Start From Emergency Doctor

Chapter 399

If you really want to compare it, I am afraid that Zhao Qiang is more serious and dangerous.

At least, the patient of Mordu Concord didn’t have two cardiac arrests, and it was the kind that Zhou Yuan rescued with perfect cardiopulmonary resuscitation.

However, even so, the final result is still not easy to accept-in the end the patient died because of ineffective rescue.

Infective myocarditis and aortic valve insufficiency both cause acute heart failure at the same time. The patient itself is already extremely dangerous. Just like walking on the tip of a knife, acute heart failure that can break out at any time is just like a knife under the foot Will take the lives of patients at any time.

What the doctor can do is to wait for the patient to walk over the tip of the knife, and then they can make a response.

It’s a pity that all the doctors at Magic City Concord failed. The patient did go to the operating table, but never came down…

And what about Zhou Yuan?

Zhao Qiang’s condition is more serious than that of the patients encountered by Mordu Xiehe. A cardiac arrest was added to the aortic valve insufficiency, infectious myocarditis, and acute heart failure…

Zhao Qiang not only walks on the tip of the knife, but also dances on the tip of the knife! In this way, Zhou Yuan abruptly rescued Zhao Qiang.

Therefore, at this moment, Zhou Yuan has a sense of accomplishment in his heart!

“Be sure to pay attention to nursing after the operation.” Zhou Yuan exhorted again.

Although Zhao Qiang’s operation was successful, whether he could survive in the end still a large part of it depends on the postoperative recovery.

What Zhou Yuan can do is Zhao Qiang puts on the operating table in the best condition. He has already done it, and then there is nothing he can do.

One aspect is blood volume. Before the operation, Zhao Qiang had increased blood volume load and left ventricular systolic dysfunction. In the early postoperative period, blood supplementation could not be too fast, but the patient himself was in a state of insufficient blood volume.

Therefore, the blood volume must be slowly supplemented in strict accordance with the optimal pressure that the left atrium can withstand or lung entrapment.

“Using a combination of dopamine and dobutamine for intravenous drip.” Zhou Yuan thought for a while and said.

Fortunately, the master-level aortic valve replacement surgery not only gave Zhou Yuan the relevant knowledge and technology of surgery, but also included part of the postoperative nursing knowledge. Although Zhou Yuan is not as good as Zhang Ling in actual nursing operations, at least it is still Know some theories.

Another point that needs special attention is the protection of important organs.(Read more @ wuxiax.com)

In patients with aortic insufficiency, due to insufficient blood supply to the arterial system and reduced diastolic blood pressure, important organs such as the liver and kidney will be damaged and functional changes will occur.

Moreover, aortic valve replacement surgery must be performed under cardiopulmonary bypass. After cardiopulmonary bypass, the patient’s cardiopulmonary function is low, and the resistance of the surrounding blood vessels will increase a lot, which directly leads to the increase of the patient’s pulmonary artery pressure and poor tissue blood perfusion.

Therefore, it may cause secondary damage to the organs. In the early postoperative care, measures such as cardiotonic and diuretic drugs, ventilator-assisted breathing and adequate oxygen supply are needed to protect the kidneys, lungs and other organs, and it is also necessary to use sodium nitroprusside, nitroglycerin, etc. as soon as possible Drugs reduce the load on the heart and the pressure on the pulmonary artery.

Only in this way can the blood perfusion of the main tissues be maintained and their normal functions restored.

There are several points in postoperative care that need special attention.

For example, in the treatment of heart rate disorders and hypokalemia, postoperative heart rhythm disorders are mainly due to hypokalemia. Zhao Qiang has had heart rhythm disorders before surgery, so he must actively supplement potassium after completing the surgery.

There is also anticoagulation therapy. Although the mechanical valve has a long lifespan, there is a particularly troublesome place, that is, the need to take anticoagulants for life, stopping for one day may cause life-threatening.

There is no hard time limit on how long to start taking anticoagulants after the replacement of the mechanical valve. Generally, you can start oral warfarin as long as the thoracic drainage is significantly reduced, and at the same time use heparin as adjuvant therapy. This time is generally 24 hours to 48 hours after surgery.

The role of heparin is to make up for the vacancy in the incubation period of warfarin from oral administration to its efficacy.

Zhang Ling said with a smile, “I know, I promise to complete the task!”

Zhou Yuan nodded, and separated from He Jianyi, Lu Chenxi and others. He Jianyi and the deputy director of cardiac surgery still had night shifts, so they stayed and prepared to go back to the office for a few minutes to start work again. Zhou Yuan and Lu Chenxi both It is packed up and ready to go back.

Sun Meng and Haiyang both served as general residents. Normally, a department does not need two general resident physicians. However, Haiyang recently went to study in hand surgery, and there happened to be no suitable candidates, so Haiyang was promoted… …

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With two of them being guarded in the hospital 24 hours a day, Lu Chenxi, who had already become the attending physician, was naturally a lot easier. The night shift was also replaced by the day shift, finally following Zhou Yuan’s pace.

After Zhou Yuan and Zhou Yuan returned home, they both fell asleep after washing up.

After a day’s operation, Lu Chenxi really didn’t have the energy to plan what to overthrow Zhou Yuan. He had this heart, but his body couldn’t keep up!

Lying on the bed a little tired, Lu Chenxi actually understood a little bit about what it feels like to say that a man has powerlessness on the Internet…

0 ……… 0

Now she wants to meet Zhou Yuan very much, and she can say a few words, but Lu Chenxi’s personality is inherently cold, she can’t be too proactive to find Zhou Yuan, and the most important thing is…she is completely absent now. Strength!

“Forget it, I’ll talk about it tomorrow.”

Lu Chenxi threw the phone aside, hugged the pillow and fell asleep.

Zhou Yuan didn’t have so much thought and activity. After taking a shower and drying his hair, he fell asleep directly on the bed.

The life of doctors is extremely boring. Apart from being busy with surgery to see patients, their free time is basically used to make up for sleep.

In mid-October, Duan Hongwei, who had caused a major car accident at the entrance of Yanjing Primary School, finally recovered to a level where he could appear in court. The court immediately issued a summons, and the issue of Duan Hongwei’s determination was brought to court for the first time .

On this day, many reporters flocked to the scene. The impact of this incident was so profound that three traffic policemen have been deployed around Yanjing Primary School, and two sentry booths have been built for traffic policemen to rest and work.

Although more than a month has passed, there are still many people paying attention to this matter. The perpetrator has caused such a serious and bad incident. What is the verdict?

And what kind of rewards will Zhao Han get when he sacrificed his life to save his life, and how to solve the compensation problem of the victims’ families.

Everyone is paying attention to this trial, and Zhou Yuan is also paying attention to Duan Hongwei’s trial. Spoon.