Chen Wenqiang returned to the emergency room with Dean Shu.The corridors of the emergency room were crowded with people, including medical staff in white coats.Seeing that they were back again, the medical staff who were watching the excitement in the hospital, as well as the cleaners and security guards who were responsible for hygiene, immediately dispersed when they saw them.The remaining patients and their attendants in the emergency room are still standing in the hallways, peering into the closed offices and emergency rooms.Chen Wenqiang glanced at the people who were hurriedly slipping away, and said to Dean Shu in a low voice, "Look at them who are idle." ”Dean Shu smiled and said, "They, they have to watch the excitement even if they leave their business." ”Which subject will have idle people before the morning meeting?
That's not doing business.The two of them walked into the emergency room, and the people who had just dispersed slowly reappeared behind them.Dean Shu didn't bother to look back at these people who didn't know what to do, and he immediately stopped Chen Wenqiang from trying to catch a few typical actions.There are such "idlers" everywhere, let's go and see the serious patients in the emergency room first.The later it is delivered, the more poisoning it will be.Those people will be handed over to Director Zhang for a while. ”Chen Wenqiang was dissuaded by Shu Wenchen and muttered unwillingly, "It's just that labor discipline is not tight." ”He snorted and followed Dean Shu into the emergency room.There are idlers who haven't missed the mark, and of course that's because there are many people like those who are working seriously in this emergency room.* Two more poisoned patients were brought in to the emergency room.One was slumped on the treatment bed, twitching from time to time, but his consciousness was equally awake.The gastric lavage liquid was packed in a red plastic bucket, and two nurses were pasting a note with the patient's name and number on the wall of the bucket.Li Min, Dr.
Liu, and Dr.
Dou were busy around her.The other one seems to be pretty good, and Director Li is dealing with it with a few nurses.Probably just had the gastric lavage tube removed, and the patient was very emotional, chattering and swearing but had no actual content.Yes, this is a delirium that has been affected by the toxin affecting the nervous system and has psychiatric symptoms."
How much egg soup did you drink?"
Chen Wenqiang stepped forward to help the nurse hold her.Director Li and several nurses worked together to fix her on the treatment bed.The woman struggled a few times and didn't break free, crying and saying to Chen Wenqiang: "You let go of me, I won't take more eggs next time."
I just took two sips of egg soup, and I didn't take advantage of it. ”Ha, this female patient's consciousness is really delirium?
Regardless of whether what is said is true or not, it can still answer the question correctly.Is this delirium?
But what kind of poison is this?
Chen Wenqiang was puzzled."
Ugh."
The woman vomited.Director Li and the others hurriedly let her go again, for fear that she would vomit something and choke on her trachea.But the man just retched and didn't vomit anything.After loosening the fixation, the woman changed her face again.She grinned and said, "Don't stop me, I'll be with the car today, seriously, I'll go with the car today." ”Sometimes sober and sometimes confused, and not accurate.As soon as Director Li waved his hand, several people immediately fixed her again, and the loose oxygen tube was inserted into her nostrils again.A nurse examined the back of her hand and patted her chest to rejoice: "Good thing this drip is not bulging." ”* Chen Wenqiang stood against the wall for a while, looking at the two patients who were in emergency treatment, there was nothing worth reaching out to do.He walked to the door of the emergency room and saw that Dean Shu was asking the two patients who looked like the drivers of the bus stops."
Did they both vomit before they were sent?""
She threw up."
A man stretched out his hand and pointed to the woman who was crying and laughing and making noise."
She likes to take advantage of small things, and today I don't know how to touch one more egg, and she didn't eat much egg drop soup.She vomited out the two eggs she ate when she heard that someone had food poisoning. ”Another added: "She's rectum, and she pulls when she eats it."
The egg soup entered her stomach, and it was estimated that it would turn into feces and urine immediately.Have you forgotten that every time before leaving the car, she has to go to the toilet for a long time and refuses to leave immediately?
You have to grind from the beginning to the end. ”As for the woman who was paralyzed there, the driver testified: "She was the last group to get out of the car, and she also drank the most egg soup."
From hot to cold, drink until I start.She didn't throw up. ”The man who sent her continued: "She told me on the way that she was dizzy, nauseous, and couldn't vomit and couldn't sit still.I saw that she was wrong, so I quickly let go of the empty station and turned around and sent her over.It's really her M's, Lao Tzu fell into a big bad luck and a group of these two girls, today's scene is a mess, alas, this month's bonus must be gone.M's, let Lao Tzu know who made this thing, I'll strangle him!
”"It's also a shame that these men in our car were in a hurry to warm up the car, so they just ate steamed buns and padded them, and didn't wait to drink the hot egg soup.""
yes, yes.All the women who were poisoned this time were the conductors. ”The two of them talked about their luck and vented their dissatisfaction with the conductor.Dean Shu smiled, no matter how dissatisfied they were, they also chose to send people to rescue first.The two were gloating verbally, completely ignoring the two unconscious female patients lying on the disposal bed.Alas, everything that has been done to save people has been done, so why bother talking like that.Chen Wenqiang couldn't ask anything, so he wanted to call the laboratory department.Dean Shu stopped him and said, "You still don't have to worry about that person doing things, he will definitely call as soon as he gets the result."
Let's go in and have a look. ”* At this time, Dr.
Dou and Dr.
Liu had already intubated the woman's trachea, and Li Min had also done femoral venous puncture and indwelling for her.Two streams of fluid were quickly fed into her body.The patient remained motionless and left them to fiddle.Occasionally twitching, rolling her trembling eyeballs, answering Li Min's questions with a pout, proving to Li Min that she was conscious."
Send to the dialysis unit."
Dean Shu spoke.The flat car is speeding at a leisurely pace.This is the third time Li Min has been to the dialysis room this morning.She tried hard with both hands to push the flat cart a little more steadily, and Dr.
Liu pinched the airbag and complained: "M's, let Lao Tzu know who has a good life."
It's okay, I'm going to strangle him!
”Dr.
Dou opened his mouth and yawned."
Da Liu, look at me, I'm on duty in the emergency department.I don't want to change shifts, Lao Ding wants to change with me.I haven't closed my eyes all night, and I'm about to get off work and I'm coming here.I didn't even write the names of the outpatient medical records of eight people. ”Dr.
Liu was deeply sympathetic to him."
Then you should write it quickly.Otherwise, you won't be able to get off work. ”"You and Dr.
Li have a lot of trouble.The two of you have done these incisions, cannulass punctures, and the same surgical records, and you both should write them first. ”"Naturally.Otherwise, we wouldn't be busy in vain.Isn't it Dr.
Li?
”Dr.
Liu asked Li Min.Li Min nodded and thanked Dr.
Dou: "Thank you for reminding us both that this emergency rescue is not written clearly, something is wrong, we are not only busy in vain." ”Nurse Ji has arrived.The patient had already been placed for femoral vein puncture, and she took the patient in and told the nurse to get on the machine.Dr.
Dou and his people were able to exit the dialysis room smoothly.The other, less serious poisoner, has already been taken over by the day shift.Li Min followed behind Dr.
Dou and Dr.
Liu, pushing the flat car back to the emergency room.When I go back, I need to immediately make up for this morning's disposition.I don't know if there are any poisoned people sent over later.Walking on the soles of the feet is tired.She kind of regretted wearing high-heeled boots.She only thought about night surgeries, and she usually didn't have to go to the operating room anymore, but she didn't expect that there would be emergencies that would have to go back and forth between the emergency room and dialysis.* Before the morning meeting of each department, the news of collective poisoning spread all over the provincial hospital.The emergency room and dialysis unit are ready to welcome the arrival of poisoned patients.But when it was ten o'clock in the morning, news came from the bus station that the eight conductors who drank egg soup in the morning.Others didn't drink it.The reason is very simple: the eight conductors are all short runs, and they have the opportunity to go to the bathroom.Others are afraid of traffic jams on the way back, so naturally they don't dare to drink water or soup.The conductors who can get a short distance are all a little bit related, or they have taken the way of talking people.It doesn't matter if the conductor has to buy a ticket on those bus lines that take an hour or more each way.In an instant, such news spread throughout the hospital by those who kept inquiring about the news.It's really a response to the sentence that blessings and misfortunes depend on each other.Such rumors flew all over the sky, and the director of the hospital office was furious, and he immediately summoned the directors of various departments and the head nurse to the large conference room for a meeting.He repeatedly emphasized: "The relevant departments at the higher level attach great importance to this incident, and there are now some unfamiliar faces wandering in the corridors of the hospital office."
If anyone discredits the provincial hospital or not, let me catch which subject is spreading rumors and rumors, then the monthly bonus of the whole department will be deducted. ”Whether Director Zhang has such a big right to deduct the bonus of the whole department, everyone will put it aside for now.However, the directors of each department and the head nurse understand that they must control the mouths of the undergraduate medical staff.Otherwise, Director Zhang would be ruthless, and he would really start from the spiritual civilization assessment in the bonus.Whoever has to support their family, who has to live with money?
The rumors that were full of various versions in the first half of the day disappeared immediately after Director Zhang finished the meeting.
*The patients were all sent to the ICU, but the police officers wearing police uniforms began to enter and leave the provincial hospital.They extracted the gastric lavage and brought the results of their interrogation to the provincial court.What is poison?
The rat is strong.The cook at the bus stop handed over the rest of the poison, and the white plastic bag was brightly printed with a light blue color: Smell to death.It is commonly known as the Du rat strong.This tasteless, odorless, and highly toxic powder, which costs less than 1,000 yuan, can be sold for more than 100,000 yuan after being made into rat poison.At present, the animal experimental data only known are that after the animal ingestion, the poison does not enter the stomach and attacks, using 0.2 mg per kilogram of body weight, it can die in a few minutes, and its toxicity is even 100 times greater than cyanide wu.Faced with the interrogation of the police, it was easy to find a cook who worked as a cook and made breakfast after retirement, and he was so aggrieved that he died.Because he bought □□it from his own purse."
Free novels bring you joy and joy ---> storyskyline.net
There's always a mouse in the kitchen, and I can't help it.I spent ten yuan to buy three packs of rat medicine.There is one pack left. ”So how did the rat run into the soup pot?
Then I don't know.Who can put this poison, which is known as "smelling to death" and "smelling and pouring", in the cupboard and egg basket?
The steamed buns are bought outside.There are only empty lunch boxes in the cupboard, and rats that have not eaten will not go.Rats do not eat whole eggs, nor do they gnaw green onions.How did the poison get to the soup pot?
Have you grown legs?
The cook swore an oath: up to the eight generations of ancestors, down to the children and grandchildren, even he did not let go.He repeatedly emphasized that he had the intention to harm others, so he would not take his lunch box and serve soup.If it weren't for the fact that the conductor came back from a short trip and vomited and became ill, the half of the lunch box of egg soup he gave himself would have gone into his mouth.Several people in the kitchen at the same time as him confirmed the incident.The old man was also responsible for boiling water.In the winter, some cars can't start and need hot water.He had to wait for all the cars to be sent out before he could have breakfast with the dispatcher and the security and maintenance personnel.In the end, there was a reassuring conclusion: it was not deliberately poisoned, and the whole incident was ingested by mistake.The dispatcher was crying and fainting.The director is retiring, and she acts as an agent for the entire station.This morning, the complaint calls have not stopped, and all the conductors who have their turn to rest have been sent by the head office to reinforce.But this morning, almost all the bus lines stopped, and there are evaluations at each station......
The bonus is definitely gone.Whether the agent can be turned into a regular agent is very mysterious.* Li Min is in the emergency office to make up the morning surgical records, and she has to keep an eye on the emergency room corridors.She and Director Li waited until 10 o'clock, and the hospital office sent a notice to all the doctors and nurses on call in the emergency room: those who work the night shift can go back to rest; Those who worked the day shift in the wards immediately returned to their respective jobs.Li Min returned to the twelfth floor, and Xiao Zhai told her that Director Shi had taken someone to the operation.Director Li was extremely tired, and after calling the operating room to ask the head nurse and learning that the operation had gone well, he changed his clothes and went home to rest.And Chen Wenqiang didn't go back to the department at all, as the medical director, the follow-up treatment was on his shoulders.But the problem facing Chen Wenqiang and the provincial hospital is that no □□ poisoning cases have been treated.Urgently sought help from the Affiliated Hospital of the Medical University, and the Affiliated Hospital of the Medical University has not received similar cases.Therefore, at the request of the higher authorities, a large number of internal medicine experts from the provincial capital quickly gathered in the provincial hospital, and after an afternoon of discussion, they finally gave a consultation opinion in the evening: "Symptomatic treatment." ”There is no other solution!
*After dinner, Li Min gave a lecture to the group of interns who were rotated to practice surgery and pediatrics as originally planned.With the experience of the previous batch of interns, this time I was much more relaxed.Thirty-two interns huddled in the director's office, watching Li Min draw a map of the blood flow in the brain on the small blackboard.Today's topic is the supratentorial artery.Li Min drew these arteries in red chalk and walked through them, and then explained the branches in detail.Finally, he emphasized: "These arteries originate deep into the central part of the brain, and the proximal trunk is difficult to reach, and once the proximal trunk has an accident, it is often impossible to treat it."
We are able to deal only with the terminal ends of these arterial branches, and only the small terminal branches of the lateral convex surface are easily exposed.But even such small branches are often hidden in the sulcus rather than exposed on the surface of the gyrus. ”"So, the incisions in craniotomy are basically fixed unlike those in general surgery.The incisions in our neurosurgery are usually selected based on the principle of being closest to the lesion site and causing the least damage to the brain tissue.But virtually every surgical approach is based on the anatomy of the affected arterial segment.Therefore, on the basis of keeping in mind the blood supply to the brain, students should remember the craniotomy pathways of some common hemangiomas. ”In other words, when you have the opportunity to have a craniotomy in the future, you have to know why you chose this way to get into the brain instead of that.Some of my classmates know that they will basically ask about anatomy before going on stage.If the dissection is not good, it is still a fool to go up, and it is better to practice knotting and thread cutting offstage. ”Regarding Li Min, these interns had heard from Director Qiu before they came."
If you do it, if you pass the basic operation, the provincial institute is an eclectic unit that uses talents, and there are people who are promoted to professional titles every year.Don't look at Li Min as a graduate of the Medical University, after five years, you have learned everything from books thoroughly, and you don't have to be scared when you stand in front of the good students of the Medical University. ”These interns were sent by Director Qiu full of chicken blood, but after three weeks of internship, except for the students on the eleventh and twelfth floors, who had taken turns with Li Min for one or two surgeries, the others were always in a state where she was nothing.Even the intern brought by Li Min and the intern of Chen Wenqiang, who was managed by Li Min, did not know much about Li Min.However, these people generally think that the ward rounds twice a day can talk about the important and representative of the hundreds of patients on the 11th and 12th floors, and they still admire this after the internship in internal medicine and obstetrics and gynecology.* Chen Wenqiang returned to the twelfth floor with a tired face, and he had to come over to see tomorrow's elective surgery to rest assured.When he couldn't find anyone in the duty room, when he returned to the director's office, he saw Li Min lecturing, and suddenly remembered that he had notified the interns of today's class last weekend.He slapped his head, it was all caused by this poisoning incident!
I actually forgot such a big thing.But when he saw the simple diagram of the blood supply to the brain drawn by Li Min on the blackboard, he knew that Li Min had finished the class for himself.When the interns dispersed, Chen Wenqiang asked Li Min, "Are there any special changes to tomorrow's elective surgery?"
”"Nope.I went to see the patient an hour ago and everything was normal.It's that he paid a little less for the hospitalization deposit, and the head nurse went to pay another 3,000 yuan.I urged him to go home this morning, but I still didn't go to make up for it before I got off work in the evening. ”"That's certainly not enough.I'll go over and ask. ”Chen Wenqiang immediately became serious.Now is not the time to be the deputy director of the department, so you can ignore the patient's hospitalization deposit and other miscellaneous matters, and only concentrate on Linchuan medical treatment.At the end of last year, the arrears of medical expenses made the leaders of the provincial hospitals, who still owed bank loans and had to repay interest every day, have to pay attention to the arrears.Saving lives and helping the injured is what hospitals should do.But what about this arrears?
What should I do?
The salaries of the staffed medical staff have not been fully funded for several years; For those who do not have an establishment, the hospital has to raise its own funds to pay salaries.The construction of the internal medicine inpatient center building, CT access, magnetic resonance imaging and other necessary medical equipment was approved by the superiors, but it was also necessary to raise funds by itself......
Therefore, for patients who are not emergency to save their lives, the hospital agrees to stipulate that there can be no more arrears.Otherwise, the department director, the head nurse, and the doctor will share it.After this decision was communicated, the people who were not working in the clinical community applauded: You can't be a clinical person, and finally we want to fill the hole with you.This money has to be filled by the provincial court from pure profits.It's hundreds of thousands.As the dean in charge of medical care, Chen Wenqiang has been dealing with patients on the front line of clinical practice all year round.This decision he initially disagreed.But in the end, he painfully raised his hand in favor.He is now shouldering not only medical safety, but also the pressure of medical capital turnover, bank loans, and wages and benefits of all employees.These are the big ones.As for the small reasons, when Li Min jokingly mentioned the matter of the deputy director of neurosurgery last time, Chen Wenqiang has been considering the possibility of neurosurgery being "forced" to go out.He began to pay attention to the cost of these hospitalization deposits and other expenses.It was all pushed to the head nurse Lu Qing, and he felt that he was not at the bottom of his heart.And whether the sub-department wants to take Lu Qing away, he didn't think about it.Li Min wiped the small blackboard clean, lifted the small blackboard and said, "Teacher, you wait for me to send this blackboard back with you." ”"Okay."
Chen Wenqiang agreed, took out a Hongta Mountain and smoked it.The only way to solve the worries is Du Kang.To him is Hongta Mountain.
*Tonight is Xie Shanqian's night shift.Probably because she had only been on duty independently for a short time and was taking students for the first time, the little girl's pretty face was tense, and she looked like she was a few years older.Only when he saw Li Min, he showed a little bit of a past, relaxed smile."
Doctor Li, Dean Chen was looking for you just now.""
Well, he's gone to the director's office.Do you work night shifts?
”"yes.""
Help me keep an eye out for patients who will have elective surgery tomorrow tonight.""
Okay.But let me tell you, Director Shi, that they stopped taking the medicine for last Friday's surgery. ”"Huh?
Why?
The one I remember was an incision and drainage of a lung abscess. ”"The head nurse said that we paid for yesterday's medicine, and today I can't afford it, and the money in his account is not enough, and he can't take out his medicine."
Every Friday, I take three days' worth of medicine, probably because the patient was operated on Friday, the cost of the operation was not calculated in time, and the hospitalization deposit was not enough.But when I picked up the medicine again today, the head nurse couldn't help him even if she wanted to.If you don't have money, you won't be able to take the stamped and unstamped prescription to the pharmacy, and the pharmacy won't be able to dispense medicine."
That's going to be a problem."
Li Min is also at a loss for such a thing.Although these belong to the director and the head nurse, Xie Shanqian said that she still has to give an adequate response.She asked Xie Shanqian: "What did Director Shi say?"
”"Director Shi explained to the patient, if not, he will be discharged from the hospital tomorrow morning.It's useless to lie in the hospital either.The medicine in the hospital is also bought from the pharmaceutical company, and the pharmaceutical company will not administer the medicine if you don't give enough money. ”"Then this matter will be handled by the director and the head nurse."
Li Min washed the chalk ash off his hands, took out hand polish and wiped his hands carefully.Leave enough time for Chen Wenqiang to smoke a cigarette, and he has to go back."
The patient's daughter-in-law was crying with the head nurse.How can the hospital not save it?!
”Xie Shanqian added.Li Min also smeared his nails with hand cream, grinned and said, "This is ready to play Lai."
I went to see the one that will be operated on tomorrow, and the head nurse said that he didn't pay enough. ”This is the case with patients in the ward, if one does not pay the full hospitalization deposit, it will soon affect other patients who are hospitalized at the same time.But at this time, if the medicine is not stopped, someone has to dig out the wallet and pay the hospitalization fee for the patient.There is no other choice!
※※※※※※※※※※※※※※※※※※※※*□□ chemical name: tetramethylene disulfoxidetetramine.□□ excreted from urine and feces in its original form, the metabolism is slow, and it can cause secondary □□ poisoning, and the toxicity is extremely strong.The lethal dose to humans is 5~10 mg.Onset occurs within minutes to half an hour after poisoning.
**This drug was developed in Germany in 1949, its toxicity is extremely high, after the animal ingestion, the poison does not enter the stomach and attacks, 0.2 mg per 1000 grams of body weight is used, and it can die in a few minutes, and its toxicity is even 100 times greater than that of □□.Because its chemical structure is very stable, not easy to degrade, and can cause secondary and tertiary poisoning, it has never been officially used as a commercial rodenticide in the world.□□ initially started from chemical factories in Liaoning, and the largest production was in Anhui and Henan.1 kilogram of original medicine, which costs less than 1,000 yuan, can be sold for more than 100,000 yuan after being made into rat poison.The dangers of □□ finally attracted the attention of the government in 1991 due to the major poisoning case in Shenyang.According to Zhao Guizhi, one of the five scientists involved in the "Qiu's rat poison case", seven to eight conductors ate egg soup containing □□ by mistake and were dying.On the same day, the news network was urgently suspended, and the incident was temporarily inserted, calling for national support.After investigation by the Ministry of Chemical Industry, it was found that it was produced by a company under the Chemical Research Institute of Shenyang City, Liaoning Province.Early symptoms include nausea, vomiting and diarrhoea, followed by headache, dizziness, dizziness, and weakness.Important features of poisoning are visual disturbances: diplopia, strabismus, mydriasis, blurred vision, and nystagmus.In severe cases, patients have difficulty swallowing, chewing, speaking, breathing, expectoration and lifting of the head, ataxia, etc., and are conscious.Symptoms continue to develop with progressive dyspnea and flaccid paralysis of the muscles throughout the body.This is followed by a rapid pulse, a drop in blood pressure, short-term convulsions, loss of consciousness, and eventually death due to respiratory failure, heart failure, or secondary pneumonia."
The main disadvantage of □□ is that it is too vilolent, acts quickly, is easy to be eaten by humans and animals, and is more dangerous.Even if there is an antidote, it is often too late to use it. ”On 9 December 2000, a villager in Fujian Province was poisoned by eating vegetables grown in soil contaminated with □□.() The distance is a bit far