After repeated cardiac arrest after acute myocardial infarction, continuous rescue for more than 3 hours, more than 10,000 compressions during the period, and finally maintain blood supply through the extracorporeal membrane lung (ECMO), after 5 days in the ICU, 70-year-old Li Bo (pseudonym) finally recovered and was discharged from the hospital yesterday, creating another miracle of life!
The reporter learned from the First Affiliated Hospital of Jinan University that the reason why Li Bo, who was critically ill, was able to fully recover without leaving any sequelae was entirely dependent on the "textbook" rescue of enthusiastic passers-by, 120 ambulance personnel and medical personnel. Professor Zhang Xiaoshen, vice president of the First Affiliated Hospital of Jinan University and chief physician of cardiac surgery, said.
Baiyun Mountain fainted, passers-by, 120, the hospital relay rescue
At 7:15 a.m. on December 22, 2021, 70-year-old Li Bo (pseudonym), who was practicing in the morning on Baiyun Mountain, suddenly fainted, and Officer Liu Yaobai of the Baiyun Mountain Police Station who was running in the morning happened to pass by, and after the initial judgment that the old man had no heartbeat, no breathing, and unconscious, Officer Liu immediately dialed the 120 emergency call and immediately performed CPR. At 7:25, 120 ambulances arrived at the scene, at this time Li Bo lost consciousness, bilateral mydriasis reflex disappeared, no heartbeat, occasional sighing breathing 2-3 minutes / time, 120 ambulance personnel relay rescue, continue to give CPR, balloon mask oxygen, open venous channel, when the ECG monitoring ECG is in a straight line, the ambulance personnel immediately give Li Bo intravenous bolus adrenaline to excite the heart. Monitoring showed that it was still ventricular fibrillation, and three more times of electrical defibrillation, endotracheal intubation... However, unfortunately, after about 30 minutes of rescue on the spot, the patient has not fully recovered his own spontaneous heartbeat, and the ambulance personnel will start and transfer him back to the Second Hospital of Traditional Chinese Medicine in Guangdong Province while continuing to do CPR for Li Bo.
On Baiyun Mountain, Officer Liu and 120 ambulance personnel urgently rescued Li Bo.
At around 8:10, Li Bo's autonomous heartbeat gradually recovered, but the heart contracted without force - blood pressure was less than 80/50 mmHg. After consultation with Yuan Ding, director of the Department of Cardiology of the Second Hospital of Traditional Chinese Medicine of Guangdong Province, considering that Li Bo is an acute myocardial infarction complicated by malignant arrhythmia, the left trunk plus three lesions are likely, the condition is critical, and there may be cardiac arrest again at any time during the coronary angiography process, and it is necessary to undergo coronary intervention surgery under ECMO, and immediately contact the cardiac surgery team of the First Affiliated Hospital of Jinan University after communicating with the family.
At 10:20, the Cardiac Surgery Team of the First Affiliated Hospital of Jinan University arrived at the Second Hospital of Traditional Chinese Medicine of Guangdong Province to insert the patient into ECMO, and then transferred the patient to the First Affiliated Hospital of Jinan University.
At 12:00 noon, as soon as the patient arrived at the First Hospital of the Great Affiliated Hospital, he was immediately sent to the interventional operating room for successful cardiac interventional surgery.
At 13:30, the surgery was completed, Li bo was transferred to the ICU ward, and the patient's heartbeat and blood pressure tended to normal with the support of ECMO and IABP auxiliary circulation.
On December 27, 2021, that is, 5 days later, Li Bo finally successfully withdrew ECMO, and on the afternoon of December 28, he also removed the intraaortic balloon counterpulsation (IABP, one of the mechanical auxiliary circulation methods, through physical action, increase the intra-aortic diastolic pressure, increase coronary blood supply, improve the myocardium and reduce the burden on the heart, and are widely used in the rescue and treatment of critically ill patients such as cardiac insufficiency). On December 30, Li Bo was transferred to the general ward, and after nearly a month of rehabilitation, Li Bo was finally discharged from the hospital yesterday.
"When I woke up, my memory was still stuck on Baiyun Mountain, and when I opened my eyes, I didn't expect to lie in the ICU. This time I was able to recover so well, I really thank you for your relay rescue! Li Bo said.
Li Bo successfully recovered and was discharged from the hospital
"Textbook" first aid allowed the critically ill Li Bo to recover and be discharged from the hospital smoothly
The reporter learned that although Li Bo's condition was dangerous, he had repeated cardiac arrest after acute myocardial infarction, but did not leave any sequelae, and his recovery was very good. Zhang Xiaoshen said that this is due to the fact that all aspects of the rescue are very fast and accurate, which is worth learning:
First, when Li Bo fell to the ground, he was lucky to meet Officer Liu. Officer Liu is a member of the Blue Sky Rescue Team (the Blue Sky Rescue Team is a professional and independent pure public welfare emergency rescue agency in China), the rescue experience is very rich, and it is judged that Li Bo may be an acute myocardial infarction and immediately after performing effective cardiopulmonary resuscitation, effectively protecting Li Bo's heart and brain and other important organs.
Zhang Xiaoshen reminded that the most scientific approach to cardiac arrest after acute myocardial infarction is effective cardiopulmonary resuscitation, you must seize the golden time of 6 minutes, more than 6 minutes patients have the risk of brain death, there will be irreversible brain damage and heart damage, we must not easily give up rescue, and as soon as possible to 120 or the nearest medical institution for help.
Second, 120 arrived at the scene in time, and 120 arrived at the scene 10 minutes after receiving the report, relaying first aid.
Third, in the process of transferring from the Second Hospital of Traditional Chinese Medicine in Guangdong Province to the First Affiliated Hospital of Jinan University, ECMO was urgently activated, and as soon as Li Bo was sent to the hospital, he was directly sent to the cardiac intervention room, and the operation was carried out in a race against time, and the root cause was removed in a timely and effective manner.
Zhang Xiaoshen introduced that at that time, after receiving the treatment instructions of the hospital's cardiac surgery team, from the departure to helping the patient complete the ECMO link and start the operation, and then to picking up the patient for surgery, the whole process was less than 2 hours, the efficiency was very high, and it created a possibility for the patient's complete recovery.
Zhang Xiaoshen introduced that After Li Bo's acute myocardial infarction, myocardial setback, severe damage to heart function, can not support the whole body circulation and cope with interventional treatment, in an unstable period, the patient has no auxiliary artificial circulation to allow the heart to rest, stop beating again at any time, the condition is critical, such as the use of conventional treatment methods has no chance. The situation is critical, so ECMO is activated immediately during the transport process to maintain an effective blood and oxygen supply to the patient, creating time for doctors to take care and for the patient's cardiopulmonary function to recover.
Fourth, the comprehensive treatment measures after surgery are appropriate. Because Li Bo had a long heart stopping and was once worried about his brain damage, the hospital's multidisciplinary consultations formulated perfect comprehensive treatment measures for him, and finally ensured Li Bo's smooth recovery.
Reminder: ECMO is a double-edged sword, and it must be used well
According to reports, although Li Bo often exercises and climbs Baiyun Mountain, he has been used to tobacco and alcohol for many years, and his diet is salty and spicy, and there are multiple high-risk factors for coronary heart disease and myocardial infarction, so he is a high-risk group of acute myocardial infarction.
And acute myocardial infarction is currently one of the most common causes of sudden death of cardiovascular disease, acute myocardial infarction if the interventional surgery in time to open the blocked blood vessels, the survival rate of patients is very high, but during surgical treatment and preoperative surgery is prone to ventricular fibrillation and even cardiac arrest, the general myocardial infarction within 72 hours of multiple, for the rescue of patients with repeated ventricular fibrillation cardiac arrest, ECMO is almost the only way to save life, this time Le Bo if there is no ECMO auxiliary support, then it is very likely to die.
Zhang Xiaoshen introduced, ECMO is a kind of artificial in vitro cardiopulmonary life support system, used to rescue patients whose cardiopulmonary function is seriously damaged and their lives are in danger, in recent years, due to the improvement of domestic medical level, more and more medical institutions have gradually carried out this technology, but Zhang Xiaoshen reminded that ECMO is a double-edged sword, it is only to provide a temporary external cardiopulmonary function support device, to create time and space for doctors to treat primary diseases, so that the heart and lungs can be better restored with adequate rest. However, ECMO is an invasive complex treatment, there may also be more serious complications and cause serious damage, if the primary cause is not effectively managed during the auxiliary period, with the extension of ECMO use time, the possibility or degree of related complications will be aggravated, and even endanger the patient's life. "Therefore, it is necessary to have a mature and closely coordinated team, and the post-management of ECMO is a key factor in determining the success of treatment."
Text, photo/ Guangzhou Daily Xinhuacheng Reporter: Zhang Qingmei Correspondents: Zhang Cancheng, Li Xiaohui
Guangzhou Daily New Flower City Editor: Wu Wanhong