Li Min found that there were a lot of things going on the night shift tonight.It is estimated that it was attracted by Dr.
Liu's crow's mouth.Not to mention the first patient with "foreign body fetish"; Then Nian Ko was so angry with her own mother that her stomach hurt; Without waiting for the obstetrics night shift doctor to come for consultation, the outpatient department admitted a patient with epigastric pain to the general surgery department.She answered the phone and hurried to the general surgery department.- This patient has eaten too much!
The unit sent a "double festival" condolence payment, and a group of workers went out to eat and drink.This person didn't drink too much wine, but ate too many vegetables, couldn't stand up straight, and then ate a few big hawthorn pills at home and it didn't work, and finally came to the hospital.The nurse looked at the doctor's order and asked Li Min, "Gastrointestinal decompression?"
I think I use the tongue depressor directly to help, and the throat and eyes are quicker to induce vomiting. ”"If he was willing to vomit, he wouldn't have come to the hospital."
Such a thin person can eat himself to the end, Li Min does not dare to underestimate any psychologically paranoid person."
You quickly decompress him and suck the food out first.If there is a blockage, do not rinse with saline and change the tube. ”"It's uncomfortable."
The nurse on duty in the Department of General Surgery tonight has a similar personality to Xiao Jiang, and she is unhurried and has her own ideas.In the face of the nurses who did not know and did not cooperate, Li Min not only had to explain his treatment opinions clearly, but also explained them clearly."
The saline from the flush tube may have aggravated the load on his stomach.I estimate that his stomach is now a balloon that is about to burst, and the 50ml or maybe 20ml of saline that flushes the tube may be the last straw that breaks the camel's back.Another induced vomiting can also increase the pressure on the stomach and can also lead to accidents. ”When the nurse saw Li Min say this, she had to stand up and go to the lower gastrointestinal decompression.The patient's family stood in the office and listened to the conversation between Li Min and Xiao Jiang, and asked Li Min: "Doctor Li, is it okay not to take out what you have eaten in your stomach?"
Doesn't this mean that you haven't eaten and suffered a sin in vain?
”Li Min patiently explained to her: "His current situation is that he has eaten too much and caused acute stomach expansion, and the consequences are very likely to burst the stomach."
As I said, it's like a balloon that blows up too much.Even if he just stands up to urinate a little hard, or sneezes to increase the pressure in his abdomen, it can cause a ruptured stomach.Now we take the initiative to use a gastrointestinal decompression tube to suck out part of the food in the stomach, so as not to suddenly burst his stomach; Maybe it's broken now. ”"Maybe it's broken now?"
The woman's eyes widened in surprise and she screamed."
Very likely."
Li Min nodded solemnly, "Even if it may be broken, he is not in danger of life for the time being, and there is no indication for surgery, what we can do is to reduce the pressure on his stomach wall." ”"Oops, what then?"
The woman was in a hurry."
How many times have I said that he eats less and eats less, but he is reluctant to eat at home, and he is afraid that he will lose less when he goes out."
Li Min was so amused by her words that she almost laughed, and she could only hold her eyes by reaching out to cover the overflowing laughter."
If his stomach is punctured and he shows life-threatening signs such as peritonitis, then we need to have emergency surgery to repair the rupture.Otherwise, the undigested food and gastric juice in the stomach leak into the abdominal cavity from the ruptured place, which will kill people. ”The woman's face changed with fright, and she followed Xiao Jiang, who had gone to the stomach tube, back to her husband.Li Min hurriedly went to write the first course of illness record, checked his long-term medical orders and temporary medical orders, and confirmed that there was nothing to modify, before going to the ward to see the patient who was doing gastrointestinal decompression.The air in the hospital room was filled with the smell of decay, and the basin at the nurse's feet pulled out a lot of stomach contents that had not yet had time to digest, and two nasogastric tubes were thrown inside."
How are you feeling right now?"
Li Min felt that she was going to vomit through the mask, so she said to the nurse who was operating: "Write down the number and throw these out first." ”The nurse in charge of gastrointestinal decompression wore a double mask, and when she saw Li Min say this, she first connected the negative pressure suction device to the nasogastric tube, and went out with the enamel basin."
I'm uncomfortable, I'm going to die."
The patient's face was gray and he looked like he couldn't afford to live.The state is much worse than just now in the nurse's office."
What's the discomfort?"
Li Min was taken aback by his appearance."
I feel bad."
The patient complained in a long voice.Li Min hurriedly took out his stethoscope and listened to the heart sounds.After listening to the chest and back, there is nothing abnormal about the heart sounds.Li Min was worried that he had developed a ruptured stomach, so he did another abdominal examination.It's nothing!
The abdominal symptoms seem to have lessened a little bit compared to just now.The patient's wife said on the side: "Everything that was eaten was pulled out by the nurse, and it was the one who was uncomfortable with him." ”Li Min heard the words and looked at the patient.I didn't want the patient to just nod and admit it."
I'm dying, and I have to pay 45 yuan for one person tonight.I'm empty now.Woo woo......
"The nurse with the enamel basin returned, and she picked up the large 100ml syringe to continue.The patient reached out to stop her and begged vaguely, "Can you leave me some?"
If you take it out, I'll eat it for nothing.Leave me some. ”The nurse looked at Li Min: "Doctor Li, what do you think?"
”"Pump.It's just a little while, you look at his negative pressure attraction box, how can he do it without pumping. ”In just ten minutes, the bottom of the negative pressure suction box is a layer.The nurse continued."
Call me if there's anything.Our department received an appendicitis case in her fifties who was pregnant with her first child in the afternoon, and had an emergency operation in the evening.She had a stomachache before you went through your department, so I asked for an obstetric consultation.I'll have to go back and see. ”"Good.Doctor Li, you're going to get busy.I'll call you if there's something going on. ”Out of the general surgery ward, Li Min found Mu Jie standing in the elevator waiting for him."
What kind of patient?"
When Mu Jie saw Li Min coming out, he immediately stepped forward and asked."
Acute gastric distention.Colleagues gathered in the AA system, and he was afraid of losing money, so he ate a lot. ”At this time of the night, there was no one walking around in the inpatient ward, and the elevator arrived soon, so Mu Jie naturally reached out and pulled Li Min into the elevator to remind her to pay attention to her step."
Be careful.Why is there everybody?
I was able to prop myself up in the hospital. ”Li Min's heart hit the deer, and he twitched his hand unnaturally, but he didn't pull it out."
yes.I'm afraid it's only starting tonight.Otherwise, you go back to Director Chai's house and go to sleep. ”"No, I don't.I'll be with you.Anyway, Ming'er is fine. ”In the quiet elevator, there were only the two of them.Mu Jie hoped that the elevator would go up and down like this and never open the door.But the two of them said these few words, and they reached the 11th floor.When Li Min returned to the trauma surgery, she went to the intensive care unit to see the pregnant old lady, and saw that Xie Shanqian was changing her dripping."
Obstetrics came for a consultation?""
It's coming.I opened the tire protector.Said to come back in an hour, if not, you have to prepare for a caesarean section, so you can get the preoperative preparations and whatever.Consultation opinion is left in the medical record.also left a message about their gynecology and obstetrics, although there are people on night duty, but several mothers seem to be giving birth soon tonight.Even if Nian Ko wants to have surgery, he has to find someone else. ”Li Min went over to listen to the fetal heartbeat for Niankou, and then put his hand on her belly to carefully feel the fetal movements and contractions.After a quarter of an hour of effort, he said to Lao Yu and his wife: "I estimate that if you continue to be so nervous, you will have to have a caesarean section nine times out of ten." ”Nianko's tears never stopped."
Dr.
Li, I don't want to do this, but I just feel angry.What do you mean when I'm so old and still have children, why can't I have children?
Why am I not ashamed?
”"Don't cry, don't cry.Let's just not interact with them in the future. ”Lao Yu held his wife's other hand without infusion, and comforted and coaxed people.Li Min didn't know what to say to comfort Niankou.When she returned to the office, she went to look at Nianko's medical records and look through the obstetric consultations.When it came to the blood type report made by Nian Ko in the afternoon, Li Min was stunned.She immediately asked Xiao Jiang, "When did this test sheet come back?"
When I took Nianko to the operating room, I called the laboratory to ask about Niankou's blood type.They just said they had found it for me, and then there was no news. ”Xiao Jiang walked over and looked at it and said, "We sent it here after we took over."
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The people in the laboratory said that it was pressed underneath, and when they were about to get off work, they wrote the shift, only to find that this one said that the emergency department was coming, and it was specially sent over.I thought you knew this in the operating room.It's not been busy tonight, I forgot to tell you.Just now you went to Puwai, and I helped you paste it when I had time.Rare, right?!
”Li Min's lips trembled a little, "Rare, too rare."
Sister Jiang, everyone has something to do tonight.I have something to do after the holiday.You have to make up a report for me tonight and hand it over to Dean Chen tomorrow. ”Xiao Jiang was stunned for a moment and asked Li Min, "Can you use it?"
”Li Min affirmed: "It is a must.You can contact the blood bank now, I have opened a blood reserve list for Niankou in the afternoon, it is 400CC blood.You see, what is on this temporary doctor's order, I wrote it clearly.Ask the blood bank if you have received an application for blood for Nianko.I drove it. ”Mu Jie was in the doctor's office and listened to Li Min's voice wrong, and walked out and asked, "What is rare?"
”"The old lady's blood type that is pregnant."
Li Min pointed to the test sheet and showed it to Mu Jie."
Type AB, Rh (-).People with AB blood type, the legendary 'panda blood'.There are relatively few people with AB blood type in the Han nationality, accounting for less than 10% of the population.The Han Chinese with Rh (-) account for less than 5% of the AB blood type.This means that Han people have very few such blood types, and it is difficult to find a blood donor once a blood transfusion is needed. ”Li Min's face is ugly, if he had to have a caesarean section when he had appendicitis surgery this afternoon, there is no AB type in the blood bank, Rh(-) blood, who is responsible?
Muljey smiled and said, "I'm also AB type, but Rh (+).When I was hospitalized in the field hospital, the doctor who operated on me said that I was lucky, fortunately it was not negative, otherwise I would not have been able to find so much blood transfused to me. ”"You had a lot of blood?""
Not much, one or two thousand milliliters."
Mu Jie spread his hands, "There are so many AB blood types in the hospital, and they have all been transfused to me."
Then I woke up and insisted I didn't want to. ”He looked at Li Min's face as he spoke, and carefully added an explanation: "I'm fine now."
Didn't you see me running this morning?
I've been back to training since last month.Nothing now. ”Xiao Jiang was on the phone, when he turned back to Li Min and said, "There is no AB type Rh (-) blood in the blood bank of our hospital.They said that they would contact the central blood station immediately, but the blood would have to be transfused after the blood was taken.They found the blood preparation list sent by our department, but it was a mess this evening, and the night shift said that they would write it down and report it to their director. ”"Tell them to call our department to confirm before going to get blood.I'll look for an obstetrician to see if I want to have a caesarean section right away.Alas, it is hoped that the central blood bank will have Rh-negative blood. ”※※※※※※※※※※※※※※※※※※※※ joke: Eat your own, don't starve; Eat your friends' and eat when you're full; If you eat the public's, don't hold it to death.
**Today's case of acute gastric dilation appears more often during the Spring Festival in the famine year, and it is rarely seen in clinical practice now.AB blood group is a blood group of the ABO blood group classification system, which is divided into four well-known blood types: A, B, O, and AB.Rh is an independent and separate blood group classification system, which is divided into negative and positive.This method is based on whether there is a special mucopolysaccharide on the surface of the red blood cell, that is, Rh antigen, which is Rh positive, otherwise it is negative.Blood transfusion is based on the principle of blood of the same type.Generally, when encountering AB blood type, there is no need to open a separate clinical order, and the laboratory will add RH classification.People with RH-negative blood are often sensitized by unintentional transfusions, and retransfusion of positive blood triggers an acute transfusion reaction.() The distance is a bit far