Chapter 479: Fulminant Myocarditis
Remember [New] in one second! The upstairs Zhou Bin mentioned is the general ward of the cardiology department, from the first ward to the eighth ward.
Once the patient in the general ward is in critical condition or suddenly worsens, he will usually be transferred to the ccu ward for more detailed and professional rescue.
Because many rescue equipment are not equipped in the general ward, such as invasive ventilators, iabp machines, ecmo machines, etc.
"I just received a call from the second ward of the cardiology department. There is a little girl who was just admitted to the hospital today and suddenly had difficulty breathing..."
Zhou Bin explained the cause of the disease to Lu Chen while walking quickly to the door of the ccu.
"Little girl with difficulty breathing? Come to the cardiology department?" Lu Chen followed closely.
The two opened the door of the ccu in advance and waited for the patient to arrive.
...
The two did not wait too long. About half a minute later, a hurried voice attracted Lu Chen's attention.
In his sight, four doctors pushed the ward and rushed to the door of the ccu ward.
Lu Chen was somewhat familiar with this scene, which was very similar to the rescue of the pulmonary hypertension patient yesterday.
Yes, there was no doctor performing cardiopulmonary resuscitation on the bed today.
Lu Chen looked at the patient on the bed.
This was a very young girl, probably only eighteen years old.
The head of the bed had been raised high.
The girl leaned on the bed, panting constantly, her lips were cyanotic, and her eyes were very blurred.
And her life value was only 32 (---)!
The trend of the change in life value was three minus signs!
"Quick, push it to the rescue room!" Zhou Bin shouted to everyone, "Grab 8!"
(Grab 8: The 8th rescue room)
In the A area of the CCU ward, there was only the last rescue room No. 8.
When the doctor accompanying the ward heard Zhou Bin's words, he immediately pushed the bed to the rescue room No. 8.
"Brother Hua, what is the specific situation of the patient?" Zhou Bin asked immediately.
The accompanying doctor in charge was an old acquaintance of Lu Chen, Li Qinghua.
He said in a deep voice: "The patient was originally admitted to the respiratory department for pneumonia, but a routine electrocardiogram was done upon admission, which showed frequent premature ventricular contractions and short bursts of ventricular tachycardia. The patient had chest pain symptoms, and her kinase indicators were elevated. Considering the possibility of myocarditis, she was transferred to our cardiology area 2."
"Less than half an hour after the transfer, the patient suddenly had difficulty breathing, which gradually worsened, and her blood pressure dropped to only 80/50mmhg, and her blood oxygen dropped to around 90%..."
After hearing all the descriptions, Lu Chen popped up five big words in his mind: "Fulminant myocarditis!"
Fulminant myocarditis, with an acute onset and a very high mortality rate!
...
However, at this time, there was no time for everyone to think too much.
All the idle medical staff in the CCU came to the rescue room.
Zhou Bin was still the commander-in-chief of the rescue.
"Push the ventilator over here, open three intravenous channels first!"
"Full-speed fluid infusion!"
"Brother Hui, help me place a central venous catheter!"
"The nurse will check a set of blood, take blood gas, and then insert a urinary catheter."
At this time, Lu Chen was already familiar with the rescue rhythm of the CCU. As a student, what he could do at present, or what Zhou Bin asked him to do, was extremely limited, that is, to do an electrocardiogram and measure blood pressure.
His movements were very quick, and he immediately pushed the electrocardiogram machine over.
"Teacher Zhou, the patient's blood pressure is 75/62mmHg, and both sides are similar. The electrocardiogram shows short bursts of ventricular tachycardia, and there are changes in ST-T."
Zhou Bin took a quick look at the electrocardiogram, then nodded and continued to direct the operation on the field.
Suddenly, the electrocardiogram monitor in the rescue room sounded an alarm.
"The patient is in ventricular fibrillation!" Li Qinghua exclaimed.
At this time, the patient stared to the right front with both eyes, spitting white foam from the corners of his mouth, and the whole person completely lost consciousness.
Li Qinghua rushed to the front, immediately jumped on the bed, and performed chest compressions on the patient.
"Quick, intubate!" Zhou Bin quickly got all the tools for intubation.
Lu Chen assisted Zhou Bin on the side.
Whatever tools Zhou Bin needed, Lu Chen could quickly hand them over.
In less than thirty seconds, the patient had been successfully intubated.
"Teacher Li, the defibrillator is here!"
After intubation, Lu Chen pushed the defibrillator over and adjusted it to the defibrillation mode.
Seeing this, Li Qinghua nodded slightly, "Watch my movements, after I withdraw, you immediately go up!"
"Got it!" Lu Chen said.
...
Li Qinghua took a step back, and Lu Chen took the defibrillator and immediately stepped forward.
Charging!
Discharging!
Beep beep beep...
On the ECG monitor, ventricular fibrillation is still there!
Lu Chen made way, and Li Qinghua continued to perform chest compressions.
"Prepare for the second defibrillation later!"
Li Qinghua pressed a few more cycles, and Lu Chen performed defibrillation again!
The second defibrillation.
When the charging and discharging were finished, the patient's ventricular fibrillation waveform had not disappeared for a second, but it reappeared!
Lu Chen's heart was already in his throat.
Everyone also stared at the ECG monitor closely, wishing they could personally knock out the ventricular fibrillation waveform.
…
The beeping sound on the ECG monitor at the bedside struck everyone's heart.
The third defibrillation!
Charging!
Discharging!
Lu Chen stared at the monitor, and when the chaotic ventricular fibrillation waveform suddenly disappeared and turned into a normal sinus heart rate, the big stone in his heart finally fell.
"Defibrillation is successful!"
On the monitor, the patient's ventricular fibrillation waveform finally disappeared completely and turned into sinus rhythm, which represents "hope".
This also means that the patient's heart has resumed beating.
However, the trend of the patient's life value change is still three minus signs!
...
At this time, Zhou Bin asked the nurse to push the ultrasound machine, and she quickly performed an emergency bedside ultrasound on the patient.
Through the screen of the ultrasound machine, Lu Chen saw that the patient's entire heart was almost "peristaltic"!
A normal heart is a strong contraction, but hers is like an old man, unable to move.
"The left ventricular end-diastolic diameter is 40mm, the left atrium, right ventricle, and right atrium are not large, the left ventricular wall motion is weakened, the segmental motion is abnormal, the EF value is about 30%, the left ventricular posterior wall is 12mm, and the pulmonary artery pressure is normal!"
There is no doubt that the patient's heart ultrasound was printed with the diagnosis of "fulminant myocarditis".
Although the rescue is over, for patients with fulminant myocarditis, the danger has just begun!
When new myocarditis breaks out, there will be waves of inflammatory factor "storms".
During this period, the fragile heart of the human body will be hit again and again.
As long as the patient cannot withstand any blow, he will not survive!
…
In the rescue room, there was no joy on the faces of the doctors after the successful rescue.
This rescue also alarmed Director Cao Zhiying.
He has already rushed to the rescue room.
Cao Zhiying looked around at everyone and said in a deep voice: "Prepare to communicate with the patient's family and use ECMO."
Li Qinghua and Zhou Bin both nodded and echoed: "It is necessary to use ECMO. If this patient does not use ECMO, the chance of survival is not high."