Chapter 309 Free Skill Card

However, Lu Chen glanced at the girl standing in the center of the consulting room.

From the outside, she didn't appear to be in any discomfort, but her expression was dull and lifeless.

Lu Chen looked above her head and saw that the girl's health was 68.

This is definitely a problem, but the problem is not life-threatening.

"Please tell me in detail how she drank mercury." Wang Xueyang asked the middle-aged man.

"Hey, it's like this..."

The middle-aged man paused and briefly explained the whole process.

This little girl is her daughter.

She was raised by her grandparents when she was a child. She was withdrawn and had a tendency to be depressed since she was twelve years old.

This time, the little girl committed suicide by drinking mercury!

At around 3 o'clock this afternoon, the girl broke fifteen thermometers on her own, poured the mercury in them into mineral water bottles, and drank them all.

However, the girl did not experience abdominal pain, diarrhea, nausea, vomiting or other discomfort after taking mercury orally.

After the middle-aged man found out, he immediately sent his daughter to the local hospital.

After completing laboratory tests such as blood routine, liver function, kidney function, and coagulation at the local hospital, no obvious abnormalities were found.

Although no abnormality was found, the parents were still uneasy.

Now for further diagnosis and treatment, he was transferred to the emergency department of Jinghua Second Hospital.

"Are you feeling uncomfortable now?" Wang Xueyang approached the girl.

The little girl frowned, looked at Wang Xueyang warily, then shook her head slightly, but still made no sound.

Upon seeing this, Wang Xueyang immediately stepped forward, placed the girl on the physical examination table in the clinic, and then "driven" other patients and family members out of the clinic.

Lu Chen gently closed the door, and Wang Xueyang began to conduct a detailed physical examination and auscultation on the little girl.

A long while.

After the inspection, Wang Xueyang breathed a sigh of relief. She did not find anything wrong with the inspection, and then said to Lu Chen: "Mercury is the only liquid metal at room temperature. Its main way of poisoning is to absorb it through the respiratory tract in the form of vapor."

"The absorption of metallic mercury through the digestive tract is very small and can even be ignored. I have seen a case report of oral administration of hundreds of grams of mercury, and the patient survived. Therefore, oral administration of mercury is generally not life-threatening."

Lu Chen understood.

He has relatively little exposure to metal poisoning.

He has seen more poisonings caused by organophosphorus pesticides and rat poisons. As for metal poisoning, it is rare and relatively difficult.

"By the way, doctor, this is an X-ray taken at the local health center."

At this time, the middle-aged man took out his backpack and took out an X-ray.

This is an X-ray of the chest + whole abdomen + pelvis.

Wang Xueyang picked up the X-ray and looked at it, with a surprised look on his face.

She muttered something under her breath.

"The mercury is almost reaching my anus!"

Lu Chen also took a look at the X-ray.

Sure enough, as Wang Xueyang said, the mercury taken orally by girls directly reaches the anus.

"Do you feel the swelling in your anus?" Wang Xueyang looked at the little girl again.

Lu Chen knew that Wang Xueyang was asking if he felt any swelling in his anus.

The little girl still shook her head.

Wang Xueyang said to the middle-aged man on the side: "The child may need to be hospitalized in the emergency ward. Although it is not life-threatening, taking a large amount of metallic mercury orally. If it cannot be excreted quickly, the mercury may be oxidized into mercury ions in the intestines and absorbed into the body." Blood. Mercury absorbed through the digestive tract mainly causes digestive symptoms and kidney damage.”

"Then where should I go to go through the formalities?" The middle-aged man immediately agreed to be hospitalized.

"I will issue a hospitalization bill for you, and then go to the payment window in the lobby on the first floor to pay." Wang Xueyang said, "During the hospitalization, you must be accompanied 24 hours a day."

"Okay, no problem." The middle-aged man got the hospitalization certificate and then left with the little girl in hand.

Looking at the two people leaving, Wang Xueyang sighed slightly.

She slowly said to Lu Chen who was standing aside: "Actually, I'm not worried about this little girl's mercury poisoning, but I'm worried about her mental state. She's only fifteen years old this year and she started committing suicide. I can't save her life this time. There will be another time.”

Lu Chen nodded slightly.

Society is developing rapidly, but many problems have also been exposed.

For example, the psychological problems of left-behind children.

Although Lu Chen has not been in clinical practice for a long time, he has seen many such patients.

In the endocrinology department before, he also saw a little girl who was suffering from depression and was poisoned by taking "licorice tablets".

Today, I met another person who was poisoned by mercury.

"Lu Chen, go and notify the doctor on duty in the emergency ward upstairs. Make sure the family members keep a close eye on the patient to avoid any further accidents in the hospital."

"Okay, Teacher Wang." Lu Chen nodded, "The person on duty upstairs tonight happens to be a classmate I know. I'll give him a call."

"Okay, go ahead and fight."

Lu Chen immediately called Cheng Peng directly.

"Fat man, a little girl with oral mercury poisoning will be coming to the emergency ward later."

"Ah? Mercury poisoning?" Cheng Peng said in shock, "This... this is really mouth-watering!"

Lu Chen briefly described what happened, and Cheng Peng was secretly shocked.

Lu Chen continued: "Fat man, the patient is a fifteen-year-old girl. She has suffered from depression in the past and has suicidal tendencies. Go and talk to the teacher on duty. Let the patient's family pay more attention and be sure to accompany her 24 hours a day. Nurse Ward rounds must also be strengthened to prevent suicides from happening again.”

"Okay, it happens to be Senior Brother Wang Xiaodong who works the night shift tonight. I'll go tell him." Cheng Peng said, "You are so generous in the emergency department and you will admit a few fewer patients."

"Don't worry, I won't collect them randomly or without them." Lu Chen smiled.

After hanging up the phone, Lu Chen turned to look at Wang Xueyang beside him.

"Teacher, I have already informed the doctor on duty upstairs." Lu Chen said.

"Okay." Wang Xueyang nodded, "Actually, in our emergency clinic, the more common patients, in addition to those with fever and abdominal pain, are those who take medicine randomly, are poisoned, and some who attempt suicide."

Those who succeed in committing suicide are taken directly to the funeral home or crematorium, without any chance of coming to the hospital.

"Teacher, do patients with mercury poisoning need gastric lavage and catharsis?" Lu Chen suddenly asked.

Because according to clinical common sense, as long as poisons enter from the digestive tract, timely gastric lavage and catharsis are required, which can reduce the absorption of toxic substances and enhance excretion.

However, mercury is special and is hardly absorbed in the digestive tract.

Wang Xueyang paused and then said after a long while: "Gastric lavage and catharsis both have certain effects. However, gastric lavage with physiological saline is avoided, especially when mercury chloride is poisoned, because it can increase its solubility and increase absorption. In the early stage, carbonic acid can be used After thorough gastric lavage with sodium hydrogen and activated carbon, milk and egg white can be taken orally. The protein can not only protect the gastric mucosa, but also combine with mercury to prevent the absorption of mercury.”

Lu Chen wondered: "For this little girl, the mercury has already reached her anus. Logically speaking, gastric lavage has almost no effect, right?"

Wang Xueyang cast an appreciative look at Lu Chen.

"I have an idea. For this patient, gastric lavage may not have much effect, but catharsis is very important. We usually use mannitol catharsis and glycerin enema to promote intestinal peristalsis, and intravenous infusion of PPI to suppress acid and protect the gastric mucosa. , alanyl glutamine protects the intestinal mucosal barrier, edaravone vitamin C resists oxygen free radicals, and even some sodium dimercaptopropanesulfonate is used as a mercury-removing treatment..."

Wang Xueyang's explanation is very clear.

Lu Chen's knowledge of emergency poisoning was not perfect yet.

As a senior attending physician, Wang Xueyang has rich emergency experience.

A small number of diseases are rare in Lu Chen's opinion, but Wang Xueyang can also tell a few things.

At this moment, a prompt popped up on the system panel.

"Ding, receive clinical toxicology knowledge."

"Congratulations, you have obtained the Emergency Toxicology Skill Card (Elementary)!"

Lu Chen was still confused when he saw this prompt.

The last time I obtained a skill card in this way was when I participated in the difficult case discussion with Li Yao.

At that time, he obtained a primary skill card for clinical thinking.

This time, unexpectedly, I got an emergency poisoning skill card!

Lu Chen was quite surprised.

During his rotation in the cardiology department, Sun Guoguo and Li Yao also taught him a lot of cardiology knowledge, but he never obtained the relevant skill cards.

Lu Chen guessed that it might involve an unfamiliar field.

In this unfamiliar field, as long as others teach knowledge, he can obtain relevant skill cards.

However, this method of acquisition should have certain limitations.

Lu Chen is still unclear about these aspects of the system and needs further exploration.

However, Lu Chen was still very happy to get a basic skill card for free.

Because in the system mall, this emergency poisoning skill card also costs 30 points of gratitude.

For Lu Chen now, every bit of gratitude is precious.

No matter how small the mosquito is, it is still meat!

…

After dealing with the mercury poisoning patient, Lu Chen and Wang Xueyang continued to see the remaining patients.

In just two hours, they had seen about forty patients.

There were many patients in the emergency clinic, but Wang Xueyang still felt that something was different tonight.

The number of patients tonight has increased by 20 to 30% compared to usual.

Wang Xueyang glanced at Lu Chen beside him.

Fortunately, there is this relatively reliable graduate student here. If a newbie comes here, there may be so many patients and he may be in a hurry.

"Doctor, UU Reading www.ukanshu.net is this the emergency internal medicine department?"

At this time, a fat middle-aged man appeared at the door of the clinic.

Next to him was an old man about seventy years old.

"Yes." Wang Xueyang nodded.

The middle-aged man quickly helped the old man into the consulting room.

"Doctor, come and see my dad. He has been hiccupping for four days."

As soon as the middle-aged man finished speaking, Lu Chen and Wang Xueyang heard "uh".

The old man's chest rose and fell slightly, and he hiccupped.

Then, less than three seconds later.

Another uh-

The man on the side made a grimace and said, "That's it, I hiccup every few seconds."