Chapter 50:I Can Do Peritoneal Dialysis!
Translator 549690339
At this moment, inside the resuscitation room, all eight emergency beds were occupied with patients!
They lay there, moaning continuously.
“Doctor, save me!”
“Doctor… I feel so unwell, my head hurts so much!
“Where am I… Save me, I’m going to die, why can’t I see anything!” Upon entering the resuscitation room, wails of distress immediately filled the air, sounding low-pitched and feeble.
Zhang Shu, upon seeing Li Baoshan come in, hurried over: “Director, you’ve arrived!”
Li Baoshan urgently asked, “What’s the situation?”
Zhang Shu said seriously, “The situation… is not promising!”
“After a thorough examination, these patients with poisoning are experiencing tachycardia, and some even have varying degrees of myocarditis, ST-segment abnormalities, and serious cases of kidney failure. Three of the patients have optic disc hyperemia, optic disc retinal edema, and vision field defects! Moreover, they’re suffering from severe metabolic acidosis!”
Li Baoshan felt disheartened upon hearing this, as all signs were pointing towards one diagnosis!
Li Baoshan: “Methanol poisoning?”
Zhang Shu nodded: “Yes, methanol poisoning. And several of them are severely poisoned!”
Li Baoshan turned to examine the patients: “Give me the lab reports.”
A doctor handed over the medical records, and the more Li Baoshan looked, the more worried he became!
After about ten minutes, Li Baoshan finished examining each patient again and asked, ” Have they had their stomachs pumped? What medications were used afterward?”
Zhang Shu nodded: “All of them have been. We used 1% sodium bicarbonate, and after that, we administered a 4% sodium bicarbonate 250ml intravenous drip to correct the acidosis, along with 20% mannitol 250ml plus tomg dexamethasone intravenous drip to prevent cerebral edema.”
“But… six of the patients’ conditions are quite critical, they might need dialysis. They have already been sent to the hemodialysis room, but now I’m worried about patients in beds 3 and 7; they have already slipped into a light coma.” Li Baoshan: “I’ll ask other hospitals if they have any dialysis machines available!”
After saying this, Li Baoshan picked up the phone to make inquiries: “Old Chen, it’s me, Li Baoshan. Do you have any spare dialysis machines at your hospital? No? Alright, thanks…”
He made four or five calls, but every hospital capable of dialysis was occupied!
What to do?
Li Baoshan was becoming anxious when suddenly he remembered something.
“Didn’t the hospital just buy a few peritoneal dialysis machines?”
With that thought, he immediately picked up the phone and dialed Director Hao’s number: “Director Hao, it’s Li Baoshan. Can we use the new peritoneal dialysis machines now? The poisoning cases are severe, dialysis is imperative, but the hemodialysis room is full, and the patients can’t afford to wait!” Hao Xuliang sighed: “The peritoneal dialysis machines have been brought in, and they can be used; we’ve tested them. However, they haven’t been officially put into use, and the doctors have also been sent out for training.” Li Baoshan, covering the phone, looked at Zhang Shu and asked, “Do you know how to perform peritoneal dialysis?”
Zhang Shu blushed slightly and shook her head: “I’ve only seen others do it, never done it myself.”
Hao Xuliang’s voice came through: “Baoshan, don’t panic. Why don’t you ask other hospitals if they have any extra staff to spare and send two over?’ Li Baoshan replied, “I just called other hospitals, they’re all busy now, there are quite a few poisoning cases this time.
“How about this, Director Hao? I’ll give it a try. Although I haven’t specialized in it, I’ve seen it done enough times. What if I try to do it?
Hearing this, Hao Xuliang was immediately startled: “Baoshan, don’t mess around! Do you take dialysis as a joke? We need to get consent from the relatives first! Who is responsible if something goes wrong?”
For a moment, the room fell into silence!
Everyone was in a dilemma!
Li Baoshan felt an overwhelming sense of helplessness! What does it mean to realize the necessity of knowledge only when it’s needed? This feeling is most evident when studying medicine!
When a living patient is placed before you, and you discover that your skills are insufficient to provide effective diagnosis and treatment for the patient, the feeling of helplessness and frustration is incomparable to anything else at any time.
Thus, the true learning for a medical student is not during undergraduate, postgraduate, or even doctoral studies, but during the clinical period! Although Chen Cang had not pursued postgraduate studies, his clinical abilities were not inferior to those who had!
After all, the clinic is the best teacher!
What to do?
The students nearby were almost crying out of urgency.
They finally found a peritoneal dialysis machine, but no one knew how to use it! Li Baoshan’s hand gripping the phone showed bulging veins, and his brows were tightly knit. What to do! What to do!
Hao Xuliang, hearing Li Baoshan’s silent, couldn’t help but say, “Baoshan, it’s not that 1 won’t let you use it, but I’m considering your situation. You’re an established doctor, you understand the rationale better than me. I’m not stopping you, but if you can find someone who knows how to do peritoneal dialysis, I’ll take the responsibility!”
Li Baoshan remained silent!
Where to find someone who knows how to do peritoneal dialysis?
The technology of peritoneal dialysis only started to emerge in the 199os, and it was only then that the world adopted this technology!
It hasn’t been introduced to China for very long, and many hospitals still have not popularized the technology of peritoneal dialysis!
Peritoneal dialysis is usually used by the nephrology department to treat diseases such as uremia and renal failure.
However, peritoneal dialysis can also be used to treat severe cases of methanol poisoning, with an apparent effect through dialysis!
And there is a significant difference between peritoneal dialysis and hemodialysis!
That is, peritoneal dialysis carries a higher risk!
Peritoneal dialysis is prone to infection, leading to peritonitis. Patients are at high risk of acute infectious inflammation within the abdominal cavity due to contamination, gastrointestinal inflammation, catheter-related infections, and iatrogenic procedures during peritoneal dialysis treatment.
So, this is not the same as administering an IV or giving injections!
If you know, you know!
If you don’t, you simply don’t!
At that moment, Chen Cang suddenly said, “Director, 1 know howto perform peritoneal dialysis!”
Chen Gang’s voice was not loud, but it resonated like thunder, capturing the attention of everyone in the quiet emergency room!
Li Baoshan turned around, his eyes filled with urgency, as if he had seen a savior!
“What did you say?”
Chen Cang slowly repeated, “I said I know how to perform peritoneal dialysis.” Li Baoshan’s gaze was intense: “Are you sure?
ChenCang: “I’m sure!”
Li Baoshan turned, picked up the phone, and said to Hao Xuliang, “Dean Hao, I found someone who knows how to do peritoneal dialysis!”
Hao Xuliang upon hearing this said, “Wait for me! I’m coming downstairs. I’ll take you to the dialysis room.”
After hanging up the phone, everyone looked at Chen Cang, their eyes filled with disbelief!
Because Chen Cang was just an ordinary, unremarkable junior doctor, a temp worker at a big hospital like the Second Provincial Hospital, hardly able to withstand any storm or attract attention.
Zhang Shu was somewhat uneasy. She looked at Chen Cang: “Chen, this isn’t a time to joke. How sure are you?”
Chen Cang: “One hundred percent!”
Li Baoshan: “Good!”