Doctor Science: Sudden chest pain is not relieved, suspect myocardial infarction, to dial 120!
However, many people say that waiting for 120 still needs time, too much delay. There are even people who say that 120 rushes to the yellow cauliflower and it is cold.
So what is the difference between a sudden heart attack, driving yourself to the hospital and dialing 120? After reading today's two cases, everyone will be clear.
Last week, we rescued 2 patients with myocardial infarction, and the incidence was basically the same, but the results were very different.
Case 1:
The patient, a male, 52 years old, suddenly suffered chest pain for 1 hour and was about 30 minutes from the hospital.
When he was a child, he felt particularly uncomfortable and asked his family to drive him to the hospital.
The family dragged the patient down to the 3rd floor and got into a private car.
(Sudden myocardial infarction, heart vessel blockage, heart muscle in necrosis, the heart needs absolute rest, this time can not be chaotic, the best or only way is to lie flat or sit well, let the heart rest well.) Any disturbance will increase the burden on the heart and aggravate the condition. ）
On the way to the hospital, about 15 minutes after getting on the bus, the patient suddenly convulsed on all fours, lost consciousness, and the patient's family members kept pinching people, patting their arms, and pounding their chests.
(When our heart stops beating, it is divided into two situations, one is ventricular fibrillation, which requires electric shock defibrillation, and the other is cardiac arrest, which requires chest compressions, cardiopulmonary resuscitation, and other rescues are futile.) ）
Wait for the patient's family to drive to the hospital, call the emergency doctor to hurry up to see the patient, the patient can not. The emergency department doctor ran to the car and judged that the patient had lost consciousness and the fluctuations in the aortic arteries had disappeared. Meanwhile, other staff members have pushed flat cars and defibrillators to the side of the car. The crowd carried the patient to the flat car, and the defibrillator showed that the patient's ELECTROCardiogram was straight, so instead of using electric shock to defibrillate, only chest compressions and cardiopulmonary resuscitation.
It took 30 minutes from the time the patient decided to go to the hospital to the time he arrived at the hospital.
(After the heart stops beating, if it can be rescued immediately, the hope of survival will increase, and the more it is delayed by one minute, the closer it will be to death.) Under normal circumstances, after the heart stops beating, there is no CPR for more than 4 minutes, then the brain will die, if there is no CPR for more than 8 minutes, then the gods cannot save it. ）
While resuscitation, the patient is pushed into the emergency room and continues to rescue.
After continuous rescue, the patient's vital signs such as heartbeat and breathing did not recover, and the patient's clinical death was declared.
We can assume that the patient did not have ventricular fibrillation or cardiac arrest in the halfway and arrived at the hospital smoothly after 30 minutes.
At this time, the emergency room doctor will ask about the medical history, will do an electrocardiogram, draw blood tests, measure blood pressure, etc., and find that hypotension will increase blood pressure. After the ECG is done, it is found that it is a myocardial infarction, and aspirin 300 mg and ticagrelor 180 mg are given immediately, and the cardiologist is called.
This time is generally within 10 minutes, and after the cardiologist arrives, it takes about another 5-10 minutes to determine that it will take another 5-10 minutes to open the blood vessel, and then it takes at least 15-20 minutes to start the catheterization chamber.
These times, it takes about 30-40 minutes before the patient can be admitted to the catheter room for surgery.
In other words, even if you go to the hospital on your own and everything goes well, it takes 60-70 minutes from the time you go out to the operating table.
Case 2:
The patient, a 54-year-old man, had sudden chest pain for 1 hour and was about 30 minutes from the hospital.
After 1 hour of illness, he felt that his condition was worsening and asked his family to dial 120.
After 120 arrived, after measuring blood pressure, it was found that blood pressure was low, and dopamine vasopressor therapy was given; after the ECG showed acute myocardial infarction, aspirin 300 mg and tigrelor 180 mg orally were given. The patient was carried to the 120 ambulance.
(After the 120 doctors arrived, they could find many problems, especially low blood pressure can be increased; diagnosed myocardial infarction can be immediately given medication.) ）
About 15 minutes after the patient got on the 120 car, he also had convulsions of the limbs, loss of consciousness, ECG monitoring prompted ventricular fibrillation, the doctor immediately shocked defibrillation, the patient's heart returned to normal beating, and consciousness was restored.
Because when the 120 doctors diagnosed that the patient was myocardial infarction, they notified the hospital to activate the catheterization room, and the patient had already taken the preoperative medication, so the patient arrived at the hospital 25 minutes after the 120 car and was taken to the operating room.
After opening the blood vessels, the patient was taken to the intensive care unit and was in stable condition.
(It takes patients a total of 50 minutes from dialing 120 to arriving at the hospital because 120 cars are faster and don't have to wait for a red light.) Dialing 120 on the surface took a little more time than going to the hospital on your own. But the time for 120 to arrive at the patient's home is 25 minutes after 120, which is 5 minutes less than the patient going to the hospital by himself. ）
That is, from the time the patient hit 120 to the time the patient was safely taken to the operating table, it took 50 minutes, and the total time was still less than that of the patient above.
So overall, it's not that hitting 120 is a waste of time.
The characteristics of the 120 are not available by self-driving:
1. 120 Found that the patient had hypotension, and immediately gave the boost therapy; if the patient was found to have hypertension, he could be treated with antihypertensive treatment;
2. The confirmed patient is myocardial infarction, so he immediately gave aspirin and other drugs, and contacted the chest pain center to start the catheter room, saving a lot of time after the patient went to the hospital on his own.
3, 120 have a defibrillator, after the discovery of ventricular fibrillation, can save the patient's life, self-driving is impossible.
4, 120 there are emergency doctors, after finding that the heart stops beating, you can press chest compressions, cardiopulmonary resuscitation, improve survival rate.
Some people will definitely ask what to do if the patient's heart stops beating at home when the 120 has not yet come.
At this time, only chest compressions, cardiopulmonary resuscitation, there is no other way. Under the same conditions, do you think about whether we have a high success rate of CPR at home, or a high success rate of CPR in a private car in the middle of the road (can we perform CPR in the back seat of a private car?). This is still a question! ）。
In short, chest pain persists without relief, suspect myocardial infarction, immediately dial 120! Increases survival chances!