"Director Xiong is polite."

Luo Tang, director of the University of Respiratory Medicine, covered his mouth and coughed twice, saying:

"Actually, I still have reservations about the postoperative complications of the surgery. Because judging from the decline in oxygen saturation, I still feel that there is a possibility of pulmonary embolism."

Xiong Yong bit his lip tightly and after listening to his speech, he said, "But the patient's breathing rate is OK and his heart function is good. Is it difficult to define whether pulmonary embolism is not easy to define."

"Some mild pulmonary embolisms are not prominent, and the high mortality rate of pulmonary embolism is due to the sudden onset and no early warning, which leads to difficulty in rescue."

Luo Tang cleared his throat and continued, "Your patient has been maintained on a ventilator, with both electrocardiogram monitoring and 24-hour nurses, so he can hold on until now. But based on my personal experience, if you continue, the prognosis will not be very good."

Qi Jing and Ji Qing sat in the last row and nodded repeatedly when they heard such suggestions.

The chief director's view is that he is different from those of the younger generations, with sharp and thorough views and reasonable evidence.

Of course, Xiong Yong is not satisfied with this.

Pulmonary embolism is just Luo Tang's opinion. Relatively speaking, the symptoms are actually very atypical. It is not easy for experts to get together, so he hopes to have more different voices:

"After the consultation, I will arrange for pulmonary artery angiography at the bedside, but what if the thrombosis is not found and the patient does not have pulmonary embolism? I hope there are subsequent plans to choose from."

At this time, Qin Yunlian, deputy director of the Emergency Trauma Department, said: "The patient has a problem with respiratory sound. The right lung is the surgical site, so there is nothing to do with respiratory sound. But the left lung is not affected, so there should not be abnormal respiratory sound."

Xiong Yong knew the patient's condition very well, so he didn't explain much and asked directly: "Old Qin, what's the reason?"

"I think it's pneumothorax."

"Pneumothorax? A patient who has been lying on the hospital bed for several days cannot suffer from trauma. The left lung is not the site of surgery. How could he have pneumothorax?"

Qin Yunlian pointed to the chest radiograph he had just done and said, "From the chest radiograph after surgery, there is such a possibility. Director Li also said that it is possible. I think this possibility should be ruled out."

People around you are puzzled. Pneumothorax must be damaged in the pleura or lungs, and the interval and atmospheric pressure will only occur, but this should not occur in the patient.

"Is it spontaneous pneumothorax?"

"The possibility of spontaneousness is too low. The patient has no relevant medical history and there is no relevant lung disease." Qin Yunlian turned the case page to the operation column and said, "What I am considering is actually the problems that occurred during the operation."

Xiong Yong shook his head: "I supervised the entire operation and the left lung was never damaged. This assumption is not valid."

Qin Yun waved his hand and said with a smile: "What I want to say is not the complications of the surgery, but anesthesia. Because the surgery is at a high risk and the process is very long, the anesthesiologist uses deep vein puncture and jamming the cannula. This method will have certain risks, that is, complications."

After explaining, several department directors around him nodded in agreement.

"Pneumothorax...pneumothorax..." Xiong Yong put his hands on his hips, chewing these two words in his mouth, walking back and forth in front, from time to time, looking up at the patient who had just returned from the gate of hell, "Old Qin, how sure are you?"

Qin Yunlian breathed and said, "It's about 60% or 70%."

"Sixty or seventy percent... enough, try it." Xiong Yong said in front of the big screen, "Percuss and find the positioning, and then close the drainage of the upper chest cavity of the left lung to see if it is effective."

The doctors on the screen were already fully armed, and nodded when they heard the director's order. Within a few minutes, the ICU prepared the drainage device and the incision pack. Several doctors were quick-witted and one talked outside the ICU to sign. As soon as the family members finished writing, the other two began to do homework on the patient.

The entire venue was waiting for the results, but only Qi Jing buried his head in looking at the patient's past medical history.

Of course he was just a little doctor, and no one would pay attention to him except Ji Qing around him.

"Director Xiong, the drainage puncture has been completed."

The doctors there finished intubation, but the figures on ECG monitoring did not change much. It turned out that the oxygen partial pressure of 91% was still 91%. Several doctors listened to the left lung in turn, but the breathing sound still did not improve at all.

Several people shook their heads, and Xiong Yong was helpless: "Director Qin, you guessed it wrong. Do you have any other ideas?"

Qin Yunlian shook his head slightly and continued to study the medical history.

Qi Rui turned the medical history one by one, looked at several electrocardiograms and preoperative color ultrasound examinations, and said: "There is no problem with the heart. When it is stable, the electrocardiogram is very stable. The increase in heart rate is certain that the lungs have problems first and then the relationship occurs."

"In fact, if the patient has pulmonary embolism, the electrocardiogram will change, but when the patient is on the disease, there is only a simple sinus speed, no T-wave inversion, and no right bundle branch block. Of course, Director Luo will definitely attribute these to the low degree of pulmonary embolism, so I have nothing to say."

After hearing Qi Rui's words, Luo Tang turned his face and held his eyes on him, then coughed a few times and turned his head back without making any sound.

The director of the Infectious Disease Department asked: "I don't think the possibility of infection can be ruled out."

Xiong Yong shook his head: "The patient's body temperature is good, the blood is routinely white blood cells are not very high, and the broad-spectrum antibiotics that have been used after the operation, do you need to consider the infection again?"

"Broad-spectrum antibiotics are just broad-spectrum, not full-spectrum." The Director of Infection corrected, "It may be other bacteria, such as mold, mycoplasma, and chlamydia, all of which are possible."

"What about the symptoms? There are no symptoms."

Luo Tang coughed twice again and continued to refute: "The patient has no symptoms of infection and his physical condition is not very good. Now the correct treatment must be given."

"It is difficult to determine unknown infections in a short period of time, but patients with antibiotics blindly increase blindly or even add other categories of antibiotics to other categories will go faster."

"I think I need to check it thoroughly no matter what, even if the possibility is low."

"When the examination is over, the patient will be almost done."

"We can only do our best. If we fail, there is nothing we can do. Besides, the pulmonary embolism you just mentioned has no typical symptoms. Shouldn't we doubt it?"

Seeing the two of them facing each other, Xiong Yong had to smooth things out: "We have considered the infection in the hospital before. We have changed the ventilator three times, and each time we change it, it has been thoroughly disinfected. But I still agree with you. All situations must be eliminated."

After saying that, he ordered the screen: "Take the sputum and send it to the laboratory department for examination, check for mold, chlamydia, mycoplasma, in short, all the pathogens that can be found in the hospital!"

"And what? Are there any other ideas?"

The audience was silent, some were just the sound of reading medical history. From time to time, several doctors would walk around and discuss the condition. Some failed to get results, while others had no theoretical basis.
Chapter completed!