunal tube.

Generally, patients will have a gastric tube inserted, but patients with pancreatitis cannot. A nasojejunal tube must be used to bypass the duodenal papilla to avoid causing pancreatic secretion and allow nutrient solution to directly enter the small intestine.

After that, Xu Qiu fell into deep thought.

Director Xiao and others were also hesitant. Should he undergo blood purification treatment in this situation?

The chance of rescuing acute severe pancreatitis is very low. Several cases admitted to the gastroenterology department before have died. Only Xu Qiu has rescued three or four patients after entering the clinic... It is precisely because of the extremely high mortality rate that clinical practice Once encountered, various effective treatments will be added.

Such as blood purification.

Similar to hemodialysis, it filters out the inflammatory mediators in the patient's body and prevents infection from spreading throughout the body through blood channels. In theory, it can play an auxiliary role in controlling the disease.

However, this operation is risky. It requires puncturing the patient's femoral artery, then inserting a catheter to drain the blood, filtering it and then reinjecting it.

Occam's razor is also very important in clinical practice. Unless it is necessary and the expectation is considerable, additional treatment measures are generally not given, especially invasive procedures, which are even more cautious.

In particular, there are no clear guidelines for the treatment of acute severe pancreatitis, and there is no evidence-based medicine to prove how effective blood purification can be. In this case, hasty puncture is not necessarily a good thing.

"Wait a moment." Xu Qiu gave the final conclusion.

He has considerable experience in treating acute severe pancreatitis.

Other doctors generally choose conservative treatment, fearing that surgery will cause pancreatic tissue necrosis, leading to internal environment disorder and directly causing the patient's death.

But Xu Qiu had no such worries.

"Dr. Xu, what's the condition of the patient's breathing?" Director Xiao suddenly asked.

Since it is not ARDS, what is the cause of the patient's rapid hypoxia?

Xu Qiu shook his head in a rare move. Clinical diagnosis is a process of finding evidence. He had several guesses, but it would take time to verify them.

Director Xiao became thoughtful.

This kind of patient usually suffers from pancreatitis that damages the lungs and then causes acute respiratory distress syndrome. He still doesn't understand why Xu Qiu dared to rule out ARDS so decisively.

"Let's go to the ICU." Xu Qiu said.

The patient has been sent to the ICU to receive tracheal intubation, ventilator and oxygenation treatment.

Until everyone arrived at the ICU, Director Xiao and others were still doubtful. Instead of inhaling oxygen from a mask, non-invasive positive pressure ventilation, and then slowly transitioning to the final ventilator, Xu Qiu directly went to the last layer of insurance. Is it really possible? Is it necessary?

However, when they saw the condition recorded by the nurse, their expressions suddenly changed.

During the period between being admitted to the ICU and connecting to the ventilator, the patient's respiratory function further deteriorated, and the blood oxygen level even reached 81 when the patient was at his worst, which is already a very dangerous signal clinically.

"Fortunately, I'm on a ventilator..." Director Xiao breathed a long sigh of relief, then looked at Xu Qiu with eyes full of admiration.

He is indeed a clinical ace.

If they were left to handle it, they would definitely not have the courage to directly use the ventilator. Waiting for the patient's blood oxygen to drop sharply before transferring him in a hurry. It is one thing to be in a hurry, but it is hard to say whether he can be rescued!

Fortunately, Xu Qiu predicted the changes in his condition in advance and connected the ventilator early, quickly bringing the patient back from the brink.

"It was almost dangerous!"

"The patient's lips are cyanotic. He was fine ten minutes ago. How could it develop so quickly..."

"It doesn't make sense. Even if it's ARDS, it won't undergo such a drastic change in such a short period of time!"

"Generally speaking, this is when the lung damage is too severe."

The gastroenterologists present were incomprehensible.

Director Jiang from the ICU also arrived. He looked at the patient's condition and said with some surprise: "It's very rare. Even in the ICU, I don't think someone like her can lose her blood oxygen saturation in ten minutes. I have encountered several cases.”

After speaking, he looked at Xu Qiu, "Dr. Xu, are you sure this person doesn't have ARDS?"

Xu Qiu didn't answer. He looked through the patient's medical records again and stared at the life monitor for a while.

Heart rate, respiration, blood oxygen saturation, pulse, etc., numbers are beating on the screen, and the sound of beeps is endless.

What's the problem?

At this moment, Xu Qiu's expression suddenly froze.