bookpower Chapter 270
Chapter 270
"Doctor Lin, you're on the national news again!"
Morning
When Lin Feng just walked into the door of the emergency department, he was greeted by the envious eyes of many medical staff.
“？？"
Lin Feng froze, dazed.
"What do you mean?"
Xiao Ai: "Ah, Dr. Lin, you don't know?"
Others spoke up.
"It was last night, the national TV's "News Network" broadcast your news, saying that there were 9 patients, because of your Weibo reminder, successfully saved the lives of 9 patients..."
"I counted, the length of the news is 25 seconds, it's long..."
"This is Dr. Lin's second time on the national news, right?"
"Dr. Lin is awesome!"
In your words and my words,
Lin Feng finally understood what was going on, it should be his two recent Weibo reminders about "Marnifi blue bacteria", "rabies myasthenia gravis", and "bee stinger allergy", which saved many people.
Click on the work group,
Sure enough, someone inside posted a clipped piece of "News Network" content.
It reads as follows:
• 3 cures of Marnifi blue, 1 misdiagnosis of rabies, 1 rescue of bee stingers... A total of 5 patients and doctors thanked Lin Feng for his words. Gathered together, formed a 25-second news...
Finally, "News Network" also promoted the positive energy: "China's medical level is gradually improving", "a new generation of medical talents is emerging", "the system is superior" and so on...
Lin Feng was happy in his heart.
Unexpectedly, he indirectly saved so many people.
Full of accomplishment!
And at this time,
Below Lin Feng's Weibo,
Fans scattered flowers and cheered.
"Idol awesome!"
"Second time in the news!"
"It's worthy of Lin Shuai!"
"Decided, apply for the doctor's specialty!"
"Don't, persuade people to study medicine, the sky is thunderous, studying medicine is very hard!"
Then began a big discussion of "whether to study medicine", shouting 666~~~ to Lin Feng by the way
......
Next
Lin Feng returned to the consultation room and prepared to start receiving patients.
On the wall, there is an extra pennant.
Pennant +8!
It was sent by the family of the patient with myasthenia gravis when he was discharged from the hospital the day before yesterday.
......
At this point,
3 kilometers away from the hospital, a Cantonese tea restaurant.
64-year-old Zhao has dinner with his 2 old friends.
Because they are all from Lingnan, even if they come to the imperial capital, they still retain the habit of drinking morning tea.
Order a few refreshments, ribs, shrimp dumplings, phoenix claws... Three copies...
Lingnan people drink morning tea, basically order a small portion, and then sit for a morning. Not to eat, but to sigh the world.
Somewhat......
Drink tea......
Chatted for about 30 minutes...
suddenly
Old Man Zhao picked up the teacup that was about to drink tea, suddenly fell from his hand, fell on the tabletop, and wet the tablecloth.
And Old Man Zhao's hands tightly covered his chest.
The expression was painful.
The other friends' faces changed drastically, and they quickly shouted.
"Old Zhao, what's wrong with you?"
"What's going on..."
All at once a mess!
The surrounding guests came over one after another, and the waiters also rushed over...
"It hurts, it hurts in the chest..."
Old Man Zhao felt a sharp pain in his chest as if he had been pricked with needles.
Beads of sweat on his forehead were already coming out.
The friend stabilized his mood at this time.
"Quick, hit 120!"
"Send to the hospital!"
Whoops~~~
At this time, Old Man Zhao suddenly fainted and fell directly to the side.
If it weren't for the old friend seeing the opportunity quickly and holding him, I am afraid that he would have fallen directly to the ground.
"It could be a heart attack..."
"Try it..."
"Pinch people!"
A personal constant suggestion.
The doctor hasn't come yet, so I can only try everything.
The manager of the tea restaurant was sweating.
The scene was chaotic for a while.
10 minutes later...
"Beep Beep ~~~~"
Ambulances from the 120 center arrived.
Carry it to the car.
"Go to Harmony Hospital, recently!"
The doctor accompanying the emergency center shouted.
Then he began to measure his blood pressure and heart rate for Zhao's old man.
Blood pressure is 88/50mmHg, which is lower than normal.
Heart rate is OK, normal range.
The doctor in the car breathed a sigh of relief.
"Do you usually have high blood pressure, coronary heart disease and the like?"
"It doesn't seem to be, Old Zhao is usually in good health and loves sports. "
The old friend said.
"Pull an electrocardiogram..."
Connect...
Soon, the electrocardiogram came out, it was normal, nothing special.
The doctor in the car was confused.
Anyway, go to the hospital first.
"Hmm... Erm..."
At this time, Old Man Zhao woke up slowly.
"Old man, how's it going?" asked the doctor in the car, looking down.
"It hurts, it hurts here..." said Old Man Zhao, pointing to the midline of his chest.
At this point,
Old Man Zhao was already sweating profusely, his breathing was a little affected, and he was a little breathless.
......
soon
The ambulance rushed to the emergency department of Harmony Hospital.
"Doctor, there is an unexplained chest pain here, help see..."
The triage nurse listened,
The possibility of feeling the heart and lungs is very high.
Without saying a word, it was assigned to Lin Feng.
In this regard, Lin Feng's strength is recognized as strong!
Lin Feng quickly walked out and waved his hand to command the nurses and interns:
"Push him to the rescue room..."
Then ask the doctor on board for details.
The doctor who accompanied the car said quickly: "The patient, male, 64 years old, eating breakfast and tea in a restaurant, eating Cantonese breakfast, sudden chest pain, checked blood pressure, low, but still within the controllable range, pulled the electrocardiogram, did not see myocardial infarction and other problems... I gave him a try of nitroglycerin, and now 10 points have passed, there is no effect, it should be able to rule out angina..."
Lin Feng nodded: "Thank you..."
Walk into the rescue room,
The nurses and interns did not need Lin Feng's orders, and began to link various instruments.
ECG monitors, oxygen masks...
ECG monitor display data:
Blood pressure: 87/46mmHg, low, but not critical.
Heart rate: 117 beats/min, ok
Oxygen saturation: 94%, not serious.
Looking at the old man again, his face was pale and his forehead was sweating.
It's a very serious look no matter how you look at it.
Lin Feng: "..........................."
So strange?
Data and performance contradict each other!
However, Lin Feng still did not dare to despise it,
"Angina" is excluded because "nitroglycerin" is ineffective.
Then you can consider "acute myocardial infarction" (foreign body blocking blood vessels, ischemia and lack of oxygen, resulting in myocardial necrosis).
Myocardial infarction manifests as chest pain, wheezing, and then further leading to cerebral ischemia, leading to syncope.
"Give him an electrocardiogram..."
An ECG is more detailed than ECG monitoring with an ECG monitor.
And the electrocardiogram made by the ambulance in front is already too 'old'.
"Yes..."
The nurse quickly connected the patient to the electrocardiograph...
Tick Tick...
Keep printing it out.
Soon, a few pages came out.
Lin Feng looked at the electrocardiogram,
· The ST-T segment is slightly depressed.
• Typical manifestations of myocardial infarction are not seen.
However, it is also possible that it is still in the hyperacute stage, and the electrocardiogram cannot be stopped, and it is necessary to review dynamically.
At this point,
The old man's condition seems to have eased a little.
Lin Feng hurried to start the consultation.
"Old man, I am your attending doctor, let me ask you a few questions..."
"Are you still in pain now?"
"It hurts... (Weak)"
"What's the pain?"
"It's like a needle prick..."
“.................."
Lin Feng was stunned.
Needle prick the same?
This is not a feature of myocardial infarction.
Myocardial infarction, the area of myocardial death is usually one by one, not a point, so the pain is basically a piece of area.
How to describe it?
It seems that there is a stone pressing against the chest ~~
Or stuffy pain or something...
Generally, it does not hurt like a needle prick as this patient said...
"Does it hurt until now?"
"Yes. "
"No relief?"
"No... Doctor, I don't dare to breathe now, it hurts, am I not able to do it?"
The old man asked with trepidation.
The old man, who has always been healthy, loves sports, just retired not long ago, it is a good time to rest and enjoy.
I don't want to die like this.
"Don't worry, when the test comes out, there will be no problem with symptomatic treatment..."
Lin Feng comforted with a smile.
Of course, the actual situation is that the condition is not known, if it is serious, this old man is 64 years old, not young, may really suddenly die.
"What about your son's daughter's phone?"
"On my phone, the number of digits is 2353, the note "neighbor", my son..."
Lin Feng gave a thumbs up.
Awesome!
"Let's draw a few tubes of blood first..."
Lin Feng opened several orders: laboratory myocardial enzymes, troponin, blood routine, liver and kidney function, electrolytes, coagulation indicators, brain natriuretic peptide and so on...
And at this time,
The nurse quickly called the patient's son to rush over.
Because the family may have to sign the "Notice of Critical Illness" later.
Because it was Lin Feng who urged and rushed, the laboratory department quickly tested the old man's blood "cardiac enzymes and troponin".
Outcome:
Cardiac enzymes, troponin, normal.
Coupled with the characteristics of electrocardiogram, "myocardial infarction" can basically be ruled out.
"Do you want to use some painkillers?" asked Wang Zirui, a trainee doctor.
"It can be used, but now the patient's blood pressure is low, which is a critical signal, some analgesics can cause lower blood pressure, and we need to find out the cause of the patient's low blood pressure as soon as possible." Lin Feng said.
The interns suddenly realized.
Learned.
Knowledge +1+1...
Lin Feng frowned and looked at the blood pressure that was lower than normal.
87/46mmHg
↓ Drop to:
82/43mmHg
"If it is not myocardial infarction, then it is necessary to consider "aortic dissection rupture and bleeding", "pulmonary artery embolism" ..."
"Aortic dissection rupture bleeding" (the specific meaning is omitted, it has been written many times) feels unlikely, because its bleeding is relatively fierce, and it is estimated that it has long been shocked.
"Pulmonary artery embolism", blood clots (a blood clot) from all parts of the body along the veins, all the way through the heart, and then to the lungs, and then in the pulmonary artery - pulmonary artery branch (blood vessels become smaller), the thrombus blocks this branch, and finally leads to the ischemia and hypoxia tissue necrosis of this part of the lung area...
These two diseases,
All have chest pain and hypotension.
Now that the maximum possible myocardial infarction has been ruled out, consider both.
"Xiao Ai, call the imaging department, cut in the line, and do a thoracic and abdominal aorta CTA. "
"Yes!"
Lin Feng cut the queue,
There will be no complaints from the imaging department.
Because there are more female doctors in the imaging department, Lin Feng is too handsome, and female doctors can't bear to refuse.
The so-called CTA of the thoracic and abdominal aorta is not ordinary CT, but CT angiography, and it is necessary to inject contrast agent to clearly see whether there is aortic dissection and pulmonary embolism.
......
"Doctor, what's wrong with my dad?"
At this time,
A panicked man in his 30s rushed in outside the door, looking at his father lying on the hospital bed, full of worry and panic.
"Are you the son of an old man?"
"Yes. "
"Go, come out with me. "
Lin Feng took the man and walked out of the consultation room.
"Your father's situation has not yet found out any problems, but it is not ruled out that it will be a more serious illness... Later, you may have to do some examinations, and you have to sign the "Notice of Critical Illness"..."
"Good...... Doctor Lin, I am also from Peng City, I know that your medical skills are very powerful, please save my father..."
The man tightly grasped Lin Feng's hand and begged bitterly.
"I will do my best!"
"Thank you. "
At this time, the man looked regretful, usually busy with work and career, and did not care much about his father.
Now, when I suddenly heard that my father might die, I was anxious and regretted it a lot!
At this time,
Nurse Xiao Ai came over.
"Dr. Lin, the imaging department has been contacted. "
"Okay, let's go!"
A group of people quickly pushed the car and rushed to the imaging department.
......