Then I added another sentence, it may not be pulmonary embolism, it is just a possibility.

Now it seems that the possibility of heart failure is high. We use diuretics again, wait a little longer to see the effect. Finally, he made another decision. He just checked his heart failure markers, and they are all relatively high and have a high possibility of heart failure.

So another 20mg of furosemide (a diuretic) was injected.

During this period, the doctor on duty went to deal with other critically ill patients.

An hour later, Lao Mo's wife couldn't help but come to see the doctor again, saying that he was still panting and had not yet relieved. It seemed to be worse. What's going on? Is it important?

It can be seen that she was very scared and her lips were trembling while she said Hu.

The doctor on duty felt something was wrong, so he quickly went over to see the patient, and secretly blamed himself for forgetting to continue following up with his situation. He was too busy to do anything.

When I went to the bed, I saw that the patient was still gasping, sweating profusely, had high blood pressure and fast heart rate.

Once again, both lungs were auscultated with wet and dry rales.

This is a typical manifestation of heart failure.

Why is diuretic and blood pressure lowering effect not good? The doctor on duty can't figure it out.

I had to ask the second-tier (superior doctor) to call the second-tier teacher over.

The second line just guided the rescue in another department. After that, he received a call from the doctor on duty and rushed over again.

When I arrived next to Lao Mo's bed, the second-line teacher listened to the doctor's medical history report, pondered for a moment, and then auscultated the patient's heart and lungs. After asking about the amount of fluid in and out, he learned that the urine volume was too low today.

So the patient's quilt was lifted to expose the patient's abdomen.

After a look at the second-line teacher, he squatted down and looked at the urine bag, and his face was not right.

Have you checked the patient's bladder? Ask the doctor on duty.

Please click to enter the picture description

No, no. The doctor on duty felt that the atmosphere was wrong and his palms were sweating. He regretted that he had just been busy and forgot to check the patient's abdomen, and he was just listening to his heart and lungs.

You should take a good look at the patient's belly and tap the bladder. The second line retreated and said lukewarmly.

The doctor on duty gritted his teeth and lifted the patient's quilt. He saw, Damn!

The patient's lower abdomen was more obvious.

What's the situation?

Knock it. The second-line teacher said next to it. Then he added, be gentle, don’t knock the bladder.

What? Bladder? Is the bulge of the lower abdomen a bladder? The bladder is so big? Why? Is it urinary retention? How can it be urinary retention? There is a urinary catheter? The doctor on duty ran over, his thoughts flying quickly and a little messy.

I touched the patient's lower abdomen with my hand and gently tapped it, making it sounded so it seemed that there should be liquid inside the lower abdomen.

Is it really caused by urinary retention caused by bladder urine? The doctor on duty couldn't believe what he saw and touched.

The second-line teacher slowly said, "I saw that the patient's urinary catheter has sediment and his urine is also turbid. Such a urinary catheter is very easy to block. If it is really blocked and his urine cannot come out, it means that he has urinary retention. The patient has had nearly 2,000ml of urine these days, but today it is only 300ml. Don't you think it's suspicious? If it is really urinary retention, of course he feels uncomfortable, and he is almost suffocated to death!"

Although Lao Mo cannot speak, he can feel the discomfort caused by urinary retention, so he will be short of breath, sweat profusely, and have high blood pressure. As the saying goes, a living person cannot be suffocated to death by urine, but if the urinary catheter is blocked and the urine is not excreted, it will be terrible.

The second-line teacher called the doctor on duty outside the door and taught him a lesson.

Then let the nurse come over and rinse the bladder.

After rinsing, the urethra was indeed blocked.

Oh my God!

After the unblocking, urine was continuously drawn out, and it was almost 1,000ml in just a few strokes. The nurse's eyes widened. She was also responsible tonight, and she did not find out that the patient's urethral catheter was blocked in time.

The patient may have heart failure, but this heart failure is called urination. If you turn on the quilt early to see his little JJ, look at the catheter, and look at the abdomen, why does this happen? The second-line teacher continued.

When the nurse heard the words Xiao JJ, she almost couldn't hold back her laughed.

But no one can laugh at this occasion.

In less than 2 minutes, Lao Mo's shortness of breath gradually eased, his blood pressure dropped, and he sweated less.

It's quiet.

The danger is lifted.

If the second-line teacher had not discovered it in time, and continued to treat heart failure and continued to use diuretics, the urine would accumulate more and more, but it would be held in the bladder and could not come out because the urine was a bit sedimented and blocked the urethra catheter. This was really fatal.

The doctor on duty was soaked on his back and blushed.

In the doctor industry, no trace of deviations cannot be deviated, and many details cannot be omitted, otherwise, a mistake will be caused. Lao Mo's wife is also very reasonable. During this period, she also knew how tired the doctors were. She also took great pains to treat his old man's illness and did not pursue the doctor on duty.

But if others don’t pursue this kind of thing, they will remember it for the rest of their lives.

Good wishes.

Male elderly patients with acute urinary retention basically do not have the prostate. After urinary retention, they are really irritable, jumping up and down, and their blood pressure is squeezing. After more than ten years of emergency treatment, it is really necessary to have as meticulous physical examination as possible! There are many patients with acute left heart failure who refuse to insert the catheter. Once diuretics and urinary retention, they will become more violent. Generally, heart failure is considered. If the oxygenation index is not high, I recommend catheterization as soon as possible, but many patients and their families disagree and insist on dragging it until they can't. I don't know who the male catheter is inserted. Our department stipulates that male patients are inserted by doctors, and we are 90% of female doctors!

But at this time, it was unlikely that Mr. Kong would walk to the hospital alone. He couldn't stand firmly, so his wife had to support him and beat him.

When the emergency department doctor saw Mr. Kong like this, he immediately thought about whether rhabdomyolysis would occur. You should know that muscle damage after strenuous exercise may lead to limb weakness. Many people who run marathons will experience limb pain and fatigue afterwards. After examination, rhabdomyolysis will occur.

However, Mr. Kong did not show any obvious muscle pain, so it seems that the diagnosis of rhabdomyolysis is not reliable.

The emergency department doctor asked Mr. Kong to lie on the examination bed and carefully checked his muscle strength. He found that the muscle strength of both lower limbs was only level 3 (a total of level 5). Such muscle strength was impossible to go 2 paths. The muscle strength of both upper limbs was better, with level 4.

Why are you here now? The emergency department doctor said casually.

I thought it was a sports injury and it would be better after two days of rest, but I didn't expect it to get worse. Mr. Kong himself was extremely upset, afraid that he would delay treatment, and that he could not walk the other way, which made him very worried.

I just don’t have the strength, doesn’t it hurt? The emergency department doctor asked again.

It was a little sore at first, but it was better these two days, and it was no longer sore, but its strength was getting worse and worse. Mr. Kong replied.
Chapter completed!