A new assistant tried to lift the arm that was in the way, but it would not budge.
A thought suddenly appeared in Zheng Ren's mind. He walked into the operating room and stood at the back to take a look.
The System panel was bright red and several diagnoses appeared in front of him.
He ignored the diagnosis of indirect inguinal hernia and gallstone. What he paid attention to was a simple diagnosis — malignant hyperthermia!
This kind of disease … could be called a disease. The incidence rate was extremely low, and it would only appear when exposed to anesthesia.
It was one of the Dark Mines that the Department of Anesthesiology feared the most.
Malignant hyperthermia is a hereditary disease characterized by hypermetabolism. Non-depolarizing muscle relaxants can delay the onset of the disease when the patient comes into contact with certain anesthetics.
"Stop the anesthetic!" Zheng Ren roared the moment he saw the System's diagnosis.
The busy doctors and nurses had no idea what to do. When they heard someone speak, and the words were filled with dignity and the unquestionable authority of a senior doctor, no one thought much about it. The anesthetist immediately stopped the anesthetic.
"Dantrolene, do you have any medicine?!" Zheng Ren almost roared.
"…"
"…"
The operating theater was dumbfounded.
Dantrolene, what the hell was this?
"Is it malignant hyperthermia?" The director of the anesthesiology department ran in from outside. He was burly like a bear, and just his figure alone could bring about a strong and violent sense of oppression.
"Yes!" Zheng Ren looked at the patient and said without hesitation.
It was not just the diagnosis on the System panel. The patient's severe convulsions, spasms, skeletal muscle stiffness, sweating profusely, and other symptoms were the most typical manifestations of malignant high fever.
He did not take the patient's temperature, but he believed it was at least 40 degrees Celsius.
The chief anesthesiologist strode to the patient's side, and the doctors and nurses on both sides consciously made way for him.
After a simple judgment, he hurriedly said, "The temperature of the cooling blanket isn't low enough. Find something else to speed up the cooling."
After saying that, he immediately took out his phone and dialed.
"I want a helicopter. Go to Concorde. I want dantrolene. A patient suddenly has a malignant high fever!" The chief anesthesiologist's voice was like a bell, and the entire operating room trembled slightly.
Malignant hyperthermia is an extremely rare hereditary disease and there is no way to prevent it. Moreover, the only hospital in the country that had research on malignant hyperthermia was Union Medical College.
Caffeine and fluoroalkane in vitro skeletal muscle contraction test has been carried out in the Department of Anesthesiology of Peking Union Medical College. Dantrolene, a special drug for the treatment of malignant hyperthermia, was only available in the anesthesiology department of Union Medical College in the country.
He had read a few reports, most of which were written by doctors in Imperial Capital and Sorcery Capital. When the doctors in Shanghai encountered such a situation, they could only watch helplessly as the patient died.
Not for any other reason, but because there were no effective drugs.
In the Imperial Capital, because of Concord, there was another option. (Note 1)
However, even if a helicopter was deployed, it was still hard to say whether the patient's life could be saved before dantrolene arrived.
"Increase the oxygen flow. Use the mask to absorb oxygen!" Zheng Ren roared. "Increase the oxygen flow to more than 10L/min!"
"Iced saline, sterile iced saline, intravenously, the fastest way!"
"Check your body temperature! Don't stop! "
"Two sodium bicarbonate injections!"
"Hurry up! Who's the one standing there? Quickly inject sodium bicarbonate! "
"Nurse, take his blood!"
"Scrub nurse, step down! There was no need for sterility! Hurry up and take a blood sample. Send it to the Medical Laboratory as soon as you're done. Tell it to the emergency department! "
Zheng Ren's roar kept ringing in the operating theater. He had forgotten his identity.
Although he had always avoided doing things beyond his authority and aroused the disgust of the doctors in the Imperial Capital Hospital, when faced with a sudden serious illness like malignant high fever, Zheng Ren threw everything to the back of his mind.
The world was big, but how could it be more important than human life?
"Call someone again to help with the physical cooling. Where's the circulating nurse? Head nurse! Hurry up and see if the amount of frozen saline is enough! "
Zheng Ren roared. He looked crazy, but he had not lost his mind. He had been calmly and steadily observing the patient's vital signs on the ECG monitor.
The patient's ECG began to show a shortened Q-T interval, a high and symmetrical T wave, and a narrow and tent-shaped base.
Soon, Zheng Ren noticed that the amplitude of the P wave on the ECG decreased. The P-R interval was prolonged until the P wave disappeared!
This was a sign of high blood potassium. Although the test value had not come out, Zheng Ren could be sure that the patient's blood potassium level might have exceeded 8 mmol/L, or even reached a fatal level of 10 mmol/L.
"Calcium gluconate, 5000mg, intravenously push!" Zheng Ren narrowed his eyes and stared at the waveform of the ECG monitor as he roared.
"5000mg …" A nurse who had just rushed over to help was stunned.
For clinical use, the maximum dosage of calcium gluconate was 3g, which was 3000mg. 5000mg. Was this amount really okay?
The chief anesthesiologist frowned and looked at Zheng Ren carefully. He did not know him.
Whose doctor was this? Why was he directing the rescue here? However, every one of them was 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 amount?"
"The P wave is gone!" Zheng Ren reached out and pointed at the screen of the ECG monitor. He roared, "The heart will stop immediately!"
Generally, when the heart stopped, he could still use a defibrillator, chest compressions, and other methods to save it.
However, the defibrillator was useless for patients with malignant high fever. Moreover, his entire body was stiff like a stone. He could not move his chest at all.
Zheng Ren was thinking that if the heart stopped, he could directly open his chest and do chest compressions under direct vision. With the addition of ice salt water in his body to cool it down, the effect might be better.
However, this method was too extreme and intense. It was best not to use it if possible. Moreover, even if it was cut open, the internal and external muscles between the ribs were tense. It was estimated that even his hand would not be able to reach in.
The chief anesthesiologist glanced at the ECG and knew that Zheng Ren was right. He immediately asked the nurse to inject 5000mg of calcium gluconate.
"How much urine volume!"
The operating theater was already busy. No one was monitoring the urine volume. Zheng Ren stared closely at the ECG monitor. After he finished asking, there was silence around him.
The chief anesthesiologist was stunned for a moment. Then, he half squatted down, looked at the urine bag, and said, "About 20ml."
"20 … No, 80mg of furosemide intravenously!" Zheng Ren said. "Monitor the urine volume and maintain it at 50-100ml per hour."
"Overventilate!"
"Yes, overventilate. It must be overdone!"
"Is the test value back?! If not, rush it! "
The instructions echoed in the operating theater in an orderly manner, surging like waves.
More than a dozen doctors and nurses flew up without touching the ground.
As for that arm, it stretched out stiffly, as if it was made of iron. It kept spasming and twitching at its own frequency.
..
Note 1: Beijing Sanbo Hospital also seems to have a sufficient amount of dantrolene in reserve.
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