Chapter 439

The flat cart pushed a middle-aged and elderly male patient straight to the emergency room like a stray dog.

Zheng Ren glanced at the system panel at the top right of his field of vision.

Weird diagnosis.

Traumatic brain injury, ketoacidosis!

These two diagnoses, in Zheng Ren's eyes, traumatic brain injury is not important at all.

Didn't even have a subarachnoid hemorrhage, would Zheng Ren care?

Traumatic brain injury is similar to the concussion mentioned ten years ago, but there is no diagnosis of concussion now.

Traumatic brain injury refers to the transient dizziness, headache, nausea, vomiting and other symptoms caused by the impact on the head of the patient without organic disease.

Because there is no organic disease, it has become the best disease to blackmail people from fights and car accidents.

It doesn't matter, the fatal thing is ketoacidosis.

Pathophysiologically, ketone bodies are intermediate metabolites of the breakdown of fat into fatty acids in the liver.

Under normal circumstances, the body produces a small amount of ketone bodies, which are transported to tissues such as the heart, kidneys, and skeletal muscles along with the blood, and are used as an energy source. Ketones were not detected.

In severe diabetic patients, ketones can be detected in urine. No matter how serious it is, when ketone bodies accumulate too much in the blood, it can turn the blood acidic and cause acidosis, which is called ketoacidosis.

Zheng Ren watched as the nurse was busy, put on ECG monitoring for the patient, left an intravenous line in place, and waited for the doctor's next instructions.

He leaned over to the patient and smelled it. It smelled like rotten apples. Now Zheng Ren had an idea in his mind, it should be ketoacidosis without a doubt.

"Test your blood sugar." Zheng Ren said, "Call the endocrinologist immediately, and ask the hospital chief for consultation."

The nurse was a little surprised. The patient's head was covered with a bandage, and there was an obvious head injury. Why did Mr. Zheng ask for an endocrine consultation?

However, due to the strict hierarchy between the upper and lower levels of the hospital, they did not express their opinions during the rescue, but chose to obey.

"Patient's family!" Zheng Ren shouted.

120 A boy of eighteen or nineteen years old was following the ambulance, and he came to Zheng Ren's side eagerly, "Doctor, is there any danger?"

At the same time, there were hurried footsteps in the corridor.

In general, the 120 ambulance allows a family member to come up and help take care of the patient. Of course, the rules are different in different places, and this is the case in Haicheng.

Other family members can take a taxi by themselves or follow the 120 ambulance to the hospital.

Zheng Renjian was a young man, a little unhappy.

The adults in this family really have a big heart. The age of the patient he saw was about 60 years old. This child may be his grandson or maternal grandson.

What do adults do to eat, how can a teenager follow in the car.

"Where are your parents?" Zheng Ren asked.

"..." The boy was taken aback for a moment, and then he said, "At work."

"Are there any adults coming?" Zheng Ren asked.

"Aunt Zhao and Uncle Li followed."

This is more difficult to deal with, and Zheng Ren is a bit difficult to deal with.

The fatal diagnosis of the patient was ketoacidosis, and death was possible at any time. But the immediate family members of the head of the family are not there...

"Then you come, who are you a patient?"

"I'm his neighbor."

"..." Zheng Ren was dumbfounded, what kind of messed up relationship is this?

"Mr. Zheng, the patient's fingertip blood sugar is 54.2mmol/L." The nurse said with admiration.

This extreme blood sugar level is rarely encountered even in the emergency department. Maybe there will be more endocrinology?

This also proves from the side that the patient's condition is critical.

Zheng Ren would not deal with ketoacidosis. It's not completely bad, but at least it's not professional.

"10u insulin subcutaneous injection, 500 normal saline. Blood gas analysis, ion." Zheng Ren said immediately.

Small doses of insulin to correct hyperglycemia, together with rehydration, to correct fluid loss and ion disturbance are the focus of initial treatment.

There was only so much Zheng Ren could do.

The endocrinology department is not far from the emergency building. It is estimated that in a few minutes, the arterial blood may not be able to be collected, so it has to be pushed to endocrinology for specialized treatment.

At this time, two middle-aged men, a man and a woman, ran in, panting.

"Doctor, how is Uncle Wang?"

Zheng Ren glanced at them and asked, "It's very dangerous. Has the patient's immediate family notified?"

"He has no immediate family members, just one person, we are all neighbors." The man said.

Well……

Zheng Ren was in trouble.

But it seems that this man's popularity is still good. The current neighborhood relationship is so indifferent, if it is a little worse, it will only be discovered when everyone dies at home.

"The patient's blood sugar is extremely high. The current diagnosis is ketoacidosis, which is very dangerous. He will be hospitalized in the endocrinology department soon." Zheng Ren looked seriously at the three people who brought the patient here, wanting to see in their eyes There are some clues.

"It's hard to say whether it can be saved." Zheng Ren said, "Someone will pay the hospitalization fee later."

"Doctor, do your best. Don't worry about the hospitalization fee. I'll pay it later," the man said.

"Brother Li, your family is not rich, and the child is still young, so let me do it." The woman said.

Zheng Ren was a little surprised.

In the hospital, in the emergency department, I am used to the indifference of people. It is really rare for such a widowed and lonely old man to have someone scrambling to pay the hospital fee.

The young man who came first said firmly: "Uncle, aunt, don't argue, I will pay first. When I was in the car, I called my dad. He was rushing back, and he asked me to pay the money first." I paid it. I still have the New Year's money, it's fine."

This side was arguing, and a deputy director of the endocrinology department rushed over.

Feng Qing, in his forties, is not tall, looks very simple and honest, and stutters a little.

Zheng Ren knew Feng Qing well, because general surgery involves surgery on elderly patients, and more than half of the preoperative evaluations require consultation from the endocrinology department.

Chronic disease consultation is in charge of deputy director Feng Qing. The emergency consultation is in charge of the hospital chief.

I don't know how he came here today.

"Director Feng, the patient's blood sugar is over 50, and he is considering ketoacidosis." Zheng Ren ignored the disputes between several neighbors and introduced the condition to Director Feng: "I have given a small dose of insulin subcutaneously and checked my blood gas. and ions."

"Okay." Feng Qing didn't talk much, because he stuttered, so he basically used one or two words to express his words.

"Admission?" Zheng Ren respectfully asked Feng Qing for his opinion.

"Okay." Feng Qing said while starting the physical examination.

The patient has problems with light reflex, and the condition has become severe to a certain extent.

"Head CT, should I do it now or go back?" Zheng Ren asked.

"Taking... Considering that it's not a head...traumatic problem, it should be caused by ketosis... admitted to the hospital." Feng Qing said "simply".