Chapter 850: Malignant High Fever
A doctor who had just come to help wanted to lift the arm that was in the way, but the arm did not move at all.
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 a few diagnoses appeared in front of Zheng Ren.
Zheng Ren directly ignored diagnoses such as oblique inguinal hernia and gallbladder stones. What he paid attention to was a simple diagnosis: malignant high fever!
This kind of ailment… could be called a disease. The incidence was extremely low, and it would only appear when it came into contact with anesthesia.
It was one of the few dark thunderbolts that the anesthesiology department was most afraid of.
Malignant high fever was a hereditary disease, and it was characterized by high metabolism. It was triggered when a patient came into contact with certain anesthetic drugs. Non-depolarizing muscle relaxants could delay the onset of the disease.
“Stop the anesthetic!” Zheng Ren shouted in a deep voice the moment he saw the diagnosis on the system panel.
The busy doctors and nurses were all at a loss. When they heard someone speak words filled with the dignity and unquestionable authority of a superior doctor, no one dared refute it. The anesthesiologist stopped the anesthetic directly.
“Dantrolene. Do you have any prepared?!” Zheng Ren said almost with a roar.
“…”
“…”
The operating theater was dumbfounded.
Dantrolene? What the h.e.l.l was that?
“Is it a malignant high fever?” The chief of the Anesthesiology Department ran in from outside. He was tall and st.u.r.dy, like a bear. Just his figure alone gave off a strong and violent sense of oppression.
“Yes!” Zheng Ren looked at the patient and said without hesitation.
Not only was the diagnosis made by the System panel, but the patient also had violent convulsions, spasms, stiff skeletal muscles, was sweating profusely, and other symptoms. These were all typical symptoms of a malignant high fever.
Zheng Ren did not take his body temperature, but he believed that the patient’s body temperature was at least 40 degrees Celsius.
The chief anesthesiologist strode to the patient’s side. The doctors and nurses on both sides consciously made way for him.
After making a simple judgment, he hurriedly said, “The temperature of the cooling blanket is not low enough. Find something else to speed up the cooling.”
After he finished speaking, he immediately took out his phone and dialed.
“I need a helicopter. Go to Concorde. I need dantrolene. A patient has suddenly developed a malignant high fever!” The chief anesthesiologist’s voice was like a bell, and the entire operation room trembled slightly.
Malignant high fever was an extremely rare genetic disease, and there was no way to prevent it. Moreover, the only hospital in the country that had done research on malignant high fever was Concorde.
The in-vitro skeletal muscle contraction test for caffeinated halothane had already been carried out in Concorde’s anesthesiology department. In the whole country, the special medicine for treating malignant high fever, dantrolene, was also only available in Concorde’s anesthesiology department.
Zheng Ren had read a few reports. Most of them were summaries of cases written by the doctors in the Imperial Capital and the Sorcery Capital. When the doctors in the Sorcery Capital encountered such a situation, they could only watch helplessly as the patient died.
It was not for other reasons, but because there was no special medicine.
In the Imperial Capital, because of Concorde, there was still an option.
However, even if they were to call for a helicopter, it was still hard to say if they could save the patient’s life before dantrolene was brought over.
“Increase the oxygen flow through the mask!” Zheng Ren roared. “Increase the oxygen flow to more than 10 liters per minute!!”
“Sterile frozen saline. IV, quick!”
“Monitor the body temperature! Don’t stop!”
“Push two tubes of sodium bicarbonate!”
“Hurry up, who’s in a daze! Push the sodium bicarbonate quietly!”
“Nurse, take the blood!”
“Scrub nurse, get off the stage! There’s no need to be idle! Hurry up and take the blood, the ions, and the blood gas. After you’re done, hurry up and send them to the laboratory department. Tell them to call the Emergency Department!”
Zheng Ren roared loudly. It was loud in the operating theater. He had forgotten who he was.
Although he had always avoided doing things that overstepped his authority and caused the original doctors of the 912 hospital to be disgusted, when he encountered a sudden and serious illness like malignant high fever, Zheng Ren threw everything to the back of his mind.
The world was so big. How could it matter more than a person’s life?
“Get more people to help with the physical cooling. Where’s the circulating nurse? Matron! Hurry up and see if the amount of frozen saline is enough!”
Zheng Ren roared. He seemed to be crazy, but he did not lose his mind. He had been calmly observing the patient’s vital signs on the electrocardiogram.
The patient’s electrocardiogram began to show a shortening of the Q-T interval. The T-waves were sharp and symmetrical, and the base was narrow and tent-shaped.
Soon, Zheng Ren noticed that the P wave amplitude on the electrocardiogram had decreased, the P-R interval had lengthened, and the P waves had disappeared!
This was a sign of high blood pota.s.sium. Although the test value was not out, Zheng Ren could confirm with a high probability that the patient’s blood pota.s.sium value might have broken through 8 mmol/L, or even reached the lethal level of 10 mmol/L.
“Calcium gluconate, five thousand milligrams, pus.h.!.+” Zheng Ren’s eyes narrowed as he stared at the waveform of the ECG monitor and roared.
“Five thousand…” a nurse who had just rushed over to help was stunned.
The limit dosage of calcium gluconate for clinical use was three grams, which was 3,000 mg. 5,000 mg… Was this amount really okay?
The chief anesthesiologist frowned and looked at Zheng Ren carefully. He did not recognize him.
Who was this doctor? Why was he directing the resuscitation here? However, every single one of them was timely, except for the excessive use of calcium gluconate.
He strode to Zheng Ren’s side and asked in a deep voice, “Is there no problem with the excessive dosage?”
“The P wave is gone!” Zheng Ren pointed at the ECG monitor. He roared, “The heart will stop immediately!”
Normally, when the heart stopped, defibrillators and chest compressions could be used to save it.
However, defibrillators were useless on patients with malignant high fever. Moreover, the whole body was stiff like a stone. They could not move the chest at all.
Zheng Ren was thinking that if the heart stopped, he could open the chest directly and do chest compressions under direct vision. In addition, he could cool down the body with frozen saline. The effect might be better.
However, this method was too extreme and intense. If he could avoid using it, he would try his best to. Moreover, even if he were to make an incision, the muscles inside and outside the intercostal s.p.a.ce would be tense. He reckoned that he would not even be able to put his hand in.
The chief anesthesiologist took a look at the electrocardiogram and knew that Zheng Ren was right. He immediately asked the nurse to inject 5,000 mg of calcium gluconate.
“How much urine is there?”
“…” The operating theater was already very busy. No one was monitoring the urine volume. Zheng Ren stared at the electrocardiogram monitor. After he asked, there was silence around him.
The chief anesthesiologist was stunned for a moment. Then, he half-squatted down and looked at the urine bag. He said, “About twenty milliliters.”
“Twenty… No, eighty milligrams of rapid urine intravenous injection!” Zheng Ren said, “Monitor the urine volume. Keep it at fifty to a hundred milliliters per hour.”
“Give excessive ventilation!”
“Yes, excessive ventilation. We must overdo it!”
“Have the test results come back yet? If not, then go and hurry them up!”
One by one, the instructions methodically echoed in the operating theater, hastening.
More than a dozen doctors and nurses ran without touching the ground.
The arm remained stretched out stiffly, as if it was made of iron. It only kept convulsing at its own frequency.