Start From Emergency Doctor

Chapter 375

The popular sentence on the Internet, “Don’t let diabetes, don’t let him taste the sweetness” does have a scientific basis.

Because of the increased glucose content in the blood of diabetic patients, the urine will have a sweet taste. Most patients are colorless, but turbid, and have a lot of bubbles.

Of course, the human senses are wonderful. In terms of taste, the perception of sweetness does not completely depend on the blood sugar concentration, so it is not rigorous to judge whether sweetness is purely based on the level of blood sugar.

However, the medical profession has indeed proved that the urine of diabetic patients is sweet. As for how to prove it, it is not known…

According to this statement, this one-hundred-three hyperglycemic patient is really a sugar man, and if a vampire sucks him, he will be killed!

Such patients are already high-risk patients. Furthermore, according to family members, the patient developed dizziness, vomiting and other symptoms three days ago, but did not improve after treatment at the township hospital, but worsened the symptoms the next day.

Then, I started to suffer from shortness of breath and unable to pass urine until I lost consciousness just now, and hurriedly sent to Yanjing Chinese Medicine.

Zhang Ling is responsible for looking for a doctor. For her, looking for a doctor is equivalent to looking for Zhou Yuan. Lin Wen went to get the blood routine and other inspection reports.

After a while, Zhou Yuan put on his white coat again and hurried over.

After a brief understanding of the situation, Zhou Yuan did a few simple checks and it was obvious that there was a rotten apple smell.

This is a very obvious symptom of diabetic ketoacidosis. After the poisoning, there will be high blood ketones, keturia, dehydration, electrolyte disturbance, metabolic acidosis and other manifestations. It is one of the common emergencies in emergency medicine.

Zhou Yuan had been exposed to ketoacidosis before, and that time the patient was suspected of having come to touch porcelain, and he was almost driven out of the hospital regardless. But fortunately, Zhou Yuan was alert and saved him in time.

Soon, Lin Wen came back with the inspection report.

Patient Lin Hai, medical records show that the patient’s past medical history includes fatty liver and chronic gastritis.

This made Zhou Yuan feel a little bit sighed. He was actually sick when he was only twenty-five years old.

The results of the examination showed that the patient’s head CT was normal. The blood gas analysis showed acid substitution, blood ketones 3.25mmmol/L, sodium 127mmol/L, potassium 3.9mmol/L, and plasma osmolality of 342.9mOs.m/(kgH2O).

Other auxiliary examinations are not optimistic.

For example, the range of lipase is 13-60 for normal people and 429 for patients. Normal amylase is between 0 and 100, and the patient’s value is 377.

Zhou Yuan’s face gradually became heavier. This 25-year-old patient was more serious than the couple in the previous night!

“How can blood sugar be so high?”

Lin Hai was lying on the hospital bed, all thoughts were grayed out, and he said nothing.

His tonnage is quite astonishing. He just reached 1.7 meters tall, he seems to have more than one hundred kilograms.(Read more @ wuxiax.com)

After inquiring, Zhou Yuan learned that Lin Hai’s living habits are very poor. Take drinking water as an example. When he is thirsty, he rarely drinks water and always uses drinks instead.

Before being sent to the hospital, he finished two large bottles of Coke.

After judging from the examination results, the diagnosis result was diabetic hypertonic state, ketoacidosis, and severe dehydration.

“Quick rehydration. Replenish according to the actual amount of dehydration in the patient.” Zhou Yuan said.

Hyperglycemia hypertonic state, also known as hyperglycemia hypertonic syndrome, is a clinical syndrome characterized by high plasma osmotic pressure, severe dehydration and progressive disturbance of consciousness caused by hyperglycemia, plus ketoacidosis. Perform rapid rehydration instead of high-dose insulin to control high blood sugar.

The patient’s family went to the pharmacy to fetch the medicine and hand it to Zhang Ling.

“There is no heart disease, right?” Zhou Yuan asked.

It is not written in the medical record, but it is always right to ask more.

“No.” Lin Hai’s father shook his head.

Zhou Yuan looked at Zhang Ling and said, “First fast and then slow. The first hour is to add 1,000 ml of normal saline, and then adjust the speed according to the patient’s dehydration status. The amount is average, and the remaining half will be completed in the next 24 hours.”

The normal saline provided by the pharmacy is hypertonic saline. Generally, hypotonic fluid is not used in clinical normal saline to avoid hemolysis and brain edema.

Of course, in addition to injecting fluids, replenishing warm water through the gastrointestinal tract is also a simple and effective method. The specific steps are to inject about 200 ml of warm water from the stomach tube at a time, and then use the nasogastric tube for fluid rehydration.

Zhang Ling began to configure quickly and prick the needle.

Lin Hai is relatively large, and the fat layer under the skin is very thick, making it almost impossible to see the blood vessels from the surface of the body.

I have tried tapping, applying iodine solution, etc., and I have tied up the blood vessels with a tourniquet. Generally speaking, the veins will bulge at this time, and the blood vessels will become obvious, but Lin Hai’s hands can even see traces of blood vessels Can’t come out…

Zhang Ling was silent with the infusion needle in her hand…

“Doctor Zhou, how about changing to a gastric tube for infusion?” Zhang Ling hesitated, not daring to get the needle.

The main reason is that there is no way to get a needle in this situation!

Zhou Yuan shook his head. For Lin Hai, injecting fluids is the quickest and most suitable method. He walked up to Zhang Ling and said, “I’ll do it.”

Zhou Yuan took the needle and vented the needle again, using his right index finger and middle finger to slowly slide across the back of Lin Hai’s hand.

He was trying to use his fingers to sense the pulsation of blood vessels, and there must be bulges caused by blood vessels on the surface of the skin, but it was impossible to observe with the naked eye.

This method of finding blood vessels is very technically demanding and requires tactile sensitivity. Zhou Yuan himself has mastered the master-class intravenous injection technique, and is very handy with various injection methods and methods of finding blood vessels.

Besides, Zhou Yuan also has a perfect compression hemostasis method that specifically deals with blood vessels!

One of the essence of the compression hemostasis method is to find the bleeding point, that is, to find the bleeding blood vessel. The perfect technique gives Zhou Yuan’s fingers a strong sense of blood vessel pulsation.

When the two medical skills were combined, Zhou Yuan quickly found his position.

“Compound iodine. Mark it here.”

Zhang Ling immediately dipped a cotton swab with compound iodine and followed the direction of Zhou Yuan’s fingers to mark.

Lin Hai’s blood vessels are relatively curved and not straight. Marking is helpful for needle insertion and observing the direction of blood vessels, and it is helpful to see the parallel needle insertion after blood return.

Moreover, Lin Hai’s blood vessels are relatively deep and the fat layer is very thick. The average person’s needle insertion angle should be as small as possible and kept below 20 degrees, but in order for the needle to enter Lin Hai’s skin, the angle is about 25 degrees.

Zhang Ling held the cotton swab with an expression of hopelessness on her face.

Who am I, where am I?

Excuse me, the nurse has been robbed of his job. Is there any good job I can recommend?

Nursing home care workers, nursing home convalescent workers, or physical health rehabilitation institutions?

I am a nurse and I have a better understanding of the human body. Otherwise, I just go for a massage. You can find the sensitive points of the customer in one go. Pressing it down is absolutely refreshing…….