Chapter 9 The Fragility of Life
It's still the same as before, the emergency department is still busy. Tang Xiaofeng leaned against the triage desk in a dejected manner, because Director Zhu's name was at the end of the shift schedule, so Tang Xiaofeng didn't get assigned any patients again today. Director Zhu and Director Sun walked out of the office.
"Hey, Director Zhu, why are there so few people today?" Tang Xiaofeng said with a bitter smile.
"As an emergency doctor, it's a good thing if there are no patients." Director Zhu looked at Tang Xiaofeng with a smile.
"Ring, ring, ring……"
"Hello? People's Hospital Emergency Department."
Nurse Wang Na answered the phone skillfully.
"A fifth-grade student from Hongqi Primary School suddenly fainted at school and has been sent over."
"Okay, got it. Preparing immediately."
At this time, the emergency department door was pushed open, and Wang Na saw two adults rushing in with a child's bed.
She hastily asked: "Is it from Hongqi Primary School?"
"Yes, doctor, please take a look at this child. He was fine during physical education class and suddenly fell down."
"Send the emergency patient over." Director Zhu said and followed by Deputy Director Sun, Tang Xiao Feng hurried over. Nurse Wang Na shouted to the two adults sending the child: "Leave one person behind to register with me."
"Over the bed, one, two, three." Director Zhu directed "ECG monitoring, oxygen inhalation."
"ECG monitoring, oxygen inhalation."
Director Zhu touched the child's red cheek with his hand, high fever, and immediately said: "Go out and ask the teacher who brought the child how long the child has had a fever." Nurse Wang Hui walked out in response.
Director Zhu began a careful examination of the child, "Signs of peritonitis, obvious jaundice, high fever. Check white blood cell count immediately, this child may have acute pancreatitis, it's very dangerous now, must be quick!" "Check white blood cell count." At this time, Nurse Wang Hui ran back and said: "Director, the child has had a fever for four days."
"Director Zhu, the test results are out." The nurse handed the test results to Director Zhu, who took a look and then passed them to Director Sun.
"Lab results show a white blood cell count of 1,700,000,000 per liter, and combined with other symptoms, it can be confirmed as acute pancreatitis. Atropine 0.5mg was administered intramuscularly, Tramadol 100,000 units was given by slow IV drip, and Ranitidine 150mg was added to the IV drip."
Atropine 0.5mg intramuscular injection, Tramadol 100,000 units intravenous drip, Ranitidine 150mg added to the intravenous drip.
"Wang Hui, this child's condition is critical and requires immediate surgery, push to the operating room."
"Good."
"The operation is in progress" three bright red characters lit up, and the family members waiting outside were very anxious.
Severe acute pancreatitis (SAP) is a common type of acute abdomen, with a high mortality rate and complex clinical course. Although the causes of SAP are diverse, including bile reflux, duodenal fluid reflux, binge drinking, and alcohol poisoning, the incidence of acute pancreatitis triggered by alcohol consumption has been increasing due to improved living standards. The severity of acute pancreatitis varies greatly, and it is clinically divided into two types: mild acute pancreatitis and severe acute pancreatitis. The former has a self-limiting course, with a relatively good prognosis and a mortality rate below 5%. In contrast, the latter has an uncontrolled inflammatory response that often affects surrounding tissues and organs, leading to damage of distant organs. Its clinical course is hazardous, with a poor prognosis and a mortality rate around 30%.
Surgery in the operating room is being performed by a tense surgeon...
One hour...
Two hours...
Three hours...
The surgical lamp went out and Nurse Wang Hui pushed the child out.
"Doctor, how is it? How's my child?" The child's mother anxiously asked as she rushed up.
"Very successful, now transferred to observation room for further observation." Director Sun replied.
"Thank you, thank you, Doctor!" The child's father let out a long sigh of relief and gave Director Zhu and the other two a grateful smile.
"Teacher Sun, this patient's left leg seems to be fractured, take a look." Zhang Wei pushed a patient in, "Has he had an X-ray?" "He has." "Where is the X-ray?" "The...X-ray, here it is." At this time, a nurse intern caught up from behind and handed the X-ray to Zhang Wei.
"Thank you!" Zhang Wei said gratefully to the nurse, who smiled and stuck out her tongue before running off. Tang Xiaofeng saw this scene and thought to himself, "Something is fishy here. It's only been a few days since they started having an affair, and now he's already making eyes at someone else."
"Careless and forgetful." Director Sun looked at Zhang Wei and criticized him.
Director Sun took a look at the film and said to the patient, "This is not a fracture, it's just dislocation. It's no big deal. Let the doctor on the orthopedic floor take care of you, and when you go back home, just don't move around randomly."
"Thank you, doctor." "It's nothing, Zhang Wei, push him away. And in the future, don't talk nonsense in front of patients." "Oh!" He replied and pushed the patient away.
"Ring, ring......" Just as the two directors were about to return to the doctor's office to rest, they were stopped in their tracks by the ringing phone on the outpatient department head's desk.
"Hello? Emergency department of People's Hospital."
"Hello? Emergency department of People's Hospital."
Two nurses on the triage desk answered their phones at the same time.
"Ximenli Community 2 Building 1 Unit 502, a boy is in critical condition." said the emergency center staff.
"Isn't there something specific?" the nurse asked.
"Don't understand, parents can't say clearly, just know there's massive bleeding."
"Okay, I'll be discharged soon."
"Director Zhu, Ximenli Community 2 Building 1 Unit 502, in critical condition, about to be discharged from hospital."
At the same time
"Doctor, doctor, come and save my son quickly!" A anxious voice came from the other end of the phone.
"Don't worry, where does your family live?" Wang Na comforted this flustered parent.
Jincheng Community Building 11 Unit 2 Room 203
"Alright, don't worry, we'll be there soon."
"Director Sun, Jin Cheng Xiao Qu 11 Building 2 Unit 203."
Zhu and Sun looked at each other and ran towards two ambulances in opposite directions.
Jincheng Community Building 11 Unit 2 Room 203
"Doctor, you've finally arrived."
"Don't rush, first lift it downstairs and put it in the car, then we'll talk, ambulance!"
Director Zhu shouted.
"Good...good..." The flustered parent seemed to have suddenly found their composure.
They helped him lift his son into the ambulance.
Ambulance
"ECG monitoring, oxygen inhalation." Director Zhu shouted after getting on the car.
"What symptoms does he have?" Director Zhu asked the child's father.
"He kept yelling that his stomach hurt, then he started vomiting and passed out."
While Father was talking, Director Zhu was carefully examining the child.
"What is he spitting?"
"Everything is there, basically I can't see anything else, just one kind: yellowish-green bile."
"What's your body temperature?"
"It started out normal, but then gradually increased." The nurse replied.
"heart rate?"
“110。”
"Abdominal breathing disappears, obvious abdominal distension, abdominal muscle tension, bowel sounds disappear, this is acute abdomen"
Typical symptoms of meningitis, rushed to the operating room as soon as he arrived at the hospital."
"Good."
"Tang Xiaofeng, doing a penicillin skin test. If no hypersensitivity reaction occurs, 25% of the penicillin is added to 250ml"
"Infuse quickly."
Do penicillin skin test, if no hypersensitivity, 25% of penicillin is added to 250ml **quickly
"Quickly, quietly, and accurately." Tang Xiao Feng repeated.
Ximenli Community 2 Building 1 Unit 502
"Hurry up and carry him downstairs to the car, quickly!"
Ambulance
"What's wrong with him?"
"I don't know what's wrong with him either." The parent was also at a loss.
"Good boy, tell me, what's wrong with you?" asked Director Sun kindly.
"I'm cold... I'm dizzy..." and then couldn't say anything more.
"Wang Hui, check blood routine and blood type."
"Good."
"Alcohol swab," said Director Sun, taking the alcohol swab and carefully wiping away the blood from the child's wound. However, the bleeding continued to seep out, and the child had begun to drift into a shallow coma.
"Director Sun, the blood test results are out, here they are." He said, handing the results over to Director Sun's hands.
Decreased blood cells and neutrophils, increased lymphocyte ratio, alkaline neutrophilic.
Elevated acid phosphatase activity, reticulocytes less than 1%, and the bleeding sites he has can confirm that it is acute aplastic anemia. Testosterone propionate 50-100mg
"Intramuscular injection, return to the hospital and go straight to the operating room."
"Testosterone propionate 50-100mg intramuscular injection."
"Come on, Zhao, hurry up." Director Sun said urgently.
"Alright!"
At the same time
"Master Yang, hurry up!"
"Got it, Director Zhu!"
Two ambulances sped off down the road at the same time.
Two cars entered the hospital parking lot one after another.
Two cars drove into the hospital's operating room one after another.
In the end, it was also two cars that came out of the operating room one after another.
The only difference is that the boy with acute aplastic anemia was covered in a white cloth!
Operating room entrance
"Your son was pronounced dead at 17:38 despite rescue efforts." Director Sun tried to make his tone as calm as possible.
"No, my child won't die, tomorrow is his 12th birthday"
"I promised him to give him a good birthday! You can't die, child... my child..." The child's mother burst into tears at that moment, and her crying voice echoed far, far away...
