Pan Chenliang and the patient
Lanzhou Evening News At about 1:10 p.m. on January 29, Pan Chenliang, a cardiologist at the First Hospital of Lanzhou University, came home from work and passed through the hospital parking lot when he encountered an elderly chest pain patient whose life was hanging in the balance, and he immediately performed cardiopulmonary resuscitation first aid on the patient... Fortunately, the elderly received the correct first aid at the onset of the illness and quickly sought medical treatment, and finally completed the operation within 35 minutes with the efforts of the emergency department and heart center team of the First Hospital of Lanzhou University, and his life was safe. As of 8 February, the patient had recovered well and was able to eat and move normally.
On the road, the life of a patient hangs in the balance, and he rushes to the rescue
"At that time, I saw two family members struggling to help an old man get out of the car, and next to the car was a flatbed truck borrowed by the family, so I quickly stepped forward to help. In the process of helping the old man to the flatbed truck, I felt bad, the old man was sighing and breathing, and began to be confused. Pan Chenliang recalled.
Out of the doctor's instinct, Pan Chenliang touched the old man's bilateral carotid arteries with his hands, found that there was no pulsation, and then patted the old man's shoulder and shouted close to his ear. "There was no response, and the red alarm in my heart immediately rang out: chest pain, loss of consciousness, sighing breathing, no beating of the aorta, and the possibility of cardiac arrest was very high!" Therefore, Pan Chenliang immediately jumped on the flatbed truck and began chest compressions, and the family pushed the flatbed truck all the way to the emergency department rescue room.
Entering the rescue room, it happened that the colleagues from the heart center who came to consult were also there, and Pan Chenliang and the emergency doctor on duty quickly made a preliminary judgment on the condition of the elderly and considered cardiac arrest. The patient's ECG monitoring suggests ventricular fibrillation, so the healthcare staff continues to perform CPR, endotracheal intubation, ECG monitoring, and cardioversion. Pan Chenliang, a member of the ECMO (Extracorporeal Membrane Oxygenation) team at Landa First Hospital, realized that the possibility of the patient needing ECMO support was very high, so he quickly left the emergency department and returned to the coronary heart care unit (CCU) to prepare the items he might need.
Pan Chenliang had just returned to the ward, and lei peng, deputy chief physician of the same department, nurse You Guangling, nurse Fan Yufang and the staff of the nursing team were ready for ECMO to go to the emergency department. Originally, on the way back to the CCU by Pan Chenliang, the emergency department colleagues continued to carry out cardiopulmonary resuscitation and multiple electrical defibrillation and other rescues for the elderly, and the elderly's consciousness, blood pressure and heart rhythm showed no signs of recovery, and the CCU consulting doctor had reported the patient's condition to Deputy Chief Physician Lu Andong and started the emergency ECMO process.
Timely rescue The surgical procedure takes less than 35 minutes
Pan Chenliang quickly changed into a surgical gown and went straight to the emergency department. Evaluation shows that the patient's consciousness has not recovered, the pupil has begun to enlarge, the light reflex has disappeared, the urinary and urine incontinence, and the rapid ultrasound evaluates the patient without heart rupture. Considering that the patient is a witnessed cardiac arrest, the cardiac arrest time is short and the whole process is timely CPR rescue, although the current patient's condition is extremely critical, vital signs have not recovered, according to the traditional cardiopulmonary resuscitation (CPR) rescue, the mortality rate of such patients is close to 100%, but ECMO can improve the survival rate of patients, and the survival rate of patients rescued by ECMO combined CPR (ECPR) at home and abroad is between 20-30%. After the team's rapid judgment, Deputy Chief Physician Lei Peng resolutely decided to implement ECMO support for patients immediately, and at the same time started the process of chest pain center in The First Hospital of Lanzhou University. Pan Chenliang and colleagues in the ECMO team quickly divided their labor and collaborated, disinfecting, puncturing, catheterizing, connecting ECMO... During this period, other doctors continued to administer chest compressions on the patient, and after 30 minutes ECMO began to turn around, and soon the patient's blood pressure and heart rhythm were stable compared with before, but they were not out of danger.
The patient is then transported to the cardiac catheterization chamber for coronary intervention. Emergency coronary angiography showed that the patient's right coronary artery was completely occluded, and the operation successfully completed coronary stent insertion, temporary pacemaker insertion and intraortic counterpulsation pump insertion, and the entire surgical process took less than 35 minutes.
The patient has recovered well and is able to move normally
After surgery, the patient is sent to the CCU for monitoring treatment. The patient's own heart rhythm has recovered, but the heart function is extremely poor, and the heart function still needs continued support from ECMO. On the first day after the operation, the patient heard the correct response such as opening his eyes and nodding his head when he heard the medical staff call, which was a gratifying result that made the medical team very happy.
"In order to allow patients to survive and recover and be discharged from the hospital, ECMO and surgery are only the first step, and there are still many difficulties in follow-up treatment that we need to help patients get through." Pan Chenliang said that the team has the confidence and ability to help patients turn the crisis into safety and fully recover.
It is understood that as of February 8, the patient has recovered well and has been able to eat and move normally.
Lanzhou Daily all-media reporter Tian Xiaodong correspondent Nanru Zhuoma wen/photo