When the Doctor Uses A Hack
Chapter 1083 - 1086: The Reaction Mechanism of Allergic Patients

Patients with acute allergic reactions might be one of the most common types of cases in emergency departments.

As one of the frequent and common diseases in emergencies, Chen Cang is capable of handling them proficiently even without any particular skills.

Seeing Chen Cang approaching, the child's anxious parents asked, "Doctor, can you take a look at my child? What's wrong with him?"

A middle-aged man was holding the boy, whose condition seemed really wrong as he was already drowsy.

Chen Cang frowned upon seeing this!

This is not about falling asleep…

Could this be… anaphylactic shock?

With that thought, Chen Cang immediately took the little boy to the resuscitation room. If it were indeed an allergic reaction and it got serious, anaphylactic shock can be a very troublesome matter.

Taking the family into the resuscitation room, Chen Cang suddenly noticed a rash on the boy's body.

He quickly lifted the clothes to reveal many red rashes on the boy's stomach and chest.

Just as Chen Cang was about to ask the little boy, he suddenly passed out, causing his mother to burst into loud wails of fear.

"Doctor, save my child, what's… what's wrong with him?"

The boy's father was also panic-stricken.

Chen Cang promptly asked Cheng Yi, who was on duty, to help connect the electrocardiogram monitor.

Turning to the parents, he asked, "What happened to him?"

The boy's mother was inconsolable, and the man, overwhelmed, heard Chen Cang's words and hurriedly said, "After dinner, he was playing mobile games, then he started to complain about chest discomfort. I thought he was just upset about losing the game, so I ignored it."

"After a while, he suddenly complained of feeling unwell, telling me he had a stomachache and couldn't catch his breath. I realized something was wrong and took him to the community clinic. They told us to rush to the emergency center immediately."

Chen Cang frowned, "The child might be allergic, did he eat anything or come into contact with any specific allergen?"

The man suddenly remembered, "Does eating a kiwi at night count?"

Just then, the monitor alarm sounded.

"Dr. Chen, blood pressure is only 80/40mmHg!" Cheng Yi urgently reported from the electrocardiogram monitor, "Breathing 31 times per minute! Oxygen saturation is at 89%!"

Having heard this, Chen Cang had a near-certain suspicion.

Anaphylactic shock!

"Prepare for intubation!"

Now even breathing is a struggle; the boy's respiratory tract must be blocked, most likely severe laryngeal edema!

First, open the airway, then administer oxygen!

"Administer 0.5 ml subcutaneous injection of 1% adrenaline."

"Start 5% glucose solution infusion to maintain intravenous medication patency!"

Meanwhile, Chen Cang turned to the family and said, "The boy is likely allergic to kiwi!"

Upon hearing this, the boy's mother said in shock, "…Is that even possible?"

"After he ate kiwi last week, he said he really liked it, so I bought some more today since it's Saturday. If it were an allergy… wouldn't he have had a reaction last time?"

Chen Cang, with no time to explain as the boy's condition had not shown noticeable improvement yet, turned to Cheng Yi and said, "Give an intravenous injection of 0.2 ml of 1% adrenaline."

Adrenaline is like the father figure of emergency medications!

It can handle many complex acute illnesses!

For anaphylactic shock, it is the first-choice drug.

It can quickly relax bronchial spasms through β-receptor effects and cause peripheral blood vessels to constrict through α-receptor effects.

It also counteracts the release of mediators from some type I hypersensitivity reactions, making it the preferred drug for treating this condition!

Epinephrine can be administered multiple times throughout the course of treatment.

However... generally speaking, after 1 to 2 epinephrine injections, the symptoms of shock in most patients can gradually subside within half an hour.

Chen Cang looked at the little boy's condition, also feeling somewhat anxious.

He's not old, only ten, and he's almost out of epinephrine.

If the shock continues without improvement, this would be a severe case, and drugs like dexamethasone would have to be used.

And the little boy's parents are also quite anxious. In the emergency room, they dared not speak loudly, but their hearts were still full of curiosity. Why was it fine the first time he ate kiwi fruit, but he had an allergic reaction the second time?

And...

After the allergic reaction, why hasn't there been an improvement yet?

Could it be a misdiagnosis?

"Doctor, I'm not doubting you... may I make a suggestion? Could it be that it's not an allergy? He was fine after eating kiwi fruit the last time, and suddenly having an allergy this time, I always find it a bit dubious..."

Now, all the patient can do is wait.

At this moment, another on-duty doctor rushed in: "Doctor Chen, can you help me take a look at this ECG? What's going on with it?"

Chen Cang was about to explain, but seeing the on-duty doctor Zhang Yuan who rushed in, he promptly took the ECG and began to examine it carefully.

Upon looking, Chen Cang's brows immediately furrowed.

"S1Q3T3?" Chen Cang suddenly said, "Did you rule out pulmonary embolism?"

Zhang Yuan, hearing this, was immediately taken aback: "Pulmonary embolism?"

Chen Cang nodded: "Yes, this ECG shows the classic S1Q3T3, along with sinus tachycardia and right bundle branch block. There's a very high chance that it's a pulmonary embolism. Have the patient complete further examinations immediately!"

"Right, notify the thoracic surgery department for a consultation first, I suspect the patient's condition isn't good, diagnose as soon as possible! Don't delay."

After hearing this, Zhang Yuan hurriedly stood up and ran out: "Thank you, Doctor Chen!"

Over here, Cheng Yi suddenly rejoiced: "Doctor Chen, the patient's blood pressure is up! Blood oxygen saturation is also recovering!"

Chen Cang sighed with relief. It seems that there's no need for too many anti-allergy medications.

The blood pressure is up, and the shock is improving. The condition should be able to stabilize.

Chen Cang turned around to explain: "The patient appears to have a kiwi fruit allergy, with symptoms of an immediate-type allergic reaction.

Such allergic reactions usually occur within 5 to 20 minutes, at most within half an hour."

"Fortunately, you arrived promptly. If such symptoms are not taken seriously or if there is a delay in seeking medical attention, it could have a very significant impact and harm to the major organs, and in severe cases, it may even be life-threatening."

"You must pay attention to this in the future!"

Chen Cang thought of the father's words about the little boy perhaps feeling unwell due to losing a game, and couldn't help but sigh.

At this moment, the little boy suddenly turned over and opened his eyes.

The little boy's parents felt a sudden sense of relief!

A heart full of anxiety finally settled down.

If something really happened to the child... both of them could not bear to imagine that scene.

"Thank you, doctor! I'm so grateful," the woman hastily said, "I was scared to death!"

After speaking, the woman quickly ran over, her hands trembling as she touched the child's face.

Chen Cang nodded: "It's nothing."

After finishing speaking, Chen Cang saw that the little boy seemed to be alright now, and he prepared to go out to see the patient Zhang Yuan suspected of having a pulmonary embolism.

Just as he got up, Chen Cang suddenly remembered something else.

That was the patient seemed to really not understand much about allergies.

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