Chapter 1792: 1730 Diagnostic Therapy

Don't spout nonsense. But what you said about rat poison is indeed possible. Zheng Ren went along with Su Yun's words, saying, "Rats aren't low in intelligence; if they eat rat poison and die, supposedly they won't touch similar things around them."

Lin Ge silently watched Zheng Ren and Su Yun discussing the condition; there was some nonsense, but these nonsense were necessary.

It was obvious that these two young people also had no idea in their hearts, gradually grasping some vague possibilities through conversation.

Well, the replacement products are all milder in drug effect and ultimately cause internal bleeding. Su Yun continued to elaborate on her view of the preparation.

This situation is indeed somewhat similar to Chen Zehui's condition progression.

Eight days ago there were symptoms of gum bleeding; exactly when it first started is hard to say.

Two days ago, a checkup at the district hospital showed no problems; up to now, only a short 40-plus hours have passed, and hemoglobin has directly dropped to 5.5 g.

The most critical point is that after the patient fainted and was sent to the 912 Emergency, the condition's continuous outbreak is shocking!

These evidences directly point to some chemical agent; according to Su Yun's statement, it should be a chemical used to poison rats.

Slow onset…… outbreak…… Zheng Ren murmured softly.

Sodium warfarin, coumatetralyl and other first-generation anticoagulant rodenticides have decent effects and milder action. When I was in the lab, there were wild big rats bullying my white mice, so I used coumatetralyl to poison them. Su Yun said proudly.

It's hardly used nowadays, right?

Well, not many nowadays. Because coumatetralyl has a weakness: its final effect isn't strong enough, so wild big rats cause considerable destruction before they die.

Do you feel this patient was poisoned by a second-generation hemolytic rat poison? Zheng Ren followed Su Yun's words, his speech speed getting faster.

The more he thought, the more reasonable it seemed.

If previously it was just speculation, now Zheng Ren has ninety percent confidence in his judgment of the patient's condition.

From the earliest symptom the patient could report—gum bleeding—up to the lab report two days ago, then to today's sudden outbreak, and finally the patient who could still struggle suddenly went into hypovolemic shock and massive hemoptysis.

Taken individually, each piece of evidence is rather bland and lacks directionality.

But when put together, Zheng Ren can be certain that Su Yun's suggestion is correct.

Is it bromadiolone? Zheng Ren recalled several case reports on bromadiolone poisoning; the described situation there was extremely similar to the patient's current condition.

I think so. Su Yun said: "It has the characteristic of not easily alerting rats and being able to exterminate rodents completely. Moreover, it has the outstanding advantage of strong acute toxicity; a single dose is effective against various rodents."

At the same time, it can effectively kill rodents resistant to first-generation anticoagulants. It has moderate toxicity toward fish, aquatic insects, and other aquatic organisms.

You say that, I feel it's bromadiolone. Zheng Ren said: "Then let's suggest diagnostic therapy. Intramuscular vitamin K1, the dosage can be a bit larger."

What if it doesn't work? Su Yun asked without thinking.

In an urgent situation, when discussing the condition, someone always has to play the most disliked role—raising objections.

Then it's up to fate; anyway, vitamin K1 promotes clotting. Even if the patient isn't bromadiolone poisoned, intramuscular vitamin K1 only has benefits, no drawbacks. Zheng Ren recalled drug side effects and said offhand.

Go tell the Inpatient Chief to proceed with diagnostic therapy. Zheng Ren gave a dry smile and didn't mind. If a rare side effect of vitamin K1 were to occur, even a fatal reaction…

Forget it; when using medication, one absolutely cannot consider one-in-a-hundred-thousand or one-in-a-million chances.

Once you think that way, no drug can be used; you might as well just wait to die.

Now the social climate and the responsibility doctors bear turn this fallacy into reality; doctors can only…

Zheng Ren really doesn't want to think about these unpleasant things.

After intramuscular vitamin K1, it takes effect in 3-6 hours.

If the patient is as we analyzed, suffering from bromadiolone poisoning, vitamin K1 is a specific effective drug.

Intramuscular absorption is too slow; better to give it intravenously. Otherwise, doing both is also possible.

If the judgment is wrong and it's not bromadiolone poisoning, then we can only do hemofiltration, and then talk about what comes next.

Zheng Ren and Su Yun rushed in; as for Lin Ge… Zheng Ren temporarily ignored him.

Lin Ge also wasn't surprised; emergency rescue, hearing it's still some rat poison poisoning, for Old Boss Zheng to have time to say a few words to me—that would be strange.

Zheng Ren knew he was being swept along by Su Yun's thinking, but logically judging, Su Yun's statement was correct, so Zheng Ren didn't oppose just for the sake of opposing.

Right, just execute it. Zheng Ren didn't really wait for Su Yun to speak; he grew more certain, his steps quickened, and finally he started running.

All the way jogging, he narrowly bumped into a nurse coming to draw blood.

Give vitamin K1! Zheng Ren entered the ICU and said directly.

Huh? The Inpatient Chief was stunned for a moment.

Just did a simple analysis, considering it possibly due to bromadiolone poisoning! Zheng Ren said: "10 mg intramuscular injection, 80 mg into the bottle!"

As he spoke, Zheng Ren's voice grew louder and firmer.

This is a state unique to rescue situations.

This drug dosage has nothing to criticize. According to the patient's weight, using 5 mg/kg is fairly standard.

The drug takes effect in 3-6 hours; intravenous administration shortens it a bit, but exactly how long is hard to say. Zheng Ren simply didn't leave, staying in the ICU to monitor this patient.

Watching the vitamin K1 intramuscular injection go in, the remaining eight vials of vitamin K1 entered the drip bottle; Zheng Ren opened the flow, letting it almost all at once enter the vein.

Hope it gets better; Zheng Ren already saw on the patient's system panel an additional diagnosis—upper gastrointestinal bleeding.

After finishing surgery today, having eaten lunch, I returned to 912 intending to check on Zhou Litao, but unexpectedly encountered this patient.

Lin Ge also followed along, getting busy.

The advance payment for the inpatient deposit, made in the name of the Medical Department. This sum of money is probably not recoverable, so the Medical Department stepping in is more practical.

Furthermore, there's communicating with the patient's immediate relatives, etc.

After 1 hour 35 minutes, Zheng Ren did not see any new diagnosis appear on the system panel.

Under the effect of three groups of hemostatic drugs, the patient also showed no signs of continued bleeding.

The patient's blood pressure stabilized and rose slightly; subcutaneous bruising was relatively stable, with no signs of spreading.

Diagnostic therapy appears to be correct; it should be bromadiolone poisoning!

But too much time has passed; the exact location of poisoning and what was ingested are probably hard to verify now.

Zheng Ren's feeling is more intuitive than anyone else's.

After intramuscular and intravenous vitamin K1, the patient's system panel color deepened for over ten minutes, then stopped deepening and began to fade.

This is taking effect.

Only when the blood pressure stabilized did Zheng Ren truly relax.

「Chief Wu, the vitamin K1 should be given for a longer period. 」 Zheng Ren finally instructed: 「Warfarin's half-life is 16-19 days; you must continuously use vitamin K1 to antagonize it, don't let the condition relapse。」

「I know! 」 the exhausted ICU Inpatient Chief replied.