bookpower Chapter 568
Chapter 568
"Xiaoru, first make him an electrocardiogram."
"Yes, teacher."
Then you get started.
Soon.
The patient's electrocardiogram was sent to Lin Feng.
Took a look for myself.
So he said softly: "There is no problem with the electrocardiogram!" You go and do the check I just said first. By the way, then do a blood routine! "
"Okay, Dr. Lin..."
After the patient left, Lin Feng asked: "Xiaoru, do you know why you want to do an electrocardiogram for him?" "
Xiao Ru thought for a while and said: "Just now the patient said that he had some chest tightness, which may be a heart problem or pneumonia. An electrocardiogram can rule out heart problems. "
Lin Feng nodded with a smile and said: "Not bad, very progressive!" "
"That's a good teacher!" Xiao Ru immediately smiled.
The next patient.
......
An hour later...
The male patient returned to Lin Feng with the checklist.
"Sit!"
Lin Feng greeted simply, took the checklist in the patient's hand, and looked at it one by one.
Blood count: slightly high white blood cell count,
Myocardial enzyme spectrum Cardiac enzyme and troponin are basically normal, and other values are fine.
Cardiac enzymes are used to rule out another disease, myocarditis.
It is very similar to a cold, but much more serious than a cold.
If the white blood cells, cardiac enzymes, and troponin are high, it means that the heart cells are damaged, and if they are normal, myocarditis can be ruled out.
Chest radiograph: suggests a little inflammation in both lungs.
See this!
Lin Feng understood that this was the problem.
Looking at the lesion on the chest radiograph, it is estimated that the patient has pneumonia more than ten days ago, but he has not cared, just as a cold treatment, no antibiotics, so it will lead to this, since this is the case, then directly on antibiotics, levofloxacin!
After hearing this, the man just asked, "Doctor Lin, can I go home?" After the injection, can I go home...."
Hearing this, Lin Feng didn't care, and said: "Under normal circumstances, you can bring medicine home for pneumonia that is not serious, but your body is too weak and your spirit is not good, I think you are not suitable to go home!" After the injection, stay for the night! "
"Understood, Dr. Lin..." the man felt disappointed.
Lin Feng explained to Xiao Ru: "Arrange a nurse, you must keep an eye on it, and you must not let him go!" "
"Got it, teacher!" Xiao Ru immediately smiled.
Get up and leave with the male patient.
Lin Feng smiled.
Three minutes, though.
Xiao Ru hurriedly ran back, and when she saw Lin Feng, she hurriedly said, "Teacher, it's not good!" Something happened to that patient just now! "
Hearsay.
Lin Feng immediately got up and said, "What's wrong!" Take me there! "
"Over here!" Xiao Ru didn't talk nonsense, turned around and opened the forest wind to lead the way.
Walk into the ward.
I saw two nurses gathered around a hospital bed, at a loss.
Lin Feng came to the bed in two or three steps.
I saw that the patient was gasping for breath, but his face was blue, his forehead was sweating, and his eyes had begun to blur!
"Don't be stunned! Give the patient oxygen! "
The nurse ran out quickly and pushed the tracheal tube, ventilator and other equipment from the outside.
A nurse pushed, and the ambulance sped over.
I took out the stethoscope and put it in the patient's chest, but unfortunately the breathing sound was too chaotic, the wheezing was too loud, and it was difficult to hear special changes.
However, the breath sounds of the patient's two lungs are basically symmetrical, indicating that there is no pneumothorax or atelectasis.
"Doctor Lin, ventilator!"
At this time, the patient's lips have begun to turn blue, which is a serious lack of oxygen, and if it does not come up in one breath, I am afraid it will be finished.
There is simply no time for chest x-rays and CT scans.
The most important thing is to stabilize the patient's life first.
Took the endotracheal intubation handed by Xiaoru, and while preparing, he asked the nurse: "What happened to the patient just now, how did the condition become so fast!" "
A nurse said nervously: "Nothing has been done, just lying here!" Xiaoru knows! "
Hearsay.
Lin Feng said to Xiao Ru: "Xiao Ru sent someone to contact the patient's family!" Notify the medical department and ask ICU to come and consult! "
"Yes, teacher!" In response, Xiao Ru hurriedly ran out.
At this moment, another nurse said: "Dr. Lin, the patient is in a coma!" "
Looked at.
Lin Feng immediately came to the bedside,
He has to put the endotracheal tube into the patient's trachea within one minute and connect it to the ventilator, otherwise the patient's heart will soon stop beating due to lack of oxygen!
Without the slightest hesitation!
Take action!
Anaesthesia......
Open the patient's mouth.
The endotracheal intubation runs quickly through the mouth and deep into the trachea.
Two nurses hurriedly came over to connect the trachea to the ventilator, and Lin Feng quickly clicked with one hand to adjust the parameters.
Pure oxygen...
Poof~
The ventilator starts running.
The patient is unconscious and still breathing rapidly, but slightly better than just now.
Heart rate: 150 beats/min
Breathing: 50 times/min
Blood oxygen saturation: 74%
The parameter of blood oxygen saturation kept rising, and finally stopped at 92%.
No matter how Lin Feng adjusted the parameters, the blood oxygen saturation did not increase in the slightest.
That's a problem!
The blood oxygen saturation of normal people is more than 94%, and the blood oxygen saturation of patients with severe pneumonia will decrease, and once connected to the ventilator to give pure oxygen, it will soon recover!
The patient in front of him has remained at 92%, indicating that he is most likely a pulmonary embolism!
To be on the safe side,
Lin Feng listened to the patient's heart and lungs again and found no big problem.
"Teacher! The family has been notified and is on their way. The ICU side has also sent someone over, and the medical department has also been notified! Xiao Ru ran in again.
"Hmm! We hit the jackpot, it should be a pulmonary embolism! Lin Feng said to Xiao Ru.
"Push the electrocardiogram machine over..."
Soon, the electrocardiogram machine was pushed in by the nurse.
Lin Feng began to do an electrocardiogram for this patient.
Sure enough.
This ECG brought unexpected gains.
The ECG showed a relatively typical performance of high right heart pressure load, and the lead deepened, and the Q/q wave appeared in the III lead, and the T wave also caused.
It is obviously a case of pulmonary embolism, when the pulmonary artery is blocked by emboli, the pressure of the entire pulmonary artery will rise, which in turn will passively cause an increase in right heart pressure, and the electrocardiogram will be indicated.
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