Hang a gleam of acute heart stem patients in the face of the life

Hang a gleam of acute heart stem patients in the face of the life
Hang a gleam of acute heart stem patients in the face of the life
Time: At 30 past 8 on June 3, 2011, the place: Doctor and nurses that the emergency department of Pok Oi Hospital of Beijing of China Rehabilitation Research Center welcomes a new one day are after handing over to the next shift early, leave all patient routine of the view room and make the rounds of the wards and make an inspection tour to the emergency department as usual. It is in perfect order to leave in the view room, walk in suddenly noticing to the cotton honour doctor 6 beds of a man patient's facial expressions of middle age was very painful ahead, the right hand presses the chest before the left, breathe and slightly show rapidly. Go to the doctor the sick bed at once, inquire this man patient gently: "How uncomfortable do you think? " "I am uncomfortable in chest. " The patient answers in a low voice. The wife of patient standing aside adds in a hurry too: "Because he felt that had a stomach upset, I accompanied him to come to the hospital to see the doctor, thought that if there is not major issue, to come back in the unit as soon as possible to go to work, a pile of things are still waiting for him. That is to say he felt uncomfortable in chest again just now, felt worse and worse at this time. " The experienced one is on the doctor will be getting alert at once: This will be probably a cardiac muscle ischemic acute coronary artery syndrome patient. "Check the electrocardiogram at once! " Assign the doctor's order to the nurse immediately the doctor. It is only 20 seconds since from beginning to end, a clear electrocardiogram has been printed out: Lead II unite,III be united to be led and aVF be united to be led (at electrocardiogram routine inspection if you can't lead, unite to several pieces,can reveal by heart situations ischemic of laying wall) Section ST is obviously raised, patient of this suggestion presents acutely and plays myocardium infarction of the wall! "The bed mustn't be changed, transfer the patient to rescuing the room at once! " Less than one minute, organize medical personnel push together with sick bed patient to, rescue room rapidly leaving the intersection of view and room on doctor, and report to head of the department Wang Zhi immediately. Director Wang Zhi hearing the news to come commands at the scene calmly and calmly rescuing. "It is guarded, observe blood pressure, heart rate, rhythm of the heart, blood and oxygen saturation lever and consciousness to change tightly that multi-functional! " "Oxygen intake of the high flow! " "Set up two intravenous passways! " "Collect myocardium enzyme, the intersection of heart and the intersection of stem and three unite, the intersection of emergency call and biochemistry, the intersection of heart and the intersection of sodium and plain, the intersection of blood and regular sample! " "Do the electrocardiogram once again! " "it if you can't have no enough time relative already, let row by price first to pay dues,it go emergency call dispensary to borrow and like first coherent to set up two pieces at once (import abroad dissolve by bolt medicine) ,Push into 15 ml of veins within two minutes immediately! Other 85 ml is a bit quieter according to speed of a milligram of one minute! " During less than one minute, director Wang Zhi assigned a lot of urgent orders resolutely. Rescue, is pushed into launching a patient and rescues the room and still less than two minutes intensely step by step without any confusion, the unexpected cramp of limbs, lockjaw, breathe and slow down, face lip cyanosis, four limbs are ice-cold, then consciousness is unclear, blood pressure drops to the mercury column of 78/45 millimetres, heart rate is only about 40 times every minute. It is in more short to rescue the air in the room. The medical personnel present is clear in the heart, this kind of symptom is because the cardiac muscle shrank the unable, whole body blood circulation obstacle to erupt source shock of heart simultaneously, it is the acute ischemic typical clinical manifestation that causes the serious arrhythmia to cause of cardiac muscle. "And then check the electrocardiogram! " Director Wang Zhi orders again. The wave form of the electrocardiogram really verifies: Patient's condition worsens further, the range of acute myocardium infarction has already not merely played the wall, the wall, and had right ventricles before but it is extensive to expand to rapidly! "Blood pressure has dropped to the mercury column of 60/35 millimetres! " " degree of saturation of oxygen has 67% only " "The heart rate is less than for 40 times every minute! " ,"Patient's clothes have all already been drenched by the sweat, consciousness is still unclear. " The nurse guarding patient's condition closely is reporting to director Wang Zhi constantly. The patient's every point slight change is seizing the heart of the medical personnel present closely. "The trachea intubate immediately, connection breathing machine! " "Step up with heavy dose of dopamine, until 10 original speed of liquid pump into per hour! " " continue using and dissolving bolt medicine, don't stop! " " . . . . . . " Director Wang Zhi makes a series of order resolutely. Because this patient lockjaws, the trachea intubate is very difficult, but under the cooperation of the doctor of department of anesthesia with consummate technology, have finished quickly, and connect to the breathing machine and go on and assist and breathe for the patient smoothly; Step up medicine, dissolve the intersection of bolt and medicine, according to the intersection of person who stipulate speed, one one and blood circulation to enter patient . Though first aid measure base that can make that should do make rescue, however, at 51 past 8, the heartbeat took place and stop suddenly to the patient! The attentive electricity guards and demonstrates a long electrocardiogram straight line making the person anxious on the appearance! "Can not hear the heart sound! " "The arterial carotis beats and can not fumble! " "Dual side pupils break up largely, left diameter is 4 millimetres, 3 millimetres of right side, to mere areflexia! " The doctor reports to director Wang Zhi urgently. Patient's life hangs a gleam of! It is more deep to rescue the atmosphere in the room. "The heart is pressed outside the chest immediately! Every minute can't be less than to press the number of times for 100 times! It can't be less than 5 centimetres to press the depth! " Director Wang Zhi sends out the instruction with firm tone. Doctor and nurse present pitch into the work by turns, spare no effort to press outside the chest for the patient, everybody oozes all over beads of sweet on the forehead. Director Wang Zhi more than 50 years old ignores everybody's dissuasion, the heart is pressed with taking turns to implement with everybody outside the chest for the patient constantly too. Training that everybody has participated in 2010 and revised " guide of recovering of the international heart and lungs " made newly, operation regulation, movement standard, conscientious and meticulous. Time is passing second by second, but the patient has no sign of any recovery. Director Wang Zhi is a whiff of strength of everybody constantly: "Park patient suddenly to the heartbeat, nothing give him chest to press, come, guarantee important blood flow of organ to be more important than us! Don't cut off to press, must insist on, only insist that hopeful to bring him back to life! " More than half an hour passed by, the breathing machine is working ceaselessly, the electricity of heart is being guarded on the appearance different figures and figures are being varied in frequent bouncing. The heart is pressed and still gone on unremittingly outside the chest. Suddenly, the electricity of heart guarded the appearance, beat independently after presenting the heart, but irregular wave form. "It is quiver to appear in the room! " Everybody nearly calls out simultaneously. Because it is quiver to appear in the room, for a patient whose heart stops suddenly, the hope of the ones that bring the life. "Defibrillate at once! " Under director Wang Zhi's conductor, head nurse Wang ShuHua opened the defibrillating device quickly, having defibrillated for patient's heart, enormous electric current energy makes the patient quiver all over, but the patient did not resume heart rate of sinus nature at once ' Normal heart rate) . "Defibrillate again, use 200 joule(J)s this time, strengthen energy! " After defibrillating for the second time, the electricity of heart guarded the appearance to reveal the law that rhythm of the heart is more obvious than the front, but fight and short the burst of speed of room early ' Unusual rhythm of the heart) Still more. Everybody does not dare to slack off and careless at all. At 26 past 9, the electricity of heart guards and presents the quiver wave form of the room again. Director Wang analyzes calmly: The distance has dissolved the bolt for already nearly one hour now, the room is quiver to probably pour into the arrhythmia again this time! Patient stem area so old heart have, blood vessel that part stop up dissolve coherent, myocardium the intersection of necrosis and material enter blood very easy kindling room quiver. She points out resolutely: "Must defibrillate again! " Defibrillate for the third time. With king pure head nurse Hua's electrode board held tight in both hands from the moment that the patient lifts outside chest, the heart gives instructions by telegraph the wave demonstrates the sinus heart rate of the law that everybody looked forward to immediately. Check patient dual the intersection of side and eyes and then, come loose loud pupil begin the retraction, light reflex appears; Blood pressure rebounds little by little gradually too; Mind is clear more and more, can answer the medical personnel's call or simple question through blinking or nodding gradually. Through the unremitting rescue of an hour and 40 minutes, this Mr. Liu's heart resumed for the stable normal sinus rhythm of the heart at last, heart rate drop to every 90~100 time about minute too, because acute myocardium a plurality of infarction lead, unite getting hunchbacked section ST (the abnormal electric figure of heart) that raise Fall after rise notably. It is successful to rescue! The medical personnel will order and hang a gleam of Mr. Lius to retrieve finally in unremitting efforts! Gathering around and rescuing outdoor patient relatives and expressing hearty thanks to medical personnel excitedly, the medical personnel clap the hands to celebrate too, feel a sincere one is happy and gratified for this successful rescue. Head of the department Wang Zhi of the emergency call says with deep feeling: "We mainly have four respects to rescue the reason to succeed this time: First, insist and carry on the heart is pressed outside the lasting chest of high quality for the patient; Second, carry on essential defibrillating; Third, adopt the early, sufficient heart stem to dissolve the bolt medicine to make the serious cardiac muscle which is short of blood must use the blood and pour into again. And the more important one is that the life is higher than it, responsibility is heavy on the mountain. People, emergency call of we, cherish all the time " Heal the wounded, rescue the dying, a patient is the highest " Faith, it can light the flame of the life, let the life radiate the unusual and different splendor! " (Document and photography are old and inferior and big Wang Fang)


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