Can ventilators help patients? It is certainly not critical. If the patient is really pulmonary embolism, we have to dissolve the thrombus immediately before we can have a glimmer of hope. But before diagnosing pulmonary embolism, the patient is already very hypoxia. At this time, the ventilator still needs to be used. The ventilator cannot reverse the condition, but it can relieve some hypoxia, because we can inject pure oxygen into the patient's lungs. If there is blood that can bypass the thrombus and enter the lungs by chance, then let them bring more oxygen to the patient to fill up and make them overload. Perhaps it can bring more oxygen to the tissues. At critical moments, it is better to take more oxygen.

Lao Ma ran back to the rescue room, and Brother Hua had helped prepare all the tracheal intubation equipment.

Have you agreed? Brother Hua asked.

I agree, let's get in. Lao Ma said.

Normally, Lao Ma in the emergency department should have intubation of the patient. After all, this is in the emergency department. But the relationship between Lao Ma and Brother Hua cannot be divided. When Lao Ma communicated with his family, Brother Hua was ready to do it for him.

No delay for a moment.

After receiving the authorization of Lao Ma, Brother Hua inserted the tracheal tube into the patient in a few seconds. The nurse quickly connected the ventilator and adjusted it to 100% oxygen inhaled. The blood oxygen saturation increased from 82% to 90%, and then it could not go up. The blood pressure also dropped, only 90/not. Because the patient's alveoli was not lacking in oxygen, the granary was sufficient, and the nanny was lacking. The nanny couldn't get to the granary and couldn't get food. At this time, no matter how much oxygen was inhaled, it could not relieve the patient's hypoxia. The reason was very simple. What we had to do was to clean the road, dissolve the blood clot stuck in the pulmonary artery, or break the thrombus or surgically remove the thrombus, so that the big nanny could enter the lungs smoothly, obtain oxygen, and then bring it to the tissue. 50mmHg.

It seems really bad.

Lao Ma had contacted the CT room and called the doctor from the respiratory department again. After the respiratory doctor saw it, he agreed to consider pulmonary embolism and CT pulmonary artery angiography. It is very important to ask for consultation at this time. First, multiple people have multiple ideas, and second, multiple people share the responsibility. This is to protect the patient and protect themselves. Lao Ma and Brother Hua both understand this principle.

Lao Ma personally escorted the patient to the CT room.

Brother Hua went back to the ICU first, and there was something he asked to deal with. On the CT side, Lao Ma could handle it alone, and the patient had been intubated and was probably able to handle it. Brother Hua had to go back to prepare the bed. If the CT result was really pulmonary embolism, he would take it in preparation for thrombolysis treatment. Only by dissolving the thrombus can the patient have a glimmer of life.

Brother Hua just reported to his superiors when he received a call from Lao Ma.

Lao Ma said in a gentle tone that it was pulmonary embolism. When he saw CT, he saw thromboembolism in many places in the pulmonary artery, but it was not completely stuck. Fortunately, there was still a little blood that could pass through, otherwise the patient would be gone in the emergency department.

The patient's diagnosis is finally clear. The patient may have pulmonary embolism from the beginning, not just pneumonia. Ordinary chest X-rays cannot distinguish between pneumonia and pulmonary embolism, and CT is required. Ordinary CT cannot diagnose pulmonary embolism, and CT is required. In other words, when doing CT, the patient must be injected with contrast agent intravenously. The contrast agent enters the pulmonary artery along the blood flow. If there is a thrombus in the pulmonary artery, then there is no contrast agent flowing through this part. At this time, CT can capture this change, and it is speculated that there is a thrombus here.

Under Lao Ma's escort, the patient was safely transferred to the ICU.

The ICU superior doctor has also come back. If you encounter such critical and severe illness, it will be safer to have a superior doctor.

The patient was already sedated by analgesia and was inserted into the tracheal tube and connected to the ventilator for ventilation. However, his breathing was still relatively rapid. This was expected. If the thrombus was not relieved for a while, the patient's breathing difficulties would definitely not be significantly relieved. The ventilator was just to buy some time for the patient.

Brother Hua found the patient's family and told them that the pulmonary embolism is currently diagnosed and the condition is very serious. If you need treatment, you can only do thrombolysis treatment. That is, we inject a thrombolysis drug into the patient's blood vessels, the drug enters the pulmonary artery, and acts on the embolism, and will gradually dissolve the thrombo. As long as the thrombolysis can dissolve, the blood will be unblocked and the patient's hypoxia will be relieved.

My eldest daughter asked, is it risky?

At this time, we don’t care about the risk. No matter how high the risk is, it needs treatment. Of course, the risk of thrombolysis is also very high. Maybe the patient will suffer from cerebral hemorrhage or bleeding in other places. Because we are using thrombolysis drugs, these drugs may not only act on thrombosis, but also on other blood vessel walls, which may cause bleeding. We are not afraid of skin bleeding, but most afraid of cerebral hemorrhage, so we will finish it. Brother Hua explained to his family that he presented an informed consent form and urgently hoped that they would sign and treat it as soon as possible.

If the thrombolysis is not soluble, the patient will die soon. Brother Hua added, "It's firm." Of course, thrombolysis may not necessarily save him, but for a chance, Brother Hua didn't dare to say anything to death.

Sometimes, if the doctor doesn't push the family, the family will not be able to make the right decision. Of course, Brother Hua will be buried at this time. If the patient dies unfortunately, he will be rescued by arguing.

Do it, do it, and the two sons-in-law express their opinions again.

The signature is still signed by the daughter. Overall, they are still very active, just because they are afraid and worried. If Brother Hua does not explain clearly at this time, it is easy to have misunderstandings.

Dry.

After everything was done, the nurse used the thrombolysis medicine with the patient.

picture

Brother Hua stared at the electrocardiogram monitoring and kept checking the patient's limb reactions and nervous system examinations. He also used a flashlight to check the patient's pupils from time to time. He was really afraid that if this injection of thrombolytic drugs was taken, the patient would suffer from cerebral hemorrhage. Once there was cerebral hemorrhage, limb examination, nervous system examination, pupils, etc. would have some prompts.

If there is any change, the head CT should be reviewed in time to see if the patient has cerebral hemorrhage. The superior doctor said that. This is actually very contradictory. The patient is currently very serious and is not suitable for going out for CT, but if we do not have CT, we cannot accurately determine whether there is cerebral hemorrhage. It is a dilemma.

Therefore, you must always pay attention to the patient's physical examination.

When it was almost dawn, the nurse woke up Brother Hua.

In trouble.

The patient had large areas of ecchymosis on his arm.

Damn, Brother Hua felt cold behind him, and his sleepiness disappeared.

The patient had ecchymosis on his arm, which means there was bleeding in the skin. This must be the effect of thrombolytic drugs. This is considered a side effect of the drug. But Brother Hua also found good news.

The patient's breathing is no longer so rapid, and the blood oxygen saturation has also increased to 97%. It seems that thrombolysis drugs are really going to take effect.

Brother Hua carefully checked the patient's nervous system, but still didn't find any abnormalities. God blessed me, don't have cerebral hemorrhage. Of course, Brother Hua doesn't believe in the world, ghosts and gods, but at this time, he had a great hope that there would be gods.
Chapter completed!