"Doctor, I feel very good in my body now, and I can drive a long distance again after the end of the year!" On the eve of the Lunar New Year, when the 58-year-old Xu Shu (pseudonym) returned to the hospital for a follow-up consultation, he happily told the doctor about his plan for a new life in the next year. Who could have imagined that a month ago, When Uncle Xu suddenly had a cardiac arrest and his life was on the verge of death, it was the expert professor of Sun Yat-sen Memorial Hospital of Sun Yat-sen University who worked together to save him.
Sudden cardiac arrest, passers-by, doctors staged a "textbook" to save people
"Hey, 120, someone here fainted, it seems like a cardiac arrest!" At about 9:20 a.m. on December 16, 2021, Uncle Xu drove the truck to deliver the goods as usual, and was preparing to pull over, when he suddenly had a cardiac arrest when he opened the car door and fainted next to the car door. At this time, a passerby found him, hurried over to check the situation, shouted a few times, and Uncle Xu did not react at all. Passers-by immediately called 120.
The emergency department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University quickly arrived at the scene after receiving 120 instructions, immediately started the CPR process, judged the patient to be "ventricular fibrillation, cardiac arrest", and quickly gave him an electric shock to defibrillate once, and then the patient recovered sinus heart rate. Team 120 continued CPR and monitoring, and quickly and smoothly transported the patient to Sun Yat-sen Memorial Hospital of Sun Yat-sen University.
Arriving at the emergency department rescue room of the hospital, Uncle Xu once again had "ventricular fibrillation", and the emergency department team immediately gave rescue measures such as electrical defibrillation, cardiac compression, intravenous adrenaline injection, tracheal intubation, ventilator assisted ventilation, and started the MDT (multidisciplinary consultation) procedure. Suddenly, experts from multiple departments such as cardiovascular medicine and ICU gathered in the emergency department to consult with Uncle Xu and discuss his condition.
"The patient has another ventricular fibrillation and is given electrical defibrillation!" In just 5 minutes of arriving at the hospital, Uncle Xu had already had 2 consecutive ventricular fibrillations. Considering that Xu Shu still has the possibility of heart deterioration again, Professor Zhang Yuling of the Department of Cardiology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University recommends immediate transfer to CCU (Cardiovascular Intensive Care Unit) for further treatment.
After Uncle Xu was transferred to the CCU, the CCU gave Uncle Xu symptomatic treatment such as mechanical ventilation, anti-infection, improvement of cerebral circulation, and nutritional support. The multidisciplinary "sudden cardiac death" emergency rapid response team composed of the hospital's cardiovascular medicine department, emergency department, cardiothoracic surgery, radiology department, etc. has escorted Uncle Xu all the way.
In the event of "cardiac arrest and sudden cardiac death" outside the hospital, the chance of being rescued is very small. "It is precisely because of the timely call for help from the passerby, the emergency team quickly put in place and standardized the recovery, seamlessly connected with the cardiovascular and other teams in the hospital, and jointly staged a 'textbook' rescue to save people, winning valuable time for the treatment of sudden cardiac death patients and creating a valuable opportunity for 'rebirth'." Professor Wang Jingfeng, director of the Department of Cardiovascular Medicine at Sun Yat-sen Memorial Hospital of Sun Yat-sen University, said.
Uncle Xu presented the pennant to the medical team to express his gratitude
The doctor loaded a sharp weapon for him to solve the dilemma of "sudden death"
On December 18, Uncle Xu finally regained consciousness, removed the endotracheal intubation, and under the dedicated treatment and care of CCU medical care, Uncle Xu's state gradually stabilized, and finally safely passed the "ghost gate".
"Uncle Xu himself has a long history of smoking, high blood pressure, and heart failure, which are all high-risk factors for sudden cardiac death." Professor Zhang Yuling said.
On December 22, in order to help Uncle Xu stop experiencing cardiac arrest caused by ventricular fibrillation, under the guidance of Director Wang Jingfeng, the ICD team of the Department of Cardiology designed a delicate surgical plan for Uncle Xu and safely implanted the ICD (Implantable Cardiac Rebalector Defibrillator) into Uncle Xu's heart.
The middle segment of the anterior hypogniovascular descending branch of the coronary artery of Xu Shu's heart is chronically completely occluded, the proximal segment of the gyratory branch is chronically completely occluded, and the right coronary artery is 60% stenosis with neoplastic expansion, resulting in heart failure, shortness of breath and other symptoms. On December 28, the expert team did a blood vessel revascularization of the occluded blood vessels for Uncle Xu, and implanted a stent to reopen the blocked blood vessels. There were no sequelae left in this treatment, and Uncle Xu was successfully discharged from the hospital. A month later, Uncle Xu will return to the hospital for blood vessel reconstruction of the right coronary vessel. In view of Uncle Xu's long-term heart failure, the medical team also carried out individual and refined medication adjustment and guidance for Uncle Xu.
In the event of someone fainting, passers-by can buy time for doctors to treat!
"Sudden cardiac death with high mortality and poor prognosis is a problem that is difficult to solve all over the world." Professor Wang Jingfeng introduced, "Sudden cardiac death refers to sudden death due to various cardiac causes. Can occur in patients with or without original heart disease, often without any life-threatening pre-manifestations, sudden loss of consciousness, death within 1 hour of the onset of acute symptoms, non-traumatic natural death, characterized by unexpected rapid death. ”
For sudden cardiac death, what non-skilled medical personnel can do is CPR, and the sooner the better. Professor Yu Tao, deputy director of the emergency department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, said that once someone suddenly falls, and then calls for unconsciousness, it should be immediately thought that the patient is likely to have cardiac arrest and needs to call for help immediately, dial the 120 emergency number, and call someone or get an automatic external defibrillator (AED) at the same time.
How to do CPR? After the call for help, the patient's breathing should be evaluated immediately, and if the patient has no breathing or abnormal breathing (inconspicuous breathing movements or sobbing breathing after a long pause), and there is no limb movement or sound, it can be concluded that the patient has cardiac arrest and requires immediate CPR.
CPR consists of three key steps:
1. Perform high-quality chest compressions. Place the patient on his or her back on a harder flat surface (e.g., floor, tabletop, etc.) with the rescuer on the patient's side. Select the patient's chest center (the lower half of the sternum, the midpoint of the male double nipple connection), contact the patient with the root of the palm of one hand, place the other hand above the palm, take the hip joint as the fulcrum, and use the strength of the entire upper body to perform rapid (100-120 times/min) and force (5-6 cm depth) compressions perpendicular to the thoracic cage. At each time, the time of compression and relaxation is roughly the same, and when the thoracic cage is relaxed, the thoracic cage should be able to fully rebound.
Interruptions in compressions should be minimized throughout the compression process, except for interruptions in compressions during the necessary operations (e.g., electrical defibrillation, artificial respiration, rejudgment of the patient's condition every two minutes, and exchange of compressions due to fatigue).
2. If possible, perform artificial respiration. If you have been trained in CPR and have personal protective equipment (e.g., portable masks or respiratory masks), artificial respiration should also be performed on patients, especially in non-adult patients or cardiac arrest due to asphyxia (e.g., drowning, etc.).
3. Timely electrical defibrillation. If an automated external defibrillator (AED) is available, it should be used immediately and electrical defibrillation performed early. The use of AED only needs to follow the voice prompts of the machine.
Text/Guangzhou Daily, Xinhuacheng Reporter: Ren Shanshan Correspondents: Zhang Yang, Huang Rui
Guangzhou Daily New Flower City Editor: Wu Wanhong
![Love to drink, not exercise, two packs of cigarettes a day... How does he beat time after a cardiac arrest?[fig]](data:image/gif;base64,R0lGODlhAQABAIAAAP///wAAACwAAAAAAQABAAACAkQBADs=)