When the Doctor Uses A Hack

It was a little past two in the afternoon when Ma Yuehui took Xu Aiqing for surgery, leaving Chen Cang in the office to see patients.

A call came in from the emergency center; minutes later, a 25-year-old man suffering from pufferfish poisoning was being rushed to the center.

Chen Cang was startled, wondering what era it was that there were still cases of pufferfish poisoning!

Nowadays, virtually everyone knows that pufferfish are inedible and highly toxic—yet some people still consumed them?

What's crucial is that pufferfish are toxic through and through—the ovaries, testicles, skin, liver, and roe all contain deadly toxins!

Especially during this period of reproduction at the winter-spring transition, the toxicity is at its strongest.

Who would dare to mess with this at such a time?

For Chen Cang, who was proficient at identifying poisoning, it had been years since he'd encountered a case of pufferfish poisoning.

Five minutes later, just as the ambulance had parked, a patient was rushed down.

It was a young man in his twenties, and after completing the handover, the accompanying doctor handed Chen Cang a camera: "This is a record of the patient's poisoning incident!"

Chen Cang was dumbfounded!

So was the nurse!

Was this a suicide attempt???

Thinking this, Chen Cang felt puzzled.

Why would someone undergoing poisoning bother to record it with such a good camera?

However, now wasn't the time to delve into that; the patient hadn't lost consciousness and was fairly lucid, though he spoke with some difficulty.

Chen Cang hurriedly beckoned the nurses to wheel the patient in, and another junior nurse brought the camera along.

At that moment, Chen Cang asked, "How do you feel now?"

The patient tried to sit up, but he was weak all over: "Save me... I don't want to die..."

Chen Cang quickly responded, "Mm, tell us, where do you feel discomfort?"

The man struggled to speak, his breathing becoming increasingly rapid: "I feel a bit numb in my mouth, my tongue is slightly numb, now my body feels numb too, I'm too weak, can't sit up, fell over while walking."

Upon hearing this, Chen Cang began to understand, "Lily, get the ECG monitor, check the blood pressure, prepare for oxygen."

"Right, get an ECG to confirm!"

Pufferfish poisoning could cause various degrees of atrioventricular block, which would affect Chen Cang's treatment shortly!

What Chen Cang was most worried about now was that the patient might suddenly fall into a coma!

Then Chen Cang took a flashlight, looked at the man's pupils, and indeed, they were somewhat constricted!

Generally speaking, constriction isn't scary, but what's terrifying is first constriction followed by dilation; at that point, it signals severe poisoning, with symptoms developing swiftly and potentially leading to death within a few hours!

The toxic components in pufferfish are primarily tetrodotoxin and tetrodonic acid.

And these toxins are potent!

Not only do they irritate the gastrointestinal tract locally, but once absorbed, they rapidly affect nerves, causing disorders in both peripheral and central nervous communication and eventually paralyzing the respiratory and circulatory centers in the brainstem, simply put, leading to death!

At that time, another nurse had sorted out the video in the camera and hurried over, saying, "Dr. Chen, we've figured it out—the patient is apparently a livestreamer, even has hundreds of thousands of followers. He planned to film a show today, eating pufferfish and then following online tutorials. Two hours later, he was poisoned!"

Upon hearing this, Chen Cang's expression instantly changed!

Livestreaming eating pufferfish!

Wasn't that just reckless?

Thinking this, Chen Cang couldn't help but shake his head.

Because of the peculiar nature of tetrodotoxin, its toxicity is extremely stable!

Even after meticulous cooking methods such as frying or stewing, or other methods like boiling, salting, or sun-drying, it remains indestructible, primarily causing paralysis of the central nervous system and nerve endings.

Are livestreamers now a high-risk profession?

Must they attract followers by eating pufferfish?

However, at this moment, Chen Cang needed not worry about why he ate pufferfish or how it tasted but to think about how to perform a rescue!

Soon, the ECG results appeared, and Chen Cang looked at them, immediately frowning—second-degree atrioventricular block!

The heart monitoring device had just been connected when the alarm immediately went off!

"Shortness of breath!"

"Blood pressure is dropping!"

Chen Cang observed the patient's obvious shortness of breath, which was due to paralysis of the respiratory muscles caused by toxins!

Chen Cang quickly turned around, "The dosage of Doxapram is 0.75 grams, intravenous injection!"

Doxapram is a respiratory stimulant. At this time, it can effectively help the patient restore respiratory function.

"1% hydrochloride promethazine 2mg! Subcutaneous injection!"

This was to relieve muscle paralysis.

After the patient's condition stabilized slightly, he rapidly organized the nurses to induce vomiting, stomach lavage, and intestinal wash for the patient.

The two young nurses moved quickly and busily, very efficiently.

But!

The patient's condition was really not optimistic.

Not only did it not improve, but it seemed to be worsening and had already fallen into a coma.

Chen Cang's face changed, and he quickly continued to make arrangements!

"Lily, continue preparing a 500ml glucose solution for intravenous drip, add vitamin C, coenzyme A, and ATP!"

These substances can promote the excretion of toxins!

"Xiao Ke, prepare dexamethasone!"

Glucocorticoids can enhance the tissue and toxins' tolerance. Chen Cang only hoped to increase the resistance and have a better chance of success!

Because truth be told!

Currently, there is still no specific antidote for pufferfish toxin poisoning.

However, the only good news is that the toxins are quickly detoxified and excreted in the body. If the patient does not die within 8 hours after onset, recovery is very likely!

Therefore, once poisoning is detected, various detoxification and symptomatic treatments should be given promptly to help the patient through the critical period.

These eight hours are a matter of life and death for the patient!

Everyone dared not waste a single moment!

Chen Cang took a deep breath to calm himself.

After all this turmoil, respiratory paralysis had not occurred.

But the man was still in a coma.

Gradually, his blood pressure normalized...

Yet, he still did not wake up.

Chen Cang was in a dilemma.

What to do?

Was there anything else he could try?

Thinking over and over, Chen Cang suddenly remembered the results of an animal experiment mentioned in the latest research report.

It was said that cysteine injections in animal tests could rapidly detoxify, and feeding animals with pufferfish eggs treated with cysteine did not lead to poisoning.

Seeing the patient's circulation getting worse, Chen Cang gritted his teeth and said to Lily:

"Cysteine 0.1g, dissolved in sodium phosphate buffer, intramuscular injection!"

This drug had been used before, but it was toxic to the liver.

But... at this time, the patient's life was more important than anything else!

Since so many resuscitation measures had already been employed and yet they had not moved out of the danger period, Chen Cang had no choice but to use this last resort!

Otherwise, if too much time passed, he might lose his life, and there would be no point in worrying about liver toxicity.