I Can See Health

   Chapter 168 Professor Lu, you are truly amazing!

  Propafenone and atenolol are both antiarrhythmic drugs.

   But one thing is very interesting, all antiarrhythmic drugs can cause arrhythmia!

   Therefore, clinically, the use of any arrhythmia drug is very cautious.

   For example, general premature beats, whether it is ventricular premature beats or atrial premature beats, as long as there is no organic heart disease, they do not need special treatment, nor do they need to take any antiarrhythmic drugs.

  Abusing drugs may lead to more serious consequences!

  …

  Lu Chen's clinical career was very short, and he never encountered propafenone poisoning.

   The drug principle of propafenone in the treatment of arrhythmia is to increase the refractory period of cardiomyocytes, thereby blocking the depolarization of ectopic cells and allowing sinus rhythm to preempt.

   However, Lu Chen encountered a case of aconitine poisoning during his internship.

  Aconitine, like propafenone, can inhibit sinus node function.

   At that time, the patient suffered from frequent premature ventricular tachycardia and paroxysmal ventricular tachycardia. He did not undergo blood purification treatment, but simply used drug treatment, and finally his condition improved.

  Lu Chen thought about it, then edited and replied immediately.

   "Director Fan, if you can stabilize sinus rhythm and blood pressure, blood perfusion may have a certain effect."

  Fan Zhiping kept staring at the dialogue with Lu Chen.

   When Lu Chen's news appeared in the dialog box, he looked happy.

   This is what he saw today, the first person to say that blood perfusion is effective.

  Fan Zhiping immediately replied: "But the patient's blood pressure is unstable, fluctuating at 90/50mmHg, and now doing an electrocardiogram, it shows fast atrial fibrillation, with a heart rate of 130 beats."

   "That might not work, the arrhythmia problem must be solved first." Lu Chen frowned.

   "Can you be cardioverted?" Fan Zhiping sent another message.

   Generally, patients with arrhythmia with unstable hemodynamics, that is, low blood pressure, can basically use electrical cardioversion.

   "This patient cannot use electrical cardioversion." Lu Chen replied, "The patient's sinus node function is suppressed, and there is potential conduction block, which is a contraindication to electrical cardioversion."

  The electrical conduction system of the heart is a system with distinct upper and lower levels.

The    sinoatrial node sends out electrical impulses, which then conduct downwards step by step.

The    sinoatrial node acts as a commander, controlling all downstream conduction systems.

  Once the function of the sinoatrial node is inhibited, without the commander, the cardiac conduction system will be disrupted.

   "Then what else can be done?" Fan Zhiping wondered.

   "Put a half atropine statically first!"

   When the message from Lu Chen appeared on Fan Zhiping's phone screen, he was taken aback for a moment.

   The blue light of the screen further accentuates the consternation on his face.

   However, the movements in his hands were not slow, and he immediately replied: "Are you sure?"

"Sure!"

   To be on the safe side, Lu Chen asked Fan Zhiping to push half atropine first.

   Seeing Lu Chen's exact answer, Fan Zhiping did not hesitate.

   He immediately placed a doctor’s order in the computerized medical record system—a semi-atropine intravenous bolus.

   "Luo Xin, give a half atropine to the poisoned patient who came here just now! I have given the doctor's order." Fan Zhiping walked out of the doctor's office and came to the nurse's station.

   "Received!" After Luo Xin agreed, he felt that something was not right, "Director Fan, the patient's heart rate is 130 beats per minute, are you sure you want to take half atropine?"

  Atropine is a heart rate-raising drug!

   In many medical dramas, an emergency case will be involved, that is, organophosphorus poisoning.

  The special antidote for organophosphorus poisoning is atropine.

   At this time, a large amount of atropine needs to be injected intravenously, so there will be various scenarios of working together to "break atropine by hand".

   But now, their heart rate for this patient is 130 beats per minute.

   Also give him atropine?

   Will the heart rate continue to soar?

  Luo Xin felt that this should be a wrong doctor's order based on his own shallow knowledge.

   "Yes, it's an intravenous injection of half atropine, push it now!" Fan Zhiping's voice was beyond doubt.

  Luo Xin could only abide by the doctor's orders.

   She came to the ward and took out the medicine on the emergency cart.

   The **** the hospital bed was slowly injected with half atropine intravenously.

   Fan Zhiping and Luo Xin were both standing beside the hospital bed, staring at the ECG monitor at the bedside.

  Atropine works very quickly.

   Just finished the static push, less than half a minute later.

   The patient's heart rhythm changes.

   On the bedside ECG monitor.

   Patient's heart rhythm changed from atrial fibrillation to sinus rhythm (normal heart rhythm)!

   Heart rate also dropped from 130 beats/min just now to 80 beats/min.

  Luo Xin widened his eyes and watched the patient's heart rhythm change with his own eyes. This scene was still very shocking.

   She stared at the ECG monitor, afraid it was just a flash in the pan.

   lasted about a minute.

   The patient's heart rate stabilized, basically maintaining 80 beats/min.

  Fan Zhiping immediately stepped forward and asked the patient on the bed.

   "Classmate, do you feel more flustered?"

   On the hospital bed, the girl nodded slightly: "After the injection just now, I feel better."

  Fan Zhiping was also amazed in his heart.

  Half atropine actually solved the problem of arrhythmia!

   Up to now, he has not figured out the rationale for this.

  Atropine is obviously a heart rate-raising drug!

  How did the patient's heart rate drop after using it?

   "Luo Xin, you take care of the patient first, and call me anytime if you need to."

"it is good!"

  Fan Zhiping immediately walked out of the ward and came to the corridor.

   took out his mobile phone, and immediately edited a message for Lu Chen in a very excited mood.

   "Professor Lu, you are amazing!"

   If Fan Zhiping couldn't hold back before, but now, he shouted out the words "Professor Lu" without any psychological burden.

   No matter how old he is, whether he is a student or whatever.

   At this moment, to Fan Zhiping, Lu Chen is like a "professor"!

   Lu Chen received this message with a smile on his face.

   It seems that the patient's arrhythmia problem has been resolved!

  Lu Chen continued: "Change to a low-dose atropine micropump, maintain a sinus heart rate of about 80 beats/min, and last for five half-lives of propafenone, about one and a half days. The other cases will be dealt with!"

   "Received!" Fan Zhiping replied immediately.

  Lu Chen's words are now the "decree"!

   "Luo Xin, change the low-dose atropine micropump to keep the patient's heart rate at 80 beats per minute!" Fan Zhiping held his mobile phone and called to Luo Xin in the ward.

   "Okay, Director."

  Luo Xin also saw Director Fan's greatness, and this time there was no doubt.

   She immediately executed Fan Zhiping's doctor's orders.

   "If there's nothing to do, I'll be busy first." Lu Chen said.

   "Professor Lu, go get busy, I won't bother you."

   Now Fan Zhiping called out the three words "Professor Lu", without the slightest embarrassment, but felt that it was very smooth!

   One more chapter. About two-thirty to three o'clock.

   (end of this chapter)