The small ICU is only two floors away from the general surgery department. Xiao Chenguang did not take the elevator, but went down the stairs all the way to the sixth floor.

During this period, he considered the patient's condition.

If the liver is not good and the irritability cannot be suppressed, there is a high probability of hepatic encephalopathy.

This is a type of change in consciousness and personality caused by liver disease.

Among them, the most common is cirrhosis caused by hepatitis, which leads to portal hypertension.

"It's better not to be this case, otherwise, I will be busy all night and even have to undergo emergency surgery."

Xiao Chenguang has been doing elective surgery for a day, starting from 7:30 in the morning when the anesthesia operating room started working until the last one was finished at 6 pm.

Three cholecystectomies, two bile duct stone removals, and an emergency operation for intestinal obstruction in the middle.

After finally finishing everything, I rushed to the small ICU and was just about to help Lao Wang guide his exercise.

Who knew that I would encounter such a thing.

"God bless you, don't make trouble, don't make trouble, I'm fine, everyone is fine..."

The mumbling voice echoed in the corridor. If someone happened to pass by, they would definitely be scared by Xiao Chenguang's red eyes.

The corridor was quiet and almost no one could be seen in the hallway, but the noisy sound in the ward, like a war, went straight to Xiao Chenguang's ears.

"Sister, listen to me, you are in the hospital now, not flying in the sky, nor swimming in the sea, you are lying in bed, being treated in the hospital, not a woodpecker that loves to peck trees..."

When Xiao Chenguang heard this inexplicable communication, he already knew the patient's symptoms, which were very serious.

"I'm not sick, you are all devils, beasts that specialize in eating people, let me go, I want to go out and find my dad, ah, dad, where are you, are you looking at me?"

In the ward, a 50-year-old aunt was panic-stricken and had to sit up from the bed to find her father.

But her father died five years ago.

The family members cried and persuaded her, but it didn't work. The doctors and nurses were on the scene, but they still couldn't persuade the old lady.

"What can I do? This is the first time I've met such a patient. She was fine just now, why did she suddenly go crazy?"

The nurse directly used the word crazy to describe the old lady in front of her.

At this moment, she was holding the treatment tray, preparing to draw blood for the old lady to test and do department education.

But now, let alone education, the old lady didn't even let her blood be drawn.

She even cursed people casually, didn't recognize her relatives, and scratched and spitted at anyone who dared to approach her, which made everyone anxious.

"Wait a minute, the situation has been reported to Director Xiao, and he will come over soon."

In front of the family members, Lin Gaoyang still called Xiao Chenguang the director.

Lin Gaoyang had never dealt with such a situation, although he knew that people with liver disease would have a bad temper.

But the neurotic performance of the patient in front of him was unexpected.

The noise here was too loud, disturbing the patients in the nearby rooms.

Even some of the patients' family members came to check on the situation.

"What happened to her? Why is she still crazy? I remember she was quite normal when she first came."

"I don't know. It feels like it's only been a while. I haven't heard such a commotion just now."

The family members outside were talking about it, and Lin Gaoyang was even more restless.

It was obviously a patient with liver pain who was admitted to the hospital for examination. How could she suddenly become like this?

Before Lin Gaoyang could figure it out, the patient's aunt became irritable again.

This time it was even worse than before.

She yelled and screamed, as if she was stimulated by something. The family members, doctors, and nurses helped to stop her, but they still couldn't hold her down.

Just when everyone was helpless, Xiao Chenguang rushed over.

He had just heard the sound, and now seeing the scene in front of him, he gave up instantly.

Hepatic encephalopathy, there is no escape.

And it was the most serious decompensation stage.

Don't think too much, just stabilize the patient first.

"It's useless to do this. The more you press her, the more she resists. She won't understand any persuasion."

"Lin Gaoyang, hold her arm. The nurse will give her the injection first. We'll draw blood later. Give her a sedative. Inject 10ml of propofol intravenously. Observe the changes in vital signs to prevent hypotension."

For irritable patients, sedatives should be used first to prevent accidents. This is the content of medical consensus later.

Especially for the patient in front of him, who obviously has a change of ideology, if he is allowed to continue at this time, the situation will only get worse.

"Okay, Director Xiao, we will do it immediately."

Xiao Chenguang's words were like clouds and sunrise, which made people find the backbone at once.

These days, because of the injury of the director in the hospital, the entire general surgery department was in a state of anxiety. In addition, Xiao Chenguang was busy from morning to night and obviously had no energy to take care of the patient.When they arrived at the department, all the burdens were handed over to Lin Gaoyang, the chief resident.

Although he worked hard, he was still a little overwhelmed after a long time.

Now seeing Xiao Chenguang coming back, everyone felt much more at ease.

When the nurse finally got the injection and was about to push propofol for sedation, an accident happened suddenly.

The agitated patient suddenly started to retch.

His originally rosy face turned pale in an instant, and his spirit was also sluggish, which was a world of difference from his excitement just now.

"It's bad! Bring a plastic bag, the patient has gastrointestinal bleeding!"

Xiao Chenguang's expression was stern, and before everyone could react, he quickly came to the bed and tilted the patient's head to one side.

Prevent suffocation.

Ugh!

The patient felt his stomach churning and hot, and suddenly a mouthful of bright red spurted out.

Seeing this, the family members were so anxious that they couldn't find a plastic bag, so they immediately took the washbasin used for hospitalization to deal with the emergency.

The patient vomited blood from his stomach, and in the blink of an eye, half a basin of blood appeared in front of everyone.

"How can so much blood come out?"

The family member's hands were shaking, and the whole person was panicking.

How can a person with a bad liver vomit so much blood?

The family member didn't understand, but Xiao Chenguang knew it clearly.

Cirrhosis caused by hepatitis causes liver cell necrosis and hyperplasia, blocking blood vessels and causing portal hypertension.

Over time, high pressure leads to esophageal varices, which eventually cause blood vessels to rupture and bleed.

"Push the rescue vehicle over, connect to monitoring, measure blood pressure, and inhale 4L/min of oxygen."

"Take 4000 units of thrombin powder orally to stop bleeding."

Due to a large amount of vomiting blood, the patient's gastric bleeding was estimated to be 1500ml. The patient's vital signs must have dropped drastically, with symptoms of fast heart rate, low blood pressure, fast breathing, and low blood oxygen saturation.

Sure enough, when the nurse connected the monitoring and measured the patient's vital signs, she was shocked by the numbers in front of her.

Heart rate over 180, blood pressure 70/95, respiration 48, blood oxygen saturation only 77%

"Somatostatin octreotide 0.6mg pumped in to inhibit glandular secretion."

"Esomeprazole 80mg intravenous drip to protect gastric mucosa."

"Ringer's injection dripped at full speed!"

Hemostasis, volume expansion, enzyme inhibition, stomach protection...

Xiao Chenguang's rescue doctor's instructions came out of his mouth.

"Family, has the patient eaten some hard things in the past two days, such as melon seeds, peanuts, and cold sweet potatoes?"

"Doctor, how do you know?"

Seeing the astonished expressions of the family members, Xiao Chenguang's mind immediately emerged with a series of diagnoses.

Hemorrhagic shock, massive gastrointestinal bleeding, hepatitis B cirrhosis with portal hypertension, and ruptured bleeding of gastric fundus-esophageal varicose veins.

There are even splenomegaly and hypersplenism, which cause blood coagulation disorders and destruction of red blood cells and platelets.

The patient in front of them was much more serious than they had imagined.