I can see health

Chapter 210 Removing the Ventilator

Isn't this too fast? !
Fan Zhiping now has a black question mark face.

Although Lu Chen's nickname is "Professor Lu", it is also academic.

As for the clinical operation, Fan Zhiping only knew that Lu Chen would puncture the radial artery.

However, Lu Chen's ability to perform bronchial intubation really stunned Fan Zhiping.

Not to say how difficult this endotracheal intubation is.

But the current medical division of labor is extremely thin, and doctors in general departments basically do not know how to learn bronchial intubation.

Lu Chen is just a first-year graduate student. Not only can he know how, but he is also so proficient, which is surprising.

Fan Zhiping took a deep look at Lu Chen.

How many secrets does he have?

……

After Lu Chen finished intubating the tube, he connected the breathing airbag and began to ventilate the patient at a constant speed.

At the same time, the nurse also pushed the non-invasive ventilator over.

With a large amount of oxygen input, the patient's blood oxygen saturation gradually increased from 80% to 90%.

At this time, Yin Xinhua also returned to the ward.

When she saw that the patient had been intubated, she was only slightly taken aback, but she was not particularly surprised.

Yin Xinhua's performance was extremely calm, which made Fan Zhiping a little puzzled.

Is everyone accustomed to Lu Chen's operations?

Lu Chen is usually too scary.

"Senior Sister, the patient's blood oxygen could not be maintained just now, so I had to plug it in for him first." Lu Chen said.

"Okay, then cancel the consultation in the anesthesiology department." Yin Xinhua said to the nurse beside him.

The role of the anesthesiologist is intubation.

Now that Lu Chen finished inserting the cannula, they are useless.

The nurse nodded and quickly called the anesthesiology department to cancel the emergency consultation.

……

At present, the heart rate and blood pressure of the patient are normal, only the consciousness has not been restored.

All rescues follow a basic principle, doing everything possible to maintain the patient's vital signs, namely blood pressure, heart rate, respiration, etc.

In other words, if the patient's vital signs are stable, it means that the patient's condition has improved.

"Observe and see for now." Yin Xinhua said, "I talked to the family members of the patients and wanted them to be transferred to the CCU, but the family members refused."

Patients who are critically ill and require a ventilator are generally transferred to the CCU for more refined treatment.

However, due to cost issues, many family members cannot afford it.

"Sister, I just checked the patient's electrocardiogram again, and there is not much change." Lu Chen said in a deep voice, "I think it may not support the diagnosis of myocardial infarction."

When Yin Xinhua heard this, she couldn't make up her mind for a while.

"Wait for the blood test results."

According to the patient's current symptoms and auxiliary examinations, myocardial infarction is still the first diagnosis, but we still have to wait for the results of the blood troponin test.

If troponin is elevated, it is likely to be a myocardial infarction.

If troponin is not high, myocardial infarction is ruled out!

As for other diagnoses, Lu Chen, Yin Xinhua and the others had no idea for a while.

……

At present, the patient's vital signs are maintained, and his life is not in danger for the time being.

Lu Chen and the others returned to the doctor's office.

Because of the bonus of the "Clinical Thinking Skills Book" in the afternoon, after returning to the office, Lu Chen started to sort out the patient's entire disease process.

From high blood pressure, headache, and later ventricular fibrillation, is there a clue that is pulling it?
……

About 10 minutes later, the nurse walked into the office.

"Doctor Yin, the patient is awake."

Everyone looked happy.

The recovery of the patient's consciousness means that everything is going in a good direction.

However, it is undoubtedly very uncomfortable for patients to perform endotracheal intubation in a clear state.

"Let's go see him."

Yin Xinhua brought Lu Chen and Fan Zhiping to the ward.

The patient was lying on the hospital bed with half-closed eyes.

On the side of the hospital bed, his son was sitting by the bed with a tense expression on his face.

"Master, how do you feel now?"

The patient's lips are pale. He can't speak now, so he can only blink his eyes, indicating that his condition is okay.

The nurse took his blood pressure again.

The sphygmomanometer showed that the blood pressure was around 130/60mmHg.

The patient's blood pressure has recovered.

……

"Doctor, when will my dad be off the ventilator? I think his condition is stable."

In the doctor's office, the patient's family asked.

Yin Xinhua frowned: "Don't worry, just wait. We will remove the ventilator in time when the patient shows signs of weaning. If we remove it rashly, it may be life-threatening."

"How long will it take?"

"About two days." Yin Xinhua thought for a while.

The patient's family breathed a sigh of relief.

"Okay, thank you doctor."

The patient's family temporarily gave up their plans to withdraw the ventilator, and then left the doctor's office.

"This son is so ruthless that he wants to remove the ventilator." Fan Zhiping shook his head slightly.

"He is still an only child." Yin Xinhua sighed, "Sometimes raising a child can't prevent old age."

……

About half an hour later.

The results of the patient's urgent blood test came out!

"Senior Sister Yin, the patient's troponin is negative!"

Lu Chen opened the test system immediately and found the test result of myocardial enzymes.

"Huh? Troponin is negative?" Yin Xinhua was startled.

Troponin is negative, which completely rules out the possibility of myocardial infarction!
What else would the diagnosis be?
Yin Xinhua frowned, she had no clue.

And Fan Zhiping and Lu Chen on the side didn't have the slightest clue.

at this time.

The nurse on duty ran into the office again.

"Doctor Yin, the patient's blood pressure is high again. I measured it just now and it is 198/110mmHg! Both upper limbs are symmetrical."

Everyone looked at each other when they heard what the nurse said.

Just now the blood pressure has dropped to 130/70mmHg, but now it has reached 198/110mmHg.

In less than half an hour, the blood pressure changed rapidly!

There must be something wrong with this!
"First use intravenous antihypertensive drugs to lower the blood pressure." Yin Xinhua said.

"Okay." Lu Chen nodded and began to give the doctor's order.

After giving the doctor's order, the nurse began to execute it.

Lu Chen glanced at Yin Xinhua and Fan Zhiping, paused, and said hesitantly, "Senior Sister, Brother Fan, do you think the patient is pheochromocytoma?"

The patient's blood pressure fluctuated rapidly in a wide range, and he also had accompanying symptoms of headache and chest tightness.

This has to make people suspect pheochromocytoma!

When Fan Zhiping and Yin Xinhua heard the diagnosis, they were slightly taken aback.

Pheochromocytoma?
The simple explanation of this disease is that there is a gland above the kidneys in the human body, called the adrenal gland (the gland above the kidneys).

If the adrenal gland has a tumor, the tumor may secrete a lot of hormones, including epinephrine, norepinephrine, and so on.

These hormones will stimulate the sympathetic nerves in the human body, such as high blood pressure, fast heart rate, sweating, excitement, restlessness and so on.

When will such hormones be secreted in large quantities?

For example, when you hold a stick in your hand and there is a lion in front of you, these hormones will be secreted crazily.

These hormones make you tense and give you more strength, whether to run away or fight.

If there are no special circumstances, hormones will be secreted according to the needs of the human body.

However, if the secretion is completely out of command regulation.

Instead, the secretion is random, concentrated secretion for a while, and exhausted for a while without secretion. The blood pressure will be like a roller coaster, with highs and lows.

This will also damage the heart, kidneys, etc., especially may cause arrhythmia.
"I think it's probably true. The patient's ventricular fibrillation and cardiac arrest may be caused by the excessive secretion of hormones by the pheochromocytoma!"

Fan Zhiping is Lu Chen's loyal supporter.

When Lu Chen made this diagnosis, he consciously matched all the symptoms!

Yin Xinhua was a little silent, she kept saying "pheochromocytoma" in her heart.

This disease is not common in clinical practice, and it may take a long time to encounter one.

The symptoms of pheochromocytoma are varied, but the most common is the paroxysmal increase in blood pressure, which fluctuates greatly!
To confirm the diagnosis of pheochromocytoma, it is necessary to complete abdominal CT or enhanced CT.

……

As for Lu Chen, when he finished saying "pheochromocytoma", a prompt popped up on the system panel.

"Congratulations, the completion of the system upgrade has increased!"

(End of this chapter)