Doctor: It's reasonable to perform surgery on yourself.

"Cough..."

Wang Shengde coughed. His expression of enjoying the pain was indeed not very elegant. He didn't care about the reputation of Joseph and others. The key was not to spread gossip about the doctors.

For example, "Everyone who comes to the doctors will become a psychopath."

Otherwise, famous doctors from all over the world would be on guard, and the inclusion of the illustrations would be a little more difficult.

"Doctor, how is my husband?"

"Doctor, is the operation going well?"

Before Wang Shengde, Wang Ping and others came forward to greet, the family members rushed forward, with snot and tears, shaking hands, and nervous and fearful expressions.

"The operation went smoothly. After waking up, he will be transferred to the ICU for testing and observation for about two days. If there is no problem, he can go back to the general ward."

As soon as Xu Qiu finished speaking, several family members softened and tears flowed from their eyes.

Several people held Xu Qiu's hand tightly:

"He just had a second child. If it weren't for you, we really don't know what to do!"

"Doctor, you saved our family... We will remember your kindness in this life..."

The family members kept talking, as if they could never finish their words, and they all prayed for Xu Qiu's son to become a dragon and daughter to become a phoenix.

"Okay, okay, if you continue, Dr. Xu's grandchildren will be blessed by you. He just experienced a car accident last night and came to help you with the operation in the early morning. Let him go back and rest first." Wang Shengde came over and said.

"Oh, I remember, there was also a doctor at the scene of the car accident last night, who saved many people, and it was you!" The family members were all shocked.

They never thought that Xu Qiu had also experienced a car accident. He saved a patient once at the scene, and now he rushed to the hospital and saved him again...

For a while, the family members felt mixed emotions, and their gratitude to Xu Qiu was difficult to express in words.

"Congratulations, you have received the heartfelt thanks of the patient!"

The system prompt that sounded afterwards also proved this point.

Xu Qiu was a little surprised.

The system has very high standards for judging the heartfelt gratitude of patients. Since his rebirth, he has only received it twice.

The last time was Shen Ma and Shen Ning, who now run a shared kitchen opposite the clinic.

The second time was Niu Niu, who has mitral valve prolapse. The complicated family relationship of Niu Niu's parents, and the loyal prostitute, have made everyone in the emergency department sigh.

And this third time is now.

The system rewards brought by heartfelt gratitude are very generous.

Medical skills +5%, physical strength limit +10%, energy limit +10%, of course, there are more specific bonuses, such as the ability to perform on the spot during surgery, which has also been slightly improved.

It can be said that every heartfelt gratitude is making Xu Qiu take a step towards the legendary doctor.

...

Shortly after the operation, Xu Qiu did not go back to the office directly, but went to the emergency room and ICU.

The car accident last night was big, and a total of seven cars were directly affected. One person died on the spot and sixteen people were injured to varying degrees.

On the contrary, the driver of the dump truck who started the incident was unscathed. In front of this type of working vehicle, private cars are as fragile as paper.

"Doctor Xu!"

"Doctor Xu is here, please help me take a look at this!"

At the ICU, the doctors were full of energy and spirit when they saw Xu Qiu. Director Jiang hurried over with a medical record.

"I was just about to go over there to see you. This patient drank trichlorfon and has more than 180 units of cholinesterase!"

The normal index is between 4.3 and 10.5, which is nearly 20 times higher.

Xu Qiu glanced at the rescue record.

After admission, he was unconscious, sweating profusely, vomited several times, and had incontinence.

After being sent to the clinic, he was immediately intubated, gastric lavage and catharsis were performed, and then he was admitted to the EICU for "organophosphorus poisoning". The treatment measures were three-pronged: atropine, ventilator-assisted ventilation and bedside blood perfusion.

Director Jiang looked solemn. "We have given a thousand doses of atropine. The patient is still in a very bad condition, but he has woken up. We are considering whether to reduce the dose of atropine."

"Go and have a look."

When Xu Qiu came to the bed, he was hit by a strong smell of garlic, which is a typical manifestation of organophosphorus poisoning.

In addition, because organophosphorus and cholinesterase form phosphocholinesterase, the activity of the patient's cholinesterase is inhibited, and the function of decomposing acetylcholine is lost, resulting in excessive accumulation of acetylcholine in the tissues...

The result is that the parasympathetic nerves are overexcited, and the sympathetic and motor nerves are continuously stimulated. The patient often dies from respiratory muscle paralysis and respiratory failure.

Fortunately, the patient was sent to the hospital in time, and after mechanical ventilation, the respiratory problem was temporarily solved. The next step is to use atropine to quickly alleviate the muscarinic symptoms and nicotinic symptoms caused by organophosphorus poisoning.

"We have used a thousand doses of atropine. The patient's symptoms have improved a lot. Muscle tremors have almost disappeared. Should we reduce the dosage?" Director Jiang asked.

After a careful physical examination, Xu Qiu shook his head and said, "Continue to use the medicine for at least two days."

A thousand doses of atropine may sound scary, but in clinical rescue of organophosphorus poisoning, the dosage must be stacked.

This type of poisoning is prone to rebound, and temporary improvement is often just a superficial phenomenon. Once the patient's various symptoms disappear, they can't wait to reduce the dosage, and the patient will eventually suddenly have various central nervous system symptoms and die.

Therefore, it is common for a hospital to use up its atropine reserves due to organophosphorus poisoning.

A thousand pills are nothing. There is even a clinical record of using up atropine in a hospital pharmacy in a small city in order to rescue a patient with organophosphorus poisoning.

Even Xu Qiu, among the patients he had rescued in his previous life, had to use tens of thousands of milligrams to save them.

The usage and dosage in textbooks are sometimes not helpful in clinical practice.

"Did the patient arrive this morning?" Xu Qiu continued to ask.

Director Jiang said: "It was around eight o'clock in the morning. It should have been more than half an hour since he took the medicine."

"How many times have you washed your stomach?"

"three times."

Xu Qiu shook his head: "Too little. Do gastric lavage for 24 hours, and flush the stomach with 500 ml of ice saline every half hour."

Everyone present was stunned.

Organophosphorus poisoning is common in rural areas, but it is less common in urban areas such as clinical doctors.

Therefore, neither Wang Ping nor Director Jiang has much experience in treating this kind of patients. They can save the patients when they come, but they have little understanding of the detailed special treatments like those proposed by Xu Qiu.

"I remember that in the clinical guidelines, the most important thing to treat patients with organophosphorus poisoning is to reduce gastrointestinal absorption. The core is gastric lavage and catharsis, but I rarely see anyone doing 24-hour gastric lavage." Wang Ping I feel a little strange.

Director Jiang thought for a moment and said, "The key is not to have gastric lavage around the clock..."

"Huh? Isn't it?" Wang Ping was a little surprised.