Chapter 427: 427: Wholeheartedly Convinced!
Chapter 427: Chapter 427: Wholeheartedly Convinced!
With the ECG machine brought in, Chen Cang quickly started connecting all the leads!
Feeling of weakness all over!
Abnormal reactions in the digestive tract!
Breathlessness, suspecting the problem lies with the respiratory muscles!
Heart palpitations!
Diabetes!
All these factors combined led Chen Cang to think of a terrifying disease that could even be life-threatening!
And it could threaten life at any moment!
However, the ECG had yet to be performed.
Xiaolin then shouted, “Doctor Chen, the heart rate is only 20!”
Chen Cang’s face immediately turned ashen, “Atropine!”
Nurse Lele hastily began the injection!
But after the dopamine injection, the effect was still mediocre!
The patient’s condition did not improve at all.
At this point, the ECG machine slowly produced the ECG printout.
Chen Cang tore off the ECG, took a close look, and his expression changed drastically.
Just as suspected!
The waveforms on the ECG, combined with all of the patient’s symptoms, made everything clear!
Chen Cang couldn’t help feeling relieved that he hadn’t rushed to hydrate the patient.
Otherwise, the old lady would have been truly done for.
By then, it would have been too late to save her.
Looking at the ECG, Chen Cang felt his hands shaking.
Xiaolin continued, “Doctor Chen, the heart rate is still dropping!”
At this time, the elderly patient’s face was contorted; already thin from years of diabetes and being eighty years old meant his face was just skin and bones!
But now, his twisted facial expression, his rapid breaths through an open mouth, and his moaning in distress caused a few trainees who had come to watch the “excitement” to involuntarily step back!
It was too terrifying!
At this time!
Atropine seemed to be of no use; the heart rate was still only 20.
Chen Cang thought it over and immediately changed the plan, “Epinephrine!”
The emergency box contained a complete set of resuscitation materials, with a full array of medicines for emergency use, and Lele quickly began to search… getting ready.
At this moment, Chen Cang said to Xiaolin on the side:
“Prepare 10ml of calcium chloride! Intravenous injection!”
“Also, insulin, 10 units, also intravenously!”
Upon hearing this, the resident trainees behind were stunned!
At this time, using calcium agents!
They were clueless and had no idea why Chen Cang started intravenous calcium supplementation after doing the ECG.
The patient… had calcium deficiency?
The group was bewildered!
And Xu Dongdong, to be honest, was also a bit perplexed, but still stood behind, jotting down every word Chen Cang said in her notebook.
Because calcium chloride and insulin were not in the emergency kit, they needed to be fetched from the nurse’s station.
Once they were obtained, Chen Cang looked at Xiaolin and instructed word by word:
“Remember! Inject the calcium chloride slowly, 10 milliliters, to be finished within five minutes!”
“Insulin is also an intravenous injection!”
After handing over the instructions, Chen looked toward the monitor, where the heart rate had by then reached 45 beats per minute!
It seemed to be the work of epinephrine!
But it wasn’t time to celebrate yet.
The patient’s most crucial underlying cause had not been removed!
This was a condition that could endanger life, instantly leading to cardiac arrest!
At this moment, Li Baoshan happened to be passing by the ER and, after learning that a patient was in emergency treatment, he hurried in!
Li Baoshan saw Xiaolin administering the medication.
He asked Chen Cang, “What’s the situation with the patient?”
At this time, all the resident trainees behind were completely baffled!
They also didn’t know what had happened.
Although they had all followed along… they didn’t understand a thing!
What exactly happened?
Why do we seem so incompetent?
And why did Chen Cang start such a complex procedure after just looking at one ECG?
Even Xu Dongdong was in the dark about this.
The man who had been talking to Xu Dongdong just before also started to lose his confidence; wasn’t it electrolyte disturbance?
Seeing the heart rate and blood pressure gradually recover, Chen Cang finally breathed a sigh of relief.
Hearing Li Baoshan’s inquiry, he quickly turned around, “Director!”
“The patient is likely suffering from hyperkalemia, accompanied by diabetic ketoacidosis, and moreover, the potassium level may be as high as over eight!”
Upon hearing about the potassium level, Li Baoshan’s face immediately fell.
Over eight for blood potassium, that’s deadly!
Normal blood potassium levels are between 3.5 to 5.5 mmol/L.
And when it exceeds 5.5, it’s hyperkalemia.
Li Baoshan, upon hearing how high the blood potassium was, immediately asked, “Aren’t the serum electrolyte levels out yet?”
Chen Cang shook his head, “I’ve just sent for them less than ten minutes ago; they can’t be that fast!”
As soon as Chen Cang’s words were out, the people around suddenly became quiet.
Without the serum electrolyte levels, how could Chen Cang declare a blood potassium level of over eight?
How did he guess that the patient had hyperkalemia?
From start to finish, Chen Cang had only performed an ECG.
At this moment, the surrounding medical trainees became quite curious!
Chen Cang couldn’t possibly say it was just a guess, could he?Nôv(el)B\\jnn
When Li Baoshan heard Chen Cang speak, he hurriedly picked up the ECG next to him and after a careful look, he immediately frowned!
“What did you use?”
Chen Cang replied, “Calcium supplements, calcium chloride. The patient’s blood sugar was over 16, so I added 10 units of insulin.”
At this time, Li Baoshan walked to the side and observed the patient.
Now, all they could do was wait and see.
Chen Cang had done all he could.
Now, Li Baoshan was growing increasingly satisfied with Chen Cang.
Having the sharpness to diagnose patients through details isn’t something just anyone can do.
Not to mention anything else, just the fact that Chen Cang could determine the blood potassium level through an ECG was a skill in itself.
It wasn’t something achievable without years of experience!
In emergency medicine, every second counts. If they really had to wait for the serum electrolyte tests, it might have been too late!
The treatment Chen Cang had provided was appropriate as well.
This evoked a sense of admiration from Li Baoshan, as Chen Cang was truly a promising young man.
Chen Cang had administered everything that was necessary, and if that wasn’t enough, dialysis would have been the next step.
Seconds ticked by.
The numbers on the heart monitor jumped continuously, like the rhythm of life itself.
The heart rate gradually stabilized around fifty, the patient’s breathing evened out, and their blood pressure stabilized.
At this moment, both Chen Cang and Li Baoshan let out a sigh of relief.
It looked like the patient’s condition should now be stable.
The elderly woman also opened her eyes and took a relieved breath; she felt as if she’d just narrowly escaped death’s door.
…
…
Meanwhile, the daughter who had brought her mother to the hospital was pacing anxiously at the entrance of the observation room.
She was terribly nervous!
Fearing the worst for her mother.
The ER security guard, Uncle Qin Taishan, seeing her state, couldn’t help but console, “Young lady, don’t worry, take it easy. Director Li is in there, everything will be fine!”
Despite his words, how could the woman be at ease?
Hearing what Qin Taishan said, her voice choked up immediately!
“I shouldn’t have scolded her, I should have fixed the glucose meter sooner, it’s all my fault!”
“I’m sure I’ve been too nagging lately, I won’t do it anymore…”
“Oh, dear God, please look after my mom, I beg you, let her pull through!”
…
The daughter’s voice was choked with emotion, and her state of distress left Uncle Qin Taishan unsure of what to say.
The nurse, observing the daughter breaking down, couldn’t help but sigh. This is the nature of daughters! When mothers make mistakes, daughters may scold them, but after all, the elderly get childlike as they age, and nobody but a daughter would bother you with constant nagging.
But nagging is one thing, and blaming is another. When the mother falls ill, the daughter truly feels as tormented as if she herself were sick.
By this time, the elderly woman was slowly, but surely, coming around.
However, they couldn’t afford to drop their guard yet.
Hyperkalemia has many causes. Diabetic ketoacidosis is one, but other possibilities could not be ruled out, so further waiting for the biochemical test results was necessary before considering a transfer to another department.
Li Baoshan made a call to the lab, and after some urging, the results came out quickly!
The nurse hurriedly printed the lab report and handed it over!
Li Baoshan took a look.
“Blood potassium: 8.1!”
Thankfully, the resuscitation was timely. If they had really waited for the serum electrolytes, it could have been dangerous.
Glancing at the report, the attendant medical trainees stared wide-eyed in disbelief!
It really was over eight!
At this moment, their curiosity intensified about how Chen Cang had actually estimated the patient’s blood potassium concentration!
Xu Dongdong was especially thrilled!
In just two days, she’d witnessed another intense emergency.
Although she felt somewhat bewildered, there was this overwhelming sense of awe.
Seeing Teacher Chen handle such an urgent condition, sorting through complex symptoms and finding the critical factors to deliver timely treatment, that was incredibly challenging!
And utterly exhilarating!
To tell the truth, right then and there, Xu Dongdong was utterly convinced by Chen Cang!
Wholeheartedly convinced!
…
…
PS: Hehe, for now, three updates. See you tomorrow at noon when the mystery will be unveiled.