radicalducati Chapter 527
Chapter 527
"What's going on?"
"Why did it suddenly become so powerful?"
blood oxygen loss,
low blood pressure,
The first reaction is to do what?
Cardiopulmonary function!
A stethoscope was quickly found to listen to the patient's heart and lungs.
This listens,
Frightened Zhang Zhuzhi!
He found that the patient's lungs were full of wheezing!
Hurry up here to rehydrate and fight shock...
Then use rescue drugs such as epinephrine, adrenocortical hormones and norepinephrine...
The operation can not continue to be done, you must find the root cause in order to continue the operation...
Wet gauze covers the surgical field and stops the operation.
And then salvage...
Then consider the "double lung wheeze"...
The first reaction is "bronchospasm" (similar to an acute asthma attack or a respiratory shock sound of laryngeal edema).
"It must be allergies, allergies lead to bronchospasm, and then anaphylactic shock ..."
"Is the patient allergic to something?"
"No, wasn't an allergy test done during the perioperative period of surgery?" How can I still be allergic? "
"Before the operation, did you ask the patient what allergies he had?"
"Asked, the patient said no..."
Everyone was confused...
Full of questions.
"Xiao Chen, go and ask the family, what is the allergy..."
Dr. Zhang ordered.
1 minute later, Xiao Chen came back quickly: "The family said, there is nothing allergic..."
That's strange.
10 minutes later...
The patient's condition began to 'heal', the wheezing, the blood pressure increased, and the heartbeat was safe.
What does this say?
Explain that the medication given to the patient is effective!
It shows that the diagnostic idea of anaphylactic shock is correct!
But
What exactly is the patient's allergen?
The patient is now under anesthesia and cannot be asked.
Surgery, stagnant.
Everyone is Muggle!
Can't find the answer.
The operation is not up or down, and there is no way to explain to the family when I go back.
"Or, Doctor Zhang, I'll call and ask Dr. Lin Feng?"
At this time, a regular trainee was Lin Feng's graduate classmate and was quite familiar with Lin Feng.
When Dr. Zhang heard this, his eyes lit up.
He is also one of Lin Feng's fans.
"Okay, you call Dr. Lin to see if he is free..."
......
Human life is a matter of heaven, of course Lin Feng is free...
After 5 minutes,
Lin Feng quickly came to the operating room.
First understand the patient's shock experience, and finally determine that it is indeed anaphylactic shock.
Then I checked all the drugs, the preparation for the perioperative period ... The possibility of allergy to the drug is excluded.
At last
Lin Feng set his eyes on the latex gloves worn by the doctors and nurses.
"It should be latex allergy..."
Lin Feng said his answer.
Latex allergy?
The doctors and nurses were confused and looked at each other.
"No, a week ago, I had my first surgery, why didn't I have allergies at that time?"
"yes... Now this operation is a second operation. "
They have worked for more than ten years and have never encountered a single such case.
Lin Feng explained: "This is to talk about the two processes of "latex allergy" in the "sensitization stage" and "excitation stage"..."
·『 Sensitization stage':
When a patient allergic to latex is exposed to latex for the first time, the B lymphocytes in the allergic patient's body make and release a large amount of IgE, that is, antibodies, that are specific to this latex.
These IgE molecules attach tightly to mast cell surfaces that are distributed in organs such as the subcutaneous, nasal cavity, upper respiratory tract mucosa, and digestive tract.
This sensitized state can be maintained from six months to several years.
Therefore, people who are exposed to latex allergens for the first time can not show allergic symptoms.
whereas
·「 Excitation phase":
When the patient comes into contact with latex again, the IgE molecules (antibodies) that have attached to the surface of mast cells and basophils are bound together by latex molecules, which is called antigen-antibody binding.
This combination induces the activation of mast cells and basophils and releases allergenic substances contained in the cells.
After everyone listened to Lin Feng's explanation,
Scales fall from one's eyes.
The young anesthesiologist felt a little ashamed, because as an anesthesiologist, he didn't understand this, which really shouldn't be.
Lin Feng: "Replace latex gloves with plastic film gloves..."
Plastic film gloves are the kind of gloves that are usually used for black ducks, pig's trotters, and lobster peeling.
The hospital has specialized membrane gloves, sterile.
But this glove is not as good as rubber gloves, easy to break, and poor feeling.
Therefore, it is generally not used on the operating table.
Wear latex gloves first, then plastic film gloves.
Continue the surgery...
Dr. Zhang finally asked Lin Feng to do this operation, because he knew that Lin Feng's operation was of high quality teaching and the preciousness of the whole hospital, and he could not miss this opportunity.
Lin Feng did not shirk.
Take over the main surgical surgery.
20 minutes later...
The operation is over!
The operation went smoothly and the patient never experienced allergies again.
So
It was determined that latex gloves caused the patient's allergy, which further led to shock.
......
Off-topic:
What allergies mean: Incorrect overreaction by the immune system misinterpreting otherwise harmless substances as potential threats to us.
......
......
Return to the emergency department from the operating room,
on the road
Bell bell bell ~~~~
A phone call came,
I was a high school classmate.
Lin Feng: "???? "
The first reaction was: Is it asking me about my illness again?
Put through.
"Lin Feng... Help me..."
"Huh? What's wrong? "
"One of my uncles went up the mountain and was bitten by Zhuyeqing... Sent to the county hospital, the doctor of the county hospital said that there is no anti-bamboo leaf green snake venom, only anti-pit viper venom, I am afraid that it will not work, ask people everywhere to find anti-bamboo leaf green venom, and then I thought of you..."
Lin Feng: "........."
Cover your face!!
Anti-bamboo leaf green venom?
There is no such thing, hey!
County hospital!
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ps: End today...
。。。。