Doctor: Picking Up Attributes in the Hospital Chapter 299: The Sleepless Night About to Begin

Returning to the ward, Liu ng couldn’t help but ask the serious-looking Zhao Heng, "Dr. Zhao, has it been confird?"

"Yes, it has been confird. The patient is indeed infected with Naegleria fowleri."

Zhao Heng nodded.

"Oh..."

Upon hearing the confird news, Liu ng’s mind went blank for a mont, not knowing what to say.

She had previously read a report about a 43-year-old man in Shenzhen who played with water at a scenic spot and experienced symptoms from headaches and coughs to death, all within a brief two weeks. Upon examination, the patient was confird to have Primary Abic ningoencephalitis (PAM) caused by Naegleria fowleri.

It’s indeed terrifying to think about; after being infected by this brain-eating amoeba, the initial symptoms include nausea, headaches, and fever, which then worsen to back pain, hallucinations, and lack of concentration. Patients typically die within two weeks.

"Dr. Zhao, how should we treat it now?"

Always the professional doctor, Liu ng quickly regained her composure after a brief shock and asked Zhao Heng.

"The pathogen is parasitizing the patient’s brain, and the patient is now experiencing severe brain edema. The brain edema will further compress the brain tissue, so currently, the most important thing is to treat the brain edema."

"First, intracranial pressure must be reduced. Next, maintain adequate cerebral perfusion to prevent further ischemia and hypoxia. Finally, prevent the occurrence of brain herniation."

Zhao Heng pondered for a mont and quickly provided a general treatnt plan and principles.

"Should we currently administer mannitol, compound glycerol, and Lasix together for the patient?"

Liu ng asked again.

Mannitol is most commonly used in clinical treatnt of acute brain edema as an osmotic diuretic. Clinically, a 20% mannitol solution is mainly used because of its strong effect and rapid excretion. In most cases, it is the first choice for treating acute brain edema.

Compound glycerol, with pharmacological effects similar to mannitol, is also a hypertonic dehydrator but without the adverse reactions of mannitol, like rebound, electrolyte imbalance, kidney damage, etc., and is especially suitable for brain edema patients with partial organ dysfunction and failure.

Lastly, Lasix, a commonly used potent diuretic in clinical settings, is an important choice for drug treatnt of brain edema. It can inhibit the reabsorption of chloride and sodium ions in the dullary and cortical sections of the ascending loop of Henle, affecting the formation and maintenance of the high osmotic state in renal dulla, reducing urine concentration function, promoting the excretion of chloride, sodium, potassium ions and water, thus resulting in strong diuretic action and alleviating brain edema.

"They can be used in combination, but for treating brain edema, simply using dehydration thods isn’t enough. Brain vascular spasms must also be prevented, and cerebral blood flow needs to be improved."

"Additionally, nimodipine should be used and mild hypothermia therapy should be administered to the patient."

Zhao Heng thought for a mont and said. Liu ng’s approach to treatnt was evidently still at the level of an ergency doctor, but for this patient, treatnt should not only consider symptomatic relief.

"Indeed, nimodipine, a dihydropyridine calcium channel blocker, can inhibit the entry of calcium ions into cells, thus inhibiting the contraction of vascular smooth muscle, providing so therapeutic effect for nerve damage caused by brain edema. Mild hypothermia therapy can further regulate cerebral blood flow, reduce brain oxygen tabolic rate, and improve cellular energy tabolism, thereby reducing the release of excitatory amino acids, diminishing oxygen free radical survival, reducing intracellular calcium overload, increasing the synthesis of neuronal ubiquitin, decreasing neuron necrosis and apoptosis, and promoting the restoration of intercellular signal transmission."

"Dr. Zhao, your treatnt plan is truly ingenious!"

Liu ng exclaid in admiration.

Before coming to the ward, she had only heard about Zhao Heng’s extrely high level of diagnosis and treatnt, but now she realized that his level was not only high but borderless.

For treating brain edema, even a seasoned ER departnt head like Song Siming might not be able to propose such a comprehensive treatnt plan during practical handling.

Zhao Heng’s treatnt plan wasn’t just symptomatic but also laid a good foundation for the patient’s future recovery.

Without extrely rich experience and high-level theoretical knowledge of dicine, and understanding of diverse drug treatnt chanisms, it would be impossible to propose such a comprehensive treatnt plan.

"It’s just a bit more experience; today, we probably won’t be able to leave work as usual. Be prepared for an all-nighter."

With a calm deanor, Zhao Heng spoke. He was quite indifferent to Liu ng’s praise, having seen such amazent on many faces before.

That’s quite normal; at this age in his early twenties, he seemingly shouldn’t possess such clinical experience.

But in the modern world, all kinds of unbelievable geniuses erge, and many people are influenced by various dia promotions, so having a genius like Zhao Heng at Eastern Hospital is not surprising.

"Well, I’ve gotten used to overti in ergencies. Dr. Zhao, I may not match up to your dical skills, but when it cos to tasty take-outs, I’m definitely more inford."

Liu ng smiled slightly as she spoke.

Working with Zhao Heng was still quite enjoyable, and as for overti, for doctors, especially those at top-tier hospitals like Eastern Hospital, it’s quite routine.

If there’s a week without overti, that would feel strange.

"Then let’s proceed with the treatnt thods we’ve discussed. Closely monitor the patient’s condition; I’ll be in the office, so co talk to anyti."

Zhao Heng nodded, stating that Liu ng was quite good, very solid professionally, though her thinking still needed to broaden.

It’s important to realize that while solid professional skills and knowledge are vital, clinical thinking is actually harder to cultivate.

In terms of treatnt thods, even the most cutting-edge, advanced thods in the extrely well-developed information society is known by doctors.

But to truly cure a patient, there are two key points. The first is diagnosis, which involves confirming the patient’s condition with minimal examinations.

The second is treatnt thods. Although textbooks offer treatnt plans for certain diseases, those are based on statistical probability and data, and aren’t applicable to every patient.

The individual differences between people are great, and disease progression within specific individuals is extrely complex, requiring targeted treatnt and personal understanding on the foundation provided by textbooks.

These two points may sound simple, but truly achieving them is exceedingly difficult. Many doctors, after decades of practice, honestly may not reach this level or achieve this realm.