Chapter 702 S1Q3T3
When others hear the patients' descriptions like this, they will at best think they are pitiful because so many people died.
But that’s not what a clinician thinks when he hears such words.
Wu Si happened to come out and heard the description of the family members.
Lu Chen turned around and asked Wu Si, "Have you had a chest CT scan?"
Of course Wu Si knew what Lu Chen meant. Lu Chen suspected that the patient might have lung cancer.
The patient's brothers both have cancer, which is a very prominent family history. A normal doctor would consider whether the patient may have lung cancer.
If the patient's lung cancer is severe, blocks the bronchus, or seriously affects the lung tissue, it may lead to hypoxia.
"I just asked the patient's family. The patient had a physical examination half a month ago and there was a CT film." Wu Si said, "I didn't see the film. There was only a report. The report did not say that there was lung cancer."
Wu Si's meaning is obvious, the patient does not have lung cancer.
If I didn’t see lung cancer half a month ago, it couldn’t be lung cancer now.
Lung cancer does not grow out in ten days or half a month and has such a huge impact.
"Most of them are still pneumonia. Only pneumonia can develop so fast." Wu Si said in a deep voice.
Lu Chen nodded slightly, temporarily agreeing with Lao Ma's judgment.
The patient's health value is 48(---).
There is no special situation that can be seen at present.
"Let's go into the ICU first." The ICU doctor said, "I'll go back and prepare first."
"Okay." Wu Si nodded.
…
However, just when the patient was about to be transferred to the ICU, his condition suddenly changed.
This is beyond everyone’s expectation!
The patient had just been pushed out of the emergency department door, and his chest tightness worsened!
The nurse rushed out and said: "The patient's heart rate is very fast, 130 beats/min, and his breathing is even faster."
Wu Si immediately shouted: "Push back to the emergency room first!"
At this time, the patient was sweating profusely and panting, and his fear could be seen in his eyes.
He told the nurse next to him intermittently, "Hurry, increase the oxygen for me, it's uncomfortable."
The blood oxygen saturation dropped to 88%.
"Okay, don't talk too much and just have a good rest!" the nurse said quickly.
On the side, Lu Chen didn't have time to leave.
"This is not a good thing." Lu Chen frowned, "The patient can't wait to be admitted to the ICU. He needs to be intubated and put on a ventilator here."
Lu Chen immediately used a stethoscope to listen to the patient's lungs.
The breath sounds in both lungs are whirring, symmetrical, not pneumothorax!
Patients with sudden worsening of hypoxia must be alert to the possibility of spontaneous pneumothorax. If a pneumothorax occurs on one side, that is, if the lung is ruptured, the breath sounds on that side of the chest will be very low or even inaudible.
If you hear symmetrical breath sounds on both sides, it is basically not a pneumothorax. This auscultation is very critical.
At this time, Wu Si also had an extra thought and asked Lu Chen, "Mr. Lu, is there a heart problem? If the patient is severely hypoxic, it may induce myocardial infarction. If it is myocardial infarction... "
Lu Chen frowned deeply.
He did not deny Wu Si's idea, "Then let's review the electrocardiogram."
Upon hearing this, Wu Si immediately asked the doctor next to him to help perform an electrocardiogram on the patient. At the same time, he increased the oxygen concentration and asked the nurse to prepare for tracheal intubation.
Another nurse also pushed the ventilator over.
…
When the patient came to the emergency department, an electrocardiogram had been done and no obvious abnormalities were seen.
Troponin and cardiac enzymes were also checked, and they were all normal.
Previous evidence does not support acute myocardial infarction.
But it’s really hard to say whether there will be a sudden myocardial infarction.
The EKG results came out quickly.
Lu Chen immediately took a look at the electrocardiogram and saw no obvious signs of myocardial infarction.
No elevation or depression of the leads was seen.
Wu Si also leaned his head over, "It seems that the patient did not have a heart attack..."
"Did his condition suddenly worsen?" Lu Chen murmured.
Just now, the patient's health value was declining at a faster rate!
If a patient with severe pneumonia suddenly develops severe shortness of breath, and common diseases such as myocardial infarction and pneumothorax have been ruled out, then the only explanation is that the condition has worsened.
For example, the patient may turn over or develop arrhythmia, which will cause the heart rate to be so fast and the hypoxia to be more severe.
"Then let's intubate. I'll talk to the family. It's safe to intubate here first, and then go to the ICU." Wu Si looked at Lu Chen aside, wanting to ask his opinion.
"Wait!" Lu Chen waved his hand and stopped Wu Si.
He frowned slightly and took back the electrocardiogram to look at it again.
He always felt like something was wrong, a patient with sudden difficulty breathing.
Did you overlook something?
It wasn't until Lu Chen looked at the electrocardiogram he had just done that he suddenly had an enlightenment!
"what's the situation?"
Wu Si saw a change in Lu Chen's expression, probably because he had made some new discovery.
When Lu Chen heard this, he immediately handed the electrocardiogram to Wu Si.
"Look at the patient's s wave in lead i, as well as q wave and t wave in lead iii. The electrical axis is deviated to the right. Does it look familiar..."
Wu Si was confused and just stared at the myocardial infarction information on the patient's electrocardiogram.
Anyway, he didn't see the myocardial infarction graphic, so he was relieved.
But now Lu Chen obviously made other discoveries, so he looked at it so carefully.
…
Wu Si took the electrocardiogram and followed Lu Chen's prompts to carefully identify the electrocardiogram again.
"Ah, s1q3t3? Could the patient have pulmonary embolism?!"
s1q3t3, and right axis deviation, the most typical electrocardiogram pattern of pulmonary embolism patients!
Wu Si was terrified when he thought of pulmonary embolism.
Half a year ago, a patient with pulmonary embolism died right under his nose.
"Yes, this is pulmonary embolism!" Lu Chen said in a deep voice.
In fact, pulmonary embolism is easy to understand.
If a thrombus forms in the human venous system and the thrombus falls off, it will flow into the pulmonary artery with the venous blood flow.
If the thrombus is stuck in the pulmonary artery, the blood cannot pass through, and the blood cannot reach the lungs, and there is no way to get oxygen.
Without oxygen supply, people may be suffocated to death!
Severe pulmonary embolism will kill instantly!
"Oh my god, we can't delay this moment!"
Wu Si was shocked.
Although pulmonary embolism is highly suspected at present, it is still difficult to diagnose pulmonary embolism with an electrocardiogram, and the electrocardiogram can only provide a rough idea.
To truly confirm pulmonary embolism, CT pulmonary angiography must be completed.
Therefore, Wu Si has already rushed out to find the family members to sign, and suggested that the family members agree to CT pulmonary angiography.
…
Outside the emergency ward. UU Reading www.uukanshu.net
Wu Si stared at the patient's eldest daughter, "The patient's condition is now more serious, and it is suspected that there is a possibility of sudden pulmonary embolism. This examination must be done."
"Do it now?" The eldest daughter was confused.
"Yes! If you don't do it, you will die. If you do it, you may not be able to save it, but at least there is a direction for treatment, and if the rescue is timely, there is still a chance."
At the critical moment, Wu Si's words were clear.
The patient's daughter was very scared. They just glanced at the patient's condition outside and roughly knew what was going on.
"Do it, do everything that helps!"
－－－－－－Digression－－－－－－
Tomorrow I will start work, tomorrow night shift
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