I Can See Health

"Junior brother, hurry up and get the electrocardiogram machine and come to bed No. 10!"

"receive."

Lu Chen immediately ran to the nurse's station and found the electrocardiograph in a corner.

He quickly unplugged the charging plug of the electrocardiograph, found the blood pressure monitor in the drawer, then pushed the machine and rushed to bed No. 10 with the blood pressure monitor in his arms.

Bed 10.

As soon as Lu Chen came in, he saw an old man sitting on the bed, breathing heavily.

The color on his head is bloody red!

The head of the bed had been shaken almost vertically to the ground.

The sweat on his forehead dripped down his cheeks, his expression was extremely restless, and his hands were waving randomly.

Sun Guoguo was already holding a stethoscope and giving the old man a quick auscultation and physical examination.

At the same time, a nurse ran into the ward pushing an ambulance.

"Give the patient oxygen, and then give him one furosemide and one Guadin!"

"Urgent blood test! Blood routine, kidney function, ions, BNP, myocardial enzyme spectrum, coagulation items and D-dimer"

Sun Guoguo began to give orders.

"receive!"

The nurse immediately started dispensing the medicine.

Lu Chen was not idle either. He immediately took out the blood pressure monitor to measure the patient's blood pressure.

The patient was a little restless and had difficulty controlling his hands.

"Mother-in-law, please help me hold it down."

The patient's family member is an old woman. Her son is not around, so she takes care of her wife and children alone.

The mother-in-law's body was still strong. She came to the bedside and reached out to hold the patient's hand.

"Old man, don't move around. The doctor wants to take your blood pressure."

With the help of his mother-in-law, Lu Chen successfully measured the patient's blood pressure.

"Sister, the patient's blood pressure is 204/114mmHg!"

Sun Guoguo nodded, and then the nurse immediately ordered: "Add 50ml of sugar with a tube of sodium nitroprusside, pump it into the vein, and walk at a speed of 5m/h."

"receive!"

The nurse had already finished dispensing Crandine and Furosemide and immediately started dispensing new liquids.

"Senior sister, should I do an electrocardiogram for the patient?" Lu Chen asked from the side.

"Okay!" Sun Guoguo nodded happily.

This junior fellow student is quite smart, and he is not a newcomer who does not understand any clinical knowledge.

Because some graduate students spend all their internship time studying for postgraduate entrance exams.

Although I was admitted to graduate school, I knew nothing about clinical practice.

There is a huge gap between book knowledge and clinical practice!

What’s more, they don’t even know how to do an electrocardiogram or measure blood pressure!

Fortunately, Lu Chen is quite reliable and is very skilled in various operations.

…

Lu Chen quickly connected the limb leads and chest leads.

However, the old man was sitting on the bed. He was thin and had dry skin, so the leads of the electrocardiograph were not easy to stick to.

"Mother-in-law, please help me again. Press the three leads here tightly and don't let go."

The old woman walked to the bed again and pressed the leads tightly with her thin old hands.

On the screen of the electrocardiograph, the waveform of the electrocardiogram slowly became stable.

"Okay, let's take a picture."

Sun Guoguo has been paying attention to the situation here.

When the cardiology department encounters a sudden illness, an electrocardiogram is extremely necessary.

It can quickly help doctors determine the patient's condition.

When Lu Chen heard this, he immediately pressed the "eject paper" button.

"嗗……嗗……"

EKG completed.

Sun Guoguo got the electrocardiogram, glanced at it, and then put it down.

Good guy, extensive lead ST depression, severe myocardial ischemia.

"Nurse, give me another dose of furosemide!"

"Okay, got it!"

As soon as Sun Guoguo finished issuing the oral medical orders, the nurse immediately began to implement them.

Within five minutes, Lu Chen could clearly feel the old man's breathing slowing down on the bed, and a trace of color returned to his pale face.

Sun Guoguo and the nurses present breathed a sigh of relief.

Heart failure, comes and goes quickly!

"Junior brother, do you know what disease this patient just suffered from?"

Sun Guoguo started the daily teaching part.

Teaching is an important part of a tertiary hospital.

Lu Chen recalled all the patient's symptoms and signs.

Sitting upright, sweating profusely, and breathing rapidly.

There were obvious crackles in the lungs and pitting edema in both lower limbs.

"Acute left heart failure." Lu Chen said, "The specific cause of heart failure may be a sudden increase in blood pressure, which causes an increase in load."

Heart failure is heart failure.

To put it simply, the heart no longer has the strength to beat and pump blood to various organs and tissues throughout the body.

This will have two main consequences.

First, various organs and tissues in the body suffer from ischemia and hypoxia, leading to functional failure.

Second, blood that cannot be ejected will accumulate in the pulmonary circulation, causing acute pulmonary edema, which is often referred to as acute left heart failure in medicine.

"Yes, that's right." Sun Guoguo nodded, with a hint of appreciation in his eyes, "This patient is a typical case of acute left heart failure. So what are the treatment principles for acute left heart failure?"

She wanted to see what level her young junior brother was at!

"The general principles are to strengthen the heart, diuresis, and dilate blood vessels." Lu Chen said, "In addition, there is oxygen inhalation. If necessary, morphine can be used for sedation, but care must be taken to avoid respiratory depression."

"Well, not bad." Sun Guoguo smiled.

Cardiotonic, diuretic, and blood vessel dilation are the three pillars of treatment for heart failure.

"What do the medical orders I just asked the nurse to carry out correspond to?"

Lu Chen recalled all the oral medical instructions given to Sun Guoguo just now.

Furosemide, fentanyl, sodium nitroprusside!

"Frusemide is a diuretic, Chuanding is an antiasthmatic agent, and sodium nitroprusside is a vasodilator!" Lu Chen answered seriously.

"Then why didn't I use cardiotonic drugs?"

Sun Guoguo smiled and said to Lu Chen.

"Because among the three methods of strengthening the heart, diuresis, and dilating blood vessels, diuresis is the most important, followed by dilation of blood vessels. Cardiac injections are only suitable for use when the first two methods are ineffective or have poor effects!"

"Why is diuresis ranked first? Cardiac strengthening is ranked last?"

Sun Guoguo was ready to get to the bottom of this. UU Reading www.uｕkanshu.net

Lu Chen frowned. This question seemed difficult to explain using medical theory.

So, let’s use another explanation.

"In fact, heart failure can be compared to a donkey walking on a muddy path carrying goods."

"The effect of diuresis is to reduce the load, which is equivalent to reducing the cargo on a donkey's back."

"The effect of vasodilation is to expand the dynamic and static blood vessels, which is equivalent to repairing the muddy path and making it easier for the donkey to walk."

"The effect of strengthening the heart is to increase the contractility of the heart, which is equivalent to beating a donkey with a whip to make it run faster."

"By comparing the three methods, we can know that although the third method of strengthening the heart can make the donkey run faster, it may cause long-term damage to the donkey and shorten its lifespan."

"The first method of diuresis is the fastest-acting method without too many side effects!"

After hearing what Lu Chen said, Sun Guoguo looked very surprised.

Is Lu Chen really just a first-year graduate student?

If she had taken off her mask at this time, Lu Chen would definitely be able to see her mouth open in shock.

Most people know about "cardiotonic, diuretic, and blood vessel dilation", but they don't know the adaptability of each method.

Cardiopulmonary injection is useful, but it is not the first choice because it may increase the patient's long-term hospitalization mortality.

"Congratulations, I received a +1 thank you from Warwick!"

Suddenly receiving a notification sound from the system, Lu Chen looked happy.

He looked at the system panel, and the system completion level became 60%.