The Enhanced Doctor

Chapter 1135: Chapter 1135: Three Symptoms in One?

(Thanks to sincostgctg, Shopaholic, Dong1, and book friend for their monthly ticket encouragement)

"Tell me honestly, did you just fail to hold it in, or did you lose control completely?"

Running to the bedside of Liu Yiqing’s patient, Liu Banxia asked anxiously.

"I... aren’t they the same?" the patient hesitated, speaking in a very low voice.

"Brother, they’re completely different. You must answer me now, is it that you felt the urge to defecate and couldn’t hold it because it came too suddenly, or did it just inexplicably come out?" Liu Banxia pressed on.

"At first there was some sensation, and then it just came out on its own," the patient’s voice was still very low.

"Take blood samples again and notify the laboratory to screen for organophosphate poisoning. Both Huang Bo’s and the patient from neuro are included," Liu Banxia said seriously.

His words startled Liu Yiqing and Su Wenhao. Organophosphate poisoning? That’s a big deal.

However, their developed habit told them they could have thoughts now, but Liu Banxia’s instructions must be followed.

Seeing them arrange things, a layer of sweat appeared on Liu Banxia’s forehead.

"Doctor, I haven’t taken any poison. I don’t want to die. How did I get poisoned?" the patient asked weakly.

"Have you had any barbecue or certain specific ingredients recently?" Liu Banxia asked.

The patient nodded, "I went to eat once the day before yesterday. There wasn’t anything special. Hmm... does a grilled sparrow count? The rest was lamb, chicken, and some vegetables."

"The name of the barbecue place," Liu Banxia asked again.

"Dahua Barbecue," the patient said.

Liu Banxia nodded and then ran to Huang Bo’s patient’s side, "You’re intubated now, just listen to my questions. Have you been to Dahua Barbecue in the last couple of days, and did you have grilled sparrow?"

"Yes, they often go to Dahua for barbecue. Is it the grilled sparrow’s fault?" the patient’s wife asked anxiously.

"Huang Bo, don’t wait for lab results. Quickly administer pralidoxime combined with atropine, perform gastric lavage and blood purification," Liu Banxia hurriedly said.

"Liu Yiqing, use a micro-pump to infuse atropine for your patient until atropinization, perform gastric lavage, and blood purification. Su Wenhao, inform neuro to confirm if the patient has been to Dahua Barbecue. If so, administer pralidoxime directly."

After saying this, he picked up the phone and called Xie Chunli from the city’s burn department.

"Director Liu, what is it?" Xie Chunli asked when the call connected.

"Director Xie, there’s an emergency. Three patients admitted to our hospital today are suspected of organophosphate poisoning," Liu Banxia quickly said.

"I’ve heard from the paramedics that the two patients admitted to your ER are similar to the three patients we’ve seen. Their common trajectory is that two of them dined at Dahua Barbecue. You can notify them to confirm."

"Okay, I will contact the ER immediately," Xie Chunli said and then hung up the phone.

He knew how serious this situation was. If the contamination source is at Dahua Barbecue, there may be more patients scattered in other hospitals or clinics.

Liu Banxia was currently extremely anxious too. Organophosphate poisoning can indeed be fatal. These three patients have already delayed some time, so the toxin’s effects have become significant.

"Banxia, is it really organophosphate poisoning?" Wang Huan asked, following along.

"Pretty much. They’ve all been to Dahua Barbecue, within the last couple of days. The problem is likely with that grilled sparrow," Liu Banxia said.

"No, I have to report this. It’s better to be alarmed for nothing than to allow more people to get poisoned. It’s a poison that can truly kill, too dangerous."

After saying this, Liu Banxia continued to make phone calls.

Although the lab results are not out yet, this issue is really significant. He’s also quite confident in his judgment, as the patient with cerebral edema also had barbecue.

"Banxia, we have patients with organophosphate poisoning?" After he finished contacting, Zhou Shuwen emerged from the office.

The commotion just now was quite significant. Not only was his voice quite loud, but patients and their families here were also discussing the matter.

"Director, let me brief you on the situation," Liu Banxia hurriedly said.

"Liu Yiqing’s patient showed initial symptoms of vomiting, fatigue, and bradycardia, and now has symptoms of bronchospasm, tachycardia, sweating, diarrhea, and fecal incontinence."

"Apart from tachycardia, there were no previous symptoms of bradycardia. The rest of the symptoms align with cholinergic excitation and muscarinic-like symptoms of a crisis."

"Huang Bo’s patient was admitted with symptoms of muscle weakness and cold symptoms. After admission, they experienced tachycardia and respiratory muscle paralysis, judged as nicotinic-like symptoms in cholinergic excitation and crises."

"Additionally, there is a comatose patient we recently admitted due to brain edema, who began to have convulsions despite receiving intracranial decompression treatment."

"Doctor Peng from neurology suspects that the central nervous system might be affected, although reducing intracranial pressure hasn’t relieved the symptoms."

"This aligns with the central nervous system symptoms seen in cholinergic crisis and excitement. The first two patients were confirmed to have been to Dahua Barbecue and ate the iron sparrow skewers. We’re still tracking down the third patient."

"I’ve also been in contact with the city hospital. According to the emergency responders, they sent over two patients today as well. This is all we know for now, and the relevant departments have been notified."

"Good, good, good, the diagnosis is meticulous and all the evidence matches. Have you administered the appropriate treatment?" Zhou Shuwen said with satisfaction.

"Yes, Liu Yiqing’s patient showed some development; we tried treatment with atropine, gastric lavage, and blood purification. For Huang Bo’s patient, we combined pralidoxime with atropine. The neurology patient is still awaiting further diagnosis," Liu Banxia quickly replied.

"Proceed with this plan, it’s excellent," Zhou Shuwen nodded approvingly.

"Director, should we contact other hospitals?" Liu Banxia asked.

"Not for now. If we contact too many, it could cause panic in a limited area. Once our lab results come out, we can report further to higher authorities, and they’ll notify the necessary parties promptly," Zhou Shuwen explained.

"They should already be heading to Dahua Barbecue. We’ve reported, so they have to respond. Though we might be rushing a bit, lives are at stake, so we can’t worry about it too much."

Liu Banxia awkwardly grinned, not realizing the potential consequences at the time.

If it wasn’t caused by Dahua Barbecue’s iron sparrow skewers, Dahua Barbecue would suffer huge losses, turning into a chaotic situation.

"Teacher Liu, how do you connect the conditions of these three patients so well?" Liu Yiqing curiously asked.

"I just had a feeling at the time, like I was onto something," Liu Banxia sighed.

"Actually, we should have paid attention when the two patients both ate barbecue. That should have been a clue, but we overlooked it."

"Then, upon hearing your patient also had barbecue, and the brain edema patient likely had central nervous system involvement, I linked the three cases together."

"They were quite unlucky, maybe the substance concentration wasn’t high. But their cold symptoms somewhat masked their real conditions."

"Now we wait for the lab results. Even if you praise me, it’s useless. If I misdiagnosed, I’d be in big trouble. Dahua Barbecue might have me on the wall by now, as they should be open."

"Teacher Liu, I think your judgment is correct. This is about saving lives. The organophosphate effect clearly worsens along with food digestion and absorption," Liu Yiqing stated.

"But why? Normally, the symptoms should be intense right from the start, shouldn’t they? It seems weaker compared to what we read about organophosphate poisoning," he added.

"It’s considered secondary poisoning. I suspect someone used organophosphate pesticides on sparrows, leaving a certain amount of residue in their bodies," Liu Banxia conjectured.

"Otherwise, their initial symptoms wouldn’t be so mild. Ultimately, they would converge into a unified symptom set."

"As for the worsening of symptoms now, I personally believe it’s due to medication retention in the gallbladder. As bile is secreted, the drug toxicity is enhanced."

"I need some water; my heart rate’s a bit too fast now. It’s really dangerous, especially since we don’t know which pesticide it is. It’s not easy to metabolize out."

"By the way, Huang Bo, perform an enema on your patient again. Was the gastric lavage done with warm water? Since we can’t identify the drug components, minimize using any agents."

"Teacher Liu, we used warm water and have also stopped glucose infusion," Huang Bo quickly replied.

"You deserve verbal praise; I forgot to mention it earlier," Liu Banxia said.

"Teacher Liu, I’ve stopped the glucose infusion too," Liu Yiqing mentioned.

"You get praise too. Why act like a child?" Liu Banxia remarked helplessly.

"I’m happy because we truly saved lives here," Liu Yiqing said joyfully.

Then she ran back to her patient’s bedside to assist the nurse.

"Teacher Liu, we’ve contacted the patient’s family and verified they indeed went to Dahua Barbecue," Su Wenhao arrived.

"Good, tell them to treat it as severe organophosphate poisoning," Liu Banxia nodded with a smile.

He felt much relieved.

It’s not just coincidence or chance; all three people went to Dahua Barbecue. Such a high overlap suggests there’s a problem.

Otherwise, he worried his premature warning might cause issues, affecting their business, which wasn’t a small matter, and could cost a lot of money.

The mood had lifted significantly, given the low toxin residue levels, causing delayed onset. As long as symptomatic treatment is provided, there should be no problem.