I can see health

Chapter 262 Pulmonary Embolism? (Fourth more cold little crane rewards plus more)
At this moment, the patient suddenly opened his eyes and passed out.

All the people present were tense in their hearts.

If the endotracheal tube is not inserted into the patient's trachea within 1 minute, and the ventilator is connected, the patient may soon have a cardiac arrest due to lack of oxygen.

However, Lu Chen did not disappoint everyone. After a few bangs, the endotracheal tube was successfully inserted into the patient's trachea from the mouth.

Seeing this, two nurses immediately came over to connect the ventilator.

Lu Chen also quickly adjusted the parameters of the ventilator.

Puff puff puff, the ventilator began to pump up the patient.

"Give pure oxygen first." Lu Chen said after wiping the sweat off his face.

Before he knew it, his back was soaked.

"What about the patient's family?"

Yin Xinhua asked the nurse on duty in a deep voice.

"I've already contacted my family members and I'm on my way," said a nurse on duty.

"Report to the medical department immediately." Yin Xinhua said seriously, "At the same time, please consult the ICU and the respiratory department."

"Okay, I'll call."

Fan Zhiping nodded and immediately walked towards the nurse's station.

On the line of life and death, without family members to accompany them, disputes are very easy to arise.

This type of patient is very special, so we must notify the medical department and let them assist in handling this.

……

On a ventilator.

The patient is still in a coma and short of breath, but slightly better than before.

Blood oxygen saturation rose from a low of 70% to 92%.No matter how you adjust the parameters, the blood oxygen saturation will not rise.

"The blood oxygen saturation cannot go up, there must be something wrong!" Yin Xinhua said in a deep voice.

The blood oxygen saturation of normal people is 100%, but the blood oxygen saturation of patients with severe pneumonia will definitely drop.

But if it is connected to a ventilator and given pure oxygen, it can also get better quickly. Like this patient, the blood oxygen saturation has been maintained at 92%...

Lu Chen thought of a possibility, and that was pulmonary embolism!

He rechecked the patient's ECG.

This time the electrocardiogram had unexpected gains.

The electrocardiogram showed a relatively typical performance of high right heart pressure load, deepened lead I, Q/q wave appeared in lead III, and inverted T wave.

As soon as professional respiratory and cardiologists see this ECG, they will know that it may be a pulmonary embolism.

When the pulmonary artery is blocked by an embolus, the pressure of the entire pulmonary artery will increase, which will cause the pressure of the right heart to increase, and the electrocardiogram will show it.

Yin Xinhua gave a wry smile and said, "Junior Brother, this should be a pulmonary embolism. We have won the first prize. But now we definitely dare not launch a pulmonary artery CTA to confirm the diagnosis. We can only wait. Let's call the respiratory department and ICU doctors first." Let’s discuss it later. Our side is responsible for stabilizing the vital signs first.”

The most important thing is that the family members of the patients have not come yet.

Any subsequent operations require the consent of the patient's family members.

Less than 5 minutes.

The respiratory doctor is here.

The patient's medical history was re-analyzed, but the patient was in a coma, and it is not easy to ask about the situation now.

After seeing the patient, the consulting doctor of the Department of Respiratory Medicine returned to the doctor's office and said to Yin Xinhua: "Judging from the patient's onset speed, performance, and electrocardiogram, it is indeed consistent with pulmonary embolism. Short-term shortness of breath, hypoxia, and respiratory failure, no pneumothorax was found. , Lung atelectasis, if possible, do a pulmonary artery CTA to see it at a glance, if it is not possible, do a color Doppler ultrasound or an electrocardiogram, you can also see some manifestations, especially a color Doppler ultrasound of the heart.”

The consulting doctor in the respiratory department also agreed with Lu Chen and Yin Xinhua's point of view.

However, Lu Chen frowned, "Sister, I have a question."

Yin Xinhua glanced at Lu Chen, "Say it."

"If you consider that the patient has pulmonary embolism, but he does not have any high-risk factors for pulmonary embolism!"

According to the patient's previous medical history, he has no history of lower extremity surgery injuries, long-term bed rest, and some congenital factors, such as protein S/protein C deficiency or anticardiolipin syndrome.

How could he have a pulmonary embolism?

This question stunned Yin Xinhua and the respiratory doctor.

It seems to be the case!

If you only pass symptoms, it is indeed very similar to pulmonary embolism.

But without risk factors, it is very rare to directly get pulmonary embolism!

"There may be other unknown factors." The respiratory doctor frowned. "No matter what you say, pulmonary embolism should be considered first."

The reason is put aside for now, and the treatment is the main priority.

Lu Chen nodded. The most important thing now is to solve the patient's cause.

Doctors from the ICU came soon.

After seeing the patient's condition, he basically agreed with the judgment of Yin Xinhua and the respiratory doctor.

However, it is unlikely that the patient will need a CT scan in this situation, unless the patient is pushed along with the ventilator, but the patient's vital signs are still fluctuating.
"Probably need thrombolysis!"

The results of everyone's discussions were consistent, but further examinations of color Doppler ultrasound or CT were needed before thrombolytic drugs were used.

If I make a mistake, I'm afraid I won't be able to eat and walk around.

Although thrombolytic drugs can dissolve the thrombus, it may cause cerebral hemorrhage in minutes, which is troublesome.

"Why don't you go to the ICU first and see the situation before we talk about it. At that time, our ICU will use our own heart color Doppler ultrasound to see if we can observe signs of pulmonary embolism. If it is really pulmonary embolism, we will consider thrombolysis. If there is If you find anything else, analyze it later. Save your life first."

The ICU doctor said to Yin Xinhua.

What patients need most right now is a ventilator, but if the patient really has a large area of ​​pulmonary embolism, the ventilator is not very effective, the reason is simple.

The working principle of the ventilator is to inject oxygen into the patient's lungs and force the input.

But if the patient's pulmonary artery is blocked by an embolus and there is no blood flow, then there is no way to carry out effective blood oxygen exchange!

Oxygen alone is not enough. Without blood flow, it cannot bring oxygen in, and there is no way to expel carbon dioxide. Patients will still die due to hypoxia and carbon dioxide retention.

Yin Xinhua nodded and agreed with the ICU doctor's opinion, "If pulmonary embolism is diagnosed and the timing is right, then thrombolysis can dissolve the embolus and restore the patency of the pulmonary artery. There should be a chance, after all, the patient is so young."

……

After about half an hour.

The family is finally here!

The medical department also communicated and explained.

However, the patient's family refused to be transferred to the ICU.

The family member is the elder sister of the patient. The patient is not yet married and lives in a rented house in Jinghua. The elder sister works here and her income is estimated to be low. The ICU is simply bad news for them.

But the existence of ICU has indeed turned the bad news of many people into good luck, and this is what many people expect from it.

The patient was quickly arranged to a separate room, and all kinds of monitoring equipment were on.

The blood pressure is low, and with active drugs, the blood pressure can barely be maintained at 90/60mmHg.

(End of this chapter)