Chapter 258 Pulmonary Embolism?

At this moment, the patient's eyes suddenly rolled and he fainted.

Everyone present was nervous.

If the tracheal tube was not inserted into the patient's trachea within a minute and the ventilator was connected, the patient's heart might soon stop beating due to lack of oxygen.

However, Lu Chen did not disappoint everyone. With a few quick movements, he successfully inserted the tracheal tube into the patient's trachea from the mouth.

Seeing this, the two nurses immediately came over to connect the ventilator.

Lu Chen also quickly adjusted the parameters of the ventilator.

With a puff, the ventilator began to pump air for the patient.

"Give pure oxygen first." Lu Chen said after wiping the sweat off his face.

Unconsciously, his back was already wet.

"Where are the patient's family members?"

Yin Xinhua asked the nurse on duty beside him in a deep voice.

"I have contacted the family members and they are on the way." A nurse on duty said.

"Immediately report to the medical department." Yin Xinhua said seriously, "At the same time, please consult with the ICU and respiratory department."

"Okay, I'll make a call."

Fan Zhiping nodded and immediately walked towards the nurse station.

On the line between life and death, without family members accompanying, it is very easy to cause disputes.

This type of patient is extremely special, and the medical department must be notified to help them deal with this.

...

On a ventilator.

The patient is still in a coma and breathing is still very rapid, but it is slightly better than before.

The blood oxygen saturation has increased from the lowest 70% to 92%. No matter how the parameters are adjusted, the blood oxygen saturation cannot be raised.

"The blood oxygen saturation cannot be raised, there must be a problem!" Yin Xinhua said in a deep voice.

The normal blood oxygen saturation is 100%, and the blood oxygen saturation of patients with severe pneumonia will definitely decrease.

But if the ventilator is connected to pure oxygen, it can also quickly improve. For example, this patient has maintained a blood oxygen saturation of 92%...

Lu Chen thought of a possibility, that is, pulmonary embolism!

He rechecked the patient's electrocardiogram.

This time the electrocardiogram yielded unexpected results.

The electrocardiogram showed a relatively typical high right heart pressure load, with deepening of lead I, Q/Q waves in lead III, and T waves.

Once professional respiratory and cardiologists see this electrocardiogram, they will know that this may be pulmonary embolism.

When the pulmonary artery is blocked by an embolus, the pressure of the entire pulmonary artery will increase, which will then cause the right heart pressure to increase, and the electrocardiogram will show some results.

Yin Xinhua smiled bitterly and said, "Junior brother, this should be a pulmonary embolism, we have won the first prize. But now we definitely dare not push it out to do pulmonary artery CTA to confirm the diagnosis, we can only wait, let's find the respiratory department and ICU doctors first, and discuss it with everyone. We are responsible for stabilizing the vital signs first."

The most important thing is that the patient's family has not come yet.

Any subsequent operations require the consent of the patient's family.

In less than five minutes.

The respiratory doctor came.

The patient's medical history was re-analyzed, but the patient was in a coma, so it was difficult to ask about the situation now.

After seeing the patient, the respiratory consultant returned to the doctor's office and said to Yin Xinhua: "From the patient's onset speed, symptoms and electrocardiogram, it is indeed consistent with pulmonary embolism. Shortness of breath, hypoxia, respiratory failure in the short term, no pneumothorax or atelectasis was found. If possible, a pulmonary artery CTA will be seen at a glance. If not, a cardiac color Doppler ultrasound or electrocardiogram can also show some symptoms, especially cardiac color Doppler ultrasound."

The respiratory consultant also agreed with Lu Chen and Yin Xinhua's views.

However, Lu Chen frowned, "Senior sister, I have a question."

Yin Xinhua glanced at Lu Chen, "You say."

"If the patient is considered to have pulmonary embolism, he does not have any high-risk factors for pulmonary embolism!"

According to the patient's previous medical history, he has no history of lower limb surgery, no long-term bed rest, and no congenital factors, such as protein S/protein C deficiency or antiphospholipid syndrome, etc.

How could he have pulmonary embolism for no reason?

This question made Yin Xinhua and the respiratory doctor stunned.

It seems to be the case!

If we only look at the symptoms, it does look like pulmonary embolism.

But it is rare to get pulmonary embolism directly without risk factors!

"There may be other unknown factors." The respiratory doctor frowned and said, "In any case, pulmonary embolism should be considered first."

Let's put the cause aside for now and treat the disease first.

Lu Chen nodded. The first problem now is to solve the cause of the patient's illness.

The doctor from the ICU came soon.

After seeing the patient's condition, he basically agreed with the judgment of Yin Xinhua and the respiratory doctor.

But it is unlikely that the patient needs to do CT in this situation, unless he pushes the ventilator to go there, but the patient's vital signs are still fluctuating. If there is a problem on the bumpy road, it will be a big deal!

"Maybe thrombolysis!"

The discussion results of everyone are consistent, but it is still necessary to further check the color Doppler ultrasound or CT to confirm before using thrombolytic drugs.

If you make a mistake, you may have to bear the consequences.

Although thrombolytic drugs can dissolve blood clots, they may also cause cerebral hemorrhage in minutes, which would be troublesome.

"How about we go to the ICU first and have a clear look at the situation. Then we will use our own cardiac color ultrasound in the ICU to see if we can observe any signs of pulmonary embolism. If it is really a pulmonary embolism, we will consider thrombolysis. If there is If we find anything else, we’ll analyze it first.”

Doctor icu told Yin Xinhua.

What patients need most right now is a ventilator, but if the patient really has a large-scale pulmonary embolism, the ventilator will not be very effective. The reason is simple.

The working principle of the ventilator is to put oxygen into the patient's lungs and force it into the lungs.

But if the patient's pulmonary artery is blocked by an embolus and no blood flows, there will be no way to carry out effective blood oxygen exchange!

Oxygen alone is not enough. Without blood flow, it cannot bring in oxygen and cannot remove carbon dioxide. The patient will still die due to hypoxia and carbon dioxide retention.

Yin Xinhua nodded and agreed with the ICU doctor's opinion, "If pulmonary embolism is diagnosed and the timing is right, and thrombolysis is used to dissolve the embolus and restore the patency of the pulmonary artery, there should still be a chance. After all, the patient is so young."

…

About half an hour later. UU reading www. uukanshu.net

The family members are finally here!

The medical department also came forward to communicate and provide explanations.

However, the patient's family refused to be transferred to the ICU.

The patient's family member is the patient's sister. The patient is not married yet and rents a house in Jinghua. The sister works here and her income is probably not high. The ICU is simply bad news for them.

But the existence of ICU has indeed turned many people's bad news into good luck. This is also what many people look forward to.

The patient was quickly placed in a separate room and equipped with various monitoring equipment.

My blood pressure is low, and I can barely maintain it at hg with the use of active drugs.

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