Chapter 308
Walking on the road, Xiao Chenguang knew that anyone who worked the night shift in the emergency department would encounter drunk people in almost every shift.
Some of them drank too much after a dinner party and talked nonsense, and some quarreled with their families and drank until they were unconscious.
And many of them happened after midnight, and a large group of people ran to the emergency department.
Some vomited as soon as they came in, and some used the hall as a toilet. Anyway, there were so many kinds that they couldn't count them all.
Xiao Chenguang didn't drink, and didn't know what was so good about alcohol.
But it was rare to see someone drinking too much in the middle of the day like today.
"Did the couple quarrel?"
Xiao Chenguang thought to himself and came to the emergency hall.
The nurse had already pushed the stretcher over, and the emergency internal medicine doctor hadn't had time to come because of a room full of patients.
"Go to the emergency room first, connect the ECG monitor, and tilt her head to one side to prevent her from suffocating."
When Xiao Chenguang saw the patient for the first time, his eyelids twitched involuntarily.
How much alcohol did this person drink?
The woman lying on the stretcher had wet hair, smelled of alcohol, snored loudly, and could not be woken up even if she was called.
Her skin was wet and cold, and when she felt her pulse, her heart rate was about to break 200 beats per minute.
She was immediately pushed into the emergency room, and began to be monitored, oxygenated, blood drawn for testing, and injected with infusion.
The nurse was busy, but the woman had no reaction, like a quiet doll that could be manipulated at will.
"Do you know how much alcohol she drank?" Xiao Chenguang immediately looked at the man next to him.
The smell of alcohol was so hot that it stung his eyes. At this moment, he hoped that the woman could be in a normal drunken state.
Not cooperating with treatment and speaking incoherently, at least she had not reached the coma stage, but was only in the middle stage of drunkenness, with ataxia.
Just like the Wang Hao who was just treated, it is a typical ataxia, with an alcohol content of about 1000mg/l.
But now the woman is in a coma, with a low body temperature, and even her lips are obviously cyanotic.
The alcohol content in the blood has long exceeded 3000mg/l. If no intervention is given, respiratory failure and death are possible.
"I don't know how much she drank. When I got home from get off work, I saw her lying alone in the room with a pile of wine bottles under her feet."
Seeing the doctor's expression was wrong, the man was also panicked at this moment.
"She kept saying that she was under great pressure at work and was not happy. I specially communicated with her and told her not to work if she was tired and to rest for a while."
"I didn't expect it to be like this when I got home today."
The man's words were anxious, and he didn't want to fake his concerned eyes. It felt a bit too wrong for her to drink so much alcohol just because she was not happy at work.
After confirming the patient's basic information, Xiao Chenguang began to give medical advice.
"Naloxone hydrochloride 0.2g + 0.9% physiological sodium chloride 500ml intravenous drip."
"Metadoxine saline drip to protect the liver."
"Omeprazole 40mg, protect the gastric mucosa."
Xiao Chenguang stayed beside the woman, not daring to leave, always observing the changes in her condition. If she continued to deteriorate, she would have to intubate through the mouth to maintain her life.
Due to the urgency of the matter, the nurse quickly took the medicine back from the pharmacy after communication.
Preparing medicine and hanging bottles.
Two channels, one in each hand, quickly started infusion treatment along the Murphy's dropper.
Xiao Chenguang turned over the patient's eyelids from time to time to observe her pupil changes, but a variety of alcohol-related complications and corresponding treatment measures emerged in his mind.
Aspiration is the most common cause of death.
Xiao Chenguang had already found a laryngoscope and tracheal tube from the rescue vehicle at this time, in case of emergency.
And the remaining more serious complications.
Such as hypothermia and hypoglycemia, stroke, myocardial infarction, pancreatitis, upper gastrointestinal bleeding, rhabdomyolysis, and disulfiram reaction of cefuroxime plus alcohol.
Each one is fatal.
Until now, Xiao Chenguang still doesn't understand what people who have to drink to get drunk are thinking.
Even if they want to drink to relieve their sorrow, they don't drink to the point of unconsciousness.
Xiao Chenguang uses rapid rehydration to increase the patient's alcohol metabolism, and then uses naloxone to help the patient wake up.
Basically, after these measures, the patient will show signs of awakening.
If not, the problem is troublesome.
Xiao Chenguang stayed by the patient's side, paying attention to the changes in her consciousness and vital signs.
Until the first bottle of drip was empty, the patient still showed no signs of improvement.
Even the patient's blood pressure and oxygen saturation continued to decline, and symptoms of respiratory muscle paralysis had already appeared.
"Are you sure she only drank alcohol and didn't take any other medicine, such as alprazolam, diazepam, and other anti-anxiety psychiatric drugs?"
If it was just alcohol paralysis, she should have signs of waking up if treated normally.
But now, Xiao Chenguang suspected that the patient might have drug poisoning.
Faced with the inquiry, the man tried to recall.
"She seemed to have said some time ago that she wanted to come to our hospital's psychiatric department for a check-up, but she only mentioned it, and I didn't see the medicine bottle at home. She couldn't have wanted to commit suicide because of this..."
The man was so scared that he couldn't speak, and his eyes were full of disbelief.
At this time, the girl's family also rushed to the hospital.
When they saw the girl's situation, they immediately told Xiao Chenguang a piece of news that made his heart sink.
"Did you take a bottle of diazepam?"
"Are you sure it was a bottle?"
The family's answer stunned everyone present.
She took a hundred days' worth of medicine in one go. Even an elephant would faint, not to mention a human.
I found out after asking carefully.
The woman's father had mental weakness and often suffered from insomnia at night. He had only come to the hospital to get medicine these two days.
When the family heard that the woman had passed out after drinking and was admitted to the hospital, they realized something was wrong and searched through the boxes and cabinets, but only found an empty bottle of sleeping pills in the trash can.
"Not sure... but this is the only bottle of medicine left at home. Is it because the girl has been under too much pressure recently and likes to keep silent and not communicate with us, so she can't get over it..."
The woman's mother burst into tears when she talked about this. Her child was good in everything. She was an excellent student since she was a child and had a stable job when she grew up. She never worried her family.
But there was only one thing, she didn't like to talk and kept everything in her heart.
She was silent every day, and no one knew what she was thinking.
Hearing this, Xiao Chenguang sighed in his heart.
Many people can't get over it and get stuck in a dead end. A large part of the reason is related to poor expression.
This is a personality problem, and there are also family reasons. Xiao Chenguang will not comment.
Now it is basically confirmed that the patient has drug poisoning.
It is also very simple to confirm the diagnosis. Once the small biochemical results are out, many things will be clear at a glance.
But before the test results come out, the measures that should be taken cannot be stopped.
Xiao Chenguang's expression also became serious.
"The patient's current condition is very dangerous and requires emergency gastric lavage. If the symptoms do not ease, intubation, ventilator, and even CRRT will be required in the later stage."
Routine drunkenness generally does not require gastric lavage.
But if drug poisoning, especially psychotropic drugs, will seriously affect the central nervous system and cause respiratory depression in patients, which is the same as what the elderly often say, "If you gasp for a while, you won't breathe."
"Doctor, as long as she can wake up, I will accept anything."
The man understood the seriousness of the matter. Although he didn't know what Xiao Chenguang meant by CRRT, as long as there are measures to save people, it is better than anything else.
"I see. Let's do a gastric lavage first to see the effect. The best outcome is for the patient to wake up. If not, we can only transfer him to another hospital for CRRT."
After asking the family to sign, the nurse pushed the gastric lavage machine over.
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