Qi Jing stayed in the emergency lounge and looked at the three confused seniors, and suddenly felt that he was not suitable for being a teacher at all, at least not yet suitable for this stage.

In fact, this medical record is very similar to the mother-in-law who had septic shock caused by mucorice pneumonia.

It’s just that Qi Jing changed the location of the infection.

He just hopes that the three of them can remember that even if they see that the patient's blood sugar is low, don't panic. The first thing to observe is always the general situation of the patient.

Check whether there are signs of hypoglycemia such as cold sweating and weakness, and check whether the vital signs are stable, which is also a plus for the quantitative positioning and qualitative analysis of chest and abdomen pain.

In fact, even if they barely pass the qualification when they talk about one of them, the three of them seem to be in a dead end.

At this time, Li Yuchuan came over to interrupt Qi Jing's original idea. At this time, he should summarize the case, point out the interests of the treatment, and then say the second case to change their ideas.

As a result, he reported all his vital signs, leaving their brains in a state of accident for a long time.

They are still students, after all, not those resident doctors who have obtained their licenses.

Patients with blood sugar 1.1 are still in normal condition, which seems to be beyond the scope for them. Even if Qi Jing came back, she reminded her blood sugar to measure her chlorella, it did not open up any situation for them. The scene was once extremely awkward.

Qi Jing had no choice but to admit his "wrong" and the case was indeed difficult.

He first explained why blood sugar 1.1 is still sober, and then explained why correcting blood sugar can cause the patient to die.

In fact, the lower value of chlorella sugar has shown that the patient's peripheral blood supply is insufficient, peripheral vasospasm, and there is a sign of septic shock.

At this time, you should first do blood gas analysis to check the electrolytes and determine the true blood sugar value. Then improve whether there are any infections or other lesions in the blood routine, and then further rely on imaging examinations to determine the problem of the pain area.

At this time, directly supplementing hypertonic sugar water without asking, will increase blood sugar reactivity.

Elevated blood sugar will affect electrolyte balance, produce permeable diuresis, further reduce peripheral blood circulation, and aggravate the symptoms of shock.

"Although these are all knowledge of electrolyte balance in internal science, it is indeed a bit difficult." Qi Jing said embarrassedly, "I'll give you a simple one next."

The second case is a patient with cancer malignant fluid. He has been in a coma and relies on the last trace of organ function to support his body.

This time, Qi Jing continued to improve some of the role-playing settings. The three of them are emergency rotation doctors in secondary small hospitals.

Qi Jing said: "When the patient came to the hospital, the oxygen saturation was 85%. You turned on a mask to inhale oxygen. A few minutes later, the nurse ran over and said that the oxygen saturation would not increase after the oxygen inhale. Let's go and see you."

"Since it is a patient with a virulent fluid, he is lying quietly on the bed, and his breathing range is almost impossible to tell. What should I do next?"

"I'm already inhaling oxygen in the mask, and my breathing is still rapid?" Boy A felt a little strange.

They understood Qi Jing's idea of ​​the question, and the real situations shown by the patients in these cases are inconsistent with the numbers displayed by the instrument.

The first one was hypoglycemia, but the patient didn't feel anything. This time, the mask gave oxygen, but the oxygen saturation was still not up.

The mask uses a large amount of oxygen to inhaled oxygen. As long as the lungs have some function, they should be able to increase the oxygen saturation. If they really encounter this situation, the patient's lungs will definitely have big problems.

It is definitely not a good thing to have an oxygen saturation below 90% for a long time. In order to improve oxygen saturation, tracheal intubation is first necessary...

Girl B lowered her head, and her thoughts became deeper and deeper. Suddenly, she raised her arm and gently patted her forehead with her palm, forcibly interrupting this inertial thinking: No, no, if you continue thinking like this, you will go around!

This time they all learned their lesson.

"First listen to the breathing sounds of both lungs!" The boy pointed to the stethoscope in Qi Jing's pocket and said, "Auscultation is the best way to tell the problem."

Qi Jing nodded, and the direction of his thoughts was correct: "You heard the patient's lungs, and the breathing sound was very shallow, but it seemed that there was no big problem. You heard some wet rosy sounds, but it should be chronic bronchitis caused by long-term bed rest."

“No problem with breathing sound?”

"That's the case for the time being." Qi Jing complained, "It's good to let you hear the Shi Luoyin."

“…”

The three of them thought it was indeed nothing wrong. They had never even had much contact with the patients, and the auscultation exercises were all models and recordings.

In actual combat, we can immediately hear that the Shi Luoyin is indeed burning the incense.

"There is no problem with breathing sound, that means the whole respiratory tract is good." The boy A frowned and guessed boldly, "Is it a problem with the mask? The tube is blocked or leaked?"

"It's not bad, the lesson just now was not in vain."

Although I praised it, the development of Qi Jing's case did not end: "You found that there was indeed a problem with the tube of the respiratory mask, and there was a crack that kept leaking air."

"You three smiled, complained about the hospital's hardware facilities, and then asked the nurse to replace it with a new one."

Before Boy A could celebrate his victory back, Qi Jing interrupted him and continued, "You just sat back on your seat and discussed what to eat for dinner next. Who would have thought that the nurse would come again in two minutes, and the oxygen saturation would still not be increased."

A, B, C:?

They were confused: Why didn't the person in front of them play according to the common sense? It's impossible that the pipe had problems with the two consecutive times.

The three of them didn't last long, and boy C immediately guessed based on the answer just now: "That's a problem with electrocardiogram monitoring."

"Yo, it's not bad, I think of electrocardiogram monitoring."

After all, they are all students selected by Qi Jing, so their thinking must be more active than ordinary students. It is normal to guess this situation according to the previous ideas.

He continued, "This is just a guess, you have to have evidence to prove it."

"I think I need to check the lines."

"Are you looking for a line outside or a machine? Even if a professional electrician comes, you may not be able to find it in a short time."

"Then see if the plug is loose."

"Are you stupid? I'm still worried about whether there is power on when I see the numbers? Besides, the ECG monitoring has its own power supply, which can be maintained for a period of time."

“Are the instruments so high-end now?”

Qi Jing shook his head and immediately pulled their thoughts like wild horses back:

"You have all attended internship classes, and you have to learn ECG monitoring. Small hospitals are not capable of human resources and financial resources. It is better to check if there is a problem with someone to check if there is really something wrong with the machine."

Speaking of this, he took out a worn ECG monitor from the corner and picked up the oxygen saturation clip: "Since there is a problem with the patient's test, what about the other person's test?"

"Other's?"

"You can pick up your own, you can pick up your own, it doesn't hurt." Qi Jing took the clip and pinched his fingers.

The three of them smiled and nodded, and they did learn it.

This is common sense for doctors, but it is a very practical trick for them.

However, when they thought the second case was finally over and preparing to welcome the new case, Qi Jing cleared his throat: "You found that after you clamped it on your fingers, the oxygen saturation exceeded 95%.

“…”

"Now you can confirm that it is indeed a problem with the patient. As for what the problem is, we need to go through further imaging examinations to confirm it."

"You asked the nurse to connect the ECG monitoring first, then fill out the examination form, and at the same time called the oncology department for consultation. However, the nurse ran over again and said that the ECG monitoring prompted the heart rate was 0."

“…”
Chapter completed!