Wine Manor, Zhou Qiao woke up in the morning and saw Luo Ya dancing on the large terrace outside in the morning's first ray of sunshine.
Her body is slender, and each move is slow and smooth, yet continuous, like flowing clouds and flowing water, without any sense of stagnation.
It turned out to be Tai Chi.
"When did you learn it?" Zhou Qiao asked in surprise.
Luo Ya just laughed: "I guess I learned it from a Chinese girl a while ago. This boxing technique is a little bit special, and I guess it won't work in actual combat, but it can still strengthen your body."
She smiled slightly and said, "I don't know if I'm pregnant or not. If I'm pregnant, I can't do too strenuous exercise, so I'll do this boxing trick to stretch my body."
She was used to exercising. If she didn't exercise for a day, she would feel extremely uncomfortable.
Zhou Qiao thought for a few seconds and said, "She should be pregnant. If not, we will continue next month."
Because it seems that the ovulation period only lasts a few days. Of course, there are also cases of sudden ovulation. But these days are actually the most likely.
And he is quite confident in his abilities.
Seeing Zhou Qiao coming out, Luo Ya came over to have sex with him.
The two were deeply in love, and just as they were considering whether to have sex on the terrace, Luo Ya's phone rang.
At first glance, it was Dean Joachim Langley's call. Luo Ya didn't bother to answer it. She threw the phone directly to Zhou Qiao and said, "Just a few more days of hard work. You'll be gone in a few days. Watch them." what to do."
Zhou Qiao answered the phone with a smile, listened to a few words, and said, "Then I'll be right over."
He returned the phone to Luo Ya and said, "In the future, we can also have remote consultations."
"It's just that you worked too hard." Luo Ya thought, Zhou Qiao worked so hard, she should show some expression.
Zhou Qiao hugged her and kissed her: "I can't help you in other places, but I'm good at this kind of professional thing!"
Luo Ya looked at him affectionately and said, "Then I won't send you off. I'll let Luciana send you off."
Zhou Qiao nodded. Although he could drive himself, he preferred to take a car. In addition, Luo Ya was worried about Zhou Qiao alone, so she sent Luciana with the intention of protecting Zhou Qiao.
Luo Ya still has several video conferences to hold later and cannot leave.
Lu Xianna was very happy and was very honored to be Zhou Qiao's driver again. She was chattering along the way. Not long after, Zhou Qiao came to Sequoia Hospital.
Dean Joachim Langre was as if he saw a savior: "Doctor Zhou, Professor Zhou, you are finally here." He quickly welcomed Zhou Qiao in and took him to the consultation room.
Although Zhou Qiao had initially heard about his condition on the phone before, it was inconvenient after all, so he still wanted to hear it in detail at this time.
The patient was a young girl, a native of Texas, newly married and without children. When the chemical plant exploded, she was not seriously injured. She only choked on the smoke a few times and escaped in time.
Because I didn't feel injured at the time, I didn't go to the clinic or hospital.
Then, the next day, I felt unwell and started to feel pain in my chest, coming and going. Every time I felt pain, I also had difficulty breathing, that feeling of wanting to suffocate.
In addition, there are symptoms of nausea, vomiting, and back pain.
Then, her husband accompanied her to a clinic near her home. After the doctor learned about the situation in detail, he arranged an X-ray examination for her, but the X-ray was taken and no obvious abnormalities were found.
In the end, the doctor diagnosed that the respiratory tract infection and asthma may be caused by inhaling smoke, which may progress to pneumonia, so she prescribed painkillers, antibiotics, and albuterol to treat bronchial asthma and wheezing bronchitis. aerosol.
She was asked to come back for follow-up consultation in three days. Of course, if her condition worsens, she can come back at any time.
The patient did feel better after taking the medicine. He thought he was fine. Unexpectedly, early this morning, the patient's condition worsened and he fell down in the restaurant and fell into a coma.
The patient's husband was so anxious that he immediately called an ambulance. He thought that the clinic was not good enough. However, Sequoia Hospital had recently treated many patients injured in chemical plant explosions. Its performance was excellent and it was commended by the governor. It was widely reported by various media. .
As a result, the patient was sent to Sequoia Hospital.
Upon arrival, the emergency doctor discovered that the patient had low blood pressure, hypoxia, myocardial ischemia, syncope, and was unconscious after first aid. He then placed the patient in the intensive care unit, put him on a ventilator, and gave him life-saving infusions, and reported it to the department director.
Since the cause of the disease is unknown and the situation is not optimistic, the patient's life is in danger every minute, so the emergency department calls other departments, such as cardiac surgery, respiratory department, medical imaging department, interventional diagnosis and treatment department, ultrasound department, etc., for multidisciplinary consultation.
However, everyone held their own opinions. When Zhou Qiao came in, the conference room was in full swing and almost jumped up and started a fight.
The director of the Department of Cardiac Surgery believed that the respiratory infection and asthma diagnosed by the doctor at that clinic were definitely wrong.
The patient's electrocardiogram shows myocardial ischemia-like changes, and coronary artery insufficiency should be considered. The patient's chest pain and other symptoms are most likely angina pectoris.
Therefore, coronary atherosclerotic heart disease should be considered, and electrocardiogram, cardiac color Doppler ultrasound and other examinations can be performed.
The respiratory department believes that the patient has dyspnea, chest pain and other symptoms before coma. The chest pain may not be angina pectoris, but may also be pleurisy-like chest pain. Combined with the significant increase in white blood cells and the increased proportion of neutrophils in his blood, it is most likely pneumonia, and antibiotic treatment is considered. .
"Keep quiet!" Dean Joachim Langley was very unhappy, and then asked the attending physician to introduce Zhou Qiao's condition.
"Let's see what Dr. Zhou says." Everyone looked over expectantly. Only Zhou Qiao can calm everyone's disputes.
Zhou Qiao listened to the introduction of the condition while flipping through the existing examination reports.
"Doctor Zhou, what do you say?" Seeing Zhou Qiao pondering for a long time, Dean Joachim Langley couldn't help but feel anxious and couldn't help but ask.
Zhou Qiao raised his head and said: "The patient's situation is more likely to be a large-scale pulmonary embolism. Hurry up and do a V/Q imaging examination and pulmonary angiography."
"Ah?" The doctors were stunned, why is it neither heart disease nor pneumonia? But pulmonary embolism?
However, they admired Zhou Qiao's strength. Although they didn't know how Zhou Qiao was diagnosed, they took action immediately.
If it is really a large-scale pulmonary embolism, it will be a serious condition, and a slight delay will be fatal.
Moreover, the symptoms of this disease are actually very subtle, making it difficult for people with little experience to diagnose them easily.
The symptoms of pulmonary embolism are sometimes similar to those of a cold or muscle injury, such as chest pain, shortness of breath, sometimes swelling or pain in the legs, and sometimes a bloody cough.
Moreover, the patient was unconscious and the patient's husband was unclear, which made the diagnosis even more difficult.
"In addition, judging from the report, the patient has cardiac dysfunction. In order to prevent acute heart failure, it is recommended to give dopamine. The interventional department should be prepared. Surgical thrombectomy may be required." Zhou Qiao stood up and walked towards the intensive care unit. Others People followed one after another.
ICU.
After Zhou Qiao went in, he saw the patient lying on the bed, wearing a non-invasive ventilator mask. However, upon closer inspection, he found that the ventilation effect was not ideal, and the oxygenation index was relatively low, only 270, and it was slowly declining.
The nurse said there were more than 300 just now.
The expressions of all the doctors changed. What does this mean? It shows that the patient's condition is getting worse all the time.
Especially the emergency doctor, he felt a little confused in his heart. Wouldn't the director and the dean blame me for not taking the first aid measures in place?
In fact, when he was responsible for rescue work, non-invasive masks were acceptable.
Zhou Qiao said: "Hurry up and get tracheal intubation!"
The doctor took action.
The intensive care unit has ready-made equipment, including laryngoscopes, intracatheter guidewires, suction tubes, dental pads, syringes, etc.
Since the patient is a woman, she is slightly petite, and the average height of American girls is only about 160cm.
The girl's airway is relatively tight, so the doctor chose a 6.5mm inner diameter trachea.
Soon, tracheal intubation was completed.
But when the doctor saw it, the oxygenation was still low and the blood oxygen saturation was only 69%. Could it be that the tube was too thin? Or is the patient's lungs seriously damaged?
Or is there something wrong with my operation?
His mind raced and he reviewed it carefully. He didn't have any knowledge of anatomy, physiology, or the various key points of tracheal intubation. It’s basically a textbook-level standard operation!
The thickness of the trachea should also be appropriate.
He looked at Zhou Qiao very helplessly.
Zhou Qiao said: "The airway pressure is too high and you inserted it too deep."
He gently reached out and pulled out the endotracheal tube slightly. Sure enough, immediately, the blood oxygen saturation soared to 95%, and the airway pressure returned to normal.
The doctor: "..."
Other doctors: "..."
They all gave thumbs up.
However, after tracheal intubation, the patient did not wake up. As Zhou Qiao expected, he began to show signs of acute left heart failure. Therefore, the nurse followed the doctor's instructions and immediately gave dopamine a 3 mg intravenous injection.
A magical scene appeared. Almost as soon as the nurse pulled out the needle, the patient slowly opened his eyes.
All the doctors: "..." They don't know how to express their admiration!
As expected, he is one of the top celebrities in North America. Dr. Zhou easily solved the condition that everyone was arguing about and felt like there was no way to deal with it!
In the meantime, ventilation/perfusion (V/Q) imaging and pulmonary angiography were scheduled.
Not long after, the test results came out: pulmonary embolism!
Those two tests are the gold standard for pulmonary embolism. Sometimes it may not be obvious just by looking at other X-rays, CT scans, etc.
All the medical staff: "..." They were so impressed that it turned out to be Dr. Zhou!
Zhou Qiao gently waved his hand, telling everyone not to be too happy. The battle has just begun and the patient is not out of danger yet.
Anticoagulation, thrombolysis.
For some large ones that are really difficult to dissolve with drugs, intervention is the only option.
Zhou Qiao once again instructed the interventionalist to provide step-by-step instructions in another room more than ten meters away to remove large thrombi in the pulmonary artery and main branches, promote the recovery of right ventricular function, and improve symptoms.
After his condition became somewhat stable, the patient was transferred to the Department of Respiratory Medicine for further treatment.
Now, he is finally out of danger.
The patient's husband was very grateful, but the doctors were very suspicious. How could there be a large-scale pulmonary embolism?
Although he inhaled a little smoke, the patient behaved like a normal person that day, right?
It's not as serious as fainting from the smoke or being poisoned.
Puzzled.
Everyone came to ask Zhou Qiao for advice. Zhou Qiao thought for a moment and then asked the patient's husband: "If you think about it carefully, besides those prescribed by the doctor in the clinic, what other medicines have you taken?"
The patient's husband shook his head blankly and said, "No, I really don't take any other medicine."
Zhou Qiao asked: "Are you sure? Think about it carefully."
The patient's husband thought carefully for a moment and suddenly felt a little embarrassed.
"how?"
Other doctors also looked over and wondered, had they really taken other medicines? Why didn't you tell me before? We almost misdiagnosed it.
The patient's husband said with shame: "After returning from the clinic and buying medicine at the pharmacy, didn't my wife feel very good? So, we did it...a few more times at night, and she took some birth control pills. .”
my God! All the doctors fainted.
Even though you are sick, you still have such interest? What kind of husband is this? He has no sympathy for her at all.
Zhou Qiao actually had a vague guess. He did not rely on the system, but he had really carefully studied contraceptive pills and the side effects of various contraceptive pills, including some special circumstances, such as inhaling smoke, which can induce and aggravate pulmonary embolism.
Because he has so many girls who don’t use T. He had thought about it, but several girls were willing to choose birth control pills, so he could only do more research and help them choose better drugs.
Zhou Qiao even made a very detailed comparison table comparing the advantages, disadvantages and side effects of various contraceptive pills on the market.
Of course, taking birth control pills alone will not directly cause pulmonary embolism. This case has its own particularities.
…
In the evening, Zhou Qiao received a call from home. His parents chatted with him about some recent things that happened at home.
First, my sister-in-law invited them to dinner. She said that after her little cousin entered the French nuclear power plant, he changed his mind and worked very hard. Although he was still in training, he had already received two awards.
Moreover, there is also a basic salary during the training period, which is about 60% of the formal salary, which is more than 2,000 euros a month.
As soon as my cousin got his salary, he gave half of the salary to his sister-in-law. My sister-in-law was so happy that she couldn't close her mouth from ear to ear, so she invited relatives and friends to dinner.
Then these days, the governor of California from the United States came to China and visited various places. When he came to Zhejiang Province, he specially came to Zhuhai County to sit at his home and gave many gifts. However, his home was too "shabby" and there was nothing valuable. I had to give him some tea in return.
Zhou Qiao said that he didn’t need to pay too much attention to it. Governor Hulk was very rich and he could just return the gift to express his feelings.
Although Zhou Qiao's parents had heard Zhou Qiao talk about it before, saying that he had many friends in the United States and was living a good life, they always thought he was bragging, but this time they really believed it.
They are good friends with the governor, so what else do they have to worry about?
When Governor Hulk came to visit, some leaders from the province and county also came. Zhou Qiao's old classmates, village party secretary Zeng Haitao, village chief Fan Zhiyong, and Gong Xu also came to accompany him.
(End of chapter)
