Chapter 2973: 2773 Bronchial Foreign Body

"Don't worry, Yun Ge'er, you better not scare me." Zhou Litao also felt a bit guilty.

"Manager Zhou, let me introduce you to a girlfriend." Su Yun suddenly threw out a huge topic.

Zheng Ren was taken aback; this matchmaker role really didn't suit Su Yun at all.

"Um..." Zhou Litao also was taken aback.

"What are you looking at me for? I'm just asking casually." Su Yun said, "An old friend of mine is coming to Di Du to be a drifter lately; he's pretty decent. What do you think?"

"I... I don't want to look for one right now." Zhou Litao sighed, "I think not being the Inpatient Chief, my first thought is to have a good rest. Being the Inpatient Chief was exhausting; I had no private life, I couldn't even binge-watch a show in peace."

"Tsk tsk, promising." Seeing Zhou Litao object, Su Yun didn't say more, just gave his shoulder a hard pat.

Zhou Litao's phone rang once; he took it out, glanced, and said, "Finished filming."

The three came to Zhou Litao's duty room, opened the workstation, and called up the just-uploaded image data.

The patient's chest X-ray showed disordered and thickened lung markings in both lungs, and blurred markings in both lower lung fields. Zhou Litao's judgment was reasonable: atelectatic pneumonia, this diagnosis is essential.

But atelectatic pneumonia is not the only possible diagnosis, because this condition develops over time; even if breathing difficulty appears, it wouldn't happen suddenly.

Aspiration, that was Zheng Ren's judgment. But Zhou Litao's account already ruled that out, since no food remnants were suctioned out during sputum aspiration, and the X-ray showed no metallic foreign body.

"What about the patient?"

"Sent straight to the ICU." Zhou Litao said, "His blood oxygen is average; I think he might need ventilator support. If there's no improvement, he'll likely need a tracheostomy. For an elderly person this age, once he gets sick it's a major illness; there's not much we can do."

"Then let's go take a look at the ICU." Zheng Ren felt it would be better to finish this matter; at least he could give an explanation to Xiao Yi Ren when he got home.

Yi Ren is very concerned about people she knows; last time, after eating that diesel‑flavored grilled fish at that restaurant, she didn't even let herself go find the boss to discuss it.

If he were to go home with just this bit of information, Zheng Ren would still worry that Yi Ren would be anxious.

"Just an ordinary patient." Zhou Litao said.

"Just ordinary?" Su Yun chuckled, "Sudden convulsions—what do you think caused it?"

"Hypoxia; I checked with neurology, found nothing else. After suctioning out the sputum, the patient's convulsive symptoms also improved." Zhou Litao said.

Su Yun smiled without speaking; Zhou Litao had only found the final result, not the preceding cause. Sudden—why did it happen all of a sudden? That's what matters.

"Let's go take a look." Zheng Ren said, "Manager Zhou, we're leaving."

Zhou Litao felt a bit reluctant; Zheng Lao Ban and Yun Ge'er hadn't come to the Emergency Department in a while. He knew they were busy. But since they rarely came over, he always felt like he was missing something.

Life had also become boring… and grew even more boring.

Zheng Ren and Su Yun left the Emergency Department and went to the ICU to check on the patient's condition. Su Yun kept holding her phone, staying in touch with the ICU's Inpatient Chief.

"Boss, they said the patient has a lot of sputum and is already undergoing endotracheal intubation." Su Yun said.

"Yeah, caused by long‑term bed rest."

Atelectatic pneumonia is one of the complications of long‑term bed rest, and also a particularly thorny one; aside from giving more meticulous care, there's no good solution besides regularly turning the patient, patting the back, and coughing up sputum each day.

If he were put on a ventilator, the cost would be secondary; based on Zheng Ren's experience, he estimates there's a high probability he won't be able to get off it again.

Finally, after the patient's family accepts the fact, they either extubate and wait for death, or keep using the ventilator until multi‑organ failure occurs, which is when the end is considered to have arrived.

Although I've seen countless such situations, every time I think about it, I feel somewhat uneasy inside.

After entering the ICU, changing clothes and slippers, and walking down the hallway, Zheng Ren came to the patient's bedside.

The patient was easy to identify; doctors and nurses were gathered around the bed, carrying out resuscitation.

The patient's system panel flashed red; aside from some geriatric conditions and the cerebral infarction that caused long‑term bed rest, Zheng Ren also saw a diagnosis—foreign body in the airway.

"What is this?" Zheng Ren was taken aback.

Sure enough, just as I had judged before—did something get into the airway?

If there were a foreign body, suctioning sputum should be able to draw it out. If the object were too large and blocked the airway, a problem would also be noticeable during suctioning.

Zheng Ren stood silently behind the doctors and nurses, carefully observing the nurse's sputum‑suctioning motion.

Following the suction tube down the endotracheal tube, there was no resistance from a large foreign object on either side.

Strange.

"Zheng Lao Ban, Yun Ge'er, you've come." The ICU's Inpatient Chief, after finishing her tasks, turned around, saw Zheng Ren and Su Yun, greeted them, and then went to the computer to look up the test results.

"How is the patient's condition?" Su Yun asked.

"His blood oxygen is fine; it's just that there's too much sputum in the airway." The ICU's Inpatient Chief said, "Arterial blood gas report: pH 7.104, PCO2 89.4 mmHg, PO2 47 mmHg, BE -2 mmol/L, HCO3 28.0 mmol/L?"

"The patient is drenched in sweat, and his ability to cough up sputum on his own is poor; he'll probably need a ventilator for a while."

"Then what?" Zheng Ren asked.

"Huh?" The ICU's Inpatient Chief was taken aback, then? Is Zheng Lao Ban testing her treatment? She thought a moment and immediately said, "The test results will be back in a few minutes; let's see the situation—the sputum has been sent for culture. Anti‑inflammatory symptomatic treatment, mainly suctioning."

"Bronchoalveolar lavage might work a bit better." Zheng Ren said.

The bronchoalveolar lavage that Zheng Ren mentioned, also called bronchial alveolar lavage, is a new technique developed on the basis of fiber bronchoscope examination.

Using the bronchoscope to instill physiological saline into the bronchial alveoli and then immediately suction it out, collecting the effective fluid on the alveolar surface, examining its cellular components and soluble substances—a method.

"You suspect there's an airway foreign body?" Su Yun immediately guessed her boss's true intention.

"Yeah, long‑term bedridden patients can possibly aspirate." Zheng Ren said.

"The probability should be low, since no food remnants were suctioned out." The ICU's Inpatient Chief's consideration was the same as what Zheng Ren had thought before seeing the system panel.

"But Zheng Lao Ban… after all, he's got the cheat on," he shook his head and said nothing.

"Give it a try, anyway let him do it himself, you go about your work." Su Yun and the ICU's Inpatient Chief communicated.

The ICU's Inpatient Chief also felt helpless; whether it was Su Yun's words or Zheng Lao Ban's request, she couldn't refuse.

It wasn't because of Zheng Lao Ban's high academic standing; rather, using the bronchoscope to take a look and performing bronchoalveolar lavage also falls within the normal scope of treatment.

"Then I'll go prepare things." The ICU Inpatient Chief said that and then got busy.