Chapter 485: Unraveling the mystery, the final truth!
has a problem!
There is something wrong with the patient's blood oxygen saturation!
He looked at Director Jiang: "After being put on the ventilator, has the patient's blood oxygen increased?"
Director Jiang quickly replied: "Yes, it was originally 81. After tracheal intubation and ventilation, it quickly rose to around 90. Now it has basically stabilized at 92."
"How long has it been going on?"
"How long? I really didn't pay attention to this." Director Jiang shook his head.
He called the bed doctor and bed nurse. After asking, the other party gave the answer.
"Almost ten minutes."
ten minutes……
Xu Qiu shook his head, this was very wrong.
The ventilator is on, and the blood oxygen should quickly rise to the normal range. Stabilizing at 92 is not good news.
Although the blood oxygen was much better than the 81 at that time, it was still within the scope of hypoxia.
"Increase the inhalation concentration." Xu Qiu ordered.
Director Jiang did not dare to be vague and quickly complied.
Everyone just waited for more than ten minutes.
Director Xiao, Director Jiang and others looked increasingly shocked.
"how so?"
"The inhalation concentration has been increased several times, but the patient's blood oxygen has not moved at all and is still 92!"
"The blood oxygen will drop immediately after turning it down, but there will be no change when the concentration is increased!"
Everyone felt that they couldn't understand.
In this case, it is obviously not credible to say that there is no problem with the patient's lungs.
"pneumothorax?"
"Still atelectasis?"
"If there is no damage to the lungs, the blood oxygen should not be unable to rise. The patient's respiratory system must be diseased!"
At this moment, after Xu Qiu discovered the fixed blood oxygen level of 92, all gastroenterologists realized the problem.
"Do you want to ask the respiratory department for consultation?" Director Xiao was a little unsure.
Pancreatitis is their specialty, but when it comes to the respiratory system, specialists have to be called in.
Everyone's expressions were very solemn.
Whether it is a pneumothorax or atelectasis, one or even both lungs of the patient will not be able to ventilate normally, which will lead to severe hypoxia in the patient.
It is easier to say that there is atelectasis. Putting on a ventilator will not have any side effects. At most, it will delay the condition.
But if it is a pneumothorax, if the ventilator continues to operate, the pneumothorax will become more and more serious and lead to more serious consequences.
When everyone hesitated, Xu Qiu took out the stethoscope.
At this juncture, only Xu Qiu dared to do this.
The other doctors are not respiratory specialists and are not sure.
After auscultation, Xu Qiu shook his head: "It's not pneumothorax or atelectasis."
"Add a CT scan?" the junior attending of the respiratory department suggested.
Director Xiao shook his head: "Are you stupid? I did a routine CT last night and found no abnormalities. It must be enhanced now, but the patient's physical condition can bear it?"
Xu Qiu nodded: "I really don't have the conditions to do a CT scan."
When the patient's oxygen concentration drops slightly, the blood oxygen will drop. At this time, the risk is too high to send the patient to the imaging department for at least half an hour of enhanced CT, which is no different than sending the patient to death.
Xu Qiu stood beside the bed, thinking silently.
The patient's condition was also listed in front of him.
Acute severe pancreatitis...
Hypoxia...
The blood oxygen is fixed at 92 and cannot be improved no matter what...
Could it be related to the patient’s previous pregnancy history?
Xu Qiu quickly shook his head.
Although the other party's rectus abdominis muscles were separated and she had given birth or induced a late-stage fetus without telling her husband, this was completely different from her current condition.
No matter how hard I look, I can't get in touch.
Back to the patient——
Combining various indicators together, the conclusion reached is almost the same as that of Director Xiao and others, that is, lung damage.
Besides injury, what else could cause the blood oxygen to show no color at all when given such a high concentration of oxygen?
"It's a pity that there is no detailed case of the patient's pregnancy history..."
Xu Qiu felt a little pity.
This is why it is necessary to ask clearly about various medical histories in clinical practice. Sometimes what is concealed is the key to saving lives.
But there is nothing we can do now. The patient is already unconscious and unable to answer any questions.
Hua Hua Hua——
Xu Qiu flipped through the few pages of the patient's medical records.
There are not many records on it. The earliest one was only three years ago. The most recent one was three months ago. I had a prenatal consultation in the reproductive department of the clinic.
Director Jiang, Director Xiao and others all sighed.
They have also read this medical record, but there is nothing valuable in it.
In the past half hour, Xu Qiu flipped through it more than a dozen times, but still didn't see anything.
"If it doesn't work, just take the risk and do enhancement. It's better than waiting..." Director Jiang glanced at the life monitor. The patient's blood oxygen dropped unexpectedly, to 90!
Others also noticed this, and their pupils shrank.
The oxygen concentration has been maintained at a high level, but the patient's blood oxygen saturation has dropped again!
"Wait a minute!"
Suddenly, Xu Qiu stopped.
Everyone's hearts were in suspense and they looked at Xu Qiu with some surprise.
That medical record...could it be that we really found some clues?
The above content is basically a medical record template used clinically. What can you tell from this!
"blood pressure."
Xu Qiuyan was concise and to the point, and immediately pointed out the anomalies in the medical records.
"The patient's blood pressure was measured three years ago in a healthy body, and it was 131/82mmHg.
Later, she basically maintained a physical examination frequency of once a year.
But just a year and a half ago, she had two consecutive examinations within two months!
The blood pressure of the previous examination was about 17Hg; the one a month later, it dropped to 128/84mmHg!
"Pregnancy-related hypertension?"
Xu Qiu immediately guessed the cause of the disease.
If this is the case, perhaps the other party really did not give birth to the child, but because of pregnancy-related hypertension, the pregnancy was terminated and an induced abortion was performed...
As for the latter examination, it is most likely a physical examination after the operation.
He also found the patient's admission examination yesterday.
Blood pressure 120/79mmHg.
The blood pressure of a normal person is between 90~140/60~90. Of course, in fact, if the systolic pressure exceeds 120 and the diastolic pressure exceeds 80, it is already abnormal. The so-called normal blood pressure and hypertension indicators in clinical practice are all formulated by the medical community, and there are many variables.
For example, in Meiguo, the standard for hypertension there is a systolic pressure greater than 130 and a diastolic pressure greater than 80.
Daxia was actually considering lowering the standard before, because in fact the blood pressure range of a healthy person should be between 90~120/60~80.
But it was not implemented in the end.
One of the reasons is that once the standard is revised, Daxia will instantly have countless hypertensive patients, and this group of people will have a great impact on medical insurance...
In short.
This patient's blood pressure is not normal no matter how you look at it.
"Moreover, her blood pressure during pregnancy reached 17Hg... Is this idiopathic hypertension during pregnancy, or other reasons?!"
At this moment, Xu Qiu felt that the truth seemed to be right in front of him.
He seemed to have grasped a vague clue, but there was still a last layer of gauze between him and the final cause of the disease!
