Chapter 259 I Am a Beginner

Since the patient's family members did not agree to transfer to the ICU, Yin Xinhua decided to do a cardiac ultrasound for the patient first, and then make plans for the next step.

If the patient really has pulmonary embolism, then a cardiac color ultrasound can also find something.

Color ultrasound can find that the patient's right heart pressure has increased, and it may also see that the pulmonary artery pressure has increased. If you are lucky enough or have good skills, you can even see the embolus blocking the pulmonary artery.

If this is true, the diagnosis is set in stone.

However, the emergency cardiac ultrasound at night cannot come immediately, and it will take about 20 minutes.

Like the last night shift, Yin Xinhua called the chief resident of the cardiology department and asked the chief resident to do an ultrasound first. After a preliminary diagnosis, wait for the professional doctor of the ultrasound department.

However, as luck would have it, the chief resident of the cardiology department was helping to rescue patients in the second area of ​​the heart, and could not come immediately.

"Senior sister, how about letting me try this first?"

When Lu Chen appeared in the ward with a portable cardiac ultrasound machine, Yin Xinhua was extremely surprised.

"You can do this?"

Recalling the last night shift, Lu Chen couldn't even read the most basic heart section.

Now, to diagnose pulmonary embolism, you need to see the image of the pulmonary artery, which is more difficult than looking at the heart structure.

"Sister, I just learned it, so I'll give it a try." Lu Chen smiled.

And Fan Zhiping stood beside Lu Chen, and he was very "contemptuous" of Lu Chen's words in his heart.

You just learned it?

You're kidding!

Fan Zhiping remembered that Lu Chen used this portable ultrasound to diagnose myocardial hypertrophy for others some time ago.

Yin Xinhua just thought that Lu Chen was really going to try it, so he nodded in agreement.

Waiting is waiting, so why not let Lu Chen practice.

……

Come to the bedside.

Lu Chen put the ultrasound probe close to the patient's chest wall.

Scanned twice, and then froze.

He frowned: "Sister, look, the patient's right ventricle is really dilated, and the pressure is high!"

Yin Xinhua was stunned, then took a closer look.

The patient's right ventricle seems to have really become larger!

At this time, the probe turned to the section of the pulmonary artery.

Lu Chen did not see the pulmonary artery embolus, but what can be seen is that the pulmonary artery has become thicker!

This ultrasound operation technique is so skillful!

Yin Xinhua looked at Lu Chen in surprise.

This kid, is he playing dumb on the night shift?

Lu Chen did not notice Yin Xinhua's expression. He said slowly: "Senior sister, although I did not see the pulmonary artery embolus, through the increase in right heart pressure and pulmonary artery pressure load, can we indirectly think that the patient still has pulmonary embolism?"

Hearing Lu Chen's words, Yin Xinhua came back to her senses.

"If ultrasound can really see these signs, then pulmonary embolism can indeed be diagnosed."

After saying these words, Yin Xinhua still looked at Lu Chen in disbelief.

This junior brother is too versatile.

Skill operation, electrocardiogram, cardiac ultrasound... all!

The only thing he can't do is that he hasn't published a paper yet.

...

At this time, the chief resident of the Department of Cardiology came to the eighth area of ​​cardiology.

"Teacher Li Qinghua again?" Lu Chen was quite surprised after seeing who was coming.

He felt that Li Qinghua was always the inpatient in the cardiology department.

He could meet him almost every night shift.

Doesn't that mean he was in the hospital every day?

Li Qinghua also noticed Lu Chen.

"Lu Chen, why is it you again?" Li Qinghua looked at Lu Chen in surprise, and then smiled.

This student left a deep impression on him.

He could meet him every night shift.

"Teacher Li, this is fate..." Lu Chen smiled.

Black face, that doesn't exist.

Li Qinghua took the cardiac ultrasound machine and smiled, "Then we are really destined to be together!"

After chatting for a few words, Li Qinghua immediately took the ultrasound machine.

He noticed that there was some coupling agent residue in the patient's heart.

"Have you seen it?"

Lu Chen nodded, "I took a quick look."

"What did you see?" Li Qinghua looked up at Lu Chen beside him. He thought Yin Xinhua had tried to do an ultrasound. "What did you find?"

Lu Chen immediately said, "Right ventricle enlargement and pulmonary artery thickening."

Li Qinghua smiled and did not reply. He concentrated on checking the patient's heart and pulmonary artery.

Although he was not as good as a professional ultrasound doctor, he could still do a rough look.

About five minutes later.

Li Qinghua said slowly, his eyes never leaving the ultrasound screen, "The right ventricle is obviously enlarged, and the pulmonary artery can also be seen to be thickened, but the embolus in the pulmonary artery cannot be seen."

Li Qinghua's ultrasound results were basically consistent with Lu Chen's!

"Thrombolysis should be arranged." Li Qinghua looked up at Lu Chen. This kid has good skills!

Thrombolysis for pulmonary embolism is different from thrombolysis for myocardial infarction.

Although both are blood clots blocking blood vessels, the thrombolytic drugs for myocardial infarction are much more urgent and must be completed within 1-2 hours, otherwise the myocardial cells will all be necrotic, and further thrombolysis may be meaningless.

But pulmonary embolism is different. The lungs have many blood supply channels. If the pulmonary artery is blocked, there are still bronchial arteries supplying blood, so it will not be necrotic so quickly, so thrombolysis of pulmonary embolism can be considered for 14 days.

But for patients like this one, it is so serious that it cannot be delayed.

If the embolus is not melted for a moment, it will always block the pulmonary artery, and the patient will still be extremely hypoxic, which is also very serious.

It is barely maintained now because the ventilator is fully powered. If there is a slight disturbance, it is easy to cause trouble.

"Then dissolve it." Yin Xinhua said. "I will go to communicate with the family members to sign."

This communication is extremely important, Yin Xinhua did not let Lu Chen go.

Because the complications of thrombolysis are very serious, especially cerebral hemorrhage, don't let the embolus not be dissolved, but cause cerebral hemorrhage, then it will be a big loss.

"But in order to see more accurately, let the cardiac ultrasound teacher come over, let them guide and confirm the pulmonary hypertension and whether there is a possibility of thrombus, so that we can feel more at ease." Li Qinghua said.

"Okay." Yin Xinhua nodded, "I will go to urge the ultrasound room, and then communicate with the patient's family."

...

Yin Xinhua left the ward, leaving only Lu Chen, Fan Zhiping and Li Qinghua.

At this time, UU reading wｗw.uukanshu.net Lu Chen looked at the patient on the bed and asked his doubts again.

"Teacher Li, the patient has no high-risk factors for pulmonary embolism, nor does he have a tumor. He only has pneumonia. Could it be that pneumonia caused the pulmonary embolism?"

Li Qinghua did not answer immediately. He pondered for a moment before saying, "Pneumonia is not a high-risk factor for pulmonary embolism, but it's hard to say. We have to think about it carefully."

At this moment, the nurse on the side suddenly said, "Doctor Li, Doctor Lu, look, what's wrong with the patient's arm?"

Her tone was incredible, and she obviously found something unusual.

Lu Chen and Li Qinghua followed the direction she pointed. It was the patient's arm, near the elbow joint.

Lu Chen and Li Qinghua were shocked when they saw it.

Why is this hand full of rashes?

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