I can see health

Chapter 706 S1Q3T3 (Fourth Update)
When others hear the patient's description like this, at most they will feel that they are pitiful, so many people have died.

But that's not what a clinician thinks when he hears such words.

It just so happened that Wu Si also came out and heard the description from his family members.

Lu Chen turned his head and asked Wu Si, "Have you had a chest CT?"

Of course Wu Si knew what Lu Chen meant. Lu Chen suspected that the patient might have lung cancer.

The patient's brothers both have cancer, which is a very prominent family history. A normal doctor's thinking should consider whether the patient may have lung cancer.

If the patient's lung cancer is severe, blocks the bronchi, or seriously affects the lung tissue, it may cause hypoxia.

"I just asked the patient's family. The patient had a physical examination half a month ago, and there was a CT scan." Wu Sidao, "I didn't see the scan, only a report, and the report didn't say that there was lung cancer."

What Wu Si meant was obvious, the patient was not lung cancer.

Lung cancer was not seen half a month ago, so it is impossible to be lung cancer now.

Lung cancer does not grow within ten days or half a month and has such a big impact.

"Most of them are probably pneumonia. Only pneumonia can develop so fast." Wu Si said solemnly.

Lu Chen nodded slightly, temporarily agreeing with Lao Ma's judgment.

The patient's life value is 48 (——).

There is nothing special about it so far.

"Go to the ICU first." The ICU doctor said, "I'll go back and prepare first."

"Okay." Wu Si nodded.

……

However, just when the patient was about to be transferred to the ICU, his condition suddenly changed.

This is beyond everyone's expectations!
The patient had just been pushed out of the gate of the emergency department, and the symptoms of chest tightness worsened!

The nurse rushed out and said: "The patient's heart rate is very fast, 130 beats per minute, and his breathing is even more rapid."

Wu Si immediately shouted: "Push back to the emergency room first!"

At this time, the patient was sweating profusely, panting, and his panic could be seen in his eyes.

He intermittently said to the nurse next to him, "Hurry up, turn up the oxygen for me, it's uncomfortable."

Blood oxygen saturation dropped to 88%.

"Okay, don't talk too much, just have a good rest!" The nurse said quickly.

On the side, Lu Chen hadn't had time to leave.

"This is not a good thing." Lu Chen frowned, "The patient can't wait to go to the ICU. If he wants to be here, he will be intubated and put on a ventilator."

Lu Chen immediately listened to the patient's lungs with a stethoscope,
The breathing sounds of both lungs are whirring, symmetrical, not pneumothorax!
Sudden aggravation of hypoxia, the patient must be alert to the possibility of spontaneous pneumothorax. If one side of the pneumothorax, that is, the lung is ruptured, the breath sound of this side of the chest cavity will be very low, or even inaudible.

If you hear symmetrical breath sounds on both sides, it is basically not a pneumothorax, and this auscultation is very critical.

At this time, Wu Si also became more careful and asked Lu Chen, "Mr. Lu, there must be no heart problems. The patient is severely hypoxic and may induce myocardial infarction. If it is a myocardial infarction"

Lu Chen frowned deeply.

He didn't deny Wu Si's idea, "Then let's review an electrocardiogram."

Hearing this, Wu Si immediately asked the nearby doctor Guipei to take an electrocardiogram for the patient, and at the same time increased the oxygen concentration, and asked the nurse to prepare for tracheal intubation.

Another nurse also pushed the ventilator over.

……

When the patient came to the emergency department, an electrocardiogram had been done, and no obvious abnormalities were seen.

Also checked troponin, cardiac enzymes, etc., are also normal.

Previous evidence does not support acute myocardial infarction.

But it is really hard to say whether there will be a sudden myocardial infarction now.

EKG results came out soon.

Lu Chen immediately took the electrocardiogram and looked at it, but there was no obvious pattern of myocardial infarction.

No lead elevation or depression was seen.

Wu Si also moved his head closer, "It seems that the patient is not suffering from myocardial infarction..."

"Could it be that his condition suddenly deteriorated?" Lu Chen murmured.

Just now, the rate of decline in the patient's health has indeed increased!

A patient with severe pneumonia suddenly has severe shortness of breath, and common diseases such as myocardial infarction and pneumothorax have been ruled out, so it can only be explained by the deterioration of his condition.

For example, the patient may turn over, or arrhythmia occurs, which will cause the heart rate to be so fast and the hypoxia to be more serious.

"Then intubate. I'll talk to the family members. It's safe to intubate here first, and then go to the ICU." Wu Si looked at Lu Chen beside him, wanting to ask his opinion.

"Wait!" Lu Chen waved and stopped Wu Si.

He frowned slightly, and took the electrocardiogram back to look at it again.

He always felt that something was wrong, this kind of patient with sudden dyspnea.

Have you overlooked something?
It wasn't until Lu Chen looked at the electrocardiogram that he had just done, that he suddenly understood!

"what's the situation?"

Seeing Lu Chen's expression change, Wu Si probably made some new discoveries.

Upon hearing this, Lu Chen immediately handed the ECG to Wu Si.

"Look at the S wave in lead I of the patient, as well as the Q wave and T wave in lead III. The electric axis is deviated to the right. Does it look familiar?"

Wu Si was stunned, and just stared at the myocardial infarction information of the patient's electrocardiogram.

Anyway, he didn't see the myocardial infarction graphic, so he was relieved.

But now Lu Chen obviously found something else, so he looked at it so carefully.

……

Wu Si took the electrocardiogram, followed Lu Chen's prompt, and re-identified the electrocardiogram carefully.

"Ah, S1Q3T3? The patient must have pulmonary embolism, right?!"

S1Q3T3, as well as right axis deviation, the most typical ECG pattern in patients with pulmonary embolism!

Thinking of pulmonary embolism, Wu Si trembled with fear.

Six months ago, a patient with pulmonary embolism died under his nose.

"Yes, this is pulmonary embolism!" Lu Chen said in a deep voice.

In fact, pulmonary embolism is well understood.

If there is a thrombus in the human venous system, and the thrombus falls off, it will enter the pulmonary artery along with the venous blood flow.

If a thrombus gets stuck in the pulmonary artery, the blood cannot pass through, and the blood cannot reach the lungs, and there is no way to get oxygen.

Without oxygen supply, people are likely to be suffocated alive!
Severe pulmonary embolism will kill you instantly!

"I'm going, then this moment can't be delayed!"

Wu Si was startled.

Although pulmonary embolism is highly suspected at present, the diagnosis of pulmonary embolism by electrocardiogram is still reluctant, and electrocardiogram can only provide a general idea.

To truly diagnose pulmonary embolism, CT pulmonary angiography must be completed.

Therefore, Wu Si has already rushed out to find the family members to sign, suggesting that the family members agree to do CT pulmonary angiography.

……

Outside the emergency ward.

Wu Si stared closely at the patient's eldest daughter, "The patient's condition is getting worse now, and it is suspected that there may be a sudden pulmonary embolism, so this examination must be done."

"Do you want to do it now?" The eldest daughter looked confused.

"Yes! If you don't do it, you can't do it. If you don't do it, you will die. If you do it, you may not be able to save it, but at least there is a direction for treatment, and if you rescue it in time, there is still a chance."

At the critical moment, Wu Si understood everything he said.

The patient's daughter was terribly frightened. They had just glanced at the patient's condition outside and knew roughly what was going on.

"Do, do whatever helps!"

　I will start work tomorrow, tomorrow night shift.

　　
　
(End of this chapter)