Respiratory Department recently admitted a patient. Everyone was very angry when they talked about it. Let’s see what happened.
cough and cough sputum
-a 56-year-old male patient was admitted to the hospital for two months of coughing sputum and feeling dyspnea. When asked about the medical history, I learned that the patient had a large number of drinking history in the past and was hospitalized for diabetic ketoacidosis .
After being hospitalized, the examination found that breathed 30 times per minute, blood pressure was 74/50mmHg, and both lungs were scattered with wet rales. The chest radiographs indicated that both lungs had consolidation and high-density sensation, and oxygenation was progressively reduced. The oxygenation index was at least below 100.
The doctor initially diagnosed it as severe pneumonia, severe respiratory distress syndrome (ARDS), diabetes , and gave active anti-infection, fluid resuscitation, respiratory function support for ventilator, and maintenance and treatment of various important organ functions.
4 days after treatment, the patient's condition stabilized, his vital signs were basically maintained, and the ventilator support was gradually reduced, and the use of sedation and analgesic drugs was gradually reduced or stopped.
is in critical condition, and the ventilator maintains
. But just when the doctor was about to re-evaluate the patient's condition and intends to be transferred to the general ward, the patient spontaneously triggered to enter a deep coma.
At the beginning, the doctor considered that the patient was severely ill, diabetes, poor physical condition, and very slow liver and kidney metabolism, and the sedative drugs in the body had not been metabolized yet. However, after sedation medication was stopped for 4 days, the patient's coma still did not improve.
At this time, the patient not only fell into a coma, but also showed symptoms such as temperature drop diabetes insipidus .
At this time, the doctor began to consider that the patient had an intracranial problem.
However, because the patient was in critical condition, he could not leave the ventilator for head CT. The patient found that the patient had purple upper limbs. It was initially suspected that the patient had trauma before admission.
Subarachnoid hemorrhage
When the doctor repeatedly asked the patient's family's medical history, the patient's family always hesitated, which aroused strong suspicion from the doctor. Helplessly, the doctors repeatedly persuaded him, and the patient's ex-wife told the doctor what he said: it turned out that the patient remarried after divorce. A few days before he was admitted to the hospital, his current wife had a dispute with him. The patient was in a bad mood and drank a few more glasses. After drinking, he had a headache and then hit the wall with his head.
The doctor was shocked after hearing this. Isn’t this an obvious history of trauma!
After the patient's condition stabilized, he quickly pushed the patient to undergo a skull CT, and it was found that the patient had subarachnoid hemorrhage!
At this moment, the family members except the ex-wife were also denied that the patient had a history of trauma, but all lies were self-defeating in the face of the patient's ex-wife's conclusive testimony.
The doctors were filled with righteous indignation: You deliberately concealed your medical history, and the patient's subarachnoid hemorrhage can endanger his life at any time!
After finding the cause, the treatment plan was immediately adjusted. Fortunately, after careful treatment and care by the medical team, the patient finally recovered and was discharged from the hospital.
In clinical work, it is not common to conceal medical history, and doctors are most worried about such things, because some medical history must be provided by the patient themselves. If the patient conceals the medical history, it will seriously affect the diagnosis and treatment of the disease. Therefore, when visiting the doctor during daily medical treatment, he should inform all relevant medical history as the truth, so that he can help diagnose the disease and treat it and recover as soon as possible. #Family Health Guardian#
