I Can See Health

   Chapter 493 Laogu's Self-Reproach

its not right!

  Lu Chen was startled. When he first came to bed number 1, he clearly saw that the trend of the patient's health was a plus.

   Why did it turn into two minus signs in a blink of an eye?

   One plus sign turns into two minus signs, which is a world of difference!

  This shows that the patient's condition at this time has suddenly changed sharply!

   Just when Lu Chen was thinking about it, he suddenly noticed the patient on the hospital bed.

   At the same time, the bedside ECG monitor sounded a harsh "beep beep" alarm.

   Lu Chen felt something was wrong, he reacted immediately and immediately stepped forward to check.

   He patted the patient on the shoulder, "Master, Master! Can you hear me?"

   The patient did not respond at all!

  Lu Chen quickly touched the pulsation of the carotid artery on the other side, and placed the stethoscope at the apex of the heart.

   No heart beats at all!

   "Oops, my heart stopped!"

   When Lu Chen saw this, he rolled up his sleeves and immediately started chest compressions.

   aside, Gu Xinyue was also quite nervous.

   He placed the applicator on the patient's puncture point while assisting Lu Chen with CPR.

   Fortunately, in the CCU ward, the nurse in charge of the bed immediately responded and called other nurses to push an ambulance from the nurse station.

   And Zhou Bin happened to be in the ward at this time. When he encountered such a scene, he immediately ran to the hospital bed.

   "Quick, adrenaline!"

   "Prepare the defibrillator!"

   Zhou Bin immediately judged the patient's condition and began to issue medical orders for rescue.

   "What happened to the patient? Didn't you pull out a tube?"

  Gu Xinyue paused and said, "Mr. Zhou, I just pulled out the tube and pressed the patient's puncture point for two minutes, but his heart suddenly stopped!"

   "Heart stopped?" Zhou Bin frowned.

   At the time of the most critical condition of the patient, he did not suffer from cardiac arrest.

  Why is my condition getting better now, but my heart suddenly stopped?

   But now is not the time to think about these things, Zhou Bin calmly issued various emergency medical orders.

   "Daily pump, another bottle of sodium bicarbonate!"

   "Ventricular fibrillation! Prepare for defibrillation!"

  …

Hard work pays off.

   After Zhou Bin and Lu Chen's alternating chest compressions, the patient's heartbeat finally recovered.

   When the faint heartbeat came from the stethoscope, Lu Chen finally breathed a sigh of relief.

   However, the patient's consciousness has not recovered, and it is still in a state of unexpectedness.

   "Phew... It's good to be able to rescue him." Zhou Bin sighed slightly.

   For a patient in cardiac arrest, the chance of being able to press back is not high.

  Lu Chen shook his aching hand, "CPR is really a physical job!"

   He came to the CCU ward just a few days ago, but he performed more chest compressions than in the past few months combined.

   In the CCU ward, rescuing patients is commonplace!

   aside, Gu Xinyue's expression was a little dazed.

   "Old Gu, what happened to you?"

  Gu Xinyue was stunned, lowered her head, her expression was a little unnatural, and she said hesitantly, "Lu Chen, you said that the patient's heart stopped, could it be because of me..."

  Lu Chen was taken aback, "Why do you think so?"

  Patients with heart disease, even if their condition is slowly recovering, may still experience malignant arrhythmias, acute heart failure, and even sudden cardiac arrest, sudden death and other unpredictable malignant events.

   "I..." Gu Xinyue lowered her eyebrows, "He was still fine just now, but after I was extubated, his heart suddenly stopped."

   "Maybe you go to extubate, it might just happen by chance." Lu Chen said, "If you don't extubate, his heart will stop at this time. We were by his side, just in time to rescue him, didn't we help him?"

  Gu Xinyue was a little silent. He glanced at Lu Chen and said slowly, "I have my own reasons."

   "What's the reason? Make you doubt yourself?" Lu Chen wondered.

   "Lu Chen, I was thinking, did I just... did I press on his carotid sinus?"

   The puncture point of this patient is not the subclavian vein, but the internal jugular vein.

  Lu Chen recalled Gu Xinyue's actions just now. After removing the catheter, he did press on the carotid sinus on one side.

   There are abundant sensory nerve endings in the adventitia of the carotid sinus vessel wall, called carotid sinus baroreceptors

   The position here is superficial. When stimulated, it will lead to the occurrence of carotid sinus syndrome symptoms, which can be manifested as decreased heart rate, decreased myocardial contractility, decreased cardiac output, and decreased blood pressure.

  Pressing both carotid sinuses at the same time can indeed make the vagus reflex hyperactive and even cause syncope.

   "Lao Gu, let's not talk about whether you pressed the carotid sinus or not." Lu Chen said, "Even if you press, gently pressing the carotid sinus on one side, do you think it will cause cardiac arrest?"

  Gu Xinyue heard the words, lowered her head and remained silent.

  Lu Chen knew that Lao Gu's mentality at this time was extremely self-blame.

   I was still communicating with the patient about the transfer back to the general ward tomorrow morning. In a blink of an eye, the person was lying on the bed, unable to wake up.

  Lu Chen patted Gu Xinyue on the shoulder, "Old Gu, let's do our own thing well, as for the rest, don't think too much and don't worry about it."

  Gu Xinyue nodded, looked up at Lu Chen, "Thank you."

  Lu Chen responded with a smile, "You can open up if you want."

  …

   Back to the doctor's office.

   Zhou Bin also knew Gu Xinyue's thoughts, so he said with relief: "Xiaogu, you said that the possibility of cardiac arrest caused by pressing the carotid sinus by yourself cannot be completely ruled out, but the possibility is very small."

   "Teacher Zhou, then, why did the patient suffer from cardiac arrest?"

  Gu Xinyue stared closely at Zhou Bin, trying to find some answers from her.

   Zhou Bin asked back with a smile: "Xiaogu, then let me ask you, a nurse can complete such a simple operation as extubation, so why do you need a doctor?"

  Gu Xinyue frowned and didn't answer for a while.

   In fact, his entire extubation operation just now took less than a minute.

   If it is just a simple extubation operation, the nurse must have it!

Seeing this, Lu Chen paused and said, "I remember a literature report that central venous catheter removal can cause accidental central venous catheter removal syndrome, manifested as tachycardia, syncope, hypoxemia, hypoesthesia, and even heartbeat and breathing. Stop, shock coma, etc., the mortality rate is 57%."

  Zhou Bin nodded with satisfaction: "Lu Chen is right, even if it's just a simple extubation, in fact, there is still a certain risk, so when extubating, the doctor must be present!"

   In addition to massaging the carotid sinus, there is also the possibility of intravascular thrombosis and gas embolism!

   However, after Lu Chen and Zhou Bin's turn of enlightenment, Gu Xinyue's mood was obviously much better.

   "Lu Chen, thank you." Gu Xinyue said softly.

   "No thanks, just bring me a bowl of beef noodles tomorrow morning." Lu Chen smiled.

   "Okay." Gu Xinyue nodded.

  …

  After half an hour, I finally got off work.

  Lu Chen's night shift also started.

   (end of this chapter)