This miracle doctor just wants to be fired!

Zhou Cheng rested for more than an hour in his rented room at noon.

I continued working in the afternoon.

Midway through, Su Yi reminded everyone in the WeChat group not to forget the dinner party that evening.

Zhou Cheng replied to a message in the group and then stopped paying attention to the group messages.

……

Zhao Rui has been keeping a low profile in the department lately, unlike usual when he was always seen chatting and laughing with the nurses.

Director Wang Jianming was also handling medical disputes, so he wasn't targeting Zhou Cheng as frequently as usual.

Zhou Cheng was naturally happy to have some free time.

However, ever since he learned about his "black face buff," he has been constantly on edge at work.

There are already quite a few critically ill patients in the emergency department. This 20% increase in the chance of encountering a severely ill patient is simply deadly!

As Zhou Cheng entered the emergency room doctor's office, he saw Zou Qian walking towards him with a worried look on her face. "Dr. Zhou, a special patient came in at noon. You're going to be very busy this afternoon!"

"What's wrong?" Zhou Cheng was also taken aback. If even the experienced Zou Qian found this troublesome, then this patient must be no ordinary person.

"A female patient with depression came in and swallowed 20 bottles of nifedipine sustained-release tablets." Zou Qian handed the patient's medical record to Zhou Cheng. "We spent the whole morning doing this, lavaging her stomach and administering laxatives."

Zhou Cheng's lips twitched. As he picked up the medical record, he said, "If I remember correctly, one bottle of bendipine sustained-release tablets contains 50 tablets. If you swallowed 20 bottles, that would be 1000 tablets, right?"

Nifedipine is an antihypertensive drug. If a patient takes so much of it at once, their blood pressure will most likely become unstable.

"That's right, it's 1000 pieces." Zou Qian nodded firmly. "So now you know why I said it was troublesome."

Zhou Cheng looked through the medical records, which contained a brief record of the patient's condition, written by Cheng Peng, the doctor on duty at noon.

Cheng Peng is a relatively young attending physician in the emergency department. He has been in the department for about three years and usually works with Zhang Biao's team.

His brief medical history is as follows.

The patient is a 32-year-old unmarried woman.

Chief complaint: Admitted to the hospital due to "self-administered oral medication 1 hour ago".

Present illness: One hour before admission, the patient took nifedipine sustained-release tablets on his own, a total of more than 20 bottles (about 1000 tablets). Afterwards, he felt swelling in his limbs and chest tightness, but no nausea, vomiting, dizziness, headache or chest pain. His family members found out and rushed him to the hospital.

Past medical history: History of depression, specific treatment details unknown.

"Sister Zou, what's the patient's condition now?" Zhou Cheng asked Zou Qian, who was standing to the side.

"We consulted with the ICU and recommended hospitalization there," Zou Qian said. "But the patient's family refused, so they can only stay in the emergency room ward now. The patient's blood pressure is low, and they are currently administering hepatitis B pump therapy."

"Okay, I'll go check on the patient," Zhou Cheng said, and then went to the ward.

He had to stand guard for the three hours that afternoon until he handed over the duties to the night shift doctor.

……

Emergency ward.

A woman in her thirties lay on a hospital bed with an oxygen tube in her nose, wires from an electrocardiogram monitor attached to her body, and two intravenous access points in each of her left and right arms.

At this moment, the female patient's face was somewhat pale, her eyes were tightly closed, and her hands were sometimes shaking involuntarily.

Beside the hospital bed sat a middle-aged woman, watching the woman in front of her wiping away tears.

Seeing Zhou Cheng and Zou Qian walk in, the middle-aged woman quickly stood up and wiped away the tears from the corners of her eyes, though her eyes were still red.

Zou Qian stepped forward and pressed the button to measure blood pressure on the monitor. A beeping sound rang out, and the cuff on the patient's arm immediately bulged.

Zhou Cheng first asked the family, "How is she feeling? Is she sleeping the whole time?"

The middle-aged woman shook her head and said slowly, "I just slept for a while, and I've been complaining of chest tightness and feeling weak all over."

Zhou Cheng nodded, then picked up his stethoscope, bent down, and began to examine the patient.

Fine moist rales can be heard in both lungs, and both lower limbs are still edematous.

On the surface, there was nothing unusual about the patient.

Zhou Cheng stood up and noticed that calcium gluconate was being infused next to him.

Nifedipine, an antihypertensive drug, is a calcium ion pathway blocker.

Infusion of calcium gluconate is used to antagonize this effect of nifedipine.

In addition, another pathway is pumping in norepinephrine.

Norepinephrine is now a commonly used vasopressor in clinical practice.

On the table next to the patient's bed, there were several boxes of medicine, including lactulose and medicinal charcoal tablets.

Lactulose is a laxative, while charcoal tablets are a type of medicine used to absorb toxins.

"Doctor, I want to ask, why is my daughter still not getting better even after we've pumped her stomach and given her so many medications?"

The middle-aged woman looked at Zhou Cheng with anxious eyes, and every now and then she would turn her head to look at the patient on the hospital bed.

Zhou Cheng patiently explained, "The medication your daughter swallowed has a strong inotropic effect, so simply lavaging her stomach won't solve the problem. A lot of the medication has already been digested and entered the bloodstream, which can lead to heart failure."

"Speak," he said, gesturing for Zou Qian to bring over the patient's medical records.

"Please take a look. These are indicators of the patient's heart function. A normal person's heart rate is below 300, but your daughter's is over 3,000, which indicates that she has already developed symptoms of heart failure."

Zhou Cheng explained each of the patient's auxiliary examinations to the middle-aged woman.

"What should we do?!" The middle-aged woman became even more anxious upon hearing this.

"We consulted with ICU doctors beforehand, who recommended that we go to the ICU ward for further treatment, which is the intensive care unit. We did not rule out the need for treatments such as blood purification."

Regardless of whether the patient's family is willing to go to the ICU, Zhou Cheng still routinely conducts thorough conversations with them.

The middle-aged woman paused upon hearing the words "ICU".

She looked at her daughter on the hospital bed with a complicated expression, then shook her head: "The ICU is too expensive, I... we have no source of income right now, we can't afford it..."

Zhou Cheng also fell silent for a while.

Once someone is admitted to the ICU, the cost will definitely be higher than that of a regular ward.

The costs of various medications, monitoring, and frequent blood tests are all significant expenses.

"Then let's observe for a while longer." Zhou Cheng understood the difficulties these people faced. "But if the condition doesn't improve, or even worsens, then they'll still have to go to the ICU."

The patient is unmarried, suffers from this kind of depression, and is probably unemployed. Under these circumstances, going to the ICU again would definitely be too expensive for them.

"Okay, thank you, doctor." The middle-aged woman nodded and then sat back down on the hospital bed.

Afterwards, Zhou Cheng checked the patient's vital signs again before leaving the ward with Zou Qian.

"Sister Zou, shouldn't Cheng Peng have called a senior physician to examine this patient today?"

"Yes, Dr. Zhang Biao came to see me and said to first give me a lot of fluids, raise my blood pressure, and give me calcium supplements, and then see how it goes."

Zhou Cheng nodded. "Okay, let's follow Dr. Zhang's instructions."

So far, there seems to be nothing wrong with the medical orders given by Zhang Biao.