Chapter 295: Breaking Atropine with Hands

Wang Xiaodong stood up immediately and ran out of the office.

Seeing this, Lu Chen followed closely.

This was the first time for Cheng Peng and Xiao Lin to come to the emergency department. When had they seen such a scene before?

The two of them were stunned for a moment, and then followed Lu Chen's footsteps and ran out.

...

Lu Chen followed Wang Xiaodong to the emergency room of the emergency ward.

"What's the patient's condition?"

As soon as he entered the emergency room, Wang Xiaodong asked.

The nurse next to the ward immediately said: "A couple each drank a bottle of dichlorvos and was transferred from the hospital below!"

At this time, Lu Chen also came to the bedside.

At this moment, the woman's life value was 36, and the man's life value was 52.

In addition, there was a medical record from a local hospital at the head of the bed, and Lu Chen quickly took out the medical record.

All the information of the two patients also appeared in front of Lu Chen.

About an hour ago, the two patients were found lying unconscious at home.

There were two empty bottles of dichlorvos beside them.

Dichlorvos (DDVP) is an organic compound and belongs to the category of organophosphorus insecticides.

The family members immediately called 120 and went to the local hospital for gastric lavage, endotracheal intubation and ventilator-assisted ventilation, and applied iodine pralidoxime 1.5g, atropine and other treatments.

After the man was intubated, his consciousness recovered, but he was still irritable.

The woman suddenly suffered respiratory and cardiac arrest on the way, and recovered after about 10 minutes of chest compression.

Next, he needed to use blood perfusion and other treatment measures. For further treatment, he was transferred to the emergency department of Jinghua Second Hospital.

…

Lu Chen immediately told Wang Xiaodong all the medical history information he had learned.

Wang Xiaodong nodded and immediately stepped forward to conduct preliminary physical examinations on the two people in turn.

Both of them were intubated.

The man's consciousness was awake, but the woman was still in a coma.

"Nurse, check the patient's blood immediately, a routine set, and also check blood gas analysis and cholinesterase!" Wang Xiaodong ordered.

"Received!" Gong Nannan nodded.

The man regained consciousness at this time, but he was particularly irritable.

"The man has obvious moist rales in both lungs!" Wang Xiaodong frowned, "Use a long-line tropine and a long-line atropine immediately."

"Received, a long-line intramuscular injection and a long-line atropine intravenous injection."

"Open another intravenous route, hang up iodine pralidoxime, and then use both medicinal charcoal and mannitol."

On the other side, the woman's condition was much more serious than the man's.

Not only did she not wake up, but her vital signs were extremely unstable, with a heart rate of 60 beats/min and a blood pressure of 85/54mmhg.

"Both of them should prepare for blood perfusion!"

Although the man's condition was relatively good, it could not avoid the occurrence of delayed polyneuropathy!

Wang Xiaodong did not dare to relax at all!

The rescue was proceeding in an orderly manner...

...

With the assistance of Lu Chen, Wang Xiaodong's rescue process was relatively smooth.

This kind of rescue is not the more people the better, too many people will affect the efficiency.

So Cheng Peng and Xiao Lin stood aside, staring at the rescue of Lu Chen and Wang Xiaodong.

Wang Xiaodong's performance was quite satisfactory, nothing to say.

But how could Lu Chen, who had just come to the emergency department, be so familiar with the rescue process?

...

At this moment, Lu Chen noticed that the woman's heart rate was slowing down!

"Brother Wang, look at this female patient..."

Wang Xiaodong was shocked and looked at the ECG monitor of the female patient.

Her heart rate dropped from 60 beats/min to 50 beats/min, and finally to 45 beats/min.

In Lu Chen's eyes, her life value was also slowly decreasing, from 36 to 32.

Wang Xiaodong said in a deep voice: "Immediately give 250ml of sodium bicarbonate intravenous drip and 5mg of atropine intravenous push!"

Atropine works very quickly. Basically, as long as it is pushed intravenously, the heart rate will rise.

But for this female patient, after the intravenous push of atropine, the patient's heart rate did not rise significantly!

At this time, the female patient's blood oxygen saturation was only 80%!

"Get ready for the machine!"

Wang Xiaodong immediately placed a blood filter.

However, no one expected that after the female patient was on the machine, her heart rate continued to drop!

"Fuck, it can't be maintained!" Wang Xiaodong cursed inwardly.

...

"The heart stopped!" Lu Chen suddenly shouted, and he had been paying attention to the ECG monitor at the bedside.

He was closest to the bed, so he immediately stepped forward and performed chest compressions.

Wang Xiaodong kept urging the nurse: "Keep pushing atropine, keep pushing!"

Atropine 5mg, 5mg, 5mg, 5mg IV push...

Lu Chen pressed at the bedside for about ten minutes, and the patient's heart rate returned to sinus rhythm, and the blood pressure was 101/90.

"Give 4g of iodine pralidoxime slowly dripped." Wang Xiaodong ordered.

Lu Chen also breathed a sigh of relief, but his heart was still tightly tied, and he dared not relax.

"Adjust the ventilator parameters, peep to 7, frequency to 17, tidal volume to 550ml." Wang Xiaodong began to adjust the ventilator.

The purpose of this is to increase minute ventilation and promote the discharge of carbon dioxide, but the dead space will increase, which is not conducive to the discharge of carbon dioxide because the exhalation time is sacrificed.

At this time, the patient's emergency test indicators came out.

Both male and female cholinesterase were less than the minimum value, female liver function glutamate 1010, glutamate 999, lactate 11.1, male and female other examinations were normal.

Wang Xiaodong said: "Let's leave it at that! There is a blood filter to protect it and it can be stabilized under high replacement."

At this time, the patient's blood oxygen saturation has been 100%.

Everyone present breathed a sigh of relief.

After the female patient was on the machine for 3 hours.

The patient's lactate dropped to 5.0, pH stabilized at 7.17, and carbon dioxide partial pressure dropped to 56!

Cholinesterase was retested every hour, and it was always less than the minimum value. The patient's heart rate has been stable at around 120.

All is good!

"I feel that the patient is coming back!"

So happy!

Lu Chen stood by the patient's bed and saw that the patient's blood pressure and blood oxygen saturation could not be measured!

His face changed, and he immediately auscultated the patient's lungs, and the moist rales increased.

The patient's heart rate did not drop?

But blood pressure and blood oxygen saturation cannot be measured first?

Instructed to take 18mg of norepinephrine, UU reading wｗw.uukanshｕ.net micro pump, first recommended 5ml, ineffective!

Instructed to take 5mg of atropine intravenously! Ineffective

Instructed to take 10mg of atropine intravenously, ineffective!

Instructed to take 5mg of atropine intravenously, ineffective!

Improved blood gas, lactic acid rose to 11, carbon dioxide partial pressure rose to 90mmhg again, ph7.06!

With ineffective, ineffective, ineffective.

Continue to instruct, 2mg long-term tranquil push!

After about 3 minutes, the patient's blood pressure can be measured! 50/30, blood oxygen saturation 100, blood oxygen saturation is a normal ripple, which proves to be true and effective!

Instructed to take 4mg of long-term atropine intravenously!

The patient's blood pressure rose to 107/90, and the blood oxygen saturation was 100!

Or atropine was used less!

Immediately order 50mg atropine micro pump 25ml per hour, so the classic scene of rescuing organophosphorus pesticides appeared.

One person gave the doctor's order, and three people broke the atropine! Soon, the emergency pharmacy used up 260 atropines!

Atropine was fixed at 25mg per hour, norepinephrine 18mg 25ml/h, blood pressure could be stabilized, and carbon dioxide partial pressure dropped to 50mmhg!