Chapter 1086: : Reaction mechanism of allergic patients

Emergency allergy patients may be one of the most common diseases.
As a frequently-occurring and common disease in the emergency department, Chen Cang can handle it even if he has no skills.
Saw Chen Cang coming, the child's parents asked anxiously: "Doctor, look at the child, what's wrong?"
Middle-aged man holding the boy, the situation seems to be very wrong, has been drowsy.
When Chen Cang saw it, he immediately frowned!
This is not sleep ...
Is this ... anaphylactic shock?
Thinking about this, Chen Cang directly took the little boy to the rescue room. If it is really allergic, once severe, anaphylactic shock is also a very troublesome thing.
Took his family to the rescue room, and Chen Cang suddenly saw a rash on the little boy.
Quickly lifted the clothes, and saw a lot of red rashes on his stomach and chest.
Chen Cang was about to ask the little boy, but he suddenly fell into a coma, and the child's mother suddenly cried in fright.
"Doctor, save the child, he ... what's wrong with him?"
The father of the little boy also panicked.
Chen Cang quickly asked Cheng Yi on duty to connect the ECG monitor.
Turned to his parents: "What's the matter with him?"
The little boy ’s mother was crying, and the man had some six gods and no master. Hearing Chen Cang ’s words, he quickly said:
After dinner at night, he was playing a mobile game, and suddenly he began to say that his chest tightness was not enough. I thought the game was lost. Treat him. "
"After a while, he suddenly told me uncomfortably, saying that his stomach hurts, and he feels out of breath. When I saw that he was not right, he was sent to the community, and the community sent us to the emergency center."
Chen Cang frowned: "The child may be allergic, have you eaten anything, or have you been exposed to any special allergens?"
The man suddenly remembered: "Is it ok to eat a kiwi at night?"
At this time, the monitor alarm sounded.
"Dr. Chen, the blood pressure is only 80 / 40mmHg!" Cheng Yi's ECG monitor was connected, and quickly said, "31 breaths per minute! Blood oxygen protection degree 89!"
After Chen Cang heard it, he was guessing.
Allergic shock!
"Prepare for tracheal intubation!"
Oxygen is enough to choke, the little boy's airway must be blocked, and the throat edema is serious!
Open the airway first, then give oxygen!
"Epinephrine 0.5ml subcutaneous injection."
"5% glucose infusion to maintain smooth intravenous administration!"
Here, Chen Cang turned to his family and said, "The little boy may be allergic to kiwi!"
After hearing the mother of the little boy, he said suddenly: "... Isn't it possible?"
"After eating kiwi last week, he said he liked it. I bought it today and Saturday. If I have an allergy ... Is it allergic last time?"
Chen Cang has no intention to explain now, because the situation of the little boy has not been significantly relieved.
Chen Cang turned to Cheng Yi and said, "Intravenous puncture is injected with 0.2 ml of epinephrine."
Adrenaline is at the daddy level in emergency medicine!
Can cope with many complicated acute diseases!
Is also the drug of choice for anaphylactic shock.
Bronchospasm can be rapidly relaxed through the β receptor effect, and peripheral small blood vessels can be contracted through the α receptor effect.
It can also resist the release of some type Ⅰ allergic mediators, so it is the first choice for the treatment of this disease!
Can be applied several times during the course of the disease.
But ... Generally speaking, after 1 or 2 injections of epinephrine, most patients can gradually recover from the symptoms of shock within half an hour.
Cang Cang looked at the little boy's situation, but also a little uneasy.
Is not very young, only ten years old, and adrenaline is almost the same.
If the shock does not improve, this is a serious case, and you have to take these drugs.
And the little boy ’s parents are also anxious. They did n’t dare to speak loudly in the rescue room, but they were still curious. Why was it all right to eat kiwi for the first time, and allergic for the second time?
And ...
After allergies, why hasn't it improved now?
Could it be a misdiagnosis?
"Doctor, I'm not doubting ... I would like to make an opinion? Wouldn't it be allergic? The last time I ate kiwi fruit was okay, this time I was suddenly allergic.
Now, all the patient can do is wait.
At this time, another doctor on duty ran in: "Dr. Chen, can you help me see what's going on with this ECG?"
Chen Cang was about to explain that when he saw Zhang Yuan, the on-duty doctor who ran in, he took the ECG and looked at it carefully.
This view, Chen Cang frowned suddenly.
"S1Q3T3?" Chen Cang said suddenly, "Did you rule out pulmonary embolism?"
After Zhang Yuan heard it, he was surprised for a moment: "Pulmonary embolism?"
Cang Cang nodded: "Well, this ECG is a typical S1Q3T3, plus sinus tachycardia, right bundle branch block, it is a pulmonary embolism out of 10, you have to let the patient improve the examination!
"By the way, you first inform the thoracic surgery consultation, I estimate the patient is not in good condition, confirm the diagnosis as soon as possible! Don't delay."
After listening, Zhang Yuan hurriedly got up and ran out: "Thank you Dr. Chen!"
Here, Cheng Yi suddenly said, "Dr. Chen, the patient's blood pressure is up! Blood oxygen protection is also recovering!"
Cang Cang was relieved. It seems that there is no need to take too many anti-allergy medicines.
Blood pressure is up, shock has improved, and the condition can basically stabilize.
Chen Cang turned around and explained: "The patient should be allergic to kiwi, and the symptoms are immediate allergic reactions.
This kind of allergic physique generally appears in 5 ~ 20 minutes ~ EbookFREE.me ~ no more than half an hour, it will appear. "
"Fortunately, if you come in time, if this symptom does not attract attention, or the time for medical treatment is delayed, it is likely that the major organs will cause very great impact and harm, and even serious life-threatening."
"You must pay attention to it in the future!"
Chen Cang thought of the child's father that the little boy might have lost his game and could not help but sigh.
The little boy suddenly turned over and opened his eyes.
The parents of the little boy suddenly felt relieved!
An uneasy heart was finally put into his stomach.
If the child really had anything else ... Neither of them dared to imagine the picture.
"Thank you doctor! Thank you so much." The woman said quickly, "Scared me!"
After the talk, the woman hurried over and touched the child's face with shaking hands.
Chen Cang nodded; "It's okay."
After speaking, Chen Cang didn't seem to have a problem looking at the little boy. He was about to go out and see Zhang Yuan's patient with pulmonary embolism.
Just got up, Chen Cang suddenly remembered another thing.
That is, the patient does not seem to know much about allergies.

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