The conditions in the ambulance were limited, there wasn't even a mobile electrocardiograph.
There are limited measures that Li Zheng can take now. He can only pray that the rain stops soon so that he can get to the hospital as soon as possible.
"The rain has subsided, hold on tight!" Chen Dayong shouted loudly in the cab, shifted into gear, stepped on the accelerator, and the ambulance sped up.
In less than 10 minutes, the rain stopped completely. The ambulance honked its sirens all the way to the emergency room of the No. 1 Municipal Hospital.
"squeak!"
Chen Dayong braked to a stop.
The medical staff at the door were all surprised when they saw the approaching car.
"Why is it another car from Guang'an County?" The doctor on duty was a little confused. This car had bad intentions and must be another critically ill patient.
"Hurry, fulminant myocarditis! Prepare an electrocardiogram! Prepare a ventilator!" Li Zheng loudly gave medical orders while dragging the patient down.
"What? Fulminant myocarditis?" the doctor on duty said in shock.
"Are you deaf? Go and prepare for rescue!" Chen Dayong cursed.
The doctor on duty quickly turned around and shouted to the nurse on duty: "Go call Doctor Sun!"
Li Zheng and others pushed the cart and ran, and soon entered the emergency room again.
"The ECG machine is here!" The doctor on duty pushed the machine to the bedside and wet the electrode clamps of the limb leads with cotton swabs.
Li Zheng quickly pulled open the patient's shirt and attached the chest lead electrodes to the patient's chest.
The doctor on duty has already clamped the limb leads.
A minute later, the machine produced an electrocardiogram.
"Extensive ST segment elevation, atrioventricular block, severe ventricular arrhythmia..." Li Zheng looked at the shocking electrocardiogram and quickly gave the diagnosis.
"Fulminant myocarditis, confirmed!" Li Zheng said in a deep voice.
The monitor was connected seamlessly and the alarm sounded immediately.
"Blood pressure 43/61!" Chen Dayong shouted anxiously.
"How much does he weigh?" Li Zheng turned around and asked the patient's wife named Cui.
The patient's wife was already stunned and stood by, at a loss. When she heard Li Zheng's question, she was startled and quickly said, "120 pounds."
Li Zheng nodded and quickly issued a doctor's order:
"600 mg of dopamine mixed with 500 ml of normal saline, pump 1 ml per minute. 4 mg of norepinephrine mixed with 500 ml of normal saline, pump 10 ml per minute!"
The nurse was a little dumbfounded. These were all blood pressure-raising drugs, but she couldn't remember so many at once.
"Don't just stand there, go get the medicine first!" Li Zheng said, "Get two more doses of methylprednisolone, four bottles of immunoglobulin G, and three doses of amiodarone!"
"Li Zheng, you're increasing the intensity again!" Sun Peng came to the emergency room and said somewhat unhappily.
Li Zheng glanced at him and said in a deep voice, "Stop talking nonsense and go get the medicine!"
Li Zheng repeated the medicine.
Sun Peng also understood this disease. He muttered, "I need you to teach me!" but hurried to the pharmacy.
"Bring the central venous puncture kit!" Li Zheng said to the nurse on duty. Because dopamine extravasation can easily lead to tissue necrosis, a central venous infusion is required.
The nurse quickly brought the puncture kit.
"Zhang Lei, you do the subclavian puncture!" Li Zheng said.
Zhang Lei quickly shook his head and said, "My puncture success rate is too low. It's okay for most patients, but with this patient, I get nervous and the success rate is even lower!"
Li Zheng did not insist anymore. He opened the puncture kit himself and started the subclavian vein puncture.
"You hit the nail on the head! Brother Zheng, you are amazing!" Zhang Lei couldn't help but praise him. If it were him, there was no way he could do that.
Li Zheng nodded and said, "When you have the chance in the future, try to do it yourself. The more you puncture, the higher the success rate will be."
I remember that when I was in the field hospital, I had to perform at least a hundred subclavian punctures a year, and sometimes several a day. That was when I honed my skills.
The central venous catheter was successfully placed, and Li Zheng drew several tubes of blood to further check cardiac function indicators such as troponin, myocardial enzymes, and brain natriuretic peptide.
At this time, Sun Peng also took the medicine back.
All five kinds of medicine were given to Li Zheng to look at.
Li Zheng said, "Give the doctor's order and ask the nurse to prepare the medicine."
"No, you do it!" Sun Peng had the previous case of the king cobra. Although he was very dissatisfied with Li Zheng's behavior, he still recognized his ability.
Although we treat several cases of fulminant myocarditis every year, the results are generally not very good. I wonder if Li Zhenglai will have a good outcome.
Li Zheng nodded and said, "600 mg of dopamine mixed with 500 ml of normal saline, pump 1 ml per minute. 4 mg of norepinephrine mixed with 500 ml of normal saline, pump 10 ml per minute! 250 mg of amiodarone mixed with 50 ml of 5% glucose, intravenous push!"
When Sun Peng heard this, he was surprised that the dose was so large, and it was very different from the ones he had treated for patients before.
But he didn't dare to doubt it anymore. Maybe this dosage was better. He quickly wrote it down in a small notebook.
"Add 1000 mg of methylprednisolone to 500 ml of 5% glucose solution, slowly drip at 60 drops per minute, and 120 grams of immunoglobulin G is intravenously dripped." Li Zheng continued to give medical orders.
The more Sun Peng listened, the more shocked he became. This dosage was far beyond what he had ever used!
"This...is the dosage too big?" Sun Peng couldn't help but ask.
"Which one are you talking about?" Li Zhengdao.
"These types... are all serious!" Sun Peng said. After all, it was in his own hospital and his own department. If something went wrong, he would be held responsible.
Li Zheng shook his head and said, "Not much. A small dose won't achieve the desired effect, and it's useless. You must use a sufficient amount. Don't worry! I'll take responsibility if there are any problems!"
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