It's not that hard to open a hospital in another world, right?

Chapter 14 No Adrenaline?Then... only use the adrenal glands
Two 10 minutes is not short, not long.

Especially when someone is beside you asking long and short questions, one question after another, and you can't kick him away... That's true, life is like a year.

Gretel stared at the child's throat with one eye, and stared at the priest with the other, gesturing, and his saliva was almost dry.It's hard to hear someone shouting: "It's red! It's red! It's a big circle!"

With a probe, the boy's left forearm was smooth and flat, without the slightest problem.On the right forearm - where the water was dripping from the fish - was very red, with a bulge and a clear wind mass.There are also strands of red lines of different lengths on the outer ring of the blush, which at first glance look like insect feet.

Flush with pseudopodia and wheals...

That's right, it's an allergic reaction, and it's a very strong allergic reaction!
Of course, the reaction is so strong, it may also be because the fish water he prepared has not been diluted at all...

Gretel felt a little guilty, but he still looked confident on the surface, and clapped his hands:
"It's certain! It's the cod that's the fault!"

"What's next?"

"Next..."

Gret speaks out.

After a skin test, the cause of the child has been determined, which is acute laryngeal edema caused by allergies.He was very familiar with the first aid method, and he could give a doctor's order with his eyes closed.Even with the doctor's order here, the veteran emergency department nurses over there have already prepared the medicine:

Subcutaneous injection of 0.1% epinephrine hydrochloride;

10ml of normal saline + 1mg of epinephrine + 10mg of dexamethasone, rinse mouth immediately for 5 to [-] minutes;

紧接着紧接生理盐水20——40ml，加肾上腺素1——2mg，再加上地塞米松10mg持续雾化。

But now, what does he have in his hand?
Nothing!
There is no epinephrine injection, no dexamethasone injection, and even the physiological saline - the physiological saline he instructed to prepare by hand, must have an inaccurate concentration, a lot of impurities, and no sterility at all...

fall!
This day is over!
Fortunately, Gretel has a plan for this problem.He pretended to think for a moment, and turned to the farmer calmly:

"I saw mutton soup in the kitchen, are the viscera still there?"

"I'm here!" Uncle Edmund, the farmer, nodded vigorously.Gretel breathed a sigh of relief: If this is not there, we have to discuss with the people on the farm and let them kill the sheep on the spot.He got up and turned to the kitchen:

"Give me the guts!"

After this rescue, Gretel had established a considerable prestige on the farm. He asked, and naturally someone would run errands.Soon, a basin of bloody internal organs was brought in and placed in front of Gretel with a bang.

Then, Gretel squatted down on the ground in front of everyone's eyes, stretched out his hands, and turned over in the tub without hesitation...

The priest, who had been following Gretel, also crouched down curiously.After watching it for a while, I couldn't get the point, so I couldn't help but ask:
"what are you doing?"

"Find a gut."

"Which one are you looking for?"

The priest stretched his neck and leaned over.The Roman knight who had been following him with his sword and fulfilled his duty of protection finally couldn't bear it any longer, stepped forward, bowed and interjected:

"Sir, your status is noble, don't..."

"Hey!" The priest flicked his sleeves impatiently.He stretched his neck, looked left, looked right, and was caught off guard by a stench of mixed blood.Just like that, before letting go of curiosity, she covered her nose and asked Xu Xu:
"Which one are you looking for? Isn't it the internal organs? Just let them go!"

"they do not know."

Grete didn't lift his head, searched intently, muttering words in his mouth: "Kidney...kidney...found! There is one more..."

"Oh, what you're looking for is Yang Yaozi!" The priest's head came over again.Gretel raised his palm covered in sheep's blood and made a gesture to push:

"Don't be noisy!"

A snort from the upper left.The Roman knight's great sword was unsheathed and stopped in front of Gretel's palm.The cold light was cold, and Gretel was taken aback by him, and the big head of the priest shrank back, muttering:

"If you don't say it, don't say it... I kindly ask you to let others find it, but you still don't appreciate it..."

Gretel ignored him, focused, rummaging in the tub.In sheep that have been slaughtered, the anatomy is completely destroyed, and finding one kidney does not mean finding another.He turned it over for a while, and took out the two lamb kidneys. With a sigh of relief, he put the pottery bowl in which the lamb kidneys were placed on the table, and carefully began to peel them off.

——From the beginning, what Gretel wanted was not the kidneys, but the adrenal glands.

Adrenaline constricts blood vessels, and dexamethasone is anti-inflammatory and inhibits allergies.Dexamethasone is a chemical synthetic preparation, so don't think about it now, but adrenaline... At least you can think about it.

With this thing, at least the laryngeal edema can be eliminated and the child can breathe normally.As for the chicken bone stuck in the airway, naturally, it can be pulled out quickly.

In theory, epinephrine is a protein hormone and cannot be taken orally because it will be hydrolyzed by pepsin.However, history is not without examples of oral epinephrine.Gretel remembers reading this account in a previous life:

In the autumn of 1893, the British doctor George Oliver, who invented the sphygmomanometer, discovered that the sphygmomanometer could detect the contraction of the radial artery of the subjects after swallowing the substance extracted from the adrenal glands of goats.

In later generations, this experiment was used as the earliest significant evidence that adrenal extracts can raise blood pressure.But, in Grete's view at the moment, it means something more important:
Epinephrine, or adrenal extract taken orally, does work!
Of course, the child cannot swallow now.But Gretel has another hope: In the epinephrine family, neither epinephrine nor norepinephrine can be administered sublingually, but isoproterenol, which can be administered sublingually!
So... adrenal extract... To be exact, the adrenal glands are mashed and mixed with water... Maybe, there is some effect... right?

Gretel was so nervous that he didn't even have time to speak. Under the dim light, he carefully peeled off the outer envelope of the sheep kidney.Sniping, pulling apart, bluntly separating... The rough iron scissors flickered gently in his hands, almost playing with the dexterity of surgical scissors.

The adrenal gland is a small one, close to the top of the kidney, and is encased in the renal fascia along with the kidney.The human adrenal gland weighs only 5-7 grams, and the adrenal gland of a goat is not much different.He had to be very careful to strip the adrenal glands completely, without breaking them at all.

I don’t know how much of the active ingredients in the two adrenal glands, and I don’t know how much can be absorbed under the tongue.He... still be careful, try not to waste it...

Gretel was attentive, and the movements of his hands were careful and gentle.The aura emanating from his work infected everyone unconsciously, and even the squeamish priest stopped, leaned on the table and looked at it without saying a word.The knight coughed and tried to say something, but he waved his hand to stop him.

It was not until Gretel completely peeled off the two adrenal glands, chopped and ground them in a clean empty bowl, and added water to let the child rinse their mouths. The priest sighed and jumped up to ask:

"Is that all right? Is it all right?"

"Wait and see..."

Gretel stared unblinkingly at the boy's neck, always on guard against the chicken bone becoming crooked.Fortunately, the child rinsed his mouth for 1 minute, 2 minutes, 5 minutes... the chicken bones were still in good condition, but the edema in the throat gradually disappeared, and the sound of air rushing through the vocal cords became more and more obvious.

"Wow! Useful! Really useful!"

"Yeah, it's really useful." Gretel secretly wiped a cold sweat, pulled out the chicken bones, and smiled wearily at the priest:
"Next, please take action and heal his wounds..."

"No problem! Look at me!"

The priest rushed forward eagerly.A child's condition, tossing back and forth all night, he can finally come in handy, and the treatment is very neat.After the wound was healed, he straightened his robe, held his head high, and stretched out his right hand to Gretel:

"Hello, young healer."

******
In order to write the adrenal extract, I spent 20 minutes looking up various goats in the UK... goat weight...  

Romney sheep, adult sheep weigh 80kg for rams and 41kg for ewes
Lincoln sheep, adult rams weigh 73-93kg, adult ewes 55-70kg
Nanqiu Ram weighs 80-88kg and ewes weigh 60-88kg
and many more……

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(End of this chapter)