Vol 3 Chapter 2449: Hot potato

Unfortunately, this momentum lasted only 3 days, and Sun Yuenan began to have a fever. At first she held back, thinking that she was young and in good health.
But soon she couldn't get up because she had a fever. There was no way but to order antibiotics in a nearby clinic.
She estimates that the area of ​​her tattoo was too large. At the time, the tattoo artist also said that after such a large area of ​​tattooing, fever may be caused.
Anything unlucky made me catch up, and Sun Yuenan had no choice but to be honest.
The condition was good and bad, almost a good day, a little more mental, and her temperature began to rise again when she was about to go to work.
Lying on the bed, Sun Yuenan could hear his heartbeat. Since the aortic valve was replaced last time, with the beating of the heart, the click of the mechanical valve sounded like an alarm clock and made her bored again.
Half asleep and half awake, the sound of clicks in the ears. In the dimness, Sun Yuenan felt very cold, and she began to shiver. The body doesn't seem to be its own, it's out of control at all, and can't stop snoring.
These days of quietness have no effect at all, and the condition shows no signs of improvement.
The person in the small clinic measured her temperature, 40.5 degrees Celsius. After seeing this temperature, they were frightened.
Such a high body temperature must not confuse people?
She wanted to ask Sun Yuenan's relatives on the phone, but she was half unconscious and had no idea what happened. There was only a trembling body and the sound of a rattling aortic valve hovering around the ear as the heart beat.
120 emergency car sent Sun Yuenan to 912 emergency department.
Litao Zhou is flipping through the New England magazine. This issue of the magazine has the case report written by Yun Geer.
Eating 5 pounds of iron nails can go to the New England magazine. My own cases are more weird and rare, and it should be possible.
Brother Yun is so good, Zhou Litao thought happily. I don't know how Boss Zheng's Nobel Prize was. He was thinking about the smell of the ink floating in the magazine.
The results may be coming in the next few days, but Zhou Litao dare not ask. Yesterday, when Boss Zheng went to Cui Lao's office to look at the medical records, he asked a question, but met Su Yun's disgusting eyes.
It was okay to be sprayed by Brother Yuner. His man had a tofu in his mouth. But Zhou Litao can clearly notice that Yun Brother cares a lot about the Nobel Prize. But then again, who cares?
There is no need to be annoying, Yun Brother is too nervous, Zhou Litao excuses Su Yun in his heart. And with Mr. Zheng in there, may he not get the Nobel Prize? He already has a blind trust in Boss Zheng and the medical team.
"Mr. Zhou, there is a patient with a high fever, Mr. Tang is busy, let you take a look." The emergency physician knocked on the door and said outside.
"Oh, okay." Zhou Litao stood up, the little freckles on his face were flying.
After Su Yun showed a clear path, Zhou Litao felt that life was full of excitement. As for the girlfriend who has been thinking about it before, it has no meaning at all.
When it comes to fruition, everything will be there. There is no need to worry about yourself.
Coming to the emergency room, the physician began to report the condition. Not to mention anything else, just a body temperature of 40.5 degrees Celsius is enough to make people pay attention.
Zhou Litao began to examine and took out a stethoscope to listen to the breathing sounds of both patients' lungs.
Pneumonia symptoms are present but not severe. When he listened to the patient's left lung breathing sound, he heard a click.
This is the standard heart sound after valve replacement. Zhou Litao stunned. Has the patient had a history of valve replacement? How could it be so young. Perhaps it was congenital heart disease, Zhou Litao immediately made a judgment.
After opening Sun Chaonan's coat, Zhou Litao saw a plum tree that was brightly dripping.
Today's young people really play. Zhou Litao just glanced at it and didn't care about it, but noticed the surgical scar hidden under the plum tree. It should be that he had undergone cardiac surgery. He has made a preliminary judgment and then started to examine the patient.
There is no bulge or depression in the anterior region of the heart, the heart boundary is generally normal, the heart rate is 54 beats per minute, the heart rhythm is uniform, the auscultation area of ​​the mitral valve can be heard, and grade 3/6 diastolic hair-like noise is heard.
Blow-like murmurs, after aortic valve replacement ... Zhou Litao's heart tightened, is it a matter of the valve?
Before the test, Zhou Litao gave the patient a routine blood collection and a cardiac echocardiography, lung CT and other tests.
The inspection was carried out step by step, and Zhou Litao soon got the information.
Nothing else to say, the problem is with echocardiography.
After mechanical aortic valve replacement, aortic root dissection aortic aneurysm was formed around the mechanical valve, left ventricular outflow tract-anterior mitral valve root fistula, anterior mitral valve root neoplasm, aortic artificial machinery Valve vegetation, moderate mitral regurgitation.
Let's go to surgery, the valve vegetation is most likely caused by the infection. This neoplasm induces infection and fever, and this is not the most terrible. If it is detached and tied in an important blood vessel, it may cause a series of complications such as cerebral infarction.
Zhou Litao made a judgment on the patient's condition, called his heart and chest, and Zhao Yunlong came down for consultation. After taking a look at the patient, Zhao Yunlong took another look at the echocardiogram and other information and connected the patient.
912 emergency department emergency, strict and accurate.
But the problem was stuck in Zhao Yunlong.
If the entire hospital was a machine, Zhao Yunlong thought he was just a part. It's important, but trivial.
He asked his medical history and learned that the patient had undergone aortic valve replacement surgery a few months ago, and this time the aortic valve appeared again.
Really special!
Zhao Yunlong knew how difficult the second valve operation was.
The speed of Zhao Yunlong's progress has been amazing since he performed a heart separation operation with a conjoined baby following Boss Zheng.
Not only others, but even he looked back inconceivable.
It's just that it's not important. Zhao Yunlong took the patient back and made a judgment on the condition. He felt that if he rashly opened his chest, he might not be able to take it down.
This is not the same as the last cycle of internal medicine who did not dare to lower the stent and had poor basic conditions. The local anatomy of patients with secondary valve surgery has changed significantly.
Can anyone do it? Zhao Yunlong suddenly thought of Boss Zheng.
He should be able, maybe ... maybe ... almost.
However, Zhao Yunlong did not go directly to Boss Zheng, but reported it layer by layer. This patient is not considered an emergency department and has no right to undergo surgery directly. Unlike the last patient in the ICU, it was a pure emergency, there was no time to wait.
The difference between them is very clear.
And the last two days are the days when the Nobel Prize results are announced. If it is possible, Zhao Yunlong does not want to disturb Boss Zheng.
The patient was admitted to the hospital to complete the relevant examinations, but the problem came immediately. Colleagues from the unit, there are only a few 20-year-old girls, they have collected a wave of money, and only a pitiful 3,000-5,000 yuan.
No amount of them. And this money is not enough to plug your teeth. ICU is 10,000 a day. Even if the operation is successfully completed, the girl will not be able to survive if she has no money.
However, this is not a problem. In such a case, just ask the medical office to come out and bake it.
The patient is here, we want to treat, it is the medical office's business to give the virtual money to the medical office. Although some of this money will eventually fall into the interior of the department, the bulk of it will be borne by the hospital.
Small hospitals may be concerned about such expenses of hundreds of thousands, millions or even millions each year, but hospitals of this size of 912 are not very concerned.
Govern first and talk about the rest later. In fact, clinically, I am most afraid of encountering this kind of problem. If the medical office gets dark and throws the pan back, the most headache is the surgeon.
Reported to the Medical Office and the on-duty professor, the professor's surname is Chen, and the level is not bad. It's just that Zhao Yunlong thinks his level should be better than himself, but according to the diagnosis and treatment process, he still called Professor Chen to see the patient.
Professor Chen glanced at the patient and then looked at the echocardiographic data. He was also very worried.
"Xiao Zhao, what do you think?" Professor Chen asked.
"I can't do the surgery." Zhao Yunlong, a carrot-like finger, clicked a point on the echocardiographic image. "The vegetation on the bioprosthesis is not a big problem, but here I consider it to be an abscess, which is deeply eroded. There is at least a 70% chance that surgery will not be performed. "
"Even if it can come down, bleeding after the operation is troublesome." Zhao Yunlong added.
This is also something that Professor Chen doubts. He knew Zhao Yunlong's level, so he didn't just treat him as a hospital general, but subconsciously discussed it.
"The left atrium is affected, and it is estimated that a part of it will be removed." Professor Chen said, "Surgery under extracorporeal circulation is likely to fail."
What the two said was one thing, the possibility of successful surgery was not high.
There is no money, no immediate family members, and the illness has returned to the sky. As long as there is a possibility for this patient, no one is willing to go to the operating table for surgery.
Well done, the entire department lost money together. Fortunately, he said that the income of the nurse was not high, and for the time being, he had to work hard to do the night shift, and he would not be able to bear it if he did not make money.
But if it can't be done well, now that there are no family members, all kinds of family members will come in, and every day they will be noisy, let the doctor who took over have a sense of dying.
If the patient does not burn so high, I don't want to return to the hospital. This kind of difficult operation, no one has the brain, how can a successful operation failed five to five.
But the patient is now confused and this cannot be pushed away. The emergency and first-aid department is responsible for countless rules and regulations that put the doctors in the circle.
But even a man like Zhao Yunlong faced a difficult case when facing such a difficult patient.
The two watched the movie with big eyes and small eyes. The director was not at home, and the second-line professor Chen had to get an idea.
"Professor Chen, the anti-inflammatory symptomatic treatment, Minger will find a consultation in the hospital. If it does not work ... just go, always try." Zhao Yunlong bit his back molars and said.
"Xiao Zhao, why don't you try it with Boss Zheng? Isn't his side able to perform surgery for patients free of charge ~ EbookFREE.me ~ And Boss Zheng's level is also high, at least he is better than us." Professor Chen In the end, there was no good way, so I said quietly.
"The operation is too difficult. I worry about Boss Zheng ..." Zhao Yunlong didn't finish his words.
Professor Chen sighed. Boss Zheng also put his head on his trousers belt for live surgery. It's justified to push patients of this difficulty directly.
There is almost no solution to this problem. After using the anti-inflammatory pain suppository, the patient sweated all by himself. But the body temperature only dropped to 39 degrees Celsius, and then rose again.
An abscess in the heart erodes the myocardium, and at least the top of the left atrium is cut even if it is surgically performed. This inflammation, if you can drop your body temperature casually, then you will see a ghost.
In the early morning of the next day, Professor Chen talked about the patient's condition after work. After watching the film and inspection report, everyone shook his head.
The patient's parents could not be contacted. It is said that they work outside the home and do not even have a signal on their mobile phone every day.
No money, no family members, and serious illness make people tussle.
The hospital consultation, as expected, has only one way of surgery. But this road is too steep for nobody to dare.
As time passed by bit by bit, Zhao Yunlong and Professor Chen looked at each other helplessly. In the end, Zhao Yunlong sighed and said, "I'll send Su Yun the image data and let him see if it works."
In desperation, Zhao Yunlong sent the information to Su Yun and sought help again.
Soon, Su Yun replied with a surprised expression and then a series of exclamation marks. Had it not been for Zhao Yunlong's knowledge of this film, he would have thought that Su Yun's mobile phone had a big problem.