When the Doctor Uses A Hack

One sentence left the surrounding crowd speechless!

Upon seeing Chen Cang, the young nurse's eyes immediately brightened.

Wasn't he the heartthrob from before?

No one expected to encounter Chen Cang again!

Without any hesitation, for there was no time to hesitate, Chen Cang quickly said, "Let's do this together!"

Shen Xiuyuan immediately nodded in agreement.

Chen Cang introduced, "This is the director of the provincial Second Hospital, Director Qin; and this is the emergency physician, Qin Yue. Let them in, I hope they can help!"

Upon hearing this, Shen Xiuyuan's eyes widened in surprise—Director Qin?

He hurriedly nodded, "Of course! Of course!"

It was a good thing to have someone offering advice, so Shen Xiuyuan quickly told the nurses, "Call Director Ji and say..."

The nurses nodded in unison.

Qin Xiaoyuan had been watching Chen Cang all along, not speaking much. He would have interjected if Chen Cang had said something wrong.

But!

He found that every choice Chen Cang had made from the beginning was absolutely correct, even the best possible ones.

Chen Cang glanced at the nurses and quickly instructed:

"Clear the oral and nasal secretions, maintain airway patency, prepare for oxygen therapy!"

After being poisoned with organophosphates, cholinesterase activity is suppressed, losing the capacity to hydrolyze acetylcholine, which leads to the accumulation of acetylcholine!

Consequently, acetylcholine receptors exhibit symptoms resembling those of muscarinic, nicotinic, and central nervous system involvement.

Therefore, the core of the treatment process is anticholinergic therapy.

But currently, there is no anticholinergic drug on the market that can effectively combat all three types of symptoms; most can only significantly impact one or two types.

For this reason, in rescuing someone from such poisoning, Chen Cang could not be careless; that's also why he didn't let Shen Xiuyuan take charge.

After all, he trusted himself more!

At this moment, the patient's blood had been drawn.

"Insert a catheter, administer diuretics!"

"Gastric lavage!"

Li Dan had already become incontinent by this time; diuretics would also help accelerate metabolism.

Four or five nurses immediately got busy!

Soon, the electrocardiogram monitor was ready.

The moment the monitor started working, the beeping alarm began to sound!

Chen Cang looked up and saw the heart rate dropping alarmingly, blood oxygen saturation declining, and blood pressure falling!

Chen Cang immediately furrowed his brow!

He hastily said, "Prepare atropine!"

Shen Xiuyuan had already begun preparations, for it was common knowledge that atropine was used for organophosphate agricultural poisonings like parathion. Shen Xiuyuan was well acquainted with this.

But then!

Chen Cang suddenly declared, "16 milligrams!"

This statement startled Shen Xiuyuan, and even Ji Qu, who had just rushed in, was taken aback!

"How much?"

Chen Cang continued, "16 milligrams, intravenous injection!"

Chen Cang's words, like a thunderclap in the ER, left Shen Xiuyuan and the emergency department's chief Ji Qu somewhat dumbfounded!

16 milligrams of atropine for intravenous injection!

Were they out of their minds?

16 milligrams!

Not intramuscular!

And certainly not an intravenous drip!

"Isn't that too much?" Ji Qu asked, frowning.

Chen Cang spoke firmly, "It has to be this way!"

At that moment, Qin Xiaoyuan also said, "Atropine must be used in a sufficient initial dose to quickly reach an effective concentration in the blood, effectively preventing enzyme aging due to poisoning and rapidly alleviating or even eliminating symptoms of poisoning!"

"The latest guidelines allow for up to 20 milligrams. It's okay, no problem, and an intravenous injection can quickly achieve an effective concentration in the blood!"

"Moreover, the patient currently has a high poisoning score, classified as severe!"

Hearing Qin Xiaoyuan say this, Ji Qu no longer argued. After all, Qin Xiaoyuan was a nationally renowned physician, a master of internal medicine.

His opinion carried a lot of weight!

That was the power of a good reputation.

That was also the reason Qin Xiaoyuan had come – he was worried that Chen Cang wouldn't be able to handle the situation.

Meanwhile, the gastric lavage had begun.

The 16 milligrams of atropine also began to take effect almost immediately!

The nurse, seeing the electrocardiogram monitor, exclaimed joyfully:

"The heart rate is back, the pulse has quickened, blood oxygen saturation is rising, nearly normal!"

Chen Cang, checking the patient, did not detect signs of atropine overdose.

Time was slipping by, second by second.

The rescue was ongoing.

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Half an hour... had already passed, Chen Cang frowned, still no response to atropine?

"Continue atropine IV injection!"

Shen Xiuyuan also did not hesitate, and continued to prepare!

Originally, this kind of resuscitation should begin with a full initial dose, followed by repeated medication!

But... he just wasn't quite clear on how much was sufficient to be considered enough!

In fact, they were still worried about atropine poisoning.

Drug poisoning is quite dangerous as well.

In truth, emergency treatment is like dancing on the tip of a needle!

It constantly stages supreme and extreme life-saving procedures.

It continuously makes appropriate adjustments and disposals based on the patient's appearance and symptoms.

This is the so-called tactic of countering moves as they unfold, to parry every thrust!

If emergency treatment is said to be the most beautiful art, surely no one would doubt it.

Because the human body itself is one of Mother Nature's most miraculous creations.

Holding human life as a stake, every time, one must go all out.

The grasp of every emergency medication is extremely important for an emergency physician!

A millimeter off at the start can lead to a kilometer of error!

And Chen Cang's grasp of emergency toxico-therapeutics was perfect, as was his mastery of emergency rescue drugs!

Through the patient's symptom and sign scoring, he could determine what Li Dan's indicators were at that moment!

Before his eyes, on the four-dimensional model, Chen Cang seemed to be able to intuitively feel the patient's current symptoms, signs, internal toxins, atropine, acetylcholine... and so on!

At this moment, Li Dan suddenly started to convulse again!

Chen Cang pondered briefly, then immediately said, "Scopolamine, 2gm, IV injection!"

Atropine mainly targets the M receptors, that is, muscarine.

Scopolamine mainly targets the N receptors, that is, nicotine.

The two are entirely different.

Scopolamine has a general effect on the cardiovascular system but has a significant effect on the nervous system, relieving central excitement, and it has a notable effect on muscle tremors.

"Pralidoxime..."

Chen Cang didn't need to say this, Shen Xiuyuan understood as well.

Pralidoxime is very effective and is currently the drug of choice for rescuing organophosphate pesticide poisoning!

One after another, the medical orders were issued!

Li Dan's symptoms were also gradually easing, and the poisoning effects were improving.

But not a single person dared to be careless.

Because, the treatment of organophosphate poisoning has a rebound issue.

And this rebound mechanism lacks clear standards.

And for rebound, there is currently no effective remedy.

Simply put, if the first round of treatment cures without a rebound, it might be safe, but if there is a rebound...

It's game over!

After being busy for most of the night, Li Dan finally stabilized.

Seeing that he had stabilized, everyone breathed a sigh of relief.

Ji Qu looked at Shen Xiuyuan, "Dr. Shen, work hard tonight, and you... Director Qin, Chief Chen, you should go back and rest too. There shouldn't be anything else to worry about."

Chen Cang nodded, looking at the time, it was already past six.

If it were summer, the sky would be getting light.

Before they knew it, it had come to this time.

Chen Cang took a glance at Qin Xiaoyuan and Qin Yue, who looked exhausted, and caringly said, "Uncle, Yueyue, don't go back today, rest for one more day, and return tomorrow?"

Qin Yue yawned as well, everyone was kind of sleepy.

Especially since Qin Xiaoyuan had come early by car yesterday, he hadn't rested well to begin with. After all this hustle, he was quite tired.

Qin Xiaoyuan nodded and breathed a sigh of relief.

Upon leaving the resuscitation room, Wang Fan's parents hurriedly stood up, their faces filled with anxiety and unease. At some point, Wang Fan had arrived, looking distraught and disoriented.

Wang Fan quickly ran over, "Chen Cang! Chen Cang... How is Dan?"

Wang Fan's parents were also anxiously looking at Chen Cang.

Chen Cang exhaled a breath of relief, "She's much better for now, but we still have to see if she can stabilize."

Chen Cang was telling the truth.

Meanwhile, Chen Dahai also rushed in hastily.

He was there to pick up Chen Cang and the others, hearing that there was no trouble, he too relaxed.

"Let's go home!"

...

PS: There's still hope with parathion poisoning, but... there's really no solution for paraquat, as readers have said, it gives you time to regret but not the chance to live.

One day I'll write about paraquat.

Perhaps with the advancement of science, all these can be saved. The only thing unsalvageable is gambling.

Cherish life, keep away from pornography, gambling, and drugs! (Not charged.)

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