Chapter 849 Vicious Hyperthermia (Leader Joywong421 Plus 5)

A new doctor who came to help tried to lift the obstructing arm, but it didn't budge.

A disease suddenly appeared in Zheng Ren's mind. He walked into the operating room and stood behind to take a look.

The system panel was bright red, and several diagnoses appeared in front of Zheng Ren.

Zheng Ren ignored diagnoses such as indirect inguinal hernia and gallbladder stones. What he paid attention to was a simple diagnosis—malignant hyperthermia!

This kind of disease... can be called a disease, the incidence rate is extremely low, and it will only appear when exposed to anesthesia.

It is one of the hidden mines that the anesthesiology department is most afraid of.

Malignant hyperthermia is a genetic disorder characterized by hypermetabolism. Triggered by patient exposure to certain anesthetic drugs, nondepolarizing muscle relaxants can delay onset.

"Stop the anesthetic!" Zheng Ren shouted in a deep voice the moment he saw the diagnosis on the system panel.

None of the busy doctors and nurses had an idea. Hearing someone speak, and the words were full of majesty and the superior doctor's unquestionable, no one thought about why. The anesthetist stopped the anesthesia directly.

"Dantrolene, do you have any medicine prepared?!" Zheng Ren almost roared.

"..."

"..."

There was confusion in the operating room.

Dantrolene, what the hell is this?

"Is it malignant hyperthermia?" The chief director of the anesthesiology department ran in from the outside. He was tall and bear-like, and his figure alone could give people a strong and violent sense of oppression.

"Yes!" Zheng Ren looked at the patient and said without hesitation.

Not only the diagnosis of the system panel, but also the patient's severe convulsions, convulsions, skeletal muscle stiffness, profuse sweating, and other symptoms are the most typical manifestations of malignant hyperthermia.

No body temperature was taken, but Zheng Ren believes that the patient's body temperature is at least above 40 degrees Celsius.

The director of the anesthesiology department rushed to the patient with strides, and the doctors and nurses on both sides consciously gave way.

After a simple judgment, he hurriedly said: "The temperature of the cooling blanket is not low enough, find other things to speed up the cooling."

After speaking, he immediately took out his mobile phone and dialed out.

"I want a helicopter, go to Xiehe, I want dantrolene, a patient has a sudden malignant hyperthermia!" The voice of the director of the anesthesiology department was like Hong Zhong, and the whole operating room trembled slightly.

As an extremely rare genetic disease, malignant hyperthermia cannot be prevented. Moreover, the only hospital in China that has researched malignant hyperthermia is Xiehe.

Caffeine halothane isolated skeletal muscle contraction test has been carried out in the Department of Anesthesiology of Union Medical College. As for the specific drug for treating malignant hyperthermia, Dantrolene, only available in the Department of Anesthesiology of Union Medical College.

Zheng Ren had read several reports, most of which were case reviews written by doctors in the imperial capital and the magical capital. When encountering such a situation, the doctors in Modu could only helplessly watch the patient die.

Not for anything else, just because there is no specific drug.

In the imperial capital, because there is Xiehe, there is another option. (Note 1)

But even if the helicopter is called, it is still hard to say whether the patient's life can be saved before the dantrolene is brought over.

"Increase the oxygen flow rate, let the mask inhale oxygen!" Zheng Ren roared, "Increase the oxygen flow rate, to more than 10L/min!!"

"Iced saline, sterile iced saline, given intravenously, the fastest!"

"Monitor body temperature! Don't stop!"

"2 sticks of sodium bicarbonate static push!"

"Hurry up, who is standing there! Hurry up and push the sodium bicarbonate!"

"Nurse, take blood!"

"Equipment nurse, step down! There is no need for sterility! Hurry up to collect blood, ions, blood gas, send it as soon as possible after the collection, and tell the laboratory department, emergency department!"

Zheng Ren's roar kept ringing in the operating room, and he forgot his identity.

Although he has always avoided doing things on behalf of others, which aroused the disgust of the doctors in the 912 Hospital, but when encountering a sudden and serious illness like malignant hyperthermia, Zheng Ren left everything behind.

The sky is big and the earth is big, can it be bigger than human life?

"Call someone again to help with physical cooling. Where is the roving nurse! Head nurse! Hurry up and see if there is enough frozen saline!"

Zheng Ren roared, seemingly crazy, but he didn't lose his mind. He has been calmly observing the patient's vital signs on the ECG monitor.

The patient's electrocardiogram initially showed shortened Q-T intervals, high-pointed and symmetrical T waves, and a narrow and tent-shaped base.

Soon, Zheng Ren noticed that the amplitude of the P wave on the electrocardiogram decreased, and the P-R interval lengthened until the P wave disappeared!

This is a manifestation of hyperkalemia. Although the test value has not come out, Zheng Ren can be sure with a high probability that the patient's blood potassium level may have exceeded 8mmol/L, and even reached the fatal level of 10mmol/L.

"Calcium gluconate, 5000mg, static push!" Zheng Ren narrowed his eyes, staring at the waveform of the ECG monitoring, and shouted.

"5000..." A nurse who had just arrived to help was stunned.

For clinical use, the limit dosage of calcium gluconate is 3g, which is 3000mg. 5000mg, is this amount really okay?

The director of the anesthesiology department frowned and looked carefully at Zheng Ren, but he didn't recognize him.

Whose doctor is this? Why did you direct the rescue here? But every one is very timely, except for the excessive use of calcium gluconate.

He strode to Zheng Ren's side, and asked in a deep voice, "Is it okay to exceed the limit?"

"The P waves are gone!" Zheng Ren stretched out his hand, pointed at the ECG monitoring screen, and shouted, "The heart is in sudden arrest!"

Generally, in sudden cardiac arrest, defibrillators, external cardiac compressions, etc. can also be used to rescue.

But for patients with malignant hyperthermia, defibrillators are useless at all. And the whole body was stiff, like a stone, unable to press the chest at all.

Zheng Ren was thinking that if his heart stopped beating, he would directly open his chest, do chest compressions under direct vision, and add ice salt water to cool down the body, the effect might be better.

But this method is too extreme and intense, so try not to use it as much as possible. And even if it is cut open, the muscles inside and outside the intercostals are tense, and it is estimated that even a hand cannot be reached in.

The director of the anesthesiology department glanced at the electrocardiogram and knew what Zheng Ren said was right, so he immediately asked the nurse to inject 5000mg of calcium gluconate.

"How much urine!"

"..." The operating room was already busy, and no one was monitoring the urine output. Zheng Ren stared closely at the ECG monitor. After he finished asking, there was silence around him.

The director of the anesthesiology department froze for a moment, then squatted down, looked at the urine bag, and said, "About 20ml."

"20... No, 80mg furosemide intravenous injection!" Zheng Ren said: "Monitor the urine output and keep it at 50-100ml/hour."

"Hyperventilate!"

"Yes, hyperventilation, it must be excessive!"

"Has the test value come back yet? If not, go and urge me!"

One order after another orderly echoed in the operating room, surging.

More than a dozen doctors and nurses flew up without touching the ground.

And that arm stretched out stiffly, like iron, only spasming and twitching at its own frequency.

...

Note 1: Beijing Sanbo Hospital seems to have a sufficient amount of dantrolene in reserve.