NovelTags Chapter 728
Chapter 728
Right at this moment.
The patient said with some hesitation: "However, after the foot was blistered, I repaired it myself with scissors and cut the blister!"
The voice just fell.
Lin Feng suddenly turned his head to look at the patient and asked, "What scissors?"
The patient was startled and immediately said, "It's an ordinary pair of scissors at home!"
"Is it rusty?" Lin Feng continued to ask.
After hesitating for a moment, the patient said in a somewhat uncertain tone: "It seems to be a little rusty!"
Thinking back suddenly, I suddenly couldn't remember clearly for a while.
At this time, the patient's wife on the side said: "Our scissors are indeed a little rusty. The last time I put it in a pot when I was repairing flowers, I forgot to take it out, and then it rained, so it rusted. But I've cleaned it!"
Now you can basically determine that the scissors are indeed rusty!
Lin Feng immediately said solemnly: "I suspect that the patient should have tetanus!"
"Tetanus! I've heard people say it's a deadly disease, Doctor, I wouldn't be so unlucky, would I?" the patient said with a smile, but the smile on his face was a little unnatural.
The patient's wife on the side immediately exclaimed: "Doctor, it's impossible!
"I hope I'm mistaken, but don't worry too much, tetanus doesn't have to be fatal!" soothed Lin Feng.
After speaking, see the wry smile on the patient's face.
I knew I was not mistaken!
The bitter smile is also a manifestation of tetanus patients, because the facial muscles are somewhat tense, the patient will smile very unnaturally, look like a bitter smile, and usually not smile is also a bitter smile.
External wounds, rusty scissors, difficulty opening the mouth, "bitter smile"!
These are all manifestations of tetanus.
It can be said that it is a very typical case!
Immediately explained to the nurse on the side: "Quickly tear off the gauze on the patient's left foot, continue the debridement treatment, and do not let the local wound form a closed hypoxic environment!"
After speaking, he looked at the patient and his wife and said: "The possibility of the patient getting tetanus is very high, and the patient's situation is basically a typical tetanus symptom!"
Although Lin Feng reassured them before that tetanus is not necessarily fatal, the patient's wife was also very worried.
Immediately asked Lin Feng: "Doctor, you must be mistaken! You haven't even checked now, why do you suddenly say that it is tetanus!"
The patient still smiled bitterly, but did not speak.
Lin Feng immediately said: "Basically, there is no need for any special examination, the diagnosis of tetanus is mainly based on clinical manifestations, relying on our eyes to diagnose!"
"As long as it is clear that the patient has no history of dog bites, rule out rabies, purulent meningitis, basically tetanus!
"Normal temporomandibular joint speech can also cause difficulty opening the mouth, but there will be no other muscle tension!"
"Tetanus is a systemic disease, in addition to the suffering of opening the mouth, there is also neck muscle rigidity, low back muscles will also be stiff, and finally there may be "angular arch opiston", and even respiratory muscles may also be affected. "
After a pause, he continued: "The patient is not only diabetic, but may not be diabetic foot at all, but at the beginning it is a common bacterial infection around it, which causes tetanus infection after lifting the rusty scissors, because tetanus bacillus is very easy to preserve in rusty iron and soil!"
Hearing this serious consequence, the patient's wife immediately stopped wondering whether Lin Feng was mistaken.
Instead, he immediately asked: "Doctor, you must save my husband!"
For the words of the patient's wife, Lin Feng just nodded.
The patient's latest treatment plan is then scheduled.
The patient was first given tetanus human immunoglobulin, which can bind to tetanus toxin after injection, thereby playing a role in resisting the toxin, as if a snake bite is injected with serum.
In a hypoxic environment, tetanus bacillus will multiply rapidly and produce a large number of exotoxins, mainly spastic toxins, which will lead to a series of clinical manifestations in patients.
So the focus of treatment is to fight these exotoxins, and immunoglobulin is the best drug.
It is likely that the medication was taken a little later.
At night, the patient's whole body is convulsing.
Frightened his wife.
Lin Feng immediately gave the patient a strong sedative, mainly to stop his muscle spasms.
At the same time, I contacted the ICU side, worried that the sedative drug was overused, respiratory depression appeared, and I might need to go to the ventilator.
But it's fine.
After the sedative drug, the patient's body is still, there is no strong spasm, breathing is also present, and there is no obvious impact on blood oxygen saturation!
After temporarily stabilizing the patient, Lin Feng explained to the patient's wife: "If the patient is not in good condition, he may need to be transferred to the ICU, need a ventilator to assist ventilation, and even need to do a tracheostomy!"
Hearing this, the patient's wife couldn't help but cry and asked Lin Feng: "Doctor, can my husband really come back?"
The most serious complication is that the respiratory muscles are affected and breathing is not smooth, so you need to go on a ventilator!"
It's just that what he thinks in his heart is resigned to fate!
Patients are also lucky!
Got God's favor.
After one week, the patient's muscle tension and spasms gradually improved.
Sedatives are also being phased out.
The wound has been constantly changing dressing.
After nearly 3 weeks of treatment, the patient's symptoms basically disappeared.
The wound on the left foot also healed.
The patient can be said to have escaped.
Today's children are born with the DTP vaccine.
This includes the tetanus vaccine, which is followed by subcutaneous injection of 0.5ml of toxoid every 5-7 years as a booster injection after receiving the vaccine.
Those who receive full course of active immunization only need intramuscular injection of 0.5 ml of toxoid after injury, and effective antibodies can be formed within 3-7 days, and there is no need for further injection of tetanus antitoxin (including immunoglobulin).
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