I Can See Health

   Chapter 566 Open the quilt early and take a look!

  From morning to now, the emergency department has given the patient at least three diuretics (furosemide)!

   However, the patient did not excrete a single drop of urine!

   This made everyone present stunned.

   Lu Chen and Xiao Shikang, who were about to leave, also stopped at this time.

   "Go and see the 12-bed old man again!" Xiao Shikang said solemnly, he was really worried.

  The Department of Cardiology pays the most attention to urine output.

  If patients with heart failure want to relieve their condition quickly, they rely on urinating as much as possible to reduce the load on the heart.

   So, Lu Chen, Xiao Shikang and Dr. Fan Jian from the emergency department came to the bedside of 12 beds together.

  …

   came to the bed.

  Lu Chen squatted down immediately and checked the patient's urine bag.

   Sure enough, there was only 300ml of liquid in the urine bag.

   "What's going on here?" Fan Jian muttered to himself, he checked the patient again, "Could it be acute renal failure?"

Xiao Shikang shook his head, "It doesn't look like it! The patient's urine output was normal for the first two days, and it has been low since last night. In addition, although the patient's serum creatinine value has increased, it has not reached the level of severe renal failure. to the point of.”

   It is not renal failure, so what is it?

  Lu Chen stood beside the hospital bed, continued to check the patient's case, and fell into deep thought.

   "Old Fan, you say, is it possible that you have heart failure?" Fan Jian suddenly said.

   "Isn't it heart failure?" Xiao Shikang wondered, "Then what do you think it is?"

   "For example, pulmonary embolism?" Fan Jian whispered. .

   The patient has been bedridden for several years, and the blood flow of the blood vessels in the lower extremities will definitely not be very good, and it is easy to form thrombosis.

   Once the thrombus falls off, it may flow into the pulmonary artery, causing pulmonary embolism, resulting in asthma, hypoxia and other manifestations.

  Xiao Shikang frowned and said, "You are right, but even with pulmonary embolism, when the patient's blood pressure is normal and the blood volume is sufficient, after taking diuretics, there should be urine, right?"

   Fan Jian scratched his head, "That's right."

   At this time, the patient's family couldn't help but ask: "Doctor, he is still wheezing and has not relieved. It seems to be getting worse. What's going on, is it okay?"

   It can be seen that the family members of the patient are very scared, and their lips are shaking during the speech.

   "The old man has never suffered from heart failure before! Why is it so serious this time?!"

   Lu Chen frowned upon hearing this.

   The words of the patient's family caught his attention. Has this patient ever suffered from heart failure before?

   His eyes turned to the old man. He was lying on the bed, unable to express himself at all because of aphasia and dementia.

   Is it really not heart failure?

   Just as Lu Chen's thoughts were running fast, a prompt popped up on the system panel.

   "Congratulations, breakthrough in clinical thinking ability!"

   At the same time, countless diagnoses and differential diagnoses flashed through Lu Chen's mind.

   All the medical records of this 12-bed grandfather quickly flashed through Lu Chen's mind.

   After just a few seconds, all the ideas finally came together.

   When Lu Chen re-examined the patient, he really found something different.

  …

  Although the cause of the patient has not been found, it is impossible for Xiao Shikang and Lu Chen to stay in the emergency department all the time.

   They still have a lot of patients in the inpatient ward that need to be dealt with.

  The patient can only be left in the emergency department first, and then transferred to the cardiology department when the condition improves, and the cause is slowly found.

   Just when Xiao Shikang was about to leave the emergency department, he didn't expect Lu Chen to walk back to bed 12.

  Xiao Shikang was about to shout to stop Lu Chen, but saw that he directly lifted the patient's quilt, exposing the patient's abdomen.

  Xiao Shikang felt a little strange, and walked to Lu Chen's side, "What's wrong?"

  Lu Chen frowned, glanced at the patient's abdomen, then squatted down to look at the urine bag, his face suddenly looked a little wrong!

   "Mr. Xiao, look at the patient's bladder..."

  You can see the patient's lower abdomen distended very obviously without using hands at all!

   At this time, Xiao Shikang also felt something was wrong.

   Fan Jian next to him patted his head, "Oh, I was busy just now, and I forgot to check the abdominal condition. I just listened to my heart and lungs."

   "Percussion." Xiao Shikang's face was a little unsightly, "Take it easy, don't buckle the bladder."

   At this time, a thousand grass and mud horses came running in Fan Jian's heart.

   bladder so big? Why? Is it urinary retention?

  He calmed down, started immediately, touched the patient's lower abdomen lightly, and buttoned it lightly.

   Voiced!

   The normal percussion sound of the abdomen should be a drum sound.

   If it is dull, it means that there is liquid in it!

   Is it really urine retention?

   In the first place, Fan Jian couldn't even believe what he was touching!

   "Old Xiao, this...this..."

Xiao Shikang shook his head slightly and said slowly: "I just checked it, the patient's urinary catheter has sediment and the urine is cloudy, such a urinary catheter is very easy to block, if he is really blocked and can't urinate, then It's just urine retention!"

   "A few days ago, the patient's urine output was close to 2000ml every day, and today it's only about 300ml. If it really is urine retention, the patient will be suffocated to death!"

   Although the old man on the hospital bed couldn't speak, he could definitely feel the discomfort caused by urinary retention!

   So you will be short of breath, sweat profusely, and your blood pressure will rise.

   As the saying goes, a living person cannot be suffocated by urine, but if the urine tube is blocked to prevent the urine from being discharged, it will be terrible!

   At this point, the nurse has come to perform bladder irrigation.

  After flushing, it turned out that the urethra was blocked!

   "My God!" The little nurse opened her mouth wide.

After the    is unobstructed, the urine is continuously drawn out from the urinary catheter, and it is almost 500ml in a few seconds.

   "Close the urethral clamp first." Xiao Shikang said, "Urinate after a while."

  If too much urine is excreted in a short period of time, the filled bladder shrinks rapidly, which is likely to damage the bladder and cause hematuria.

   The little nurse has lingering fears. Today, she is also responsible for not finding the patient's urinary catheter blockage in time.

  Lu Chen finally breathed a sigh of relief!

  Patients may have heart failure, but this heart failure is called holding back the urine!

  Xiao Shikang whispered to Fan Jian beside him: "Old Fan, if you opened the quilt earlier, looked at the urine tube, and looked at the abdomen, why would you do this?"

   In less than 2 minutes, the old man's shortness of breath gradually eased, and his blood pressure also dropped.

   Safe!

  Crisis, lifted!

   Fan Jian's back was soaked, his face was red and his ears were red.

   He knew that if Lu Chen and Xiao Shikang didn't find out in time, they would continue to treat heart failure and continue to use diuretics...

  The urine will accumulate more and more, but it will be held in the bladder, then it is really terrible!

   As the doctor on duty, he has an unshirkable responsibility!

   "Old Xiao, thank you for today!" Fan Jian said solemnly, "When I look back, please give me a good meal."

  Xiao Shikang shook his head slightly, "Lu Chen noticed it first, if you want to thank him, thank him!"

   Fan Jian looked at Lu Chen beside him, and made no secret of his gratitude, "Dr. Lu, thank you! Come to me anytime if you have anything in the future."

  Lu Chen smiled, "Mr. Fan, your emergency department is too busy, it is inevitable that there will be negligence, I can understand."

   Hearing this, Fan Jian felt a little better.

   But in the profession of a doctor, you can't deviate in the slightest.

   A lot of details cannot be omitted, otherwise, mistakes will eventually lead to big mistakes!

   The patient's family is also very reasonable. During this time, she also knew how tired the doctors were. She also took great pains to treat her old man's illness, and did not pursue Dr. Fan Jian.

   But Lu Chen also knew that this kind of thing, if others don't pursue it, the person involved will remember it for a lifetime!

   (end of this chapter)