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339. Check all negative respiratory failure

Qi Jing was still analyzing Wang Pingshi's medical records in his hand, and was thinking about talking about diagnosis ideas when Xu Jiakang was free. Who would have thought that the other party was even more anxious than him? As soon as he met, Qi Jing made a comeback and became a person from the hospital.

"Are you a little too much? I'm just here to visit the door, why did I get me on duty?"

"There are so many people, so the power is so great."

Putting on the white skin, Qi Jing looked at the intern in front of him with a confused look on his face, then looked at himself again, twisting his body and feeling uncomfortable all over: "Classmate, what size are you wearing? You have a similar figure to me, why are your shoulders so wide?"

The intern has never experienced such a thing, and he can only listen to the orders of his superior doctor: "It is said that if you have to choose a bigger number in a white coat, I will be bigger."

"This is something I've been with you for a year, why is it so casual..."

"Ah, it's all burning. You're still discussing the size of the white coat." Xu Jiakang grabbed his arm and walked straight to the iCu, "Director He was in a hurry to scratch his head there."

"You don't pay for your salary, so you don't want me to be a freelancer and you won't complain?"

After a while between Xu Jiakang and Qi Jing, they knew him a little and knew very well what this guy liked the most.

As soon as he entered the door of the ICU, Xu Jiakang stuffed the medical record on the nurse's table at the door into Qi Jing's arms. Now the patient has entered the critical period, and only the medical record that records the initial complaints and pre-processing plans is not very useful to them, but for Qi Jing, it is a good thing that can understand the condition as soon as possible.

Just after taking a look, Qi Jing disappeared from the complaint he had just said: "It's really interesting."

He Tianqin was standing by the patient's bed at this time, holding the first aid record sheet that had just been released, and his eyebrows were tightly twisted together. Hearing someone opened the automatic sliding door, he turned around and saw that it was Qi Jing. He finally smiled on his face: "It's really Xiao Qi, why are you here?"

Qi Jing looked at the patient's medical record and previous treatment methods and explained casually: "I accompanied a friend to see the doctor. He fell and dislocated his hand. He just solved it. I happened to be idle, so I came over to see you."

"Oh, that's right, are you going to have a break today?"

Qi Jing then remembered that he had passed the shift, so he nodded naturally: "Well, that's right."

He Tianqin's brows only stretched for a short time, and then frowned again after a while, "It's okay for you to come. This patient is very difficult. Just read the medical record and I can just listen to your opinions."

Qi Jing scanned the patient's medical records all over and roughly understood the reasons why the patient came to the hospital.

However, the more I learned, the more strange Qi Jing felt: "He came to the hospital because he had muscles damaged by running? Shouldn't he be in orthopedics? Why were he sent to the internal medicine department?"

"That's right. The orthopedic doctor thought that she might have a torn tendon, so he asked to take an X-ray. After the patient finished filming, he was waiting for the report in the emergency room. Suddenly, he felt stuffy and breathless in his chest, so he was pulled here by the nurse and nurse."

Xu Jiakang recalled the previous rescue process and was still scared: "Since I felt chest tightness, shortness of breath and I couldn't breathe, it developed to this point. It only took more than an hour during this period. We took the medicine in time, and we could get all the routine, but we couldn't hold it, and we couldn't hold it at all!"

Qi Jing looked at the bed surrounded by three other doctors in the corner and frowned. Now his ears were filled with the sound of ventilators, and he could tell that the patient was very critical by listening: "Is he weakened?"

"Well, I got on the ventilator a quarter of an hour ago." Xu Jiakang shook his head helplessly, "It's progressing too fast, I'm about to start to suspect poisoning."

"The speed is indeed fast enough, but the possibility of poisoning should not be high."

Qi Jing looked at the patient's main complaint and explained: "I jogged outside for more than an hour and felt something was wrong with my ankle while running. Including the time I arrived at the hospital, I haven't touched anything I had eaten for more than three hours, and the ones I drank were all sports drinks that replenished electrolytes. I looked at the electrolyte report, which was a little low in potassium and low in sodium, but it was completely within the controllable range and could be replenished in a while."

Of course Xu Jiakang knew about this, and there was really nothing to doubt.

The patient's electrocardiogram is normal, and the chest X-ray is also very clean and there is no body temperature. I have never heard of him having an upper respiratory tract infection. Blood pressure and heart rate have also changed reactively due to respiratory failure. After getting on the ventilator, it is also good.

The ordinary electrolyte tests performed are just slightly lower, and they basically float around the lower limit of the normal value, and have not reached the point that affects the heart at all.

Because after exercise, the patient's skeletal muscle is consumed in large quantities, and creatine kinase will definitely increase. However, creatine kinase isozyme and lactate dehydrogenase, which are specific to myocardial muscle, are good. Combined with electrocardiogram, it can eliminate many heart diseases.

Judging from these tests, the cardiopulmonary function is perfect. I'm afraid that there are not many of the ICU's medical staff who can catch up with her. In the end, all I can think of is the central nervous system that controls breathing. Unfortunately, everything is normal after taking the CT scan.

"I also know that breathing depression that develops so fast cannot have such a long pre-term." Xu Jiakang shook his head helplessly, "But now I really can't think of anything other than poisoning."

When Qi Jing first looked at the patient, he also found it a little incredible.

However, any disease has its own reasons for its development. It is impossible for a good person to suddenly fail. Even if there is, it is just that the doctor has not found the reason. If you want to see the problem thoroughly, you have to start with the patient's daily life.

"Where is the family?" Qi Jing asked.

Xu Jiakang raised his hand and looked at his watch: "I just asked the intern to call, so it should be coming soon."

Qi Jing sighed and looked at He Tianqin: "Then can I see the patient?"

He Tianqin understood what he meant. When he met a patient in the first hospital, he must have to go through the consent of the chief doctor: "Go and have a look. The patient is sleeping all the time, and the Grass score is falling."

......

It was just a few simple conversations, and the three doctors by the bed had already seen the signs: the person coming was not simple.

Who is Xu Jiakang? A famous figure in the critical illness discipline, he has already decided to be the next person in charge of the internal emergency. He usually competes with others in everything, and his patients are even more covered, for fear that someone will intervene. But now he actually asks an outsider to help, who will believe it if he says it?

Not to mention He Tianqin.

After following Director He for so long, they certainly knew the old man's temper. The last young man who made him so concerned was Xu Jiakang, a graduate of 200 years. Going forward... they have never heard of it.

There are only a few young people who can be seen in the first hospital. After removing the surgery department, they all know the rest. I haven’t heard of He Tianqin this year that he accepted any amazing students. Who would this person be?

Qi Jing didn't care what they were thinking, and when he got a seat, he began to observe the patient in front of him.

The young woman in her 30s looks very well maintained and very slim. She put a hand on her forehead, and she really has no body temperature. Combined with the completely normal blood routine, the possibility of respiratory and central nervous system infections can be basically ruled out.

"It's strange."

Instead of continuing to do too much rest in the patient's nerves and breathing, Qi Jing began to stretch his vision away from the local area to the whole body. The most concerned one was not the torso, but the limbs.

As a young man who loves sports, the patient has good figure and some tight muscles that are within reach. However, there are some scratches and bruises on her knees and arms. They don’t look serious, but there are quite a lot of them. The most troublesome thing is the right ankle, which has now swollen a bag, which is obviously a sprain.

These are nothing in the eyes of the three doctors around you. Bruises and injuries in daily life are nothing. It is impossible to be caused by domestic violence at such a small scale, so these minor injuries were completely covered by Qi Jing's exaggerated examination actions.

It was really because Qi Jing was too bold, and the three doctors next to him were a little bit stingy.

A patient with weak breathing had his internal organs placed without checking, but went to check his limbs. He had no scruples. If the family members of the patient were replaced by the patient, he would have cursed and treated him as sexual harassment.

However, Qi Jing didn't take this seriously at all, and did it more and more. After lifting the quilt, he began to unbutton the patient's body.

Even when using ECG monitoring, the nurse only separated two buttons to protect the patient's privacy. This allowed the wire to penetrate the gap and blocked the sensitive area without embarrassing. However, Qi Jing regarded these buttons as obstacles and wanted to get rid of them quickly: "Why are the buttons in your urgent hospital gowns so tight? Don't look at them stupidly, help untie them together."

The three of them did not dare to object, nor did they dare to follow them. They looked at He Tianqin, who was talking to Xu Jiakang in the distance, and they didn't dare to speak out.

"Brother, what are you doing?"

"Check." Qi Jing simply put on both hands and unbuttoned the first button on the collar. "You guys should help, unbutton her buttons!"

"What kind of check do you need to unbutton so many times?"

"I want to look at her shoulders." Qi Jing didn't understand what they meant at first, but then he realized after thinking about it, "I'm not embarrassed, why are you embarrassed? There was a wound on her shoulder. I went to the hospital a few days ago, and I wanted to see how the wound healed."

"Wound?"

"What does a wound have to do with respiratory failure? The patient's blood is good and his body temperature is not strong, so it is absolutely impossible to be an infection."

"Don't say so much. What if the patient's immunity was suppressed, and now the normal blood image is caused by the increase in reactivity after infection?" Qi Jing retorted casually, "If this is the case, should she have a full body examination when the internal organs are intact to see if there are any other places infected?"

I have to say that these words make sense, which makes these three doctors feel very similar after hearing this: "It seems to make some sense."

“There is indeed a possibility.”

"If you think it makes sense, why don't you come and help me?" Qi Jing chuckled twice, "The button is too big, and it's too difficult to untie it. I don't know which factory made it? The quality is so poor."

"Let's do it."

"Well, after all, it's our urgent patient..."

He Tianqin was still discussing the patient's next diagnosis and treatment plan with Xu Jiakang, waiting for Qi Jing to give some constructive opinions. But unexpectedly, in the blink of an eye, a "beautiful" scenery appeared in front of him.

Three doctors surrounded the patient, leaned forward, stretched all six arms forward, and even looked from a distance, they felt something was wrong.

"What are you doing?" He Tianqin has never seen his subordinates perform such a grand occasion even after so many years of clinical practice. He hurried forward a few times, "Why are you unbuttoning her clothes if you have nothing to do? Are you crazy?"

When the three of them saw that it was He Tianqin, they trembled and quickly stood up and pointed at Qi Jing, who had already been away from his home. However, Qi Jing, who should have been by the bed, had long disappeared. Just as they unbuttoned, he had already returned to the gate and picked up the medical record and read it again.

Escape too fast...

The three of them knew He Tianqin's violent temper and quickly pointed at Qi Jing and explained: "It was him who said that the patient may be immune to suppression, but the reaction is increased due to the infection, and then he accidentally got a normal blood image..."

"Thinking that the patient's internal organs are fine, and considering that there are many wounds on the patient's body, I want to check whether some of the wounds are infected."

"Now it seems that the hole on your shoulders is the most serious."

The patient's hospital gown had been opened, and the five pairs of eyes, including He Tianqin and Xu Jiakang, all fell on her right shoulder. It was a hole about 8cm long. It looked like the stitches had just been removed, and the stitching needle holes could be seen around her. Overall, it was healing well.

"Do you think there is something wrong with this wound?" Xu Jiakang was puzzled by the reason.

He Tianqin squeezed to the edge of the bed and looked at the wound carefully for a check: "The wound is not red, swollen and oozing, and it is not good to match, and it is healing without problems."

The three of them were completely panicked: "Then...is it the wound behind them?"

“It’s possible.”

"Yes, yes, why don't you turn her over?"

He Tianqin glared at the three of them, turned around and looked at the gate: "Xiao Qi, did you say that just now seriously? Do you think the patient has immune deficiency?"

"Oh, no, I'm just talking casually." Qi Jing looked at the medical record in his hand and said with a smile, "In order to ask them to help, I have to find a better reason."

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