Chapter 334: Fat emulsion can also cure allergies?
"It's okay." Luo Hao smiled slightly, "Qingqing, our family...just find anyone."
The corners of Chen Yong's mouth rose.
After 912, Luo Hao is afraid that he will never have the shame to say that our family is in harmony, which really makes people feel happy.
“Isn’t this the most convenient way to find you, otherwise I would have to find my dad.”
"Okay, I'll go there." Luo Hao smiled and hung up the phone.
"Okay, the food is almost gone." Luo Hao said, "Old Bai, I have worked hard this time, and I will work hard for you in the future."
Watching Bai Di become successful Luo Hao felt a little weird after getting rid of the cow and horse.
"It doesn't matter." Bai Dicheng replied.
"I'll go with you." Chen Yong paid the bill and followed Luo Hao.
"Aren't you going to accompany me?"
"It's inconvenient." Chen Yong was a little embarrassed.
Luo Hao chuckled, Chen Yong had indeed changed, but he didn't know what Lao Liu was capable of to conquer Chen Yong.
But it’s hard to ask about these things. In this world, everything comes down.
Lao Liu is the brine, and Chen Yong is the piece of tofu.
"Chen Yong, you insist on raising Gu insects, why? It makes you sick just looking at it." Luo Hao waited for the online taxi and asked his doubts.
"King of Gu, that's King of Gu! What a Gu, you look uneducated. Fang Xiao, Chen Yan and Boss Chai, how can they be the same?"
"Okay, okay, okay. , Gu King.”
Although Luo Hao felt that Chen Yong’s metaphor was unreasonable, he still agreed.
"The King of Poisons eats hundreds of insects, it is written in the book. I am wondering if I can change the treatment method if I encounter patients with parasites in the future."
Luo Hao was stunned. This idea was a bit big and had no practicality.
A patient with liver echinococcosis was sent to the hospital. Chen Yong took out the King of Gu, and the liver echinococcosis came out along the mouth and nose.
That picture is so weird.
No, hepatic hydatid grows in the liver parenchyma, so how it can enter the digestive tract is a big problem.
Bile duct?
Liver duct?
Luo Hao began to think about it.
"Hey, this makes sense!" Chen Yong thought Luo Hao was questioning himself, so he defended.
"It's a bit interesting. What's the principle?" Luo Hao asked.
"The mind of a mouse with parasites will be affected. This is the example you just gave. Is it common sense for a mouse to attack a cat?"
"Yes."
"Luo Hao, what kind of parasite is so powerful?" Chen Yong asked.
“Toxoplasma gondii can permanently change the brain tissue structure of mice.” After Luo Hao finished speaking, he added, “A research team from the University of California, Berkeley, published a report in the American magazine PlosOne. . They have done many similar studies."
"You are really good at talking about the United States."
Luo Hao said seriously, "Learn from advanced experience. Catch up as soon as possible, or just have another troll on the Internet, which one do you think is more suitable?”
Chen Yong thought about it and did not argue with Luo Hao.
“And they have done detailed research, not just to cure diseases.”
“What else?”
“Poisoning, there are water sources in Gaza Hepatitis A virus, polio virus, etc., aren’t the COVID-19 cases in previous years just examples?”
Chen Yong nodded in agreement.
"Tell me more about your affairs in Nanyang."
"What, you want to raise the Gu King?" Chen Yong was eager to give it a try.
"No, if my speculation is reasonable, the way Gu King has grown up from ancient times to the present is wrong. There is no need to travel thousands of miles and use the blood of so many people to provide support. One Ecmo, part of the nutrient solution , enough. ”
“! ”
“It doesn’t comply with the physical rules of this world to study the blood components before and after absorption. ”
"More..."
Luo Hao told Chen Yong what he was thinking, and Chen Yong was stunned.
He even felt that Luo Hao really wanted to raise the Gu King and throw it to Baltimore.
This bitch Luo Hao really holds a grudge, really.
After getting in the car, Luo Hao paid attention to what he was saying, talking about some theoretical things and not letting the brother from the imperial capital interrupt.
There was also a traffic jam in the Imperial Capital in the middle of the night. Although it was not blocked and I could still move, it was not smooth anyway.
It took more than half an hour to arrive at Xiehe.
Before getting off the bus, Chen Yong put on a mask.
The weather is still a bit sultry, and Chen Yong has sweat on his forehead and temples.
"You must have suffered a lot." Luo Hao looked at Chen Yong with a smile and asked jokingly.
"It's not bad, otherwise I'll suffer even more."
How could Luo Hao feel that Chen Yong's tone sounded like something he said - the flavor of my family's Xiehe.
But it is just a suspicion, there is no evidence.
Ye Qingqing was not at the door. Luo Hao called her, but Ye Qingqing didn't answer either.
This kid is really awesome.
Although Luo Hao cursed a few times in his heart, he still had a smile on his face.
Entering the emergency department, a cold air hit my face.
Although he knew that this was probably the air-conditioning blown by the central air conditioner, Luo Hao had another idea in mind.
He has been to the emergency departments of many hospitals. Regardless of the direction, the emergency departments always have a chill.
Maybe it’s because there are so many dead people here and the yin energy is relatively strong.
Moreover, the background of many urban legends is the emergency department, and Luo Hao doesn’t know if there is any scientific basis.
The emergency department corridor is quiet.
Luo Hao had a bad thought in his heart, but he glanced at the system panel. There were no emergency tasks, and his luck value was shining brightly there.
The entrance to the emergency room is also quiet.
It should be fine.
"Fat emulsion, push quietly!" A voice came to Luo Hao's ears.
Gan!
Something happened!
"Fat emulsion? What is it used for?" Chen Yong was confused.
"The medium and long chain fat emulsion we usually use is generally used for rehydration." Luo Hao said as he strode over.
The flat car was rolled out from the treatment room. There was a female patient lying on the flat car, with Ye Qingqing beside her.
She did not cry, but her face was indifferent. It seemed that her best friend fainted suddenly, and Ye Qingqing was not prepared at all.
The tomboy-like Ye Qingqing was stunned by the sudden blow. This situation often happened to Luo Hao.
But... didn't you say you have to sew it up yourself?
Luo Hao was still thinking about how to tell the people in the emergency department about this along the way.
Although I have made friends with people in various departments under the name of Dr. Xiehe Luo, this kind of thing is indeed a bit out of bounds.
Looking from a distance, the patient was shivering all over, his hands were twitching, and his head was shaking.
The doctor ran and shouted. The patient could open his eyes, but there was no response.
I couldn't cooperate with the pain localization examination. I was very irritable and the ends of my hands and feet were cold. After being pushed to the emergency room, he was connected to ECG monitoring. His blood pressure was 109/62mmHg, his heart rate was 100 beats/min, and his blood oxygen was 92%.
"Luo Hao, what's going on?" Chen Yong asked doubtfully.
There are traces of suturing on the patient's right eyelid, which should have been completed.
Is it because of needle fainting?
But this kind of needle fainting is a bit too serious.
“Didn’t you hear about using fat emulsion? It’s caused by allergy to lidocaine.”
“What? Lidocaine can also cause allergies?! Can fat emulsion also treat allergies? !" Chen Yong was surprised.
In clinical applications, lidocaine is administered directly to the patient without even a skin test.
Every interventional surgery is performed locally with lidocaine for anesthesia. Chen Yong has used lidocaine at least a thousand times since he came to the clinic.
I have never seen or heard of any allergic reaction to lidocaine.
And Chen Yong has never heard of fat emulsion treating allergies.
Luo Hao did not go to the rescue. This is Xiehe, not a county hospital, and his technical level is at the domestic ceiling level.
Although they encountered an extremely rare situation, the emergency doctors of Xiehe University still carried out rescue operations in a meticulous manner.
Intravenous injection of 10 mg of dexamethasone for anti-allergy, intravenous injection of 10 mg of diazepam to suppress convulsions, intravenous injection of 20% fat emulsion to antagonize the effect of local anesthetics, and intravenous injection of epinephrine.
Soon, the patient lost consciousness, the fluctuations in the large arteries in the neck disappeared, and the patient paused in breathing. He was considered to be in respiratory and cardiac arrest.
The emergency doctor immediately gave chest compressions. After about 10 seconds, the patient regained consciousness and breathing.
Heart rate is 100 beats/min, blood oxygen is 89%, blood pressure is 90/50mmHg, and he still continues to twitch.
"Luo Hao, go ahead." Chen Yong urged with a frown.
"The same goes for me. Teacher Sun is on duty in the emergency department. He was the one who took care of me back then."
Luo Hao shrugged and spread his hands.
Besides, he didn’t even wear white clothes, the situation was still within control, and Luo Hao didn’t want to get into trouble.
It looked scary, with respiratory and circulatory arrest, but he came back after 10 seconds of chest cardiac compression. It was probably transient.
Luo Hao knew it well.
Continue to intensify fluid replenishment. After 15 minutes, apply diazepam 10mg again to suppress convulsions. Connect ECG monitoring to show sinus tachycardia.
Emergency doctors keep giving orders.
Relevant departments in the hospital were invited to come for consultation and treatment was given in advance.
The purpose of the consultation is...to make a collective decision, but when we arrived, we came up with similar plans, so we gave them first.
The patient was given promethazine, methylprednisolone sodium succinate for injection, fat emulsion, and intensified fluid replenishment. And give imidazole diazepam, keep warm, catheterize and other anti-allergic measures. Treatments include inhibiting convulsions, antagonizing the effects of local anesthetics, and replenishing blood volume.
Before everyone in the hospital could arrive for consultation, the patient's condition had improved.
Ten minutes later, the patient was conscious, answered questions on topic, stopped convulsing, had a rosy complexion, warm skin, blood pressure 104/69mmHg, heart rate 90 beats/min, and blood oxygen 100%. Catheterization 850ml. The condition is relatively stable.
"Here." Luo Hao stood at the door and looked at the monitor, "It looks scary, but it's actually very simple."
Chen Yong knew that he should talk less at Luo Hao's home court, otherwise You will be put on a fake show anytime and anywhere.
But even if he didn't speak, Luo Hao said naturally, "Fat emulsion, the 20% kind, very few people know that it can also neutralize lidocaine. I went to the emergency department when I was the general manager of Donglian Mine, and it didn't work at all. There is no prepared 20% fat emulsion."
"..."
"If something happens, I don't know how to rescue him." Luo Hao was helpless, "I asked the pharmacy to borrow it. The bottle of fat emulsion was placed in the emergency department, and was later sent back by the head nurse, who said it was part of the cost. "..."
"Actually, I don't know if I should meet one. For similar patients, the head of the emergency department has a good memory and the world is at peace.”
"It's peaceful today, it's peaceful tomorrow, but it may not be peaceful the day after tomorrow."
"Then what did you do?" Chen Yong still couldn't hold back and asked.
“It’s an exam.” Luo Hao smiled, “To neutralize acute lidocaine allergy, I used 20% fat emulsion. I took their exam at least 10 times. It was mixed in the exam questions as an emergency department One of the performance appraisal results. ”
“! ”
“I think it will be useful if I see such unfamiliar questions. There is no way. I have never seen this kind of emergency allergy and I really don’t know.” (Note)
Chen Yong expressed regret for Luo Hao's nonsense, but when he thought about it, he really didn't know.
"Here, let me test you." Luo Hao looked at the patient who had returned to normal and relaxed, "Tell me about the core content of the rescue you just saw."
"You Tell me quickly, I don’t have to hold a pen and paper like Lao Meng to take notes. “Lao Meng has a very good brain. I just show it to me. Is this a sense of ritual?”
"Huh? Lao Meng is such an old yin!" Chen Yong scolded.
"The sense of ritual is very important, especially when bringing in new people. If there is a sense of ritual, they will be more serious. You still have to learn some things from Lao Meng." Luo Hao smiled.
"Let's talk."
"First, protect the airway and give pure oxygen. If necessary, perform tracheal intubation to control the airway to avoid hypoxemia and hypercapnia. Generally Hyperventilation should be adopted, and the airway should be quickly established at this time to avoid using local anesthesia for superficial anesthesia."
"Second..."
"Sixth, give 20% fat intravenously as soon as possible. Milk.”
Luo Hao told Chen Yong the emergency first aid procedures with his fingers.
Chen Yong listened and checked the scenes he just saw.
Indeed, just as Luo Hao said, doctors in the Union Emergency Department encountered extremely rare patients with lidocaine allergies, but they were busy and unhurried, and every step was very formal.
As Luo Hao said, it seems that there should have been systematic training in the Union Medical College.
He wrote it down secretly.
If after an independent operation, the patient becomes allergic just after the anesthesia and rescue begins, I can't just call Luo Hao.
Of course, the phone call must be made.
Luo Hao didn't care at all about shaking people, and even instilled things like shaking people and collective decision-making into Chen Yong unknowingly.
But I have to do something when Luo Hao comes, like now.
Doctors from various departments took a look. They were all relaxed, and some even joked - the patient is fine, why did you come to me?
About this, Chen Yong silently wrote it down.
"Senior brother." Ye Qingqing didn't come out until this moment.
"It's a near miss." Luo Hao first characterized the matter, "If I came, I would definitely have to be allergic and rescued. But as long as people are fine, allergies are minor problems. It's better to have allergies in Xiehe than in Other small hospitals are allergic.”
“Brother, I don’t think so,” Ye Qingqing said firmly.
"Harm, how is it possible."
"You have always been very lucky. My dad said that if you do some bad things, it will always go smoothly. Maybe if you do the sewing, you won't have allergies."
Although Ye Qingqing did not study medicine, But she came from a medical family and was well-informed. Instead of complaining about the emergency doctor, she attributed everything to that person's bad luck.
After saying this, Luo Hao had nothing to say and thought Ye Qingqing was right.
"Luo Hao." Chen Yong was deep in thought when he suddenly spoke, interrupting the conversation between Luo Hao and Ye Qingqing.
“What’s wrong?”
"I remember that you always chatted for a while when giving anesthesia to the patient. Is it to prevent allergies?"
Luo Haoyi raised his eyebrows, and Chen Yong was really attentive. I remember this.
Every time I perform an operation, I give a little lidocaine subcutaneously, chat with me, wait a few minutes, and see that there is no allergic reaction before actually starting the anesthesia.
It's a bit complicated, but Luo Hao is a doctor who has seen how terrible lidocaine allergy is, so he would rather have a little trouble than get into a similar predicament himself.
Even though Luo Hao knows the rescue of lidocaine allergy by heart.
"Yes."
"Trouble, is there any other good way?"
"Do a lidocaine skin test before surgery, but few hospitals will have this skin test content , the nurse is very unhappy, and the patient’s family will also think it is overcharged, so they can only give a little before the operation and then chat.”
Chen Yong thought thoughtfully.
“Qingqing, how are you studying?”
"Brother, I'm about to graduate as a graduate student, and you're asking me about my studies? Shouldn't you be asking me about scientific research and experiments?" Ye Qingqing asked.
Luo Hao breathed a sigh of relief, indeed.
When Ye Qingqing took the college entrance examination, he was tutored by himself, and he was easy to answer.
“What are you trying to do?”
“Liquid deformable metal.”
"???"
"Terminator?" Chen Yong asked.
“It has something to do with medical care. My tutor is in poor health and is retiring. It happened that Teacher Qi from the University of Technology was working on related projects, so my boss wrote a note and asked me to follow Teacher Qi to continue research. "
"Is it related to medical treatment?" Luo Hao thought for a while, "I remember there was news a few years ago that the liquid metal robot of the University of Technology had entered the clinical trial stage."
< br>"Senior brother~~~" Ye Qingqing chuckled and hugged Luo Hao's arm, "When I do it, I will leave all these contents to you."
Luo Hao smiled and nodded.
It is estimated that there is some communication gap between Qi Yuanliang and the doctor, and the communication is not so smooth.
Also, it is extremely difficult to find a reliable doctor to cooperate with clinical trials.
Not only clinical trials, but also finding relevant points, which is not something ordinary doctors can do.
Every line is like a mountain, and progress is slow as it should be. If it were him and Ye Qingqing, it shouldn't be a big problem.
Luo Hao expressed emotion that the playful tomboy Ye Qingqing could engage in such high-end research.
Children will grow up one day.
"Then it's agreed! I'll go to Teacher Qi's laboratory at the University of Technology after the Chinese New Year."
"Okay." Luo Hao agreed, "Just don't be naughty then."
“How old am I? Brother, can you stop looking at me through colored glasses?”
Luo Hao smiled, took out his arm and raised his hand to twist Ye Qingqing's hair.
Her hair was very short, and it returned to its original state after shaking her head. It looked like she had been used to it after being tied to Luo Hao for who knows how many years.
"Luo Hao, what should I do if the patient is allergic?" Chen Yong was still confused about lidocaine allergy.
“Lipid local anesthetics include procaine, chloroprocaine, and tetracaine.” Luo Hao explained, “We don’t always keep them, but I have two procaine in the cabinet. ."
"Tetracaine? I remember this is from the otolaryngology department..."
"Tetracaine is a mucosal surface anesthetic, and its mechanism of action is different."
Although Luo Hao explained patiently, Chen Yong vaguely heard Luo Hao's voice - doctors who graduated from other medical schools were really dissatisfied. solid.
He took out his phone and searched for procaine.
Procaine was an early ester local anesthetic. Its skin and mucous membrane penetration is weak, so it needs to be administered by injection. In order to reduce toxicity and prolong the action time, a small amount of epinephrine is often added to mix it, and the action time can be extended by 1 to 2 hours. The common concentration is 1% to 2%.
It turned out to be a lipid-based anesthetic, and Chen Yong gradually figured it out.
It turned out that there were so many clinical details, and Luo Hao didn't tell him. Chen Yong glared fiercely at Luo Hao, who was chatting with Ye Qingqing.
During the chat, the patient had fully recovered, as if he had not suffered a respiratory and circulatory arrest just now. He had asked to go to the ground and have the urinary catheter removed.
After all, she is Ye Qingqing's best friend. Luo Hao is not wearing white clothes, so it is not easy to go in and take a look.
Avoid suspicion when it's time to avoid suspicion. Luo Hao is very cautious about this.
"Then get busy. Remember to tell me when you go to the provincial capital and I will pick you up." Luo Hao warned.
"Okay."
"I will go back tomorrow. If you need anything, tell me in advance. Your senior brother and I are too busy right now."
"Do you need to be so serious about acting as a teacher? ?”
“You can’t mislead others.”
A simple explanation, Luo Hao and Chen Yong left.
Chen Yong had been thinking about the use of lidocaine, and despite the huge buff from Union Hospital, he still had the courage to ask Luo Hao more related information.
Fortunately, Luo Hao didn't show off, nor did he tell Chen Yong that his basic skills were poor. He explained to Chen Yong bit by bit.
"Why didn't you tell me before?" Chen Yong was a little dissatisfied after asking.
"There are too many relevant details, and you will be impatient." Luo Hao smiled, "I will tell you after you see it, you will remember it deeply."
Chen Yong thought of what his old man always said when he was a child. talk.
Luo Hao's "daddy" feeling is getting stronger and stronger, which is beyond words.
Go back to rest, spend the night without talking, and rush back to the provincial capital the next day.
It was just that when Luo Hao carefully examined the system panel before going to bed, he found that the currency in the system mall had increased by 10!
He thought carefully and judged that it might be because of this incident.
But the abominable system did not provide instructions for the mall, leaving Luo Hao to fumble on his own.
Everything finally returned to calm. Every day, patients were admitted, surgeries were performed, and medical records were written. The days were like running water.
Generally, the Qing Qian review is held in the middle of the year, but this year's Qing Qian has been postponed. Luo Hao has no choice but to watch the long-term main quest and covet the rewards.
Summer passes and autumn comes, and the leaves gradually turn yellow.
Chen Yong also obtained the interventional imaging license and can perform surgeries by himself.
Despite this, Luo Hao still did not let him operate independently.
Normally, Luo Hao would perform one operation by himself, and let Shen Zizai and Director Shen watch Chen Yong perform the other operation.
After all, Chen Yong has just been exposed to interventional surgery for less than a year, but Luo Hao still prefers to be cautious.
One day.
Shen Zizai sat leisurely and contentedly next to Technician No. 66, holding only a small teapot in his hand.
Although he was wearing a lead suit, he could not see the slightest thought of having surgery.
It's more like an old director who was rehired from retirement and is only responsible for holding down the battle. As for charging into the battle, there will be successors.
"Director, Dr. Chen's surgery is getting more and more stable, but it's not good for you to enjoy it so much." Technician No. 66 asked while watching Chen Yong anesthetizing the patient in the operating room.
“It’s not good, it’s not good, isn’t it good.”
……
……
Note: I have used thousands of lidocaine injections and have never seen anyone allergic to it. It is truly a rare situation, and I admire the diagnosis, treatment and handling of the hospital emergency doctors who reported the case.
(End of this chapter)