Wang Songhe, a student at Binhai University, was a middle schooler Yan Feifan had once tutored.
Seeing the unconscious young man wearing an oxygen mask, his face pale, Yan Feifan helped push the gurney while questioning the paramedic who had brought him in.
"What’s the patient’s condition?"
The paramedic pushing the gurney, a man of about thirty, initially looked annoyed at the question.
But when he glanced at Yan Feifan, his tone quickly became respectful. "Mr. Yan, the patient has hypokalemia."
"During potassium replacement therapy at the campus clinic, he lost consciousness and developed symptoms like irregular breathing and an arrhythmia."
"The campus clinic didn’t dare continue treatment, so they had us transfer him here."
Hearing the paramedic’s report, Yan Feifan’s heart sank.
Irregular breathing, arrhythmia... these were signs of severe hypokalemia. Wang Songhe needed rapid potassium replacement, or his life would be in danger.
Just then, a girl rushed in.
She saw Yan Feifan, froze for a second, then ran forward and grabbed his arm.
"Mr. Yan, you told him not to drink so much soda and to drink more mineral water, but he just wouldn’t listen."
"It was no use when I tried to persuade him, either."
Yan Feifan recognized her. It was Wang Songhe’s girlfriend, Qiao Nan.
After a few words of regret, Qiao Nan’s voice broke as she pleaded, "Mr. Yan, please, save him, save him..."
By now, Yan Feifan had pushed the gurney into the emergency treatment area.
He took charge of the rescue effort without hesitation.
Yan Feifan glanced over Wang Songhe’s treatment records from the Binhai University clinic. He saw that Wang Songhe had been admitted due to flaccid weakness in his limbs.
The clinic had detected a blood potassium level of 2.06 mmol/L and diagnosed him with hypokalemia. Their treatment plan was a slow IV drip of 15 mL of 10% potassium chloride in 500 mL of normal saline, along with oral slow-release potassium chloride tablets for symptomatic treatment.
Half an hour later, the patient suddenly lost consciousness, his breathing became shallow, slow, and irregular, and the ECG monitor showed an arrhythmia.
After reading the treatment record, Yan Feifan also noticed that Wang Songhe’s body was damp. He immediately deduced that the clinic’s conventional potassium replacement method hadn’t worked as intended, or that he was losing potassium faster than it was being replenished.
In Wang Songhe’s condition, standard IV potassium replacement was too slow. An unconventional method was required.
Potassium needed to be administered via a central venous catheter using an infusion pump.
This procedure not only demanded a high level of experience and skill from the physician but, more importantly, carried significant treatment risks.
Yan Feifan didn’t hesitate. He immediately shouted, "Get him on a cardiac monitor and prep a ventilator!"
"Get me a central venous Puncture Needle and an infusion pump."
"Also, 5% dextrose solution with 10% potassium chloride, diluted to 100 mmol/L."
As he finished speaking, the three nurses who had gathered around began to work quickly and methodically.
At the same time, one nurse intercepted Qiao Nan, gently persuading and ushering her out of the resuscitation area to prevent her from interfering with the doctors and nurses.
By the time Yan Feifan had put on a sterile gown and gloves, the Puncture Needle, infusion pump, and potassium solution he had ordered were brought over.
Puncturing the vein, removing the stylet, and connecting the infusion pump—Yan Feifan did it all in one smooth motion, setting the infusion rate to 20 mmol/h.
Once the infusion began, Yan Feifan closely monitored the changes in Wang Songhe’s vital signs.
Such a rapid potassium infusion could easily cause localized or transient hyperkalemia, which could trigger a fatal arrhythmia or even cardiac arrest.
Moreover, hyperkalemia severely affects renal function. For those with kidney deficiencies, it could easily induce fatal renal failure and uremia.
Yan Feifan needed to pay close attention to the changes in Wang Songhe’s vitals and adjust the potassium infusion rate accordingly...
Ten or twenty minutes later, Mr. Wan Yuming came over. He checked the patient’s vitals, looked at the resuscitation chart, and noted that the infusion rate had been lowered to 6.7 mmol/h. He gave a slight nod.
"Feifan, your bold decision saved this patient’s life."
"Your fast, stable, precise, and decisive treatment style is perfect for the emergency department. With you here, our success rate would increase by at least five percentage points."
"Feifan, have you ever thought about..."
Mr. Wan stopped himself mid-sentence.
He shook his head and sighed. "Your medical talent shouldn’t be wasted in the emergency department, just saving a few people at a time."
"It should be applied to medical research, to benefit thousands upon thousands of patients."
Yan Feifan chuckled, replying without a hint of modesty, "Teacher, I’ll work hard in that direction."
Wan Yuming laughed. "You little rascal. Give you an inch and you take a mile."
After a pause, he waved his hand dismissively. "This patient is out of danger. I’ll keep an eye on him. You should head on back."
"Then I’ll leave him in your care, Teacher." Yan Feifan didn’t stand on ceremony.
After taking off his sterile gown and gloves, Yan Feifan went to the family waiting area, updated a worried Qiao Nan on Wang Songhe’s condition, and then left the emergency department with Yu Suye.
"Mr. Yan..."
The person who called out to Yan Feifan was Lv Xin, an ER nurse who had changed into her street clothes.
She hurried over to Yan Feifan and said quickly, "Mr. Yan, I’ve decided. I want to get cosmetic surgery."