"Oh, then please notify her family immediately. We will do our best to save her, but some treatments require the family's consent."
One of the workers nodded and said, "Okay, I'll go find her parents right away."
At this time, two policemen came in and asked, "Someone just reported that someone was killed at the Huang Xing Ji Fan Factory? Who was the patient?"
police?
Human life?
The doctors and nurses present were full of questions.
Since someone has reported the case and the police have arrived at the scene, let others deal with it. Chen Xia still has to continue rescuing the patient.
"Wu Shaochen, did you find anything during the physical examination?"
"Report: The patient is in a light coma. Both pupils are equal in size and round, with a diameter of 4.0mm. The light reflex is slightly dull. The lips are not cyanotic but slightly pale. The jugular veins are engorged..."
Jugular vein fullness? Chen Xia couldn't help but feel a little puzzled, but did not interrupt Wu Shaochen's report.
"The patient's neck was soft and there was no resistance. The breath sounds in both lungs were clear, with no dry or wet rales. The heart rate was 102 beats per minute, with a regular rhythm and no murmurs."
Chen Xia was worried, so he listened to the heart valve himself and heard no noise.
He took out the percussion hammer again, took off the patient's socks and scratched them, but no Babinski sign appeared on both sides.
That's strange. What exactly caused the patient to fall into a coma?
Chen Xia suddenly remembered that the workers in the dormitory usually used coal stoves to cook, so he asked several accompanying workers, "Does the patient have a coal stove at home?"
The workers thought about it carefully and denied it: "No, Li Guizhen was lying in the corridor at the door at that time, not in the house."
It seems that carbon monoxide poisoning can be ruled out.
At this time, the doctor on duty prepared an electrocardiogram and handed it to Chen Xia.
The electrocardiogram showed sinus tachycardia, significant ST segment depression (0.1-0.3 mv) in precordial leads V1-V4, and inverted T waves.
Chen Xia looked constipated and examined it several times, feeling confused.
At this time, the police also briefly inquired about the patient's condition and asked the two neighbors about the situation at the scene and Li Guizhen's personal information.
Li Guizhen is 29 years old, married but childless. Her husband works for a construction company, but has been assigned to another city for a year. Several coworkers said she doesn't have any enemies, just...
Seeing the worker's hesitation, the police officer's professional sensitivity came to the fore, and he asked with wide eyes:
"What's wrong? Are you hiding something? Don't feel pressured, just tell us everything you know."
One of the women lowered her voice and said, "In recent months, we've often seen Deputy Factory Director Zhu Hongzhong sneaking into Li Guizhen's house. It seems a little unusual."
The young policeman rolled his eyes and said, "Damn it! He didn't get to the bottom of the murder case, and after all this time he found out it was a sex scandal."
The older police officer, more experienced, said seriously, "This needs to be investigated. Let's not alert the deputy director yet. Could this worker please do me a favor and get Deputy Director Zhu over? Just say there's an accident with a worker and they're rescuing him."
The worker nodded and ran out of the emergency room.
Chen Xia was right next to him and happened to overhear what was going on. He was actually quite interested in this kind of gossip. Under normal circumstances, he would have just grabbed a bag of sunflower seeds and listened to some interesting stories, but right now, he was still trying to save a patient...
"Having a lover, is there any necessary connection between that and Li Guizhen's coma?"
At this time, Bai Hua came running over, "Section Chief Chen, the arterial blood gas analysis results are out."
Chen Xia quickly took it and looked at it carefully:
PH6.70, carbon dioxide partial pressure PaCO2: 41mmHg, oxygen partial pressure 185mmHg, bicarbonate 5.3mmol/l, blood sodium 147mmol/l, chloride 114mmol/l, potassium 4.3mmol/l, blood glucose 13.1mmol/l, lactate 21.0mmol/l, AG 28.3mmol/l.
Wu Shaochen and Bai Hua both leaned over, and the three of them immediately began to discuss it.
The patient was lying on the bed, his life or death uncertain. Chen Xia didn't have time to test them, so he quickly analyzed the situation for them:
"Look at this report, and let's look at it in several steps.
1. This patient's pH is 6.67＜7.35, which means acidosis.
2. The patient's bicarbonate is equal to 5.3, which is less than 24, and the partial pressure of carbon dioxide is equal to 41, which is greater than 40, then the diagnosis of metabolic acidosis + respiratory acidosis can be confirmed.
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 level reaches 21mmol/l, and the condition is extremely critical. The main causes are hypoxia and circulatory failure, with an extremely high mortality rate!
5. The oxygen partial pressure in the blood gas is 185 mmHg, and what is seen is arterial blood drawn under oxygen inhalation, which means type I respiratory failure exists.
In addition, the low carboxyhemoglobin level rules out acute carbon monoxide poisoning, and the normal methemoglobin level rules out nitrite poisoning. There is also hypernatremia and hyperchloremia.
Young doctors Wu Shaochen, Wang Jinfa, Bai Hua, Mo Yongfang and Tao Lili looked at "Mr. Chen" with great admiration. He could analyze so many problems from a simple examination report. It was really amazing.
As they listened, they took notes in their notebooks, preparing to study the report carefully later. This was all medical experience.
There were no more auxiliary examinations. Chen Xia fell into deep thought again while holding the blood gas analysis and electrocardiogram. What exactly caused the patient to fall into a coma?
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