Zheng Ren glanced at the System's panel on the upper-right side of his vision.
What a strange diagnosis.
Brain injury and ketoacidosis!
In Zheng Ren's eyes, these two diagnoses were unimportant.
There was not even a subarachnoid hemorrhage. Why would Zheng Ren care?
Brain trauma was similar to being concussed. However, there was no actual treatment for concussion.
The patient did not have any organic lesions but because of the head impact, he had temporary dizziness, headache, nausea, vomiting, and other symptoms, all of which were collectively known as brain trauma.
Because there were no organic lesions, the reasons for his brain trauma were probably due to fighting and or a car accident.
This was not important compared to fatal ketoacidosis.
Under pathophysiology, ketosomes were the liver fat decomposition into fatty acids of the intermediate metabolites.
Under normal circ.u.mstances, the body produces a small amount of ketosomes, along with blood transport to the heart, kidney, and skeletal muscle and other tissues. Used as a source of energy, the blood concentration of ketosomes was very low, generally not more than 1.0 mg/dl. Therefore, you could not use a urinal test to detect ketosomes.
For severe diabetics, ketosomes could be detected in the urine. No matter how serious it was, when the ketosomes acc.u.mulated too much in the blood, it could cause the blood to turn sour and lead to acidosis, known as ketoacidosis.
Zheng Ren watched the nurse as she busied herself. She put the patient on electrocardiogram monitoring and left an intravenous channel, waiting for the doctor's next instructions.
He moved closer to the patient and sniffed. There was the smell of rotten apples. Zheng Ren knew it was coming from the ketoacidosis.
"Take a blood sugar test," Zheng Ren said. "Call the endocrinology department's Chief Resident for an immediate consultation."
The nurse was a little surprised. The patient's head was bandaged. It was obvious that it was a head injury. Why would Chief Zheng ask for an endocrine consultation?
However, there was a strict hierarchy between the higher and lower levels of the hospital, so they did not express their opinions during the rescue. Instead, they chose to obey.Find authorized novels in , faster updates, better experience, Please click /book/the-surgeon's-studio_16489637605120805/a-sociable-elderly-patient_49977379333919170 for visiting.
"Where's the patient's family!" Zheng Ren shouted.
An eighteen or nineteen-year-old teenager was following in the ambulance. He rushed to Zheng Ren's side and asked, "Doctor, is the injury severe?"
At the same time, the sound of hurried footsteps could be heard coming from the corridor.
Under normal circ.u.mstances, the ambulance would allow a family member to come up and help take care of the patient. Of course, the rules were different in different places. This was the case in Haicheng.
Other family members could take a taxi or follow inside the ambulance to the hospital.
Zheng Ren was a little unhappy when he saw that it was a young man.
The a.d.u.l.ts in this family were really caring, huh. He looked at the age of the patient, who was about 60 years old. This child might be his grandson or nephew.
Where were the a.d.u.l.ts? How could they let just a teenager follow him?
"Where are your parents?" Zheng Ren asked.
The teenager was stunned for a moment, then he said, "They're at work."
"Are there any a.d.u.l.ts coming?" Zheng Ren asked.
"Aunt Zhao and Uncle Li are coming over."
This was more difficult to deal with than he would have liked. Zheng Ren was a little troubled.
The patient's fatal diagnosis was ketoacidosis, so he could die at any time. However, the more immediate family members were not here...
"You'll have to do for now. Who are you to the patient?"
"I'm his neighbor."
Zheng Ren was dumbfounded. What kind of goddamn mess was this?
"Chief Zheng, the patient's blood sugar is 54.2 MMOL/L," the nurse said with a look of admiration.
Such a high blood sugar limit was rarely seen even in the emergency department. Perhaps the endocrinology department would have encountered a similar case before?
This also proved the patient's critical condition.
Zheng Ren did not know how to deal with ketoacidosis. It was not completely impossible, but it was not a part of his expertise.
"10 U Insulin subcutaneous injection, 500 saline. Blood gas analysis, ions," Zheng Ren immediately said.
Small doses of insulin to correct high blood sugar, plus fluid replacement, to correct the loss of body fluid and ion disorders, was the focus of the initial treatment.
Zheng Ren could only do so much.
The endocrinology department was not far from the emergency building. In a few more minutes, the blood gas and arterial blood might not last, so they had to push the patient to the endocrinology department for specialized treatment as soon as possible.
At that moment, a man and a woman, both middle-aged, ran in out of breath.
"Doctor, how's Uncle Wang?"
Zheng Ren glanced at them and said, "His condition is critical. Has the patient's immediate family been notified?"
"He doesn't have any immediate family. He's alone. We're all his neighbors," the man said.
What...
Zheng Ren was in a dilemma.
However, it seemed that this man had quite a good relationship with people. The relationship between neighbors nowadays was usually very cold. If no one had noticed him, he would die at home and only been discovered when his body was rotting.
"The patient's blood sugar is particularly high. The diagnosis is ketoacidosis. It's very dangerous. He'll have to go to the endocrinology department for in-patient treatment later." Zheng Ren looked at the three people who brought the patient in, trying to figure out what they thought about it.
"It's hard to say if he can be saved," Zheng Ren said. "Who will pay the hospitalization fee later?"
"Doctor, do your best. Don't worry about the hospitalization fee. I'll settle it," the man said.
"Brother Li, your family is not well-off. The child is still young. Let me do it," the woman said.
Zheng Ren was a little surprised.
In the hospital and especially in the emergency department, he was used to seeing people who were indifferent. It was rare to see people fighting over the hospitalization fee for an old man like this who likely widowed and lonely.
The young man who came first said firmly, "Both of you, please don't argue. I'll pay first. When I was in the car, I called my father and he's rushing here. He asked me to pay the fee first. I still have cash on hand so it's fine."
While they were arguing, the endocrinology department's Deputy Chief rushed over.
Feng Qing was in his forties. He was not tall and looked simple and honest. He stuttered a little when he spoke.
Zheng Ren knew Feng Qing. Because the General Surgery Department involved elderly patients in surgery, more than half the preoperative evaluations required endocrinology consultations.
The slow consultation was handled by the Deputy Chief, Feng Qing. The emergency consultations were handled by the Chief Resident.
He did not know why he came here today.
"Director Feng, the patient's blood sugar is above 50. My suspicions are ketoacidosis." Zheng Ren ignored the argument between the few neighbors and turned to introduce the patient to Chief Feng. "A small dose of insulin has been injected subcutaneously. Blood gas and ions have been checked."
"Okay." Feng Qing did not say much. Because he had a stuttering problem, he basically used one or two words to express himself.
"Should he be admitted into the hospital?" Zheng Ren asked for Feng Qing's opinion respectfully.
"Okay," Feng Qing said
as he began the physical examination.
The patient had a problem with his light reflexes. The condition had already reached a certain degree.
"The head CT. Do you want to do it now or back in your department?" Zheng Ren asked.
"I... I don't think it's an external...trauma problem. It should be caused by ketosis... He should be admitted to the hospital," Feng Qing said as best as he could.
Chapter 440 - Societal Status
Zheng Ren heaved a sigh of relief when the patient was taken away by Feng Qing.
He had more faith in Feng Qing's skills. Although he could not speak fluently, Feng Qing was still proficient at what he did. It was not like his ability to speak translated to his abilities as a doctor. After all, doctors were not required to have a glib tongue.
The Chief Resident who had originally planned to come for a consultation on endocrinology might have reconsidered whether the patient should go to the neurosurgery department due to the head injury.
The patient's luck was not bad. He had a few neighbors who were willing to spend money to treat him, and he could even meet a doctor of higher standards like Feng Qing.
After sending him out of the emergency department, the consultation room was already packed.
In less than half an hour, there were nearly twenty patients waiting in line outside.
Zheng Ren also felt very helpless. The emergency department... No wonder no one wanted to work here.
Along the way, Zheng Ren took a patient with acute appendicitis to the in-patient department and called Su Yun to inform him to prep for surgery.
When he called, Zheng Ren's mood was slightly uneasy.
Usually, he would answer the phone. However, he was now the one making the call. The switch in roles gave him an inexplicable feeling.
Just after lunch, the sky had already turned dark. Zheng Ren was too lazy to order dinner. It was not until six o'clock that the patients in the consultation room were cleared out.
Now that he could catch his breath, the next thing he had to do was wait for the patients after eight o'clock to trail in.
Zheng Ren took some time to drag Fan Tianshui to the side entrance to smoke. He had just taken two puffs and before he could say anything to Fan Tianshui, he heard a voice coming from the corridor.
"Doctor... My stomach hurts..."
Zheng Ren was stunned for a moment before his mood turned sour. He opened the door and shouted, "Please be quiet. I'm in no mood for your jokes."
Su Yun stopped laughing and walked over to Zheng Ren.
"I'm here to see you," Su Yun said with a smile.
"Are you done with the appendicitis?"
"It was over a long time ago. Let me tell you, the interventional department's professor and Deputy Chief from the First Affiliated Hospital of Provincial Capital Medical University have been waiting for you all afternoon," Su Yun said.
Zheng Ren shook his head and sighed. "I don't have time for them."
"I'm here to take your place for a while." Su Yun blew at the black hair on her forehead and said, "You should try your best with these academic types. Just be careful, Boss Zheng."
As he said this, Su Yun put on an extremely serious face and said, "A new surgical method for TIPS surgery. Don't tell them everything. At the very least, you have to wait for the professor and I to publish the article first."
"There's no need." Zheng Ren waved his hand.
Zheng Ren's idea was very simple. Right now, he was probably the only doctor in the world who was at master level. With his ability, he could completely crush other people. There was really no need to worry about these things.
Su Yun was a little surprised. He glanced at Zheng Ren, his black hair fluttering in the wind.
After a few seconds, he said casually, "Boss, sometimes I think you're playing dumb. Other time, I actually think you really are dumb."
"That's more or less the same thing."
"Well, if you add something like life or love, your words will turn into a thick, greasy chicken soup," Su Yun said. "Do you know that a brand-new surgical method can improve your academic status... It's the best way to improve your status in medical scene."
Zheng Ren smiled and looked at Su Yun. He said seriously, "There's no need. If everyone knows it, then we can treat the patients earlier. More people will benefit from it. There's no need to hide it. That's just how life works."
Su Yun's gaze suddenly became sharp. Zheng Ren knew that he was prepared to go all out and defend himself.
Fan Tianshui looked at the two of them bickering without hesitation and smiled honestly.
But before Su Yun could say anything, the nurse shouted, "Chief Zheng, there's a patient."
Zheng Ren quickly put out the cigarette and hurried back to the corridor.
A middle-aged man in his fifties with a rosy face and a hint of worry was being pulled forward by a child to him.
The middle-aged man kept saying no, while the young man had a stubborn look on his face.
The young man looked like he was around 19 or 20. He was at the peak of his health. Although the middle-aged man was determined to struggle, he could not fight against him.
"Doctor, please take a look at my grandpa. Save him!" The young man said, practically sobbing when he saw Zheng Ren rushing over.
Zheng Ren took a glance at the system diagnosis in the upper-right corner of his vision and his heart turned cold.
His inside became numb.
Su Yun said in a strange tone, "Why are you guys fighting in a hospital?"
"Su Yun!" Zheng Ren scolded him in a low voice. After that, he came in front of the two of them and asked in a deep voice, "What's wrong?"
Su Yun was a little surprised but then realized that there must be something wrong with the patient. Otherwise, an honest man like Zheng Ren would never talk to him with such a tone.
He followed Zheng Ren and carefully observed the middle-aged man.
"Doctor, my grandpa drank pesticide!" The young man was about to cry. He grabbed Zheng Ren's arm and said, "Doctor, please save him."
"Su Yun, take the patient to have his stomach pumped." Zheng Ren's voice was very low, sounding just like a senior doctor.
Su Yun knew that the matter was serious from the sound of his voice but seeing that the middle-aged man was alive and kicking, he felt strange.
Suddenly, it clicked and his expression changed.
Without bickering with Zheng Ren, Su Yun took the middle-aged man directly to the resuscitation room to have his stomach pumped.
"You, follow me." After Zheng Ren said that, he brought the young man to the internal medicine consultation room and asked him to sit down. Zheng Ren then asked, "What kind of pesticide did he drink? How much was consumed?"
"I don't know what kind it was. He drank more than half the bottle." As the young man said that, he placed a canvas bag in front of him. After opening it, he took out half a bottle of pesticide.
"Doctor, this is it." The young man's tears were already flowing. "I know. It'll be fine after the gastric lavage, right?"Find authorized novels in , faster updates, better experience, Please click /book/the-surgeon's-studio_16489637605120805/societal-status_49977380407661012 for visiting.
Zheng Ren took a look at the pesticide. The System's diagnosis was right. It was indeed f*cking paraquat!
This was the first time Zheng Ren sincerely hoped that the System would give him a wrong diagnosis.
However, the System coldly proved once again that it was correct.
"What's your name?" Zheng Ren tried his best to soften his tone to comfort the young man.
"My name is Chu Wenshan," said the young man.
"Little Chu, do you go to school or work?" Zheng Ren did not continue to talk about his illness. Instead, he chatted with Chu Wenshan about his daily life.
Chu Wenshan felt that something was strange. He stood up abruptly and tears streaming
down his face.
"Doctor, I'm a junior doctor in the Provincial Capital," Chu Wenshan said. "You... What do you... What do you want to say? Just say it."
"Sit down first," Zheng Ren said as he looked into his eyes.
Chu Wenshan seemed to have heard what Zheng Ren was thinking. He sat in front of Zheng Ren shakily.
"It's paraquat. There's still hope in small doses. Although...the chances are still slim then. However, the patient drank so much so there might not be much we can do." Zheng Ren helplessly told him the truth.
Chapter 441 - Forced To Give Up
When the young man heard Zheng Ren's words, he looked shocked. His face was pale as his entire body was wracked with sadness.
Zheng Ren did not know what to say either.
Paraquat, as its name implied, was a herbicide.
It was extremely toxic to the human body, its mortality rate extremely high. There was no special treatment or medication that could deal with it.
Under a certain oral dose of paraquat, the patient would exhibit symptoms of poisoning.
In the body poisoning symptoms, the most prominent was lung damage. The histopathological changes that would occur were similar to oxygen poisoning.
If the patient took a large dose of paraquat orally, there was a high probability of one to two days of acute respiratory distress syndrome, followed by delayed pulmonary fibrosis, and progressive respiratory difficulties, resulting in respiratory failure and death.
With most other pesticides consumed orally, gastric lavage and a range of other means could be used to treat it.
With paraquat, there was none.
The worst thing about consuming paraquat orally was that the patient basically had no symptoms of discomfort. In fact, he looked rosy and healthier than before.
A small number of patients would have acute symptoms, but for most, patients would suffer from pulmonary fibrosis ranging from three days to three months.
The specific time was related to how much was consumed.
Pulmonary fibrosis was irreversible, especially after paraguay had been consumed orally. The patient's pulmonary fibrosis would continue to progress until the patient died.
This was a poison that was incurable but would not act immediately.
The Surgeon's Studio c1-799 Page 207
