Chapter 17 Perfect vascular palpation! 100% mortality rate
"I can tell you.
I have been practicing medicine for more than 30 years and have encountered six patients with pulmonary embolism.
All six people were dead, and none of them could be saved.
I can't achieve a treatment rate of 30 to 40%.
Maybe it’s because my level is relatively poor…”
Everyone laughed a few times.
Director Wang Ping’s level is poor?
Can a person who writes pulmonary embolism textbooks be bad at treating pulmonary embolism?
Wang Ping added: "Of course, when I first compiled the textbook, I wrote a mortality rate of 90% to 100%. In the end, they revised it for me and replaced it with the above value.
What I want to tell you is, don’t be superstitious about textbooks!
When it comes to clinical practice, the various tests for pulmonary embolism written in the book are meaningless.
Once chest pain triple occurs, treat it directly as pulmonary embolism.
Otherwise, the patient will be gone within fifteen minutes at the fastest! "
He sighed.
After all, textbooks and clinical practice are two different worlds.
He was silent for a while, and the six patients who died in front of him flashed before his eyes, his eyes a little lonely.
"Ouch!"
Suddenly, the patient cried out in pain.
Wang Ping became very vigilant and immediately tore off the patient's clothes and listened a few times with a stethoscope to the murderer's mouth.
At the same time, he asked: "Do you feel anything?"
The patient seemed to have recovered and said, "Doctor, I just had a sudden pain in my leg."
"What now?"
"Now, I feel... I feel like someone is pressing my mouth!"
Wang Ping was silent for a few seconds.
The doctors behind him burst into laughter.
Wang Ping asked seriously: "Do you feel pain in your chest?"
The patient shook his head: "No."
"What about breathing? Is it difficult to breathe?"
"nor."
Wang Ping breathed a sigh of relief.
Putting the stethoscope back into his pocket, he immediately changed his face and lectured:
"In situations like this, we must pay special attention. It is very likely to be pulmonary embolism!
The triad of pulmonary embolism symptoms: chest pain, dyspnea, and hemoptysis.
There are also typical signs, including P2 hyperactivity and systolic murmur in the tricuspid valve area.
If none of these items are present, the diagnosis of pulmonary embolism can be ruled out for the time being. "
Fortunately, this patient did not have pulmonary embolism.
Otherwise, he might have to spend his life to teach the doctors a lesson.
Wang Ping put his hands behind his back and prepared to leave the ward.
But, right now!
Xu Qiu emerged from the crowd and placed her palms on the deep veins of the patient's lower limbs.
Wang Ping was about to scold him, but when he saw it was Xu Qiu, he stopped where he was, wanting to see what the other party was going to do.
The others also stared at Xu Qiu.
In the emergency department, there are only a few people who don't know Xu Qiu.
Everyone knows that Xu Qiu is very skilled in medicine!
So everyone waited quietly.
On the other side, Xu Qiu, beside the hospital bed, closed her eyes, and her mind completely sank into her right hand.
The perfect blood vessel palpation experience plays its role at this moment!
Blood vessels that have lost their elasticity,
Hypercoagulable blood,
And...damaged endothelium!
Xu Qiu opened her eyes suddenly.
He saw that in the deep vein near the knee, there was a fresh remnant of a broken thrombus!
This means that a thrombus has entered the blood, and is likely to return to the right heart along the veins, and eventually enter the pulmonary artery, blocking it here, causing pulmonary embolism!
"Blood pressure, 80/60mmHg. Jugular vein distension...mild edema of left lower limb..."
Xu Qiu pressed the patient's blood vessels and subconsciously judged the blood pressure.
Wang Ping was shocked.
Are you kidding me?
When you palpate and feel your blood pressure, do you think you are a blood pressure monitor?
"Take your blood pressure!"
Wang Ping didn't know what Xu Qiu was doing, but he still asked the doctor to take out the electronic blood pressure monitor.
Ten seconds later, a quick blood pressure reading: 81/62mmHg.
Wang Ping rolled his eyes.
Is this a mistake?
Simply amazing!
At this moment, Xu Qiu's quick voice sounded: "Uncle, what is your financial situation? Should you use expensive medicine or cheap medicine?"
"Young man, just help me use the best medicine, and my medical insurance will reimburse 95% of it."
"Okay, let's rt-PA!"
After hearing the last name of the medicine, Wang Ping completely understood it, and his expression instantly became solemn.
Immediately arranged: "Open a green channel for chest pain! Be careful, don't change the patient's position easily!"
Everyone immediately became busy.
Just been transferred to the emergency room,
The patient who was still joking ten seconds ago suddenly shrank his pupils and his expression was extremely ferocious.
"ah!"
He grabbed the sheets and broke into a cold sweat at the severe pain from the murderer's mouth.
At the same time, his breathing became faster and faster, as if he wanted to suck all the air around him, but his face became paler.
"Pulmonary embolism!"
Alarm bells rang in Wang Ping's heart.
He looked at Xu Qiu with a look of disbelief.
But now is not the time to ask.
He immediately came to the main seat of the rescue room, and the medical staff who had been prepared for rescue were also in place.
Almost as soon as the elderly suffer from pulmonary embolism, the most precise and effective treatment comes.
"Take a shot of rt-PA!"
rt-PA, the full name is recombinant tissue plasminogen activator.
This is one of the best clinical thrombolytic drugs.
But the price is also very expensive, one costs eight to nine thousand.
One rescue, two or three shots, and tens of thousands of dollars are gone.
This is also the reason why Xu Qiu asked about the economic situation before.
"Subcutaneous injection, low molecular weight heparin!"
rt-PA, thrombolysis.
Heparin, anticoagulation.
This is the standard rescue process for high-risk pulmonary embolism.
For more than 30 years, Wang Ping has been operating in this way.
However, none of the six patients with pulmonary embolism survived...
Ding ding ding--
At this moment, the alarm of the life monitor brought Wang Ping back to reality.
The nurse exclaimed in surprise: "Director Wang, the blood pressure is back!"
Wang Ping raised his head in astonishment, looking at the blood pressure gradually rising on the monitor, his joy was beyond words.
This is the emergency room.
A life is lost, and a life is revived, just between a medicine and a thought.
This place gives people the heaviest painful memories.
But, in the same way, the correct rescue process and emergency medicine can also get the fastest feedback in the patient's warming vital signs.
"Congratulations, Director Wang, you have rescued a patient with pulmonary embolism!" A doctor came over and said excitedly.
But Wang Ping ignored it.
He glanced at the emergency room but didn't find the person.
He ran to the corridor again, looking for Xu Qiu.
Finally, he saw him at the nurse's desk in the emergency hall!
Wang Ping quickly chased after him. At this moment, he felt the long-lost surge of emotion. The seventh person... survived!
"Doctor Xu!"
Wang Ping rushed to Xu Qiu with great speed.
At this moment, he forgot that he was the director of the entire department and addressed the young doctor in front of him with a respectful title.
The next moment, his words stunned the nurses at the nurses' station.
