Poor medical care can never avoid topics.

Every year, countless patients are discouraged from the high medical expenses. Even if they spend money and spend all their belongings, they still cannot escape the disease and seek life. Some of them have no reaction at all and suddenly become ill and leave the world in a hurry.

Things in the world are impermanent, nothing more than this.

Qi Jing is a human being but not a god, and he is helpless when encountering this situation, even the cases he is interested in. Even if he is rich and the richest man in the world, he will not be able to save everyone in the world. This is an unsolvable proposition.

But now there is a patient who is even more worried about him.

"It's burning again?" Qi Jing gasped, stood on the bustling pedestrian street, and asked to the microphone, "How many degrees?"

"It's 38 degrees after five o'clock, and it's 38.5 at nine o'clock." Qu Yi stared at Pei Hongying's temperature sheets these two days. His nearly U-shaped curve was particularly eye-catching. "There is only one in the infectious department who is hospitalized on duty now. After consultation, he said he would continue to hang levox."

Qi Jing looked up at the dazzling lights of the building on the street, thinking about Pei Hongying's diagnosis and treatment process over the past few days: "Is levox effective?"

"It looks very small. After hanging it for more than an hour, the body temperature has been rising." Qu Yi said, "Do you want to take antipyretics?"

"Now body temperature is an important indicator. After using antipyretics, the subsequent changes in the condition will be invisible." Qi Jing said, "Are there any symptoms?"

"Why do I call you if you have symptoms? It's okay to have a full set of physical examinations." Qu Yi was also in a dilemma, "I just checked my blood. The white blood cells were high, the proportion of medium-grain was high, and there was still a significant bacterial infection. Yan Dingfei asked Director Wang and said that he would take a look for it for one night, as long as the body temperature did not rise anymore, wait for the symptoms to come out by himself."

Qi Jing nodded: "This is the only way now. If it breaks through 39.5, it will first reduce the temperature."

"All right."

After the call was finished, Hu Dongsheng slowly caught up from behind.

"Brother Qi, you are too, you are running too fast." He gasped for several times, supported his knees with his hands, and sweat as big as beans kept sliding down his cheeks, dripping on the ground, "Your face, your face is not good, whose phone number? It's not my sister-in-law..."

"Pei Hongying."

"Pei Hongying's phone number?" Hu Dongsheng felt Qi Jing's surprised gaze, and then he put away his joking tone.

"Bed 19?" He recalled the briefing he had just described and said, "When I went to see it at four o'clock, my body temperature was 37.6. The levox was maintained well with it. What happened?"

"The body temperature has risen again." Qi Jing sighed, "I feel that levooxygen is no longer effective."

"The culture and drug sensitivity will only result after the day. How to survive tomorrow?" Hu Dongsheng thought for a while, "Will it be too much to apply carbapenems or glycopeptides?"

Carbonpenems were the atypical beta-lactam antibiotics with the widest antibacterial spectrum and the strongest antibacterial activity in 2003. Vancomycin, a representative drug of glycopeptides, is a popular antibiotic and has a very wide range of applications.

Their mechanism of action is very domineering, just like using an iron hammer to completely smash the cell wall on the surface of bacteria to kill bacteria. Moreover, because the binding sites of the two act differently, the effect is even stronger when combined with medication, and can almost kill all bacteria.

Strong is really strong, but these two medicines are the last killer weapon. After using the doctor, there will be no trump card in his hand.

In most cases, before bacterial culture and drug sensitivity results come out, few doctors will directly apply to these two types of antibiotics. Because in the arms race between humans and bacteria, humans are always in a backward position, and a multi-drug-resistant super bacteria will pop up and mock the current antibiotic levels at any time.

"It's a bit over."

Qi Jing said: "As Director Wang's opinion, let's take a look first. It's best if the symptoms can show tomorrow. If it really doesn't work, have a full body examination and go through it all."

......

The next day, Pei Hongying still had a high fever.

The levofloxacin used is not completely useless, but the body temperature that has just been pressed will rise soon. The maximum body temperature in one night has risen to 39.7℃, and the lowest is 38.8.

"I can't hold it back anymore." Wang Ting looked at the temperature sheet with one hand and helped him make a pot of tea with the other, "Come on, tell me what you think."

"Did the original bacteria become resistant?"

"The bacteria directly undergo drug resistance mutations?" Qin Xuefeng looked at Pei Hongying's medical record and frowned, "Why do you want to change the medicine and try again?"

"What to change?"

"Ceftriaxone and levofloxacin both have obvious effects on Gram-negative bacteria. Since it is useless now, you can try anti-Gram-positive bacteria." Qin Xuefeng held Gao Jian's pen and tapped the paper gently, "Try amoxicillin, which is better for positive bacteria?"

Wang Ting just nodded and turned around and looked at Ren Ding Xingwang's internal emergency treatment room: "Xiao Hu, why are you here?"

"I'll take a rest today." Hu Dongsheng scratched his head and explained with a smile, "I was very interested in this yuenan before, so I came here to see the situation."

Wang Ting nodded and passed by several doctors in the room, Qu Yi, Chen Xiao, Yan Dingfei, Ji Qing and Qin Xuefeng. The three of them were very immature in the hospital for antibiotics. Hu Dongsheng was just a piece of white paper and was completely novice in the medication. Although Yan Dingfei was the main treatment, he basically did not receive encephalitis in the department, so he was not very familiar with the fight against infection.

Qin Xuefeng, who experienced the baptism of the internal medicine work in the 1980s, had his own experience in using infection medicine.

In addition to Lao Qin, Qi Jing can also give some advice on this situation.

"It doesn't matter if you change the dressing, but it's also important to find the infection stool." Qi Jing felt Wang Ting's gaze and said, "I think I need a full-body census to see what went wrong."

"The examinations I did before seemed useless." Qin Xuefeng said, looking at the inspection report lists, "I have to check again after only two days? Does the patient's family agree? And I am also pessimistic about the results."

After that, the two of them expressed their opinions between investigating or not, and the final decision was definitely not in their hands.

"Old Qin, I'll talk about the interests of the patient's family later. In the end, it's up to them to decide whether to check it or not." Wang Ting took a sip of tea and took out another medical record book. "What I want to say now is the patient at four o'clock in the middle of the night, who is lying down now..."

"Bed 23." Qu Yi took the speech and replied.

This patient was not sent by an ambulance, but the hospital he walked to. When he first arrived, he took the regular route to register at the registration fee. However, not long after entering the emergency hall, he started to pant and fell to the ground after a while.

"Chest tightness, dizziness, difficulty breathing, pale face, why does it sound like shock?" Qi Jing said.

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