We saved a girl, from common cold symptoms to stop breathing, just a day away.
The autopsy did surprise us. Because this is theoretically difficult to do.
It happened 11 years ago, when I was working in the field, and it happened to be an emergency room.
I was in E.R. for three months.
For three months, I’ve met thousands of patients, of whom this 23-year-old female patient is branded in my memory.
The patient’s last name was Shaw, and two weeks ago she started coughing and feeling exhausted.
He thought he had a common cold, bought his own medicine at the pharmacy, ate bad results and went to the local clinic with his roommate.
Initial consideration by clinic doctors is also the upper respiratory infections, which are treated with oral drugs.
However, the patient still coughs, is weak, feels panicful when coughs are severe and feels the whole heart is about to come out.
The clinic doctors have increased their vigilance to consider not excluding the possibility of myocarditis, especially viral myocarditis.
You know, a common cold can’t be panicking.
The common cold is an infection limited to the upper respiratory tract, most of which is ailment, fever, inactivity, cough, etc.
In the event of ulcer and panic, beware of possible heart problems, especially heartitis.
That’s how the clinic doctor analyzed it.
Oral drugs are no longer possible, and myocardiitis requires rest, as well as care-giving medication and intravenous medicine.
So I took a drop at the clinic.
Two days, still no good.
The clinic doctor advised the patient to go to the city hospital (where I worked), to do an electrocardiogram, cardiac color, etc., and to take a blood test for myase, calcium, blood protocol, liver and kidney function, electrolyte, etc.
But even with myocarditis, there is no very good drug.
Most of this disease is caused by viruses, and we don’t have very good antivirals, but we can only support treatment.
The vast majority of myocarditis can be healthy for themselves, don’t worry.
As long as it’s not an outbreak of myocarditis.
The patient did not know what an outbreak of myocardiitis was, and the clinic doctor further explained that he had seen it before in his studies at a major hospital, and that it was violent and was the most serious of myocarditis, and that he was not able to save his body before he could save him.
The patient was said to be afraid and rushed to the city hospital the same day.
However, because of the sheer number of people in the city hospital, the fear of trouble and the fact that the patient was not too uncomfortable to endure, he did not go to the hospital and returned to the clinic.
The clinic doctor reopened some of the medication to assist the heart and several more medium-sized drugs.
She was instructed to rest, to refrain from activity, to give her a time to recover her heart, and to send her back to the city hospital, where she was to be lined up, not to be surprised.
However, the patient has just graduated from university, has not found a job, has little money, has thought that the hospital may be more expensive, has thought that the clinic doctor said that myocarditis is mostly self-healing with mildness and has no intention of being hospitalized.
During the afternoon of the day when the medicine was taken at the clinic, the patient’s cough was suddenly increased and his chest was depressed.
The roommate saw her in bad condition.
That’s exactly the car I left with my superior doctor.
When our car came to the patient, she was already unconscious. Lips are blue, and they look like oxygen.
I wasn’t very experienced, I didn’t see a big scene, and I was a little scared by the patient’s condition.
The superior physician, on the other hand, experienced the same practice, immediately arranges for oxygen inhalation, EK custody, opening of an intravenous route, and is prepared to receive emergency hospital care.
The patient’s roommates were accompanied to the car, and her medical history was provided.
They both stayed together these days, so she was familiar with the patient.
We found her parents’ phone on the patient’s phone, contacted them and sent them to the hospital.
On the road, combining the pre-incidental condition of the patient, the superior physician considers an outbreak of myocarditis or severe pneumonia, and only serious cardiovascular and pulmonary disease can lead to such an apparent aerobic deficiency and dysentery.
But since the patient does not have any tests on his hands, we can only guess.
All we can do in the car is suck her oxygen, make her an electrocardiogram, general rehydration.
When I pulled her the EKG, she felt her limbs were cold and her blood pressure was low, and the superior doctor said she was in shock and had to intensify her rehydration to resist the shock, while urging the driver to move faster.
My heart beats fast, I stare at the patient, I stare at the cynics, and I’m afraid she won’t be able to find anyone.
No one’s ever hitched 120 cars, probably not knowing how hard the driver drove.
I usually get sick in their cars, and if I’m not in a hurry, I’ll make them slow down, turn around, or I’ll spit on the driver.
But that day, I wanted the driver to drive faster, faster.
Because I can even feel that the breath of the patient seems to be abating, and although the vital signs can be sustained, I’m really worried that she may not be able to do it next second.
Because of my high concentration, I didn’t feel any carsick at that race.
But the accident happened.
When the patient was about 10 minutes away from the hospital, he was suddenly convulsed and incontinent.
It scared her roommate and scared me.
That’s the first time I’ve seen a twitched patient so close, the whole bed is shaking.
There was also a sharp alarm from the CPR, and as soon as I looked at the CPR, the room was tremors, and the heart beats straight.
The superior doctor was in bad shape, touching the carotid artery and not moving, confirming the presence of a cardiac arrest.
The car was rushing to give her a tube intubation, which took almost a minute because the car was moving too fast and shaking a little bit.
I remember either too clearly or longer than usual.
I’m in a hurry to grab the airbag and get a handout.
The nurse was in charge of the push, mainly adrenaline, and I rotated with my superior physician to press the pressure and air.
I’m the first time I’ve had CPR in such a closed environment, and I’m a little nervous myself, and the car is shaking, and I’m all wet.
That ten minutes, it was a long time.
The superior doctor didn’t say anything, but he pressed it so hard that his sweat was worse than mine and his forehead, arms and palms were all wet.
We came back to the emergency room, and we rushed the patient to the rescue room.
Although we did not stop pressing out of the chest for a moment, the patient’s examination still showed no signs of life, and the replacement continued to press for several minutes, repeatedly pushing various life-saving drugs, to no avail.
The patient was pale, his hands fell out of the bed, his fingernails were very purple, and that was the first time I had seen a dead patient so closely.
The parents finally arrived.
After the superior doctor spoke to his family, they cried.
And then we stopped the out-of-heart pressure, and the examination of the patient’s pupils had been extremely dispersed, the heart could not hear, the aneurysm could not be touched, there was no self-respiration, and the whole body had a hair.
A young life, gone.
The superior physician again reviewed the patient ‘ s morbidity, considering that there was a high risk of an outbreak of cardiacitis.
Only an outbreak of myocardial inflammation can explain how fast she has progressed, with a lack of oxygen, shock, even a stoppage in her heart.
The convulsions that took place in the 120 car are supposed to be ases syndromes, which can result in brain dysfunctions such as convulsions, incontinence, as a result of severe heart disorders, which result in no blood in the heart pump and severe brain deficiency.
Because the patient ‘ s condition is too serious, it does not help even with the timely intubation of the tube.
Patients suffer from heart disease, heart failure, and can’t save them.
This is exactly what the clinic doctor told the patient.
That’s how bad it is for patients to experience rare outbreaks of cardiacitis.
The superior doctor is outraged that the viral myocardial inflammation is much more visible, most of it mild, and the patient has only a small chest and, at best, a little airy.
But it usually takes some time off, with some medication, and it’s easier to get better, and it’s rare to see such a severe outbreak of myocarditis.
There’s really nothing to do.
Patient roommates freak out.
The parents of the patients also died of paralysis several times, and they were unable to understand why a normal, live daughter would suddenly leave.
They had to accept reality.
Soon they responded that the body could not be cremated, could not sign and asked for an explanation.
Why did the child die for no reason, whether there were problems with hospital treatment and whether there were problems with medication at previous clinics.
We’d rather die together than find out.
This is a big deal.
The superior doctor was innocent and repeatedly told his family that the patient was dying by the time he received him. There’s no chance of a cure. There’s nothing wrong with it.
The family went to know someone, probably a doctor, and came up with an idea to question why we got in 120 cars and waited until we had a convulsion.
All we can say is that the patient at the scene is still breathing, and that it’s a complex environment, and it’s impossible to move immediately to an intubation tube, and it’s okay to assess further treatment in the vehicle.
It would also be appropriate to give oxygen first, in the event that the tube is not working and the patient struggles, etc., causing greater oxygen deficiency.
Words.
It won’t help. Let’s do an autopsy. Let’s figure out the cause of death.
What if there is a risk of an allergic drug, the drugs in the clinic, and the drugs of the emergency doctor, there is a risk of an allergic drug.
In addition, it was found that the clinic doctor had prescribed Chinese medicine and that there was a risk of Chinese poisoning. The blogger says:
Moreover, the patient’s death may be sudden, with myocardial infarction, aortic pulmonary embolism, brain embolism, etc. It’s just too late to diagnose.
The parents of the deceased were so excited that they were close to our emergency cola banner.
Let’s do an autopsy and get ready for the case.
It took me a long time to get the autopsy results out, and I left E.R.
But my superior doctor told me the results, which were unexpected.
The victim’s pulmonary artery and the right and right pulmonary artery were blocked by a large number of embolisms, as were the pulmonary artery branches.
Further examination revealed the formation of a clot in the patient ‘ s lower cavity vein and in the two-sided gill general vein.
The heart itself is not incapacitated and does not correspond to an outbreak of myocarditis.
The truth is clear.
The patient did not have an outbreak of cardiacitis.
He died of severe pulmonary embolism!
The pulmonary artery main branch was blocked by the embolism, and the blood could not flow, and it could not be oxygenated with the oxygen of the pulmonary bubble.
Patients quickly suffer from a lack of oxygen, manifested in suffocation, short breath and difficulty in breathing, and if the embolism is not lifted in time, the patient will soon be in shock, unconsciousness or even death.
Unfortunately, such a large area of pulmonary embolism cannot be dissolved by itself.
Unless the doctor immediately diagnosed a pulmonary embolism and then used a soluble in the first place, the process starts with a diagnosis, taking, pushing, etc., and takes more than an hour at the fastest.
Don’t say an hour, even a minute, is unbearable to the patient.
The brain is short of blood in over five minutes.
Somebody’s gonna ask, so why don’t you open up your chest and cut your veins and pull out the bolt?
Okay, but it’s more time-consuming and patients can’t wait.
And this surgery is so traumatic that it is likely to die of severe bleeding.
So it’s not realistic to have a blood bolt.
The large area of pulmonary embolism, which is so sudden, does not provide any treatment in time, and there is only one option to wait for the patient.
Death.
The family accepted the fact that the daughter died of pulmonary embolism.
How did you get this?
The autopsy structure was also shared with you because of the hemorrhage in the lower cavity, in the gill veins, which had a hemorrhage, which, if sufficiently large, could fall off at any time, followed by a flow of blood into the pulmonary artery, causing pulmonary embolism.
How could my daughter have formed such a deep vein?
An investigation. It’s been discovered.
The victim took a three-month pill.
The pill? Does the pill cause her to form such a severe clot? Everybody can’t believe it.
The main components of the pill are estrogens and gestational hormones, which increase the risk of haematosis, not necessarily.
The pill itself was a very good thing to reduce unwanted pregnancies and the rate of abortion, but very few people took it at that risk, and the risk varied from person to person, and she was not fortunate enough to take the pill, which led to the formation of a clot.
That’s guess.
But that speculation is logical.
Following the autopsy results, the diagnosis, which the clinic doctor had consistently considered to be incorrect.
The patient is not myocardiitis, much less an outbreak.
The patient may have been embolised at first, except for the fact that there are not many embolisms that have just begun to fall, and the pulmonary artery is not completely clogged, so it is merely a coughing, chest suffocation, or even a bit of a short-temporal panic at a time when, if the doctor is sufficiently vigilant, he should be advised to have a heart gravitation or a chest CTA.
Too bad the victim didn’t make it when he first came to my hospital. That’s what his roommate said.
Everything is fate.
Then, suddenly, the embolism fell off and, like an avalanche, quickly blocked the main pulmonary artery, and the blood could no longer flow, and then the tragedy happened.
Cope Class: How to avoid pulmonary embolism?
Is the pill so dangerous? How dare you take the pill?
Of course, such cases are rare, and the benefits of the pill are far greater than the disadvantages. If a married woman does not want a child for the time being, she can use the pill, and of course the risk is on the female side. My personal idea is to suggest that men wear condoms, which is the safest and least side effects.
In practice, many women take contraceptives without any obvious adverse effects, provided that they are used under the direction of a doctor.
Is the outbreak of myocarditis really that scary?
Horror. Fortunately, the vast majority of myocarditis is common, light, non-lethal. It can be restored after rest and conservative treatment. The problem is that we’re looking at the possibility of turning into serious myocarditis.
Severe myocarditis, which by its name is acute heart muscle inflammation, leads to a heart-pumping functional failure to pump blood, which leads to shock and no specific treatment, with emphasis on support for treatment, including by means of ECMO.
What’s a pulmonary embolism? How to avoid pulmonary embolism?
In short, anything blocking the pulmonary artery is a pulmonary embolism, but the most common embolism is a thrombosis, so pulmonary embolism usually refers to pulmonary embolism.
Pulmonary embolism is subject to a number of risk factors, and any factors that lead to a veinal haemorrhage, intravenial skin damage, high blood condensation can induce pulmonary embolism, such as trauma/surgery, brain organs, kidney syndrome, smoking, pregnancy/pregnancy period, slab abnormalities, malignant neoplasms, oral contraception, long-distance air travel, etc.
To prevent pulmonary embolism, it has to start from the top, to be simple, to be difficult. In general, pulmonary embolism does not occur in the general population, and most patients with underlying causes are susceptible to embolism. Record number: YX11DnOqxDn
I don’t know.
Keep your eyes on the road.
