一念之间,生死两边!在急诊目睹的两例患者……

2018-05-04 巍子 医路向前巍子

案例一今天诊室夜班,医院的急诊无论何时都是人来人往,一位50岁的男性,走进了我的诊室。“大夫,给我看看,刚才被蜜蜂蜇了,现在全身痒,起了不少疹子。”病人边说边把一只被拍死的蜜蜂递给我看:“这是这种土蜂子蜇的,劲还挺大”。我示意病人脱掉上衣,查看被蜜蜂蜇到的颈部,发现仍有蜂刺刺入而未拔出。我带他到换药室,用止血钳完整的取出了毒刺。但当撩起他衣服的时候却发现病人的前胸、后背,腹部,大腿布满了红色密集

案例一

今天诊室夜班,医院的急诊无论何时都是人来人往,一位50岁的男性,走进了我的诊室。

“大夫,给我看看,刚才被蜜蜂蜇了,现在全身痒,起了不少疹子。”病人边说边把一只被拍死的蜜蜂递给我看:“这是这种土蜂子蜇的,劲还挺大”。

我示意病人脱掉上衣,查看被蜜蜂蜇到的颈部,发现仍有蜂刺刺入而未拔出。我带他到换药室,用止血钳完整的取出了毒刺。但当撩起他衣服的时候却发现病人的前胸、后背,腹部,大腿布满了红色密集的皮疹。

“除了痒,有心慌憋气的感觉吗?”

“没有,就是被土蜂子蜇了一下,您给我开点外用止痒的药就行”。病人回答了我

“止痒药肯定要给您用,但是您现在已经过敏了,没有出现憋气、呼吸困难有可能是暂时的,应该去抢救室,给您系统抗过敏治疗,防止症状加重”。

“不用,不用,还去抢救室,就被蜇一下,没什么大不了的,我本来都不想过来,孩子不放心,您就给我开点止痒药,我回家了,还去什么抢救室。”病人有些不耐烦了,觉得我大惊小怪了。

“蜜蜂蜇一下虽然是小事,但是您已经出现了过敏现象,为了防止过敏引起的休克和喉头水肿引起的呼吸困难,一定要治疗和观察后才能回家~~~”我还想再解释,忽然发现病人面色潮红,呼吸急促,眼皮半睁半闭,身体摇摇晃晃。

我赶紧一把抱住了他。就在我抱着他的那一刻,他的身子完全软了下来,差点我们俩一起摔倒。

在病人孩子的帮助下,将他扶到诊室的床上,孩子搂着他,惊慌的看着我不知所措。我迅速通知抢救室推来平车,将他推入抢救室,吸氧,静脉输液扩容,大剂量激素抗过敏性休克治疗等,我甚至请喉科来会诊以防喉头水肿压迫气管紧急行气管切开。

10分钟后,患者睁开了眼,血压也恢复了正常,呼吸也变得平稳了。3个小时后,患者无不适症状,在孩子的陪同下离开了抢救室。

临走时特意到诊室和我说了声谢谢,说我救了他一条命。

我想以后他对蜜蜂会更加”情有独钟“的

故事说完了,这个病人很庆幸,及时来到了医院,及时的治疗,没有出现严重的后果。但是这让我想起去年这个时候的一个小女孩

案例二:

也是在5月份的这个季节,五一节假日,城里的一对年轻父母带着5岁的女儿回姥姥家,姥姥家在农村。

这个季节正是鲜花盛开的时候,花丛中也少不了勤劳的小蜜蜂,当然小女孩都喜欢鲜花,小孩子一朵一朵的采摘着,她想摘一捧五颜六色的鲜花送给妈妈,但是不小心被一只蜜蜂蜇到了手,小女孩疼的哭喊着妈妈,一家人看着小宝贝疼的一直哭都很着急,最后还是姥爷有办法,拿出牙膏涂在了蜇伤处。似乎有了些效果,小女孩不哭了。

小女孩小名就叫朵朵,而且长的也像那一朵朵鲜花一样美丽。

一家人看朵朵不怎么哭了,才放下心来,各自去干别的事情,朵朵自己继续玩着刚刚摘来的花朵~~~

过了20分钟,朵朵的妈妈切好了一盘水果端去给朵朵吃,随着盘子清脆的摔碎声音和妈妈的尖叫,一家人都冲进了屋子里,躺在地上的朵朵不停的抽搐、呕吐、眼皮肿的根本睁不开,小脸通红,身上密密麻麻的红色疹子。

一家人真的慌了,抱起朵朵冲出了家门。

然而,一家人并没有选择只有3分钟路程的社区卫生医院,他们可能觉得社区医院的医疗条件有限,而选择了30分钟路程的当地大医院。

那天我值班,孩子到的时候早已经没有了呼吸和心跳,我们努力的抢救,努力的想把孩子从死神手里夺回来,努力的盼着奇迹的出现,但是最终没有奇迹。

妈妈抱着冰冷的朵朵,爸爸抱着悲痛的妈妈,姥姥已经哭的晕了过去,姥爷用拳头捶打着地板,讲述着事情的经过,抢救的医生护士都哭了,我忍着眼泪,不敢直视他们,宣布了临床死亡。

转身后我的眼睛也模糊了。

我甚至不敢去告诉这一家人:如果当时抱着孩子去3分钟就能到的社区医院治疗,朵朵有九成活来下的可能,我怕再增加这一家人的悔恨与自责。

他们错了,他们耽误了孩子最佳的抢救时间。

我心里好难受,后来的一个班,一个护士对我说,那天那个小女孩真可惜,回家后她抱着自己的女儿哭了半天。

何尝不是,我相信那天参加抢救的医生护士都流了泪,那种不甘,那种无奈,那种无力回天的感觉充斥着每个人的心,久久不能平静。

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    2018-05-13 大爰

    学习并分享!!

    0

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    2018-05-07 changjiu

    学习一下谢谢

    0

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    2018-05-05 张新亮1853311252142e2fm

    好文献学习了

    0

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    2018-05-05 871538379

    非常敬佩作者 感谢分享

    0

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    2018-05-04 大爰

    学习并分享!!

    0

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    2018-05-04 1e0f8808m18(暂无匿称)

    抢救过敏休克.时间就是生命.

    0

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    2018-05-04 天地飞扬

    了解一下.谢谢分享!

    0