Li Qinghua doesn''t understand what Ren Haitao said.
He knew that the West dasainai medical center, which is a huge private hospital, is rarely known in China, but it has an unusual position in the United States.
Isn''t it good for cardiac intervention experts at the West Dakota medical center to stay in the United States and earn a lot of dollars? Why do you want to be a clinical doctor in China. And according to Ren Haitao, it was not dug up with a lot of money, but rushed up and down... It''s unimaginable.
The two chatted. The little doctor in lead finished the film, packed up the film and went to the radiology department to wash the film.
Ten minutes later, the little doctor came back with a bedside chest film.
Ren Haitao stood in front of the film reader for a long time, then took photos and sent out the image data.
"Lao Ren, what do you feel?" Li Qinghua asked again.
"But it''s definitely negative pressure pulmonary edema. The diagnosis is relatively clear. Because it''s rare, I must ask Mr. Wu to give me a hand."
Ren Haitao said while watching the film, "Qinghua, the low tidal volume and high-frequency breathing you give after a short laryngeal spasm may be the cause of negative pressure pulmonary edema."
Li Qinghua frowned, but did not refute Ren Haitao.
"Laryngeal edema is a manifestation of upper respiratory tract obstruction. The positive end expiratory pressure should be changed, and the patient''s symptoms will be relieved soon." Ren Haitao did not notice the change of Li Qinghua''s expression, and continued, "the low tidal volume and high-frequency ventilator assistance mode you gave the patient increased breathing efforts, produced negative pressure in the chest, and further aggravated pulmonary edema."
"..." Li Qinghua sighed deeply.
Ren Haitao doesn''t seem to know the distance. He just starts from business and doesn''t consider his feelings.
Oh, but I can''t say he''s wrong.
This man... What a fool. In the past, Ren Haitao''s position in the second hospital of Medical University was embarrassing. Director Xu couldn''t live without him and had to be wary of him. Ren Haitao didn''t seem to be aware of it. He worked and studied foolishly every day.
Li Qinghua reminded him of these things many times, but Ren Haitao listened in his left ear and burst out in his right ear. He didn''t pay attention to these important interpersonal relationships at all.
"Wait a minute. Mr. Wu doesn''t reply in five minutes. I''ll call." Ren Haitao looked at the film on the film reader without blinking. His face reflected the light of the film reader, so focused.
Within five minutes, Ren Haitao''s cell phone rang.
He glanced at his cell phone with an excited look on his face.
"Qinghua, I''ll answer the phone." Ren Haitao answered the phone while running away. "Hello, Mr. Wu, I''ve caused you trouble."
"The patient''s..." he walked farther and farther, his voice was intermittent, and Li Qinghua didn''t follow, but looked at the patient''s ECG monitor.
Although the heart rate is sinus, it jumps about 140 times per minute, which makes Li Qinghua a little upset.
To tell the truth, Ren Haitao''s "outspoken" made him very uncomfortable. But after years of old relationship, he knows Ren Haitao''s personality.
This is also one of the reasons why Ren Haitao''s goods can''t be mentioned in his sophomore year of Medical University. There is no one behind. That broken mouth always tells the truth. What truth do you want to tell... Of course, it is needed now.
Is there any mistake in your own disposal? Li Qinghua has been thinking about it.
When changing the ventilator data at that time, there should be no problem, but how did the patient have negative pressure pulmonary edema.
"Qinghua, the peep of the ventilator is 7... No, 8." soon, Ren Haitao came back and said confidently.
"So high?" Li Qinghua was stunned.
When the positive end expiratory pressure reaches 8, can the patient still breathe? Is Lao Ren sure he''s not kidding? If he had not known Ren Haitao, Li Qinghua would have cursed.
"Well, the increase of positive end expiratory pressure can reduce the excessive alveolar surface tension caused by insufficient alveolar surfactant, and improve the imbalance of ventilation and blood flow ratio." Ren Haitao said, "give 10mg of ground rice, 20mg of furosemide. Observe the changes of the condition and expect to see you in 1-2 hours."
Li Qinghua doesn''t have any ideas. Let''s do what Ren Haitao says.
He had heard of negative pressure pulmonary edema, but there was no research at all. Even if you tell him the diagnosis and what treatment plan you want to propose, you still need to find data. The difference between the data and the actual situation is too large, and there is no clinical experience to rely on. If there is a handling error, the patient may have to undergo tracheotomy or even sudden death.
According to Ren Haitao''s confident words, and let the legendary teacher Wu help take a look. It doesn''t matter to try first.
10mg hormone and 20mg furosemide will not lead to the death of a 19-year-old young woman. What worries Li Qinghua most is that Ren Haitao said to raise the positive end expiratory pressure to 8 cm water column. Can the patient stand such a high pressure?
After some psychological struggle, Li Qinghua had no choice but to do what Ren Haitao said.
Adjust the ventilator parameters, give medicine and shake the head of the bed 30 °.
He was uneasy and sat by the patient''s bed to observe the changes of his condition. After about 30 minutes, the blood oxygen saturation displayed on the monitor began to rise gradually.
It worked! Li Qinghua was delighted. He observed carefully for another 20 minutes. The patient''s oxygen saturation was indeed rising, not rising temporarily, and then falling off a cliff.
Li Qinghua listened to the patient''s respiratory sounds on both lungs with a stethoscope. The rales decreased significantly and the respiratory sounds increased.
Li Qinghua knew how to use furosemide to increase micturition and improve cardiopulmonary function, but he didn''t dare to use it casually at that time.
Without knowing why, any change may lead to worse results. Li Qinghua is still very cautious.
The improvement of ventilator peep does not seem to have side effects, but brings a series of positive changes.
He gave the medicine twice intermittently. Ren Haitao''s eyes lit up and stared at the values on the patient and the machine. With the patient''s blood oxygen saturation rising continuously and slowly, Li Qinghua''s heart gradually put down.
It''s almost midnight.
One day, Li Qinghua was tired and wanted to find a place to sleep. But Ren Haitao also stared at the patient''s vital signs energetically without blinking, and he was embarrassed to go.
Until 1:30 in the second half of the night, the ventilator was stopped to give oxygen, and the nasal catheter 25% ethanol humidified inhalation was used to give oxygen 3lminl.
After stopping the ventilator, Li Qinghua knew it was all right. He didn''t expect to be offline so soon. Before looking for Lao Ren, Li Qinghua was even ready for tracheotomy.
Fortunately, Lao Ren can see negative pressure pulmonary edema,
Fortunately, I didn''t hesitate to ask Lao Ren for help,
Fortunately
Li Qinghua thought.