Chapter 2088: 2016 Milk, Manual (Anniversary, Seeking Full Subscription)

2016 Milk, Manual (Anniversary, Seeking Full Subscription)

Zheng Ren thought for a full ten Minute, still had no Conclusion.

Big Pig Trotter is usually reliable, but so far there have also been several occasions when it failed to give a diagnosis.

The most dangerous incident was the one where animal thyroid was consumed; afterward it was proven that Big Pig Trotter still has some internal operating logic.

And this time? Why didn't Big Pig Trotter give a diagnosis? Could it be that someone made a video livestream of eating it?

Zheng Ren looked at the patient's stable condition, the ventilator and monitor running steadily, began to Doubt that the patient himself had no illness.

But if we are to say that, we must have solid diagnostic basis.

"I'll go look at the medical record." Zheng Ren said in a low voice, then returned to the workstation on his own, starting to look through the medical record.

The patient's condition is relatively simple, same as what the Inpatient Chief introduced earlier. Just because of old age, after surgery he was only observed in the ICU for a few more days.

This is also a very cautious practice.

Shou Bing, according to the surgical record, also has no problem.

Zheng Ren then began to look at the lab report.

Su Yun glanced at the various materials Zheng Ren had flipped through, and asked: "Chief Yang, during the Shou Bing you didn't touch the gallbladder and liver, right?"

"No, the colon's position, even if touched, wouldn't reach." Chief Yang said confidently.

"That's strange." Su Yun also couldn't figure it out.

From the patient's lab report, the condition is improving bit by bit; today he can be transferred out of the ICU ward.

But just before the transfer, green urine appeared.

After looking at all the lab sheets, Zheng Ren began to look at the medical orders.

"Boss, Doubt it's caused by medication?" Su Yun asked.

"We can only Doubt that; other diagnostic procedures are fine, if there is a problem it can only be a medication issue." Zheng Ren said.

ICU uses little medication, unlike some small hospitals' nonstandard ICUs, where at the slightest issue they'd throw on several groups of drugs at once, and even many patients' conditions worsen due to medication.

After the surgery, only 24 hours of antibiotics were used, the rest being nutritional support.

Strange, where exactly is the problem?

Bit by bit looking at the medical orders, Zheng Ren didn't even miss many medications that had already been stopped.

This time his speed of looking at things wasn't fast; rather, it was slower than when he had looked at lab reports and medical records before.

Others didn't know what Zheng Lao Ban was doing, but Su Yun suspected his own Boss was recalling the manual for each medication.

"Su Yun."

In the silence, Zheng Ren suddenly called out.

"Huh?"

"Look up the manual for milk." Zheng Ren said.

As it turned out, the Boss didn't remember everything either; thinking of this, Su Yun felt much happier.

What's the point of looking up the manual for milk?

Milk, the milk Zheng Lao Ban spoke of, is not the milk usually drunk at home, but rather the nickname for propofol.

Propofol, also called propofol etc., is a milky white liquid; anesthesiologists call it "milk".

Its Function is the induction and maintenance of general anesthesia, often used together with spinal and epidural anesthesia, and also used together with typical pre-anesthetic drugs such as neuromuscular blocking agents, inhaled anesthetics, and analgesics.

In clinical use, no contraindications have been observed, and there are hardly any side effects.

Even with long-term heavy use, patients' bodies can tolerate it. Patients on ventilators, some for a whole month, also show no side effects from propofol.

Has the milk run into trouble?

Su Yun, while trying to recall, also asked the nurse for the manual of propofol.

Impossible, how many general anesthesia surgeries does the Operating Room do each day? Not to mention in 912, when I was a graduate student, I was always in the Operating Room and never saw a case of green urine.

Taking the nurse's handed-over medication manual, Su Yun eagerly began to narrow his eyes, searching line by line for medication contraindications and side effects.

Soon, in the medication side effects column he found six tiny characters he had never noticed before—rare urine discoloration.

This is the first time Su Yun knew propofol also had this effect.

"Boss, there it is!" Su Yun said, not excited but somewhat bewildered.

"Let me take a look."

"Just six characters, nothing worth looking at." Saying this, Su Yun handed the medication manual to Zheng Ren.

Zheng Ren glanced, smiled and said: "Consider it caused by propofol; we can reduce the dosage, stop the medicine and observe, then do offline extubation."

"..."

Chief Yang felt his eyes were blurred, the characters on the manual could be as small as they wanted, yet Zheng Lao Ban spotted them with just a glance?

He suspiciously took the medication manual, earnestly searching the side effects column.

"Brother Yang, here." Quan Xiaocao, still younger, with good eyesight, found those six characters faster than Chief Yang.

Rare urine discoloration...

Is this the cause? Tossed and turned in the middle of the night… Right, I seem to still have diarrhea!

Earlier, highly tense, Chief Yang had forgotten this matter.

Once remembered, a wave of tsunami-like sound faintly came from the stomach.

MD! He covered his stomach and cursed inwardly.

"Zheng Lao Ban, I haven't seen it." The ICU Inpatient Chief also saw those six characters, speaking softly.

"There are some case reports, but the published literature isn't very common, and they're all little tofu-block articles." Zheng Ren laughed: "Looking back now, there should be about ten or so articles on this."

"..."

"It's possible that the phenol's green fluorescent group is metabolized in the liver and then excreted with urine." Zheng Ren gave a simple explanation.

As for over-explaining, Zheng Renye didn't know what to say.

This involves deep biochemistry research; to explain it, one would need to open the biochemical Skill Tree and reach at least Master-level.

"I have a suggestion; let's discuss it when the chief comes for morning rounds." Zheng Renye knew his reasoning wasn't enough to convince the ICU Inpatient Chief, so he spoke softly.

"The patient is fine; we can stop the medication and remove the tube. If you think there's a problem, consult the Anesthesiology Department, then change the sedative and check again." Zheng Ren let out a breath.

After thinking about green urine all morning, I still haven't eaten.

Although he usually eats little, Zheng Ren still pays close attention to breakfast.

Skipping breakfast easily leads to gallstones, which eventually require gallbladder removal. Zheng Ren really doesn't want to end up with diarrhea after eating meat—that would be terribly annoying.

To some extent, gallstones are considered an incurable condition.

In recent years, some have tried removing gallstones by opening the gallbladder, but postoperative complications are frequent and the outcome poor, so the general clinical view is to simply remove the gallbladder.

"Then we're leaving." Zheng Ren felt he had solved the problem, glanced at the patient, and finally used the System Panel to double-check the vital signs.

No problem.

Zheng Ren turned and left.

……

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Tomorrow Afternoon at 2 (Oct 27), YY voice channel: 1449838393 – everyone's invited to a casual chat; Xiao Lu has arranged for Zao Lao tou zi and all the adults to have a friendly talk, so come join the fun!