Emergency admission: The patient's life is hanging by a thread in the chest pain
In the early morning of April 1, the emergency room of the Emergency General Hospital welcomed a middle-aged male patient in critical condition. The patient is 45 years old and has undergone cardiac stent surgery and has been on dialysis for a long time. He arrived at the hospital that morning with chest pain lasting 7 hours and severe wheezing for 2 hours. Blood pressure drops sharply, cyanosis is obvious, and acute myocardial infarction with acute left heart failure and cardiogenic shock is diagnosed, and the situation is very critical.
The medical staff acted quickly and quickly gave the patient non-invasive ventilator support and vasoactive drug treatment in the emergency department, the patient's wheezing and chest pain symptoms initially improved, and the blood pressure did not drop further. The patient's ECG shows the characteristics of acute massive myocardial infarction, and if the blocked blood vessel is not opened in time, it will be life-threatening.
Precise treatment: multidisciplinary collaboration shows great powers
In the face of such an urgent condition, Wu Di, the president of the Emergency General Hospital, led the cardiology team to quickly formulate a treatment plan, and Cheng Qinghao, director of the anesthesiology department, led the anesthesiologists to be on call in the catheterization laboratory at any time. After entering the catheterization laboratory, the patient has frequent nausea, vomiting, dyspnea, wheezing, and blood pressure drops again, and his condition is critical, and circulatory collapse or cardiac arrest may occur at any time.
At the same time, Fan Yudong, deputy director of the Department of Cardiology, urgently implanted an intra-aortic balloon pump (IABP) for the patient to provide hemodynamic support and stabilize blood pressure. Angiography showed that the patient had severe stenosis (90%) in the anterior descending artery (LAD) and 95%~99% severe stenosis in multiple places in the right crown (RCA), and the blood flow was slow.
Speed of life and death
In order to restore effective myocardial blood supply as soon as possible, Dr. Wu immediately decided to treat LAD first, and then RCA, he quickly implanted a stent in the anterior descending artery, and used a drug balloon to dilate multiple severe stenosis and calcified lesions of RCA, so that the blood flow of the two blood vessels could be fully improved. As treatment progressed, the patient's condition gradually stabilized and he was subsequently transferred to the CCU intensive care unit for follow-up treatment.
Decisive battle with the Grim Reaper
Fine management: life care in the intensive care unit
After transfer to CCU, patients face many challenges in their treatment and management. Because the patient has kidney failure and anuria, regular dialysis is required. At the same time, the patient also has severe pump failure and requires respiratory support with a noninvasive ventilator. In addition, an IABP pump was placed in the patient's body for continuous hemodynamic support, both to ensure adequate anticoagulation and antithrombotic therapy, and to prevent serious bleeding complications such as the digestive tract. It is also necessary to accurately adjust vasoactive drugs to maintain systemic circulation, ensure microcirculation perfusion of vital organs, and reduce blood lactate levels.
Team battles
Under the careful treatment of medical staff, the patient's condition gradually stabilized. Through aggressive hemodynamic monitoring, physicians are able to precisely adjust the patient's volume load, on the basis of which the dose of vasoactive drugs can be precisely adjusted, acid-base imbalances and electrolyte imbalances can be corrected, and dangerous conditions such as hyperkalemia can be prevented. At the same time, doctors and nurses continue to actively encourage patients to strengthen supportive treatment, correct severe anemia, prevent infection, etc. After several days of meticulous treatment, the patient was finally out of danger and the IABP pump was successfully removed.
Overcome difficulties
Teamwork: Overcome difficulties together and show the benevolence of doctors
Behind the successful rescue is the close cooperation of multiple departments of the Emergency General Hospital and the hard work of medical staff. From the emergency department to the anesthesiology department, to the catheterization laboratory and cardiology department, each department gives full play to its own professional advantages and provides a strong guarantee for the treatment of patients.
Throughout the treatment process, the medical staff always maintained a high sense of responsibility and mission, and they stayed by the patient's side day and night, always paying attention to the changes in the patient's condition. Their exquisite skills and selfless dedication have not only won the trust and gratitude of patients, but also demonstrated the noble spirit of benevolence of doctors.
Get back on your feet
Patient Rehabilitation: A New Life Shows the Future
After careful treatment and care by medical staff, the patient's condition was effectively controlled, and both the ventilator and the IABP pump were deactivated. At present, the patient's vasoactive drug dosage is very small, the circulation is stable, and the cardiac condition is basically stable.
Looking back on the entire treatment process, it can be said that it is a thrilling speed of life and death. But it is the skill and teamwork of the medical staff that enables patients to turn the corner and regain their lives.
This successful rescue case not only demonstrates the superb technical level and teamwork ability of the Department of Cardiology of the Emergency General Hospital, but also reflects the strong strength of the hospital in dealing with critically ill patients. In the future, the Emergency General Hospital will continue to uphold the service concept of "patient first", continuously improve the level of medical services, and escort the health of more patients.
Source: Emergency General Hospital
Correspondent: Mo Peng
Editor: Chen Shirui