Chapter 242

The small intensive care unit was only two floors away from the general surgery department. Xiao Chenguang did not take the elevator, but followed the stairs all the way down to the sixth floor.

During this time, he considered the patient's condition.

If the liver is not good and you are irritable and unable to hold back, there is a high probability of hepatic encephalopathy.

This is a type of change in consciousness and personality caused by liver disease.

The largest number of them is cirrhosis caused by hepatitis, leading to portal hypertension.

"It's best not to be in this situation, otherwise, you will definitely be busy all night, and you may even need emergency surgery."

Xiao Chenguang has been undergoing elective surgeries for a day, starting from the time when the anesthesia operating room started working in the anesthesia operating room at 7:30 in the morning, until the last one was completed at 6 pm.

Three cholecystectomies, two bile duct stone removals, and one emergency surgery for intestinal obstruction.

After finally finishing all the work, I rushed to the small intensive care unit and was just about to help Lao Wang instruct him to exercise.

Who knew this would happen.

"God bless, don't bother, don't bother, hello, me, hello, everyone..."

The muttering voice echoed in the corridor. If someone happened to pass by, they would definitely be startled by Xiao Chenguang's red eyes.

It was quiet in the corridor, and almost no one could be seen in the corridor, but the noisy sound in the ward, like a war, reached Xiao Chenguang's ears.

"Sister, listen to me, you are in the hospital now. You are not flying in the sky or swimming in the sea. You are lying on the bed now, being treated in the hospital. You are not a woodpecker that loves to peck trees..."

When he heard this inexplicable communication, Xiao Chenguang already knew that the patient's symptoms were serious.

"I'm not sick. You are all devils, beasts that specialize in eating people. Let me go. I want to go out and find my dad. Ah, dad, where are you? Are you looking at me?"

In the ward, an aunt in her fifties was so frightened that she had to sit up from the bed and go to find her father.

But her father died five years ago.

The family members cried and tried to persuade her, but to no avail. Doctors and nurses were at the scene, but they still couldn't persuade her.

"What should I do? It's the first time I've met such a patient. He was fine just now, but why did he suddenly go crazy?"

The nurse directly used the word crazy to describe the aunt in front of her.

She was holding the treatment tray at the moment, preparing to draw blood tests for the aunt and do some education on admission.

But let alone preaching now, the aunt won’t even let her draw blood.

He even cursed people casually, refused to recognize his relatives, scratched, scratched and spit on anyone who dared to come close, which made everyone anxious.

"Wait a minute, the situation has been reported to Director Xiao. He will be here soon."

In front of his family members, Lin Gaoyang still called Xiao Chenguang director.

Lin Gaoyang has never dealt with this situation, although he knows that people with liver disease are very angry.

But the patient in front of me, who appeared to be neurotic, was really unexpected.

There was so much noise here that the patients in the adjacent rooms were unable to rest.

Some family members of patients even came here to check on the situation.

"What's wrong with her? Why is she so crazy? I remember she was quite normal when she first came here."

"I don't know. I feel like I haven't heard such a fuss just now in just this moment."

The family members outside were talking a lot, and Lin Gaoyang was even more uneasy.

He was obviously a patient suffering from pain in the liver area and was admitted to the hospital for examination. Why did he suddenly become like this?

Before Lin Gaoyang could figure it out, the patient's aunt became irritable again.

This time it's even more powerful than before.

She was yelling and screaming, as if she was being stimulated in some way. Family members, doctors, and nurses all helped to stop her, but they still couldn't hold her down.

Just when everyone was helpless, Xiao Chenguang rushed over.

He had heard the sound just now, but now that he saw the scene in front of him, he gave up instantly.

Hepatic encephalopathy cannot be escaped.

And it is the most severe decompensation period.

Don't think too much about anything, just stabilize the person first.

"It's useless. The more you press her, the more serious her resistance becomes. She won't understand any words of advice."

"Lin Gaoyang, grab her arm. The nurse will inject the needle first and draw blood later. Then give her a sedative and intravenous injection of 10 ml of propofol. At the same time, observe changes in vital signs to prevent hypotension."

For irritable patients, sedatives should be used first to prevent accidents. This is the content of the later medical consensus.

Especially the patient in front of me has obviously changed her ideology. If she is allowed to continue at this time, the situation will only get worse.

"Okay, Director Xiao, we will execute it immediately."

Xiao Chenguang's words were like clouds opening up and the sun rising, making people suddenly find their backbone.

These days, because the chief director is injured and hospitalized, the entire general surgery department is in a state of anxiety. In addition, Xiao Chenguang is busy from morning to night, and obviously has no energy to take care of Corey. All the burdens are handed over at once. It fell into the hands of Lin Gaoyang, the chief resident.

Although he worked hard, over time, he was still unable to do what he wanted.

Now that Xiao Chenguang is back, everyone feels much more at ease.

When the nurse finally put the injection in and was about to inject propofol for sedation, the accident happened suddenly.

The agitated patient suddenly began to retching.

His face, which was still rosy at first, suddenly turned extremely pale, and his whole spirit became sluggish. This was completely different from the excited look just now.

"It's broken! Bring a plastic bag over here, the patient has gastrointestinal bleeding!"

Xiao Chenguang looked serious. Before anyone could react, he quickly came to the bed and tilted the patient's head to one side.

Prevent suffocation.

Ugh!

The patient felt his stomach churning and hot, and suddenly a mouthful of bright red blood spurted out.

The family members saw this and were so anxious that they couldn't find a plastic bag, so they immediately took the wash basin used in the hospital.

The patient spurted out mouthfuls of bright red blood from his stomach, and in the blink of an eye, half a basin of blood appeared in front of everyone.

"How can so much blood come out?"

The family members' hands were shaking, and they were panicking.

If the liver is not good, how can you spit out so much blood?

The family members didn't understand, but Xiao Chenguang knew it clearly.

Cirrhosis caused by hepatitis causes liver cells to necrotize and proliferate, blocking blood vessels and causing portal hypertension.

Over time, high pressure leads to esophageal varices, which eventually cause blood vessels to rupture and bleed heavily.

"Push the rescue vehicle over, connect to the monitoring, measure blood pressure, and inhale oxygen at 4L/min."

"Take 4000 units of thrombin powder orally to stop bleeding."

Due to a large amount of vomiting blood, the patient's vital signs will definitely drop drastically, with symptoms of fast heart rate, low blood pressure, fast breathing, and low blood oxygen saturation.

Sure enough, when the nurse connected the monitoring and the patient's vital signs were measured, she was shocked by the numbers in front of her.

Heart rate above 180, blood pressure 70/95, breathing 48, and blood oxygen saturation only 77%

"Inject 0.6mg of somatostatin octreotide to inhibit glandular secretion."

"Esomeprazole 80mg intravenous drip to protect the gastric mucosa."

"Ringer's injection drip at full speed!"

Hemostasis, volume expansion, enzyme inhibition, stomach protection...

Xiao Chenguang's rescue doctor's instructions came out of his mouth.

"Family, has the patient eaten some hard food in the past two days, such as melon seeds, peanuts, and cold sweet potatoes?"

"Doctor, how do you know?"

Seeing the shocked expressions of the family members, Xiao Chenguang immediately came up with a series of diagnoses in his mind.

Hemorrhagic shock, massive gastrointestinal bleeding, hepatitis B cirrhosis with portal hypertension, and ruptured bleeding of gastric fundus-esophageal varicose veins.

There are even splenomegaly and hypersplenism, which cause blood coagulation disorders and damage to red blood cells and platelets.

The patient in front of them is much more serious than they imagined.