I Can See Health

   Chapter 483 Explosive Myocarditis

   The upstairs that Zhou Bin mentioned is the general ward of the Cardiology Department, from the first ward to the eighth ward.

  Once a patient in the general ward is in a critical condition or suddenly deteriorates, he or she is usually transferred to the CCU ward for more detailed and specialized rescue.

  Because many rescue equipment is not equipped in ordinary wards, such as invasive ventilator, IABP machine, ECMO machine, etc.

   "I just received a call from District 2 in my heart. There is a little girl who has just been admitted to the hospital today and suddenly has difficulty breathing..."

   Zhou Bin explained the cause to Lu Chen and walked quickly to the gate of CCU.

   "The little girl with breathing difficulties? Come to the Cardiology Department?" Lu Chen followed closely.

   The two of them opened the door of the CCU ahead of time and waited for the arrival of the patient.

  …

   The two didn't wait too long. About half a minute later, a hurried voice caught Lu Chen's attention.

   In his sight, four doctors pushed the ward and rushed towards the gate of the CCU ward.

   This scene, Lu Chen is somewhat familiar, is very similar to the rescue of the patient with pulmonary arterial hypertension yesterday.

   Yes, there was no doctor in the hospital bed doing CPR today.

  Lu Chen looked at the patient on the hospital bed.

   This is a very young girl, about eighteen years old.

   The head of the bed has been shaken high.

  The girl was leaning on the bed, gasping for breath, her lips were cyanotic, and her eyes were very blurred.

   And her HP is only 32 (---)!

   The changing trend of life value is three minus signs!

   "Quick, push it to the rescue room!" Zhou Bin shouted to the crowd, "Grab 8!"

   (Rush 8: The 8th Rescue Room)

  CCU Ward A, only the last rescue room No. 8 is left.

   The doctor accompanying the ward heard Zhou Bin's words and immediately pushed the hospital bed into the emergency room No. 8.

   "Brother Hua, what's the specific condition of the patient?" Zhou Bin asked immediately.

   The accompanying doctor in charge is an old acquaintance of Lu Chen, Li Qinghua.

He said solemnly: "The patient was originally admitted to the Department of Respiratory Medicine with pneumonia, but an electrocardiogram was routinely performed on admission, which showed frequent premature ventricular tachycardia and short bursts of ventricular tachycardia. The patient had symptoms of chest pain, and her kinase indexes increased. High, considering the possibility of myocarditis, it was transferred to zone 2 in our heart."

   "In less than half an hour after the transfer, the patient suddenly had difficulty breathing, which gradually worsened, the blood pressure dropped to only 80/50mmHg, and the blood oxygen dropped to about 90%..."

   When Lu Chen heard all the descriptions, five big words popped out in his mind: "Explosive myocarditis!"

   Explosive myocarditis, rapid onset, high fatality rate!

  …

   However, at this time, it was simply too late for everyone to think about it.

  All the free medical staff in the CCU came to the rescue room.

   Zhou Bin is still the commander-in-chief of the rescue.

   "Push over the ventilator and open three venous channels first!"

   "Full speed rehydration!"

   "Brother Hui, you help to do a central venous catheter!"

   "The nurse checks a set of blood, collects blood gas, and then inserts a urinary catheter."

  Lu Chen is already familiar with the rescue rhythm of the CCU at this time. As a student, what he can do at present, or what Zhou Bin asked him to do, is extremely limited, that is, doing an electrocardiogram and measuring blood pressure.

   His movements were very quick, and he immediately pushed the electrocardiograph over.

   "Mr. Zhou, the patient's blood pressure is 75/62mmHg, both sides are similar. The electrocardiogram shows short burst ventricular tachycardia, and there are ST-T changes."

   Zhou Bin briefly glanced at the electrocardiogram, then nodded and continued to direct the operations on the field.

  Suddenly, an alarm sounded from the ECG monitor in the rescue room.

   "The patient has ventricular fibrillation!" Li Qinghua exclaimed.

   At this time, the patient's eyes were staring right and forward, foaming at the corners of the mouth, and the whole person completely lost consciousness.

  Li Qinghua rushed to the front, immediately jumped on the bed, and performed chest compressions on the patient.

   "Quick, endotracheal intubation!" Zhou Bin quickly got all the tools for endotracheal intubation.

  Lu Chen cooperated with Zhou Bin.

  What tools Zhou Bin wanted, Lu Chen could quickly hand them over.

  In less than thirty seconds, the patient has been successfully inserted into the tube.

   "Mr. Li, the defibrillator is here!"

   After inserting the tube, Lu Chen pushed the defibrillator over and adjusted it to the defibrillation mode.

  Li Qinghua nodded slightly when he saw this, "Look at my actions, after I withdraw, you will go up immediately!"

   "Received!" Lu Chen said.

  …

  Li Qinghua stepped back a little, Lu Chen took the defibrillator and stepped forward immediately.

Charge!

   Discharge!

  Beep beep...

   On the ECG monitor, it is still ventricular fibrillation!

  Lu Chen stepped aside and Li Qinghua continued to perform chest compressions.

   "Wait for the second defibrillation!"

   Li Qinghua pressed a few more cycles, and Lu Chen performed the defibrillation again!

  Second defibrillation.

   When charging and discharging are over, the patient's ventricular fibrillation waveform has not disappeared for a second, but it reappears!

  Lu Chen's heart had already reached his throat.

   Everyone is also staring at the ECG monitor, eager to get started and destroy the ventricular fibrillation waveform.

  …

   On the ECG monitor by the bedside, the sound of Didi struck everyone's heart.

   The third defibrillation!

Charge!

   Discharge!

  Lu Chen stared at the monitor, when the chaotic ventricular fibrillation waveform suddenly disappeared and became normal sinus heart rate, the big stone in his heart finally fell.

   "The defibrillation was successful!"

On the    monitor, the patient's ventricular fibrillation waveform finally disappeared completely, and turned into sinus rhythm representing "hope".

   This also means that the patient's heart is beating again.

   However, the trend of the health value on the patient's head is still three minus signs!

  …

   At this time, Zhou Bin asked the nurse to bring the ultrasound machine, and she quickly performed an emergency bedside ultrasound for the patient.

   Through the screen of the ultrasound machine, Lu Chen saw the patient's entire heart, almost "squirming"!

  The normal heart is a strong contraction, but hers is like an old man, unable to move.

   "The left ventricular end-diastolic diameter is 40mm, the left atrium, right ventricle, and right atrium are not large, the left ventricular wall motion is weakened, the segmental motion is abnormal, the EF value is about 30%, the left ventricle posterior wall is 12mm, and the pulmonary artery pressure is normal!"

   There is no doubt that the patient's echocardiography was printed with the diagnosis of "explosive myocarditis".

  Although the rescue is over, for patients with fulminant myocarditis, the danger is just the beginning!

  In the outbreak of new myocarditis, there will be bursts of "storms" of inflammatory factors.

   During this period, it will cause fatal blows to the fragile heart of the human body again and again.

   As long as they cannot resist any blow, the patient will not survive!

  …

   In the rescue room, there was no joy on the faces of the doctors after the successful rescue.

   This rescue also alarmed Director Cao Zhiying.

   He has rushed to the rescue room.

  Cao Zhiying looked around the crowd and said solemnly, "Prepare to communicate with the patient's family and go to ECMO."

  Li Qinghua and Zhou Bin both nodded and said, "It is possible to get ECMO. If this patient does not get ECMO, the chance of survival is not high."

   (end of this chapter)