This doctor has a system

Chapter 407 472. Let him die inside!

The general direction of this matter has been decided for now, but it will take a long time before the final decision is made.

If the patient is gone, the family members will naturally not be able to accept it in the short term.

At first, their attitude was that one life was worth one life, and they hoped to kill the doctor in charge. Of course, it would be better if the dean could also be killed.

Of course, this requirement is obviously unrealistic.

Later, they called the police and asked the police to arrest the doctor in charge and the doctor on duty for medical malpractice. It would be better if they could be sentenced to life or something.

But this was obviously a medical dispute, and the police refused to file a case.

Now they are asking for huge compensation. In the eyes of the family members, the patient's life is priceless, and 500 million is a small amount.

But it is impossible for the hospital to approve it.

After all, the medical appraisal showed that the hospital was only slightly responsible, and 500 million seemed too exaggerated.

Jiao Chengxi's father was standing outside the emergency intensive care unit with an extremely anxious expression. He was just such a son.

Xue Donglai felt very depressed. He and Jiao Chengxi were just acquaintances. He was not the one who organized the game at noon, but he had a higher status in it, so this incident came to him.

"Have you taken any medicine recently?"

"I have a friend who was unwell and was taken away by the ambulance of your hospital." Xue Donglai said, "My name is Jiao Chengxi."

Then this is strange. Why did he suddenly fall into coma for no reason? Blood potassium is still so low.

According to Jiao Ting, his son has a good drinking capacity and there is no chance that there will be any problems with the four ounces.

"Low potassium?" Gao Feng.

But from the hospital's perspective, it definitely wants to lose less money. Otherwise, if everyone follows suit in the future, it will be very busy.

Ting Jiao is Jiao Chengxi's father and currently works in the commission.

But I have never seen a patient with Gao Feng as low as 0.9mmo/l.

Moreover, the patient himself has advanced lung cancer. Even if he can receive perfect treatment, his survival period will not be too long.

However, Gao Feng still sympathized with the family members from the bottom of his heart. Even if the patient had advanced lung cancer, he would suddenly die like this. How sad he must be.

Excessive elevation of blood potassium concentration can cause weakened neuromuscular excitability, resulting in symptoms such as numbness of limbs, weakness of limbs, slowing of movements, loss of tendon reflexes, and flaccid paralysis.

"How much wine did he drink at noon?" Gao Feng asked.

"There is nothing wrong with him. He is usually in good health." Jiao Ding broke into a sweat and said, "He was fine yesterday. I don't know what happened!"

But why is potassium suddenly low?
There are only a few reasons for low potassium: 1. Reduced intake, long-term partial eclipse, anorexia, weight loss, etc.

"About 4 taels." Xue Donglai also rushed over at this time, "I filled the disposable cup with a full cup."

"No, I don't know that anyway." Jiao Ting wiped the sweat from his head, "He has always been in good health."

3. Loss of gastrointestinal tract, long-term massive vomiting, diarrhea, gastrointestinal biliary drainage or fistula, etc.

The two sides have great differences. The hospital wants the family members to sue in court, and the hospital will pay whatever amount is awarded by the court.

"He's in the emergency ICU." Li Youliang quickly found out. "The patient's condition is very bad. They said he had low blood potassium."

The family members are unwilling, and everyone can guess the specific reasons.

"What?" Gao Feng was stunned for a moment, "So low?!"

Pulled here by ambulance? Is it serious?
"I don't know the specific situation." Xue Donglai explained, "We had some drinks together at noon today. He seemed to be feeling particularly uncomfortable at night. It was Jiao Ting who called me."

"I'm at home, but my home is right next to the hospital." Gao Feng replied, "What's wrong? Brother Donglai"

The normal range of serum potassium concentration in the human body is 3.5~5.5mmol/L.

Low potassium can also cause nausea, vomiting, loss of appetite, and bloating.

2. Increased potassium entering the cells, for example, during the recovery period of metabolic alkalosis or acidosis; using a large amount of glucose solution, especially when insulin is used at the same time; rare during treatment with antipsychotics (such as risperidone, quetiapine) Complications and more.

"Yes, 0.9mmol/L." Li Youliang said.

High potassium has an inhibitory effect on the myocardium, which can cause slowed heart rate, weakened heart sounds, and arrhythmias, such as premature ventricular contractions, atrioventricular block, ventricular fibrillation, and cardiac arrest.

It’s not a bad idea to lose more money, he thought.

But low blood potassium can also be harmful to the body.

When the serum potassium is less than 3.0mmol/L, the patient will show fatigue. When the serum potassium is less than 2.5mmol/L, the patient will have general muscle weakness, and even difficulty breathing and swallowing. In severe cases, he may suffocate. Some patients are accompanied by numbness of limbs and muscle pain, and those with long-term chronic potassium loss have relatively mild symptoms.

At the same time, there is also a disease called hypokalemic periodic paralysis, which often occurs suddenly in the middle of the night or early in the morning. The limbs, mainly the lower limbs, are weak and weak, which usually lasts for several hours. The symptoms of some patients can be relieved by themselves, and the symptoms of individual patients can last for several hours. day.

"Yes, I also confirmed it specifically." Li Youliang.

"Gao Feng, are you in the hospital?" Xue Donglai called Gao Feng after not seeing him for a long time.

"Let me go take a look." Gao Feng said immediately.

Gao Feng had seen a patient whose blood potassium was 1.5mmo/l before. At that time, the patient had symptoms of suffocation. Thanks to his family members, he saved his life by sending him to the hospital in time.

He was still working overtime at his workplace, and suddenly he received a call saying that his son had been taken away by an ambulance at home. At that time, he was confused.

"We talked on the phone around 6 o'clock, and he asked me if I would go back for dinner." Jiao Ting tried hard to recall useful information. "His voice was a little tired at that time, and I didn't care at the time."

The patient has had an emergency head CT, and no obvious abnormalities were found. Hypokalemia is still considered the cause of the coma.

4. Urine loss, such as kidney diseases, such as renal tubular acidosis, Liddle syndrome, Bartter and Gitelman syndrome, acute renal failure and polyuria phase, etc.;

Certain endocrine diseases, such as primary or secondary hyperaldosteronism, Cushing syndrome, heterologous ACTH syndrome, etc.;

Diuretics, such as furosemide, bumetanide, hydrochlorothiazide, mannitol, etc.;
hypomagnesemia;
Certain antibiotics such as penicillin, gentamicin, etc.

5. Loss of sweat and excessive loss of potassium. Failure to replenish it in time will cause potassium deficiency, such as long-term high-temperature work.

6. Others, such as large area burns, abdominal drainage, ascites drainage, etc.

But the patient's condition was obviously puzzling. When Gao Feng entered the doctor's office, the critical care doctor on duty wearing a colorful hat was staring at the computer with a solemn expression.

"Hello, Director Gao." Seeing him come in, the doctor on duty quickly greeted him.

"How's that Jiao Chengxi in bed 6?" Gao Feng asked.

"The potassium in the blood is extremely low. I have been pumping potassium chloride but still can't get it up." The doctor on duty had a headache. "I just woke up for a while, and then I started vomiting desperately."

Then the oxygen saturation also dropped. After evaluation, it was found that the situation was very bad. The patient has now been intubated.

Gao Feng took a look at Jiao Chengxi. After being put in a sedation tube, the patient's vital signs were relatively stable, and his heart rate was slightly faster. "After checking around, the main problem was low potassium, and no other major problems were found." The doctor on duty reported, "The current treatment plan is to supplement potassium first, and at the same time continue to find the cause of low potassium."

If the cause of the disease is not found, the only option is symptomatic treatment. The patient's current blood potassium is so low that the risk is very high. It is definitely right to increase the blood potassium as soon as possible.

"It's quite puzzling. The patient is fine," said Li Youliang, who was making soy sauce on the side. "Could he have taken something by mistake?"

Gao Feng also has no clue. The patient is currently in a coma, and there is no way to know anything from his mouth.

He ran through the possible causes of hypokalemia in his mind.

Nothing gained.

With doubts, Gao Feng returned home.

His wife Li Xinyao was watching TV in the living room, and her son had already fallen asleep. It was a rare moment of leisure. Seeing him coming back, Li Xinyao poured him a cup of tea.

"Xin Yao, what are the reasons for low potassium?" Gao Feng asked.

"It's a lot. The intake is reduced and the loss is too much." Li Xinyao replied, "By the way, poisoning is also okay."

"Poisoned?"

"Yes, a senior brother of mine does this. Barium poisoning can cause stubborn hypokalemia." Li Xinyao said casually.

Gao Feng stood up immediately, and he suddenly remembered.

Barium is a slightly shiny silver-white metal that is non-toxic, but its compounds, namely soluble barium salts, such as barium nitrate, barium chloride, barium hydroxide, etc., are highly toxic.

Barium and its compounds can enter the body through the respiratory tract, digestive tract and damaged skin, and can also cause death through intravenous administration. This disease is a rare disease, no wonder Gao Feng couldn't remember it for a while.

As an extremely potent myotoxic substance, barium compounds can produce excessive stimulating and excitatory effects on smooth muscles, skeletal muscles, and cardiac muscle, and then turn into inhibition, leading to paralysis.

0.5 to 2 hours after oral administration, a burning sensation in the mouth and esophagus will first appear, as well as gastrointestinal irritation symptoms such as salivation, nausea, vomiting, diarrhea, and abdominal cramps, as well as dizziness, headache, general fatigue, and symptoms around the mouth and nose, face, and Numbness or tingling in the extremities;

If it is not treated in time, as it progresses, symptoms may include numbness all over the body, cold limbs, cold sweats, palpitation, muscle tremors, spasms, etc.

Patients with severe symptoms have quadriplegia and drooping eyelids. Difficulty in pronunciation, swallowing, and breathing. Paralysis of the limbs is severe at the proximal end and mild at the distal end. It is accompanied by decreased muscle tone and slow or absent knee reflexes. Stubborn hypokalemia may occur, leading to cardiovascular damage such as heart rhythm disorders and ventricular fibrillation.

Thinking about it now, Jiao Chengxi's symptoms seem to be completely consistent.

But could he really be suffering from barium poisoning? Gao Feng hesitated.

Barium poisoning usually has a clear history of exposure to barium salts, and patients usually work in jobs where they are exposed to barium. For example, barium and its compounds are used in industries such as radios, pesticides, papermaking, rubber, ceramics, and glass.

But the patient obviously has nothing to do with this. He is just an ordinary second-generation person who usually goes out to drink. How could Bubble Girl be exposed to barium salts?
But Gao Feng came to the hospital again.

The doctor on duty was very interested in his guess and thought he could check it out.

Barium poisoning requires toxicology examination, but the provincial doctor does not have this condition.

But this is not a big problem for Jiao Ting. He has been working for so many years and has many connections. Even in the medical industry where he knows nothing about, he can find capable people.

Soon someone from the testing company drove over quickly, and the nurse handed the blood sample to him.

"If it's barium poisoning, then it's severe." The doctor on duty checked on Baidu and said.

Symptoms of severe poisoning include flaccid paralysis of the limbs, muscle strength levels of 0 to I, and even respiratory muscle paralysis. Electrocardiogram and serum potassium show obvious hypokalemia, often accompanied by severe arrhythmia and conduction block.

"Yes." Gao Feng said.

"I will prepare sodium sulfate now." The doctor on duty said, "Waiting for the test results. If it is true, give him medicine immediately."

"Don't wait, it's best to use it now." Gao Feng said, "You go prepare the medicine, and I'll talk to the family."

The patient's condition was not good, and he was worried that there would be unpredictable consequences if he waited any longer.

Because judging from the test results, Jiao Chengxi's kidney function has begun to be damaged, which is not a good thing.

Although Jiao Ting tried his best to stay calm, his voice was still trembling when he spoke.

"Use it, I'll listen to your doctor." He was actually undecided at the moment. The dean and several directors came to see him just now. Everyone discussed it in a flurry, but no one could explain why. .

Jiao Ting now had an unknown premonition and wanted to cry.

To everyone's delight, the patient's condition improved after the application of sodium sulfate. First of all, the blood potassium was increased to 2.9mmol/L. Although it was not normal, it was a relatively safe value.

Another thing is that when the patient wakes up, he can only lie down and cannot speak loudly because the tube is still inserted.

"I finished drinking and went out to book a room with my girlfriend." Jiao Chengxi said weakly to Gao Feng, "I started to feel uncomfortable after I came back. First I felt nauseous, and then I became very dizzy."

Then he didn't know what happened next.

"What did you do together?" the doctor on duty asked.

"Do it" Jiao Chengxi was stunned for a moment, ".love"

"I didn't ask you this." Li Youliang said, "Did you eat or drink anything? Or go to some special places?"

"Have you been exposed to barium compounds?"

"What is barium compound?" The patient looked confused. "We drank some plum blossom wine together, and I also took sildenafil."

Gao Feng subconsciously felt that this plum blossom wine was crucial.

"If it doesn't work, call his girlfriend over first and ask." Gao Feng said to Jiao Ting, who quickly took out his son's mobile phone. The password Jiao Chengxi had just said. .

He flipped through the address book, and then his expression became very strange, because there were more than a dozen business cards with girlfriends in them.

Moreover, there were three sets of numbers written behind each name, which made Jiao Ting a little confused.

"What is this?"

"It should be the measurements." Gao Feng said.

"Measurements? What measurements?" Jiao Ting was confused.

"It's the bust, waist and hip circumference." Li Youliang on the side explained, "It seems that your young master is quite a careful person."

"Let him die inside!" Jiao Ting said angrily. He felt that he had no face at all now. .

The doctor on duty quickly went inside to confirm which girlfriend it was, and the patient said a name angrily.

But when I call it, it prompts it to shut down.

At this time, news came from the inspection company.

(End of this chapter)