This doctor has a system

Chapter 513 576. Water Knows

The so-called disulfiram reaction refers to the disorder of certain metabolic reactions in the body before or after taking certain drugs with the same structure or mechanism of action as disulfiram, or after consuming products containing alcohol, leading to a poisoning reaction of "acetaldehyde accumulation" in the body.

Patients may experience facial flushing, headache, nausea, mild chest tightness, palpitations and other reactions, most of which are not life-threatening.

But some unlucky people may experience tachycardia, low blood pressure, difficulty breathing, electrocardiogram changes, and even death.

Every year people die from this disease.

Many people know that you cannot drink alcohol after taking cefuroxime, but in fact, this is not the only drug that can cause a disulfiram-like reaction with alcohol. Other drugs such as nitroimidazoles and hypoglycemic drugs can also cause it.

Therefore, no matter what kind of medication you take orally, drinking alcohol is not recommended.

Among the many cephalosporins, the cefoperazone sodium and sulbactam sodium infused by this old man causes the most disulfiram-like reactions and is the most sensitive.

You have to be the boss to seek death.

"Did you do an electrocardiogram?" Gao Feng asked.

"Yes, it's fine." Bu Zhengyang replied. He was also quite cautious. Although the patient had a clear history of drinking and his symptoms were consistent with a disulfiram-like reaction, he was old after all and was about to die.

The heart is definitely not as healthy as that of young people, so it is easy for problems to arise over time.

There are many cases of serious heart problems caused by drinking alcohol, and the old man drank quite a lot, half a bottle.

After hearing Bu Zhengyang's words, Gao Feng felt relieved. It shouldn't be a big problem. After drinking some fluids and waiting for the alcohol to be metabolized, the old man should be full of energy again.

He went to see Tingting, who was doing nebulization and greeted him when she saw him.

"Brother, Tingting is much better." Gao Zhenzhen reported, "How long will she stay here? We still have to go back to class."

"Let's check it again later." Gao Feng said nonchalantly. Besides, what's the use of taking that class? He thought to himself.

It's useless.

Gao Feng was not in a hurry to leave today. He went through all the patients in the department.

The conditions of the vast majority of patients are relatively stable, most of whom suffer from heart and lung diseases.

There were also more serious cases, such as a 97-year-old man who had an acute myocardial infarction and was hanging in the emergency room. His family had already bought his funeral clothes and were just waiting for him to die.

It’s not that his children are unfilial, it’s just that the old man has reached the point of being exhausted, but his vitality is tenacious and he is still holding on.

The 68-year-old eldest daughter has taken the burial clothes back and forth several times. Every time she sees that the old man is about to die, she quickly takes out the bought burial clothes and puts them on him.

Then after a few days he felt better, and then he took it off again, and it happened over and over again.

Sometimes when the attending physician makes rounds, he wonders whether it is the medicine that is working or whether there is something to the explanation for the shroud.

"The old man is waiting for his youngest son to come back." The third daughter told everyone that the old man had 4 daughters and 2 sons. The eldest son died at the age of 3. The youngest son was naturally the treasure in the old man's heart.

The latter is now working abroad and will be back in two days.

Some people are sad about birth, aging, sickness and death, while others are confused about relationship problems.

"Brother Liang, my girlfriend"

"Love grows over time." Wang Liang said perfunctorily, "Didn't I tell you before?"

"No." The team member said, "I want to know whether she loves me or not."

"Who knows?" Wang Liang said.

"Shui knows?" The team members were very puzzled, what does that mean?

Gao Feng was just about to leave when a nurse came into the office. Seeing Gao Feng sitting there sorting out medical records, she quickly called out "Director".

"What's wrong?" Gao Feng asked. The nurse looked unfamiliar, probably new.

"I'm looking for the doctor on duty." The nurse was indeed new and a little nervous. "The old man in bed 10 still has some chest tightness."

"Let me go and take a look." Gao Feng stood up.

He came to the ward and saw the patient in bed 10's wife feeding him an apple. When she saw the doctor coming, she stood up quickly.

"Are you still feeling uncomfortable?" Gao Feng asked.

"Yeah." The patient frowned and said, "I'm not as panicked as before, but I still feel chest tightness."

"Isn't the chest tightness relieved at all?"

"That's right," the patient said, "about 3020-% reduction."

Gao Feng picked up the stethoscope and listened. The heart rate was still regular. "Let's do another electrocardiogram for him," he said to the nurse beside him.

In fact, these are all jobs that only humans can do, but the interns should be eating in the duty room at this moment. Since the director has spoken, she naturally doesn't dare to argue and quickly goes to push the electrocardiograph.

Gao Feng compared the two electrocardiograms and found that there was no change.

"Draw blood and recheck the cardiac enzymes, myoglobin and calcium."

The patient grimaced when he heard that he would need his blood drawn, but he did not dare to object in front of the doctor and just stretched out his arm obediently.

"I told you not to be so delicate. Now it's okay. We need another check-up." After Gao Feng left the ward, the patient's wife couldn't help but complain.

"I just feel a little uncomfortable." said the patient.

"Who told you to drink? You deserve it!" His wife thrust the apple into his mouth. "Just die. I'm too lazy to serve you anymore!"

The patient didn't dare say anything now.

Before leaving, Gao Feng told the doctor on duty to remember to check the results later.

The doctor on duty was also new. His name was Mao Wen. He had an ordinary appearance and wore thick glasses. From a distance he gave people an honest and simple feeling.

At this level, when he gets older, he will definitely be trusted by his patients. If he becomes bald by then, it will be a fatal blow.

If you say he is not an experienced expert, the patients probably won't believe you.

"Okay, Director." Mao Wen said quickly, "I will definitely remember to read it."

After Gao Feng left, he set an alarm clock to avoid forgetting it due to sleeping too deeply.

The general medicine department is much better than other departments in this respect. There are very few seriously ill patients in the department, so there is naturally less work at night. Some of the work related to colds, fevers, and diarrhea can be completed by those interns who work like slaves.

After the results came out, Mao Wen took a look and found nothing unusual. He felt relieved and went to sleep.

But at around 2 a.m., the intern woke him up again.

"Teacher Mao, bed 10 looks pretty uncomfortable. Please go over and take a look."

Mao Wen quickly got up, but his heart was full of resentment towards the old man in bed 10.

Why are you drinking alcohol when you are fine? Especially when you are in the hospital. Who is looking for trouble?

"Doctor, I still feel chest tightness." The patient looked distressed, "I can't sleep because of the tightness."

His wife looked very apologetic and felt very sorry for calling a doctor in the middle of the night.

Mao Wen just started working and has little work experience, but he is meticulous in his work and has a strong sense of responsibility.

He looked at the vital signs carefully. The blood oxygen saturation was good, 97%. The heart rate was not fast, 84 beats/minute. The blood pressure was a little low, 84/44 mmHg.

"I remember you have high blood pressure, why is it so low?" Mao Wen asked, "Did you take blood pressure medicine at night?"

"No, because of low blood pressure, the nurse said I can't take the pill tonight." The patient's wife said that the patient was taking nifedipine sustained-release tablets, twice a day, one pill each time.

Without taking antihypertensive drugs, blood pressure is still so low? Mao Wen was a little uneasy. He hesitated and prepared to call the second line. If he was not sure, he had to report more. Although he might be complained by the second line, it was better than getting into trouble.

Just as Mao Wen was about to take action, his cell phone rang. He looked and saw it was the director calling.

"Xiao Mao, are you asleep?"

"No, Director." Mao Wen replied, "The old man in bed 10 is still complaining of chest tightness. I'm by his bedside."

"That's what I was going to say." Gao Feng's voice came over the phone, and it had an ethereal feeling in the quiet night. "His blood pressure was a little low when he left."

“I didn’t think too much of it at the time, but there might have been something wrong.”

Gao Feng asked Mao Wen to do another electrocardiogram on the patient and recheck the muscle enzyme indicators.

“Communicate well with the patient.”

The patient must have some complaints after having his blood drawn several times.

Sure enough, when he heard that he needed to undergo another examination, the old man's face looked a little unhappy.

"Can you use some special medicine? Drawing blood doesn't cure the disease."

"Look at what you said. If there is any special medicine, do you need to tell me?" Mao Wen said, "I'm sure it would have been used for you a long time ago."

"Besides, if you didn't drink, there wouldn't be so many problems."

"Yes, old man, your blood vessel is not easy to puncture," the nurse agreed.

Now the patient was too embarrassed to complain and could only cooperate with a bitter face.

The electrocardiogram has indeed evolved compared to the last time, and the muscle calcium value has increased.

"It should be a myocardial infarction in the anterior wall." Gao Feng said, "Please ask the cardiology department to take a look. Forget it, it's too late. Let's transfer the patient to the CCU."

The doctors on duty at the CCU had no complaints, as they were responsible for doing such hard and dirty work, and this patient did not seem to be a big problem.

"Why does this place look so gloomy?" The patient was a little scared.

"How can it be gloomy? Isn't it quite bright?" the CCU nurse replied, "Uncle, your eyesight is not good."

"Why aren't they moving?" the old man asked, pointing at a patient.

"Oh, he's been in a coma for more than 20 days." The nurse sighed, "I guess."

"What about that one?"

"The patient's condition is not serious and he is much better now," said the nurse.

"Then why doesn't he move?"

"Uncle, it's 2:45 in the morning, people are sleeping."

"Is that so?" The old man breathed a sigh of relief. Just now, he saw these patients lying motionless on the bed and was extremely scared.

"How is the patient? He seems to be okay." asked the doctor on duty at the CCU.

"He drank some wine during the day and took Shupushen, and then he kept complaining about chest tightness." Mao Wen replied, "He took medicine, but he kept complaining about chest tightness symptoms."

"Then we just checked the electrocardiogram again, and our director said it was probably an anterior myocardial infarction, so I thought of pushing it over to you."

The doctor on duty at the CCU took a look at the electrocardiogram and felt a little confused. Even if the troponin level was slightly elevated, it could not be determined from this electrocardiogram that it was a myocardial infarction.

"Did Director Gao say that?" he confirmed.

"Yeah." Mao Wen replied, "Isn't it a bit strange?"

He smiled and said, "To be honest, I just noticed some changes compared to the last electrocardiogram. There seems to be a little bit of myocardial infarction on the anterior wall."

But their director is not an ordinary person. Although he has some doubts, he is still willing to believe it in his heart.

Besides, it is definitely safer to push it to the CCU. If it really is not the one, the worst that can happen is that you can transfer it back.

"Director Gao's level is beyond our reach." The doctor on duty at the CCU said with a smile, "Then I will observe closely."

However, he felt a little bit disapproving in his heart. Everyone can make mistakes. Maybe Director Gao was overthinking it this time.

"Should we use dual antibodies first?" asked the nurse.

"Well, why don't we wait."

Soon it was 5 a.m., and the patient woke up after just sleeping for a while. "My chest feels more stuffy and a little painful."

"Quick! Take another electrocardiogram and check the muscle enzymes!"

The freshly-released electrocardiogram revealed crucial information at this time, with the ST segments in leads V2 to V4 significantly elevated.

"Oh shit, anterior wall myocardial infarction!" the CCU doctor shouted.

Gao Feng went to see the old man the next day. After a night of tossing and turning, the patient felt much better.

"Gao Feng!" Director Lu came forward and greeted him with a smile, "You haven't been here for a long time."

It was true. Ever since he went to work for Academician Bao, he had never been to the CCU of the Provincial Hospital again. During this period, Director Lu called him once and asked him to help solve a problem with an ECMO device.

"Your level has improved a lot." Director Lu sighed, "Our doctors on duty told me about what happened yesterday. Now everyone admires you very much."

"It's just a blind guess." Gao Feng laughed. There was indeed an element of luck involved in this matter.

The two chatted for a while and made an appointment to have dinner in two days.

"Gao Feng, your third uncle is coming to the hospital for an IV. Please take care of him." Gao's father called.

"Third Grandfather? Is he still alive?"

"How can you talk like that, kid?" Gao's father scolded, "I'm in good health. I've always said that good people don't live long, but bad people do..."

"You kid, you've led me into a ditch!"

The Gao Feng family does have some blood relationship with this third grandfather's ancestor, but by this generation it has become as shallow as clear water.

He also didn't like this Third Grandfather. When he was a kid, he wanted to eat a tomato, so he secretly went to their vegetable garden to pick one. Unexpectedly, he was discovered, and the old man beat Gao Feng up, and he was particularly cruel.

He also spread rumors in the village that Gao's father and mother did not know how to educate their child, and that the child became a thief at a very young age.

Gao's mother was very angry at the time. Every year during the wheat harvest, their family would go to help the third uncle's family with work. For a tomato, she beat her son's butt so hard that he couldn't even sit on the stool.

Thinking about it now, Gao Feng still remembers it vividly.

Well, I thought of him now.

But Gao Feng was puzzled. This old man was usually mean and vicious, and many people disliked him, but he was able to survive.

My third uncle has a very special hobby. Whenever he feels uncomfortable, he has to receive an IV drip. No matter if it is a headache, a cold, loss of appetite, or constipation, they are all indications for IV drip. Moreover, he has to receive cephalexin every time. If there is no cephalexin in the IV you give him, he will think that you are fooling him or even deceiving him.

His son advised him against this many times.

"Whether it's effective or not is determined by me, how could I not know?" Third Grandpa said confidently, "Isn't it all thanks to cefuroxime that I've been in such good health for so many years?"

"You should lose a little bit at ordinary times."

"Isn't it because my mother takes good care of you that you are in good health?" the son said speechlessly.

"What do you know?" Third Uncle looked disdainful as if he was talking to a cow, and the whole family was at a loss as to what to do with him.

"Why did you decide to come to the Provincial Hospital this time?" Gao Feng asked curiously. Could it be that the clinics in the village and town could not meet his needs?
(End of this chapter)