This doctor has a system

Chapter 532 595. Wang Guifen, come on!

The reason is simple. Like most rare diseases, acute intermittent porphyria cannot be cured.

Patients need to take medication for life, and the drug Hemin used to treat the disease is expensive and unaffordable for ordinary families.

Fortunately, there are other alternative treatments. The simplest one is the "glucose effect". Reasonable incorporation of carbohydrates into the diet can inhibit the activity of ALA synthase, thereby reducing the production of porphyrin precursors.

"Director Gao, thank you so much." Director Ding thanked Gao Feng. His niece was lucky, otherwise it would take who knows how long it would take to find out the cause of the disease.

After the cause of the disease was identified, Xiao Meng's treatment entered the fast lane and she soon met the conditions for discharge.

"What kind of treatment is this?" Director Ding's sister-in-law was very dissatisfied. "Such a big hospital, and the director, is this the level?"

"It's just that the child's condition is too complicated." Director Ding said, "My brother is a doctor, not a god!"

"Anyway, I feel like he just didn't do his best!" The eldest sister-in-law insisted on her opinion, "Go talk to your brother again and put some pressure on him!"

"Why don't you go? I can't just keep putting pressure on you! Am I a gas tank?" Director Ding was a little annoyed. "Don't make trouble. Doesn't the child look fine now?!"

"What do you mean it's good! Don't you think she looks dumber than before?"

"No way?" Director Ding was a little panicked. "Ni'er, are you okay?"

"Of course I'm fine." Xiao Meng said unhappily, "Why don't you take my mom to see a doctor? Don't you think she has a problem with her brain?"

"Hey! How can you be so disrespectful, kid?!" Xiao Meng's mother was angry, "How can you talk about your own mother like that?"

"Wife, I think, since we are here now," Director Ding said politely, "I personally think there is nothing wrong with you, but since the child said so, why don't we check your brain or something."
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General Practitioner Demonstration Room

Bu Zhengyang was giving a lecture to the students, and Gao Feng was watching. Most of these trainees were fresh graduates, and they had never managed patients independently, and their clinical experience was almost zero.

"If you meet a patient injured in a car accident on the road, with multiple rib fractures, bleeding, hemothorax, and confusion, what should you do?"

"The boy in the black short-sleeved shirt, stop looking down! It's you! Tell us something."

"Well, call 120." The short black boy said, "Then call the traffic police."

"No more?" Bu Zhengyang asked in disbelief, "That's all you do?!"

"I'll help him hold down the bleeding area." The short black boy thought for a moment and said, "To prevent excessive bleeding."

"The long-haired girl, can you tell me what to do if you encounter this situation?"

"I think we should stay out of other people's business." The female classmate was more honest. "What if we can't save him and his family members blackmail us?"

"Don't think about this!" Bu Zhengyang said angrily, "From the perspective of saving lives, what can we do?"

"Well, check to see if he is still breathing. If he is, ask him where he feels uncomfortable, and then take the next step based on his description."

"What if he is dead?" Bu Zhengyang asked after taking a deep breath.

"Call the funeral home directly?" The female classmate was not sure. "Isn't it a little early? I think we should let the family see him one last time."

"Is that all?" Bu Zhengyang asked calmly.

"If there is a white sheet at the scene, you can cover it." The female student added, "By the way, it's best to put a cone next to it, in case it is run over by passing vehicles."

"No! Why are you here for training? Why don't you just become a traffic policeman?"

"My fault, the teacher didn't explain it clearly." Bu Zhengyang said in a complicated tone, "It's about the problem of hemothorax. As a doctor, how can we simply deal with it when we encounter it?"

"Forget it, let's talk about some theoretical stuff later." Gao Feng concluded, "It would be better for them to let the patient lie on the ground and wait for the ambulance."

This way the chances of survival will be greater.

"Nurse! Doctor! Someone come quickly!"

There were hurried shouts from the corridor.

When the two nurses heard the sound, their hearts trembled and they ran into the ward at full speed.

The one who shouted was the old man in bed 22. He looked panicked and was struggling to get out of bed.

"Uncle Hu, what are you doing?" A nurse hurriedly held him down, "What's wrong with you? Where's your wife?!"

"I'm fine!" Uncle Hu was almost dying of anxiety, "It's my wife who's not feeling well!"

"Where is she?" asked the nurse.

"at home!"

"at home?!"

Uncle Hu is also an old patient in the general practice. When he was young, he smoked all year round and would smoke a cigarette no matter what. Now that he is old, he has been diagnosed with chronic obstructive pulmonary disease. Whenever it is hot, cold, or unlucky, he would come to the hospital to contribute his light and heat to the sustainable development of the Provincial Hospital.

In addition, he also has sequelae of cerebral hemorrhage and hemiplegia of the right limbs.

The cause of cerebral hemorrhage is high blood pressure. Every time Mr. Hu talks about this, he feels like he’s about to break his thigh.

He was diagnosed with high blood pressure early on, but he has always refused to take medicine. Don't ask why.

The questions are: 1. Are you scaring me again? 2. All medicines are poisonous 3. I don't feel dizzy.
Then one morning three years ago, he suddenly suffered a cerebral hemorrhage. When he was sent to the hospital, he had his pants in his pockets. It was said that he was scared.

Because the bleeding area was quite large, and despite timely treatment, his right limbs no longer responded to his brain's control. He now needs a cane when he goes out, and has successfully become a four-legged man.

This time, because the air conditioner was on for too long, Mr. Hu caught a cold, which triggered an acute attack of chronic obstructive pulmonary disease, so he was admitted to the general practice department.

His home is right next to the Provincial Hospital. His condition has stabilized a little in the past few days. His wife prepares meals at home at noon and in the evening and brings them to him. She is very considerate.

"I've called several times, but no one answered. Something must have happened!" Uncle Hu was very panicked. He was inexplicably frightened and that's why he made the call.

"Uncle, maybe your wife didn't notice it." The nurse comforted.

"Impossible, it's been more than 10 minutes, and our house is very close to here." Uncle Hu was so anxious that tears came to his eyes. His son was on a business trip and his daughter-in-law couldn't come over for a while.

"Can you guys help me check my house?"

Gao Feng and Bu Zhengyang also came to the ward at this time, and immediately agreed after understanding the situation.

"Ma Liang, are you going to work?"

"Go ahead, what's wrong?"

Li Youliang briefly explained the situation to him, "It is very likely that something has happened to the person. Can you send a car?"

Of course they could, the ambulance took everyone out.

Mr. Hu's home is on Jingsan Road, and it only takes 3 minutes to drive to the community. The old man at the door was dozing off, but when he saw the ambulance, he was startled and ran out quickly, kicking the cone bucket aside.

"Uncle, which building is Building 8?" Wang Liang asked.

"It's the one in front." The old man pointed and said, "Forget it, I'll take you there."

"Don't you need to stand guard?" "No, there's no point for me to stay there." The old man was very honest. He never closed the electric door at the door. Many old ladies didn't bring their cards when they went out, and when they came back they would shout at him to open the door. Later, he simply left it open.

"Thank you then."

"Building 8, 1802? Isn't that Wang Guifen's home?" The doorman was stunned for a moment, "Did you make a mistake? Her husband is living in the hospital now."

"It's not her husband. Maybe there's something wrong with her." Ma Liang explained, "I can't get in touch with her."

"Ah? No way?!" The expression on the old man's face suddenly changed, and his pace quickened. "Gui Fen even said hello to me when she came back at around 11 o'clock!"

"You know her?"

"We are dancing partners!" The doorman was a little anxious, "Let's not let anything go wrong!"

A group of people soon arrived at Uncle Hu's door.

"Wang Guifen!" Ma Liang banged on the door, "Are you home?!"

"Open the door quickly! Check the urine chart. Ahem. We are doctors from the Provincial Hospital!"

"say!"

"Wang Guifen!"

No one responded.

"What should we do?" Ma Liang was anxious, "Why didn't her family bring a key?"

This is really unfair to Mr. Hu. He has hemiplegia and never goes out alone, so there is no point in carrying a key.

"I'll call the fire department right now!" said Li Youliang.

"Forget it, it's too late." Gao Feng said. If there really was any problem, it would be too late.

Gao Feng motioned for everyone to stand aside, then kicked the door hard. The door did not open, but it was obviously deformed.

There is a play!

He then kicked the door three more times and successfully cleared it.

Everyone rushed in and found old lady Wang Guifen lying at the kitchen door, her face pale and her breath barely alive.

"Wang Guifen!" Ma Liang shouted, "Wake up!"

"Gui Fen!" The gatekeeper was so distressed that tears came out of his eyes. "What happened to you? Wuuwuwu."

Hearing the old man's voice, the old lady tried hard to open her eyes, and then closed them again.

"It's so hot here." Li Youliang, who was just hanging out, was sweating all over. The 18th floor was the top floor, and it was so hot that it was soaking hot. There was no air conditioner on in the room, and it was so hot that it made people feel uneasy.

The nurse quickly injected a bottle of saline solution into the old lady, and several people carried her onto a stretcher. At this time, taking her to the hospital first was undoubtedly the most correct choice.

"Cerebrovascular accident? Heatstroke?" Ma Liang asked. He touched the patient's forehead and found that the skin temperature was very high, even a little hot.

"It should be heatstroke. I estimate the temperature in her home is 35 degrees Celsius." Gao Feng said, "The patient should have just cooked and didn't turn on the range hood."

As for why Gao Feng knew that the old lady didn't turn on the range hood, the answer is very simple. When he was at the patient's home, he glanced at the surrounding environment and found that the plug of the range hood was hanging aside. The socket was located very high, so it was unlikely that it had just been unplugged.

What’s even more amazing is that the cabinet air conditioner in the living room is covered with a cloth cover, so there is no need to worry about the air conditioner being damaged even in such a hot day.

After arriving at the hospital, Wang Guifen was sent directly to the emergency intensive care unit.

Everyone initially thought that the problem was not serious. They thought that if it was not a cerebrovascular accident, the person might wake up quickly if they gave him some fluids if it was heat stroke.

But Gao Feng keenly sensed something was wrong. The patient's condition did not look like a mild heatstroke. His forehead was very hot, but his hands and feet were a little cold and clammy. His heart rate was very fast and his breathing was obviously rapid.

Heatstroke refers to an acute disease with central nervous system and/or cardiovascular dysfunction as the main manifestation, caused by dysfunction of the temperature regulation center or failure of sweat glands, as well as excessive loss of water and electrolytes in an environment with high temperature or humidity and no ventilation.

The weather is hot in summer. When the average daily temperature is >30 degrees Celsius and the relative humidity is >73%, the probability of heat stroke will increase significantly.

my country has a relatively large area of ​​tropical and subtropical regions, an increasing degree of urbanization, and an increasingly dense urban population, which has resulted in an "urban heat island effect" and a gradually increasing incidence of heat stroke among urban residents.

Depending on the severity of the disease, heat stroke can be divided into three types: pre-heat stroke, mild heat stroke and severe heat stroke.

Premonitory heatstroke and mild heatstroke are generally not serious problems. All you need to do is replenish fluids in time and get out of the high temperature environment, and you will soon be back to full energy.

But severe heatstroke can be fatal, and Gao Feng felt that Wang Guifen was most likely suffering from severe heatstroke.

Depending on the pathogenesis and clinical manifestations, severe heatstroke can be divided into three types: heat cramps, heat exhaustion and heat stroke.

These types can occur in the same patient one after the other or simultaneously, and are often difficult to distinguish. Heat stroke is the most serious of all.

“I hope the patient is not so unlucky.”

But the patient's condition cannot change according to human will, and Wang Guifen's condition is obviously worse than everyone imagined.

"It's most likely heat stroke!" Gao Feng said to the doctor on duty in the emergency department with a frown. He had just examined the patient carefully and found that the patient's condition had worsened again in a short period of time and he was currently in a coma. You know, he still had some response in the ambulance.

Doctors on duty in the emergency department are overwhelmed. If heat stroke patients are not treated in time, the mortality rate can reach 80%. Some patients who recover from heat stroke may have permanent neurological or mental sequelae.

"Where are the family members? We need to get them here quickly!"

Bu Zhengyang in the general practice ward also had a headache. Mr. Hu suffered from hemiplegia, and he knew that it would probably not be of any use. Instead, other problems might arise due to his emotional excitement.

He quickly called Mr. Hu's son, who was extremely anxious and said that his lover was already on the way to the hospital.

"I'll book a ticket back now!"

"Please save my mother!"

The results of the emergency blood test came out quickly, showing hyperphosphatemia, elevated lactate dehydrogenase, myoglobin, and creatine kinase levels, which were suggestive of rhabdomyolysis.

Low blood calcium may be caused by muscle damage.

Increased blood urea nitrogen and blood creatinine indicate abnormal renal function.

There were also problems with liver function. Wang Guifen's serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) levels were significantly elevated.

The electrocardiogram showed tachycardia, and blood gas analysis showed respiratory alkalosis.

It's so hot today, it's okay not to turn on the air conditioner, but even if you don't turn on the range hood when cooking, you might get heat stroke at home.

The TV drama is correct, people named Guifen are indeed ruthless people.

"No way?" Li Youliang asked in surprise. Could it be possible to break it?
"The tube has been inserted, and all possible means have been used. Let's see how effective the treatment is in the next two days." Gao Feng said helplessly. If the old lady died, Mr. Hu probably wouldn't be able to live for many more years.

By the way, the gatekeeper should be very sad too.

"Wang Guifen, come on!" Gao Feng shouted in his heart.

(End of this chapter)