I Can See Health

  Chapter 169 Long Experience (Yesterday's Third Update)

   Jinghua Second Hospital.

  Guipei Building bedroom.

   "Congratulations, +1 for the thank you from Fan Zhiping!"

  Because it was a private chat with Fan Zhiping, other people in the group didn't know it, so they didn't harvest their gratitude.

   But it's better than nothing...

   But Lu Chen felt that he had to communicate in the group next time, otherwise it would be too bad!

   At least a few dozen points of gratitude!

  Lu Chen sighed, his consciousness re-entered the virtual space of the system, and began to train his skills.

  …

   Jinghua Electrophysiology Exchange Group.

   "Half atropine was pushed! The patient regained sinus rhythm with fast atrial fibrillation!"

   Fan Zhiping's sudden message caught the attention of all the cardiologists in the group.

   "Rapid heart rate atrial fibrillation, intravenous atropine?"

   "Director Fan, are you sure the patient's heart rhythm has recovered?"

   "Just kidding, Lao Fan, I've never seen atropine with a fast heart rate!"

   In the group, all cardiologists questioned Fan Zhiping's doctor's order.

   There is only one exception.

   That was Min Xiaobo, another elite member of the Electrophysiology Association in the group.

   He has been following this case in the group.

   It’s just that he didn’t have a clue for the time being, so he didn’t speak.

   And he has been looking forward to the appearance of Lu Chen in his heart.

   "Atropine?" Min Xiaobo raised his brows, could it be...

  …

   Seeing that everyone in the group did not believe it.

  Fan Zhiping first reviewed an ECG for the patient and sent the reviewed ECG to the group.

   Then, he recorded a short video of the patient's bedside ECG monitor and uploaded it to the group.

   When everyone in the group saw this living evidence, they had to believe it.

   "I'll go, Lao Fan, you can do it!"

   "Director Fan, what is the principle?"

   "Why does atropine lower the heart rate? It doesn't make sense, right?"

   Fan Zhiping looked at everyone's inquiries, but smiled helplessly.

   He himself did not know the reason for using atropine.

   "It's all under the guidance of Professor Lu." Fan Zhiping sent another message.

   This message detonated all the doctors in the group at once.

   "Wow, you really deserve to be our Professor Lu!"

   "Old Fan, you actually chatted with Professor Lu privately. You are trying to teach Professor Lu to teach you a secret!"

   "Director Fan, we are very interested in this case, so please don't give a shit! Tell us about the principles of medication."

  Fan Zhiping is also very helpless!

   It’s not that he doesn’t want to say it, it’s that he really doesn’t know!

   "Professor Lu only talked about medication, not the principle of medication."

   Seeing Fan Zhiping's message in the group, everyone was a little disappointed.

   "Where's Professor Lu? @Professor Lu, come out and help us explain!"

  I don't know who is in the group @Luchen.

   followed, one after another.

   There was a group member Aite Lu Chen who tried to summon Lu Chen.

   "@Professor Luchen!"

   "@Professor Luchen!"

  Fan Zhiping added quickly: "Professor Lu has something to do."

   It's just that this news from Fan Zhiping was quickly overwhelmed by everyone's "summoning technique".

  …

   Jinghua Second Hospital, the dormitory of Jipei Building.

  Lu Chen was in the middle of a virtual training session when suddenly the series of WeChat alerts interrupted.

   Training was interrupted again!

  What's up today?

  Lu Chen exited the system virtual space with doubts.

   Picked up the phone and saw the content in the Jinghua Electrophysiology WeChat group, all of which are @own.

  He blocked group messages, and ordinary messages could not be received.

   kept scrolling up, and when Lu Chen saw everyone's demands, he couldn't help but smile.

   He was still lamenting that he had not received thanks from others.

   Now everyone has taken the initiative to send thank you points!

   "It seems that everyone wants to know the principle of using atropine."

   After all, in the traditional concept, this is a drug that increases the heart rate, which runs counter to the treatment of atrial fibrillation.

   In fact, he was able to solve this case entirely thanks to the "Elite Group Assessment" he participated in some time ago.

The    elite group assessment not only examines ECG knowledge, but also comprehensively examines basic electrophysiology, ECG interpretation, and arrhythmia treatment.

  Lu Chen went through countless electrophysiology books some time ago!

   In addition, the aconitine poisoning that Lu Chen had encountered was also treated with atropine.

   An experience, coupled with a wealth of clinical theoretical knowledge, allowed Lu Chen to successfully solve this problem.

  …

   "Has anyone carefully read the instructions for propafenone and atenolol?"

  Lu Chen's question appeared in the group, and the noisy WeChat group suddenly became quiet.

  Fan Zhiping immediately went to the Internet to look up the instructions for these two drugs. After finding the results, he immediately copied and pasted them in the WeChat group.

   "This is the instruction of propafenone: if there is a high degree of sinoatrial or atrioventricular block, it can be rescued by intravenous injection of sodium lactate, atropine, isoproterenol, or metarenaline."

"This is the instruction manual for atenolol: Overdose: Severe bradycardia can be given atropine 1-2 mg intravenously, followed by high-dose glucagon 10 mg intravenously if necessary, which can be repeated according to response or followed by intravenous infusion Glucagon."

   Everyone in the group saw the instruction manual sent by Fan Zhiping.

  All of them have an idea in their hearts, their common rescue drug is: atropine!

   "Professor Lu, although the common rescue drug for the two drugs is atropine, both of them are aimed at slow heart rate, and there is no mention of treating rapid atrial fibrillation?"

   Fan Zhiping's remarks expressed what everyone was thinking.

  Although on the surface, atropine is a rescue drug for two drugs at the same time, but its pharmacological indications do not include atrial fibrillation, but only sinus bradycardia.

  Lu Chen smiled and replied quickly: "This involves the mechanism of the poisoning of the two drugs."

   Toxicity Mechanism?

   Everyone in the group was a little stunned.

   It’s okay to let them and other clinicians treat the disease, but what kind of pathogenesis and other issues have to be dealt with, which makes them a big head!

   As soon as Lu Chen said these words, the originally noisy group instantly became quiet again.

In the message box of the    group chat, there were only messages sent by Lu Chen alone.

"Atenolol suppresses sinus rhythm, ectopic heart rhythm begins to depolarize, and propafenone blocks ectopic heart rate, which leads to slow atrial fibrillation, resulting in hemodynamic changes, myocardial cell damage, and rapid atrial fibrillation and ventricular premature fibrillation. , propafenone poisoning can certainly aggravate other serious arrhythmias..."

  …

   Looking at Lu Chen's message, Fan Zhiping could only sigh.

  Professor Lu, awesome!

   These drug mechanisms, he knows more or less.

   But it is very difficult to combine his clinical work with practical problems!

   Most of the people in the group were ignorant about Lu Chen's words.

   Except for one person, that is Min Xiaobo.

  Lu Chen opened his head, and Min Xiaobo immediately understood what he meant.

"I see!"

"The cardiac reaction caused by the poisoning of these two drugs involves not only atrial fibrillation caused by conduction problems, but also severe sinus node depression caused by atenolol, which should also be the cause of aggravation of atrial fibrillation, correcting the root cause of the heartbeat. Restoration of sinoatrial node function is needed to enhance the impulse from the anteroposterior pacemaker."

   "Atropine increases the activity of the sinoatrial node and enhances the sinus rhythm to regain the leadership of the sinoatrial node, improve the inhibition of the atrioventricular node, and enhance the ventricular rhythm."

   "It's really insightful that it can be treated like this!"

  Min Xiaobo slapped his thigh and shouted loudly, frightening the students who were on duty alongside him.

  Mr. Min, what's the matter?

   stared at the phone, frowning for a while, laughing again for a while.

   Where is Mr. Min, who is usually unsmiling in the department?

   This chapter is the one that was not published yesterday. (Drinking Red Bull or sleeping)

   Today is Monday, another night shift.

   Tomorrow, the day after tomorrow, rest and work harder. More time today.

   (end of this chapter)