"Oh, please inform her family immediately. We will try our best to rescue them, but some treatments must be agreed to by the family."

One of the coworkers nodded and said, "Okay, I'll go find her parents right away."

At this time, two policemen came in and asked, "Someone came to report the case and said that someone had died in the Huang Xingji Fan Factory? Which patient is it?"

police?

Human life?

The doctors and nurses present were full of questions.

Since someone reported the case and the police arrived at the scene, let others deal with it. Chen Xia had to continue to rescue the patients.

"Wu Shaochen, have you found anything when you check the body?"

"Reported, the patient was in a shallow coma, with a large and equal circle on both sides of the pupil, a diameter of 4.0mm, slightly dull to light reflection, no cyanosis on the lips, a little pale, and full jugular veins..."

The jugular vein was full? Chen Xia couldn't help but feel a little confused, but did not interrupt Wu Shaochen's report.

"The patient's neck is soft and has no resistance, and the breathing sounds of both lungs are clear, there is no dry and wet rosy, the heart rate is 102 times per minute, the heart rhythm is uniform, and there is no murmur."

Chen Xia was worried, so he listened to the heart valve himself, but no noise was heard.

He took out the percussion hammer and took off the patient's socks and scratched it. No Babinski sign appeared on both sides.

That's strange. What exactly causes the patient to fall into a coma?

Chen Xia suddenly remembered that employees usually cook with coal stoves in the dormitory, so he asked a few accompanying workers: "Are the patient burning coal stoves at home?"

The workers thought about it carefully and denied it: "No, Li Guizhen was lying in the corridor at the door and was not in the house."

It seems that carbon monoxide poisoning can be ruled out.

At this time, the doctor on duty made an electrocardiogram and handed it over to Chen Xia.

Electrocardiogram shows: sinus tachycardia, the ST segments of V1 to V4 of the chest lead are significantly lowered (0.1 to 0.3mv), and the T wave is inverted.

Chen Xia looked constipated and looked at it several times, puzzled.

At this time, the police also asked the two neighbors about the situation at the scene and Li Guizhen's personal information.

Li Guizhen is 29 years old, married and has no children. Her husband is in a construction company, but has been sent to another place for a year. Several workers said that she has no enemies, just...

Seeing the coworker's hesitant look, the police's professional sensitivity rose and asked with wide eyes:

"What's wrong? Do you have any hidden things? Don't be stressed and tell us everything you know."

One of the women lowered their voices and said, "In recent months, you can often see deputy factory director Zhu Hongzhong sneaking to Li Guizhen's house, which seems a bit abnormal."

The little policeman rolled his eyes, NND, the murder case was not questioned, but it was actually a romantic news after a long time.

The old policeman was more experienced and said with a serious look on his face: "This is something that needs to be investigated. Don't alarm the deputy factory director first. Please ask this worker to help me and invite Deputy Factory Director Zhu? It's said that an employee had an accident and was rescued."

The coworker nodded and ran out of the rescue room.

Chen Xia was right next to him and just listened to it. In fact, he was quite interested in this kind of gossip news. If he could still take a bag of melon seeds and listen to interesting news, but he is still rescuing patients...

"If you have a good person, is there any necessary connection with Li Guizhen's coma?"

At this time, Bai Hua hurried over, "Secretary Chen, the results of the arterial blood qi analysis have come out."

Chen Xia quickly took it over and looked carefully:

PH6.70, carbon dioxide partial pressure PaCO2: 41 mmHg, oxygen partial pressure 185 mmHg, bicarbonate 5.3 mmol/l, blood sodium 147 mmol/l, chlorine 114 mmol/l, potassium 4.3 mmol/l, blood sugar 13.1 mmol/l, lactic acid 21.0 mmol/l, AG 28.3 mmol/l.

Wu Shaochen and Bai Hua both stretched their heads, and the three of them immediately started to study.

The patient was lying on the hospital bed and his life was uncertain. Chen Xia had no time to test them, so he quickly analyzed it to them:

"You can read this report, let's take a look in a few steps.

1. If the patient has a PH of 6.67 <7.35, it means acidosis.

2. The patient's bicarbonate is equal to 5.3, less than 24, and the partial pressure of carbon dioxide is equal to 41, greater than 40. The diagnosis of metabolic acidosis + respiratory acidosis can be determined.

3. Before the anion gap increases, the actual bicarbonate = 18.3+5.3=23.6, which is between 22 and 26, indicating that there is no metabolic alkalosis.

4. The patient's lactic acid reaches 21mmol/l, and the condition is extremely critical. The main reason is hypoxia and circulatory failure, which has an extremely high mortality rate!

5. The partial oxygen pressure in the blood gas is 185mmHg. What you see is the arterial blood drawn in the oxygen inhalation state, so there is type I respiratory failure.

In addition, carbooxyhemoglobin is not high, which can rule out acute carbon monoxide poisoning, and methoglobin normally eliminates nitrite poisoning. At the same time, there is also hypersodium hyperchloremia."

The young doctor Wu Shaochen, Wang Jinfa, Bai Hua, Mo Yongfang, and Tao Lili looked at "Chen Laoshi" with great admiration. With a simple inspection report, he could analyze so many problems. It was simply amazing.

While listening, these people were recording with small notebooks, preparing to look back and study this report. This is all medical experience.

Without more auxiliary examinations, Chen Xia fell into deep thought with this blood qi analysis and electrocardiogram. What exactly caused the patient to fall into a coma?

He always feels that things are not that simple. What are the causes of acid substitution and acid respiration? Is it the direct cause of the patient's coma?

In my heart, Chen Xia kept silently reciting the "Coma Mantra", AEIOU, low sugar and liver heat.

A=cerebrovascular disease; E=epilepsy; I=infectious disease; O=toxicity; U=uremia; low=hypoglycemia; low=hypotension; sugar=diabetes; liver=hepatic encephalopathy; heat = heat stroke.

Which one is it?

Since one person can't figure it out, then everyone will work together.

Chen Xia looked at the little doctors in front of him and said:

"What do you think about this patient? We can discuss it. How about expressing your doubts?"

Wu Shaochen was the first to speak: "The patient was dysconscious, had no convulsions, no incontinence, no pathological signs, and there was little possibility of cerebrovascular accidents."

Bai Hua said: "The patient has shock, but hemoglobin has 14.8, so hemorrhagic shock is not considered, so ectopic pregnancy or dissection rupture may not be large, and allergic shock should be considered."

Tao Lili added: "The patient has lactic acid 21, but his blood sugar is 13.1, his blood sodium is 147, and he doesn't know whether he has diabetes in the past, and the patient's body is obviously dehydrated. I don't think it's like diabetic ketopathy coma."

Wang Jinfa's last speech: "From the onset, it is also necessary to consider whether there is any trauma. The bilateral respiratory sound is symmetrical, except for pneumothorax, hemoglobin stable, and abdominal organ bleeding shock is basically the case, but the possibility of cervical spine injury needs to be considered."

Chen Xia touched his chin: "The patient's jugular vein is full, and there is no exclusion of pulmonary embolism or pulmonary artery hypertension. Next, we should also pay attention to the lower limb vascular conditions and D-dimers to understand whether there are high-risk factors for pulmonary embolism."
Chapter completed!