One of the patients had an old three-to-five-mg that could have died and got numb and his heart stopped.
He was covered in pipes, saved several times, and finally, on the third day, the patient was awake.
It was Ma who was on duty in the emergency section, after having been busy with a few patients, who were in a bad mood and who couldn’t breathe, and who suddenly saw someone rushing into the office hall and screaming for help.
After all the fighting, the horse felt something big.
It was a middle-aged man who fell and fell into the emergency room, saw an empty bed with a pusher, did not greet a doctor or nurse, and went straight to bed, crying out the last wiring: help!
Then nothing happened.
Then, the middle-aged man lay in bed like he was dead, scrambling his head.
A few nurses came forward to ask what had happened, but did not think how to call the middle-aged man, and he did not respond.
The nurse realized that the situation was not good and quickly examined the men ‘ s carotid pulse and breathing.
Shit! The patient’s heartbeat is gone!
“Saving for help! I’m sorry.
The old horse went up with an arrow and put a chest pressure on the man.
The nurse also responded and quickly transferred the patient to the rescue room, where she was placed under EKL.
“Let’s give him a vein. The old horse presses, and the nurse next to him says,
In fact, without waiting for the old horse, experienced nurses are ready to give the patient a shot.
The patient’s heart stopped, which means he died, and if the life-saving drugs were not used in time, the probability would be fatal.
So it’s important to open the veins in time.
What’s an IV? It’s white, it’s a needle in the vein, usually a vein.
“The blood pressure can’t be measured. The patient’s pupils have also expanded and the light reflection is weak. The nurses are anxious to say,
Patients are pale, pupils expand, light reflect is weak, which means the heart rate is really stopped and the brain is bleeding.
And it’s not good to rely on heart pressure alone.
Bad.
Damn it, the patient was crying for help.
What the hell happened.
The horse was sweaty and had no idea what was going on in the first place, and had to keep pressing outside the chest for help to see if it could regain its autonomy.
“Bring the defibrillator! “The old horse shouts for the people around him.
The patient’s heart stopped, causing sudden death.
The most common reason for this heart rate to stop is room tremors.
Due to various causes, the blood pump is not normal in the heart room and is replaced by tremors, so the patient is bleeding all over the body and dies soon.
If we are to be rescued, we should remove the tremors as soon as possible so that the heart can return to normal.
The defibrillator will soon be in place.
The horse paused the pressure outside the chest, quickly picked up the defibrillator and placed it on the chest of the patient.
The defibrillator identified the patient’s heart rate as room tremor!
Yes! The patient is really shiver!
Internal tremors indicate that the patient ‘ s heart cannot beat normally, but is tremors like worms, which are very weak enough to pump blood into the heart, so that the patient will surely die.
The early defibrillation of electricity and the ability of the defibrillator to send a powerful current through the heart in an instant would remove arrhythmia and allow the patient to return to his or her diarrhea.
Get rid of the tremors!
Once the electric tremor had ended, the horse continued to pounce on the chest and press the pressure.
“1mg adrenaline, push! “
Adrenalin is the most powerful, heart booster, a necessary drug to save a cardiac arrest.
It’ll work. I’ll talk to you later.
Dr. Phoebe’s here, too.
The ecstasy pressure is a physical work, and the general doctor is tired when he presses for a few minutes. As a middle-aged doctor who’s going to be bald, the horse’s physical strength will soon fail to keep up, as Dr. Friede certainly sees.
Dr. Frepe on top, the horse back off. It’s only then that the back was all wet.
“Sensei, what caused the patient’s heart rate to stop? Dr. Pepe asks the old horse while pressing.
For ordinary people, you see a patient on the ground, and your heart stops, and all you have to do is press and hit 120 on the chest.
For emergency doctors, however, in addition to continuing rescue efforts, it is necessary to analyse the underlying causes of the disease, and only when a patient who actually causes a cardiac arrest is identified and treated for the cause will he/she be able to survive.
Of course Ma knows that, but he’s just trying to save us.
Now that it’s eased, the brain starts to fly fast, thinking about the possibilities of the disease.
At the same time, at the most rapid rate, the patient was provided with a pipe intubation and a respirator.
At least this will guarantee the patient’s freedom of air.
After that, Ma told Dr. Fupé that most of the men in the middle of the sudden heart stoppage were acute myocardial infarction.
Furthermore, the movement of the patient ‘ s hands to cover his chest before he loses consciousness means that the patient may have chest pains, but it is not possible to say so.
As chest pain is the most important symptom of acute myocardial infarction, acute myocardial infarction is the first consideration.
“What about the family? The old horse asked the nurse, “Did the family come along?” I’m sorry.
The nurse said that he had not seen his family on several occasions and that the patient had come to the emergency.
No family, it’s the hardest. If the patient doesn’t come back, he dies in E.R., and the family is going crazy.
Ma sent someone to report to the Medical Section, saying that there was a patient with no family members whose heart rate had stopped and that he was still in the process of being rescued.
The diagnosis of acute myocardial infarction usually requires indicators such as EKG, blood-testing myocardial enzymes, etc.
It is clear, however, that the patient is unable to stop to make an EKG and cannot be delayed in making an EKG.
Even if an EKG was made, it is estimated that there is little to see, as the patient has suffered an ulcer tremor or cardiac arrest, and the EKG cannot record signs of myocardial infarction.
However, a blood test for myocardial enzymes is possible, so the horse had the nurse take the patient’s blood and test the indicators.
If it really is acute myocardial infarction, it means that the heart of the patient has been strangled, that the heart has not been provided with sufficient blood, that myocardial cells are dying of hunger, and that if the heart does not jump, there will be no humans. In order for the patient to survive, there is only an emergency intervention procedure (capal pulsation) or a drug solution.
In addition, there are two possible causes of a patient ‘ s heart stoppage.
One is the fracture of the aorta and the disease also has severe chest pains, and if the artery is broken, the blood flows out of the abdominal cavity like the flood of the breaker, and the patient quickly loses a haemorrhagic shock and then dies.
At the moment, the patient’s heart stopped beating and his blood pressure was small, and if it was really caused by a fracture of the aorta, it would have been impossible for even the dalits.
Fortunately, the examination showed that the patient should not have sustained a fractured hemorrhage from the aorta.
There’s also the possibility that the pulmonary embolism caused the heart to stop.
Pulmonary embolisms also have severe chest pains, and if they are not dissolved in time to restore the pulmonary artery to a good condition, the patient will die in a short time.
In other words, only serious CPR can cause a heart attack.
Theoretically there’s a third type of disease: cerebral vascular accidents, like brain haemorrhage.
Severe cerebral haemorrhage can also cause a cardiac arrest, but brain haemorrhage can cause brain dysfunction, most of which can cause physical dysfunction, such as paraplegic paraplegia.
The patient had just rushed into the emergency, and there was nothing wrong with it.
So it’s possible that heart and pulmonary diseases cause cardiac arrest.
There is also a high probability of acute myocardial infarction.
The horse’s analysis is logical and logical, but it doesn’t work.
Because the patient’s heart is still not beating, it’s not possible to send it to the intervention room for a coronary support.
“Why don’t you ask a cardiologist to come down? Dr. Frepe is breathing and asking the horse.
“When we get the patient back, it’s not too late. I’m sorry.
The Ma knew that Dr. Fupé was tired and was ready to replace him and press.
It may be a chance to save a patient whose heart rate has stopped and try not to interrupt the pressure time outside the chest, with the necessary drugs.
Just as the old horse was up and ready to take over, the nurse cried out and the patient’s heart beat back!
The old horse looked up, and it was true that there was a relatively normal heart rate on EK custody, which was certainly not room tremor.
The heart rate of 120 per cent is estimated to be related to the use of a few adrenalines, which are the strongest acetals.
It’s been pressing for almost 10 minutes.
The horse quickly looked at the patient’s pupils, which were smaller than just now, and seemed more sensitive to the light.
Blood pressure’s up.
Looks like he’s got a little bit of a smile on his face.
But not yet.
“Put a EKG and let the cardiologist come down and assess the probability of myocardial infarction, and if you want to go directly to the cavity cavity and do a coronary support. The old horse told Dr. Frepe.
Dr. Pepe has just left, the nurse has called out again.
I’m getting a call from the nurse. My head’s getting bigger! Come on, hurry up and keep trying.
Again!
At the same time, the chest pressure continues. Use anti-heart disorders.
I hope it works.
Why does the patient have a second shiver? This indicates that the heart condition of the patient is extremely unstable and is likely to be a heart storm, in which case the patient ‘ s mortality rate is very high.
Think of it, the old horse pulls out the cold.
It’s back! The nurse called out again.
It’s true that the heart rate has recovered. This time, the heartbeat was restored after more than a minute of pressure.
However, the horse was not at all excited, as he knew that all of this could be short-lived and that the patient would be at any time likely to tremor or cardiac arrest again.
The patient’s blood withdrawal came out, and the old horse was surprised that myocardial enzyme indicators had not risen significantly.
Isn’t it acute myocardial infarction?
Or is myocardial infarction too short and myocardial cells not completely destroyed, so myocardial enzyme hasn’t leaked out of myocardial cells, so the indicator has not risen?
The old horse is confused.
And looking at the other indicator, D-2, there’s a slight rise, which means that there’s condensed blood in the veins and there’s fibrosis.
Doctors use this indicator to make a preliminary assessment of whether the patient has pulmonary embolism.
Are patients really pulmonary embolisms now due to heart arrest, tremors, shock, and oxygen deficiency?
But the possibility of pulmonary embolism was soon denied by the horse.
If it’s a pulmonary embolism, and it causes a cardiac arrest, it’s a serious pulmonary embolism.
With so much pulmonary embolism, the pulmonary veins are completely blocked. They are not air-traffic. They should have a clear low-oxygen haemorrhage, and the respirator is not easy to correct.
But in fact, the blood-oxygen pressure of the patient is not so bad.
So it’s probably not pulmonary embolism either.
The best way to remove pulmonary embolisms or acoustic cavity is to make a CT, but in the patient ‘ s current condition it is not possible to introduce it.
So what caused the patient’s cardiac arrest and tremors?
The horse is still in the fog.
Only one diagnosis of suspected acute myocardial infarction can be temporarily withheld.
The cardiologist also arrived to assess the patient ‘ s condition and to assess the possibility of acute myocardial infarction.
If circumstances permit, it is recommended that the catheters be delivered immediately, with a first coronary pulse.
If myocardial infarction is dealt with immediately, and if not, further aneurological, pulmonary animation is done directly on stage, which does not take much time to determine whether or not there is no active lacerations or pulmonary embolism.
The situation is moving rapidly, and patients may die if they are not in time.
Ma agrees with the cardiologist.
A middle-aged woman came in. She’s the wife of the patient.
You’ve been looking for your family for so long.
Instead of finding the family, the family came by themselves.
After meeting the family, the horse was very excited, which meant that a reliable medical history could be obtained from the family.
In the face of a patient whose heart stopped, the lack of the necessary medical history would have allowed the doctor to walk a lot of turns, of course Ma knew that.
What the hell is going on?
What happened when the patient came to the hospital alone and his heart stopped beating.
The old horse was so anxious that he asked a lot of questions.
The wife of the patient was also frightened and stammered and described everything before the patient came to the hospital.
Ma finally got it.
Turns out this middle-aged man’s last name is Ho, 51 years old, a construction worker, and he’s got a vertebrae accent, a pain in his back and a lot of medication.
An hour ago, he met a fellow worker who said that he had been in the family for over a decade and that he could get rid of his back pains with a few sips, which would have worked well.
Mr. Ho was too happy to take his wife’s advice, so he drank a few of them when he came back with his medicine.
His wife has been worried that other people’s alcohol is painted. Why does it have to be internal? It’s not a good thing if it’s not poisoned.
Soon after the gin went down, something went wrong with Mr. Ho.
At first, the face was numb and the tongue numbed, initially thought to be alcohol, but the numbing was getting worse and there was nausea and vomiting.
Mr. Ho’s feeling bad, bad, looks like he got his wife. I can’t drink this. I’m dying today.
What do we do? Get to the hospital.
Mr. He ran and threw up, stopped a taxi on the road, went directly to the hospital emergency, got out of the car and threw up several times, all of which were seen on surveillance video.
Mr. Ho ran all the way into the emergency room. There’s everything the old horse sees.
His wife was worried and followed me, but she was almost 30 minutes late because of traffic delays.
So, the patient is not an acute myocardial infarction, an artery, pulmonary embolism, etc.
The old horse is so aware.
The cardiologist also lamented the possibility that the patient would have been placed on the operating table if the family had not provided this history.
What a shock.
The patient clearly drank the medicine and then something happened. Some toxins can affect the functioning of the heart, and even cause malign cardiac disorders, leading to tremors and less violent.
The patient’s wife blames herself, knowing that he should have stopped him from drinking the wine, which hurts people.
The old pony was so big that he wanted to blame them for the fact that he had no idea where he came from and had no idea what he was drinking.
But at this point, blame does not make any sense, does not help, but adds to the psychological burden on the family. The old horse swallows it back to his mouth.
“Do you want a stomach? Dr. Friede asks the horse.
There’s no time for stomach washing.
On the one hand, the patient is in a coma and it is easy to wash the stomach to cause liquids to enter the lungs, leading to wrongful ingestion.
On the other hand, the heart rate is still unstable and there is a possibility of retortion at any time.
In addition, alcohol absorption is rapid, and it is estimated that at this time there is nothing to wash, which can only exacerbate the stomach-washing complications.
Patients suffer from a malignant cardiac disorder, which means that the drugs are already bleeding, and we need to find a way to remove the toxins from the blood.
This requires bedside blood purification.
But that’s the problem. The patient’s heart rate is not stable, he’s still alive and dead, and how can he be cleansed?
It’s like, the patient’s re-emergence!
The electrocardiological surveillance sent a sharp alarm, which frightened the patient ‘ s wife and the horse was sad.
It’s really endless.
Dr. Pepe was quick to catch the defibrillator and quickly gave the patient another defibrillation once after having obtained authorization from the horse.
Keep pressing the chest.
“Don’t stop, keep pressing, maybe there’s a chance. I’m sorry.
But he knew that it would not be possible.
It is likely that the patient ‘ s heart rate stops as a result of poisoning, and it is difficult to reverse the pressure and electric tremors from the chest alone.
Even if you press back, you’ll be in a second room tremor. And then the heartbeat stopped. It was a heart storm.
Heart beats don’t come back, and all follow-up treatments are useless.
Only death can be declared.
What do we do?
The patient’s wife is crying, she can’t die, she’ll pay for it.
Of course they won’t stop, and we’ve got the milk.
Respirators breathe to patients, at least to ensure oxygen supply.
But it’s still a dead end.
The respirator alone can’t do it.
I thought it was myocardial infarction, and there might be a wiring in the catheter room.
But it is now almost clear that poisoning, rather than myocardial infarction, does not help to open a vein or anything.
But isn’t there nothing we can do?
No, there’s one more way!
The old horse took care of the patient’s wife and said that there was only one way to save the patient.
What?
Artificial pulmonary machine!
That’s ECMO, which uses this machine to temporarily replace the patient’s CPR function, to stabilize life and to try to remove the toxin from the body, if it’s a drug poisoning.
Ma believes that the patient is likely to suffer from drug and alcohol poisoning, but there is still room to speak.
As long as you can help. The family cry.
This machine goes up, increases the chances of saving lives, but it’s not 100%.
Plus, the machine is expensive, and if you’re going to be treated for a week, it’s going to cost 15-20 million. The health insurance covers the portion, but the big guy does it himself.
This is a huge sum for any family.
But at this point, don’t say it’s huge. Even in astronomical figures, the patient’s wife can’t afford it. How much more! Let’s get people back.
Ma has repeatedly stressed to her that the use of artificial heart and lung machines has only increased the success rate of rescue, not that it is certain that the death will come back to life.
The patient’s family is crying, understand? I’m grateful to the doctor. I’m sorry.
Ma got the answers she wanted and immediately assembled her men and asked the nurse to prepare the ECMO pipeline.
The principles of ECMO are not complex. First, the patient is given a catheter for a large vein piercing, where the blood is drawn out of the vein, passing through the oxidizer, inhalation of oxygen, release of carbon dioxide, and a complete simulation of the human lung function. When the blood is transferred back to the patient, the patient gets enough oxygen.
ECMO has two common ways: V-V ECMO, V-A ECMO. V-V ECMO is the blood that comes out of the veins, then back from the veins, without the heart, so there’s no obvious pressure relief, protective effect on the heart, in short, the artificial lung.
The V-A ECMO, which refers to blood from the veins and then back from the artery, is very helpful to the heart, which reduces the heart, so this is an artificial CPR, which replaces both the lungs and the heart.
For the patient in front of us, there’s room tremors and heart failure. It’s not appropriate to just do V-V ECMO.
The EMS ECMO team quickly arrived and took almost 30 minutes to finally get this ECMO machine operational.
In this 30-minute period, CPR has to continue and cannot be interrupted. This is a big challenge for doctors and nurses.
Those who have been pressured outside the chest are aware that the whole body is shaking when the patient is pressed, which certainly makes it more difficult to get into the veins.
It’s hard to get on the plane. The horse’s relieved and his back ache.
Dr. Pepe’s first meeting with the ECMO scene was a shock.
Because when the ECMO started to move, the flow of oxygen-filled, red-tired artery blood went back to the patient, and the saturation of blood finally slowed to 100%.
The old horse called Dr. ICTU down for a consultation, and that’s the only way to go to ICT.
The patient eventually moved to ICU.
Before leaving, the horse pointed at the patient and said, “There’s this ECMO in, even if the patient’s heart doesn’t beat, he’ll survive, even if he talks, and that’s where the A.C.B. is shocking.
The patient’s life has stabilized. It’s just for a while. Because now all the indicators are based on respirators, ECMOs, and if they are removed, the patient will be able to get back to his original form.
The patient is a drug and alcohol poisoning, and the next key is blood purification, blood flow, and cleaning up all the toxins in the blood. Otherwise, the ECMO would be just a temporary stabilization, as much as it would have been if the ECMO had not been removed in a week.
You can’t keep bringing an ECMO, right, for days, weeks, even months, but what’s the point?
So, cleaning the toxin is the top priority!
Fucking gin! What the hell is this? It’s terrible that Ma hasn’t seen so much wine in 20 years of medical practice, that she reacts in a few minutes, and her heart stops.
Later, it was analysed that alcohol would have contributed to the absorption of toxins, that patients had gone all the way to the emergency room, and that they had contributed further to the absorption of toxins.
The principles of blood purification are not complicated, either.
It’s just that ECMO replaces lung, heart function, and blood purification replaces kidney function.
It is also a needle in the patient ‘ s main vein, a catheter enters, pulls the vein out, passes through an in vitro blood purification machine, which simulates the kidney function and can also use different filters for the purpose of cleaning up the blood toxin, cleaning up the clean blood and re-transmitting it back to the patient.
The patient was lying in an ICU bed, full of large and small pipes, stomach tube, gas tube intubation, urine tube, ECMO pipe, blood-purification pipe road, veins for intravenous refilling, and all sorts of things that looked terrible.
But it’s these horrible channels that help the patients step by step.
Stay in ICU for the third day, the patient is awake.
Everyone is so happy.
The patient was at last sobered by repeated room tremors, cardiac arrest, unswerving pressure on the chest, catheters to respirator, timely use of ECMO, subsequent blood purification treatment, etc.
It’s a miracle.
The doctor also found out what the patients were drinking.
After chemical analysis, the herbals contain sauerkraut, highly toxic, ooze and grasshoppers that have the effect of active haematosis, hysterectomy, defunct and cold pain relief, which is often used by the population to make wine, treat joint pain, rheumatism, etc., but if the gun is not properly made, overdose can lead to poisoning or even death.
According to data, urin alkali can be poisoned by an oral dose of 0.2 mg, resulting in 3-5 mg death. The clinical symptoms of intoxication can occur in a few minutes after the drug is administered, and are manifested in arrhythmia caused by locomotion of nerves, as well as numbing of the tongue and limbs due to neurotoxicity in the surrounding area.
The most common causes of death from luminous alkali poisoning are indoor conductive retardation caused by cardiac toxicity, multi-source indoor cardiac hyperactivity, room tremors, cysts, etc.
More crucial is the synergy between urin and high alcohol concentrations, which exacerbates the occurrence of heart disorders.
The key to the treatment of urin poisoning is its removal.
The key to this patient’s success is that the ECMO stabilized his life and bought follow-up rescue time. The essence of the rescue is that blood purification treatment removes the toxin.
In the fifth day of ICU, the patient had successfully evacuated the ECMO and the respirator, and the blood purification machine was removed and transferred to the normal ward.
This is a real escape.
I would like to advise you not to drink alcohol from an unknown source or composition.
Even if the ingredients are clear, if the herbs are not fabricated in a rational way, they may be toxic, or they may lead to poisoning if they are slightly careless.
Cope mini-class: What are the possibilities for heart failure?
What should ordinary people do when their hearts stop?
The first thing we have to do is to judge if the man is awake. If you’re awake, it’s definitely not a cardiac arrest. If the patient is not awake, be careful. Of course, if you’re not awake, you don’t have to have a heart attack or just a coma.
At this point in time, the heart beats and breathes can be further assessed, and we can use our hands to touch the patient ‘ s carotid pulse and listen to the patient ‘ s breathing with our ears. If we can still feel the pulse and hear the breath, the patient ‘ s heart is still beating, we do not need CPR. We help fight 120 just fine.
But if the patient’s carotid pulse is gone and his breath is gone, his heart is stopped, and the patient is not just unconscious, he has a cardiac arrest. Except to call immediately 120. There is also an immediate need for CPR.
Only timely and effective CPR can patients have a chance of survival. Cardiopulmonary resuscitation typically includes ecstasy pressure and artificial respiration, but for the general population it is not necessarily daring or able to perform artificial respiration, but ecstasy pressure is possible. So now the guide recommends that ordinary people, when they encounter a patient with a cardiac arrest, all we have to do is press out of the chest immediately.
The movement of blood in the body, through constant chest out-pressures, to the purpose of crushing the heart, while far less than normal heartbeat activity, is better than if there is a single piece of blood that can be squeezed into the brain, maintains the basic function of the brain, minimizes brain damage and buys time for subsequent rescues. That’s what CPR means.
Is it a cure? In most cases, problems arise.
First of all, let’s be clear: the equation is not the same as Chinese medicine. Many of the sides are mixed up, and the pot cannot be carried by Chinese doctors. In addition, many people who come out of the square do not know the medicine themselves. He only has one, and many people can’t tell about the functions and side effects of the drugs. We don’t want to use this side. It may be true that a certain disease has been cured with a partiality, but I believe that most people with a partiality are ill-treated and may cause many problems.
We have to be scientific about disease. Even with Chinese medicine, it is justified and not unauthorized. It is entirely avoidable that this patient has urin poisoning. It’s supposed to be painted, with a much smaller side effect, but if it’s a suit, it’s really dangerous. Even for external use, there are side effects, and if they are large, they can be poisoned. So we have to be careful with the other side.
Is ECMO a life-saving device? Is it really that high?
As a result of the outbreak, a lot of ordinary people learned about the ECMO and the artificial lung was a lifesaver. But what we need to know is that the ECMO is a temporary replacement for the heart, the lungs, and it does not cure the heart and the lungs of the patient. Some serious CPR diseases that could be reversed, ECMOs would be very helpful, such as the outbreak of myocarditis, viral pneumonia, etc. But if it’s a terminal disease, or a disease that can’t be reversed, the ECMO can’t help but think that it can come back to life.
The ECMO used to be very expensive, about 60,000, mostly for materials. After that, about 20,000 a day. Many hospitals now have ECMOs that are partially reimbursable, with different regional policies, but in general, the burden on patients is lighter. If the condition is changed and the financial situation allows, it will also be of great help to the patient. Record number: YX11dP3bNDr
I don’t know.
Keep your eyes on the road.
