Recently, Minle County People's Hospital
Through the pre-hospital "double bypass"
Race against death for the relay of life
1 Successful Rescue
Patients with acute inferior myocardial infarction
The D2W time took only 56 minutes,
It has refreshed the treatment speed of our hospital and even Zhangye Chest Pain Center.
It is also the best record since the establishment of the Chest Pain Center in our hospital!
On the evening of April 16, the staff of Sanbao Central Health Center urgently uploaded an electrocardiogram to the interventional physician of Minle County People's Hospital with the help of the joint treatment network platform of the Chest Pain Center, which showed sinus rhythm and ST-T abnormalities (II, III, AVF, V3, V4, V5, V6). Consider an acute inferior myocardial infarction, which is critical. The on-duty doctor of the Second Department of Cardiology of Minle County People's Hospital responded quickly, made an accurate judgment on the report, and immediately contacted the physician of the health center, inquired in detail about the patient's specific condition and past medical history, and instructed to give bispecific antibody treatment to stabilize vital signs.
After the patient was sent from Sanbao Central Health Center to Minle County People's Hospital, he went directly to the interventional operating room through the pre-hospital "double bypass" (bypass the emergency department and bypass the CCU of the cardiology department), and it took only 56 minutes from the patient's arrival at the hospital to the smooth opening of the blood vessels, opening up a "road of life" for the patient.
Acute myocardial infarction is the most critical cardiovascular disease, characterized by rapid onset, rapid progression, severe disease, and can develop into cardiorespiratory arrest and even death within minutes.
Case sharing
Patient Liu, male, 62 years old. Retrosternal tear-like pain in the precordial area, radiating pain in the left shoulder of the back, a sense of near-death with sweating, and irritability. ECG shows sinus rhythm and ST-T abnormalities (II, III, AVF elevation, V3, V4, V5, V6 depression). BP:90/60mmHg; Three returns of myocardial infarction were extracted: cTnI 0.018ng/ml, Myo 3.05ng/ml, and CK-MB 1.57ng/ml. Diagnosis: acute ST-elevation inferior myocardial infarction.
▲ Preoperative ECG
▲ Postoperative ECG
Through the seamless connection of "urgency, speed, accuracy and stability" of the interventional team, a high-speed life channel has been opened for patients.
Under the leadership of He Yongqiang, the director of the Second Department of Cardiology, the interventional team began a race against time with death: the patient entered the hospital gate at 17:57, the operation began at 18:15, the proximal occlusion of the right coronary was confirmed by intraoperative coronary artography, the guidewire was opened at 18:53, and the operation was successfully completed at 19:26. Due to timely and appropriate treatment, the patient's infarcted blood vessel was restored to grade 3 blood flow after surgery, and the patient's cardiac function was well preserved. At this time, the patient only took 56 minutes from admission to the completion of the operation, which is 34 minutes faster than the 90 minutes required by the current chest pain center certification in mainland China! (The "D to B" time of the mature chest pain center--- that is, the time from the time the patient enters the hospital gate to the time when the guidewire or balloon passes through the occluded lesion during the operation, should be less than 90 minutes. ) "outperformed" more viable cardiomyocytes for the patient.
Speaking of the situation at that time, Uncle Liu was full of emotion: "I still feel scared when I think about it now, but I feel that I am lucky to meet the good doctors and nurses of Minle County People's Hospital, I am especially grateful to them!"
The Chest Pain Center of Minle County People's Hospital has successfully passed the national standard chest pain center certification in 2021, and the chest pain green channel is open 24 hours a day, giving priority to patients with acute myocardial infarction, and has accumulated rich clinical experience in the treatment of cardiovascular critical and emergency patients, and enjoys a good reputation and popularity in the region.
The "Minle County People's Hospital Medical Community ECG Network" realizes the data interconnection between the primary medical institutions and county-level hospitals in the medical community. Patients undergo ECG examinations in primary medical institutions, and the data can be uploaded to the chest pain treatment center group of Minle County People's Hospital in real time, and experienced doctors will make quick judgments and quickly give solutions. This method not only solves the problem of inconvenience for grassroots patients to go to higher-level hospitals, but also makes up for the shortcomings of grassroots doctors in ECG recognition ability. The "One ECG Network of the Medical Community" has opened up the "first kilometer" of chest pain treatment and the "last kilometer" of chest pain center construction in Minle County, realizing the efficient and collaborative treatment of chest pain patients.
In recent years, the cardiac interventional surgery of Minle County People's Hospital has developed rapidly, the hospital has developed an efficient rescue process, all core departments have worked closely together, and the interventional team has worked together to open the occluded blood vessels for patients in the shortest possible time. In particular, the members of the cath laboratory who are always preparing for emergency surgery are particularly touching, whether they are day or night, windy and rainy, hot and cold, as long as they are called, they can rush to the treatment scene as soon as possible, and escort patients with acute myocardial infarction as soon as possible.
In the case of chest pain and tightness, an electrocardiogram is not simple, and it is one of the important means to diagnose acute myocardial infarction. Whether it is in the grassroots township or in the ambulance, the electrocardiogram examination can be carried out anytime and anywhere, and the People's Hospital of Minle County has opened up a network for chest pain treatment, and experts can interpret it in real time, make rapid diagnosis, and send it back in time, so as to open up the first kilometer of chest pain treatment and guard the first pass.
"1120 myocardial infarction treatment day" 1120 has two meanings
One is "I have chest pain, I'm going to call 120."
(Chest pain is a hallmark symptom of a myocardial infarction, call 120 immediately after an acute myocardial infarction)
The second is "myocardial infarction treatment, strive for 120 minutes of gold."
(If acute myocardial infarction can be completed within 120 minutes from the onset of the onset to the opening of the infarct blood vessels, the mortality rate and disability rate can be greatly reduced, and a good treatment effect can be achieved)
What is an acute myocardial infarction
Acute myocardial infarction is caused by the sudden occlusion of the arteries (coronary arteries) of the heart, resulting in myocardial necrosis of any size due to ischemia and hypoxia.
Symptomatic manifestations of acute myocardial infarction
In the most severe form of a heart attack, it can be a direct manifestation of cardiac arrest, also known as "sudden death".
Some people present with uncomfortable symptoms such as dyspnea, chest tightness, and shortness of breath. Other symptoms may include irritability, cold sweats, nausea and vomiting, palpitation, fear, occasional sense of impending death, and even blackness and fainting in front of the eyes.
"Call 120 for a heart attack, chest pain center for help"
急诊科：0936 - 4421120
Department of Cardiology: 0936 - 4458409
Department 2 of Cardiology: 0936 - 4455163
Expert recommendation
He Yongqiang
Director of the Second Department of Cardiology
Deputy Chief Physician
Graduated from the Department of Traditional Chinese Medicine of Gansu University of Traditional Chinese Medicine with a bachelor's degree. He has been engaged in cardiology for more than 10 years, and has studied in the Department of Cardiology and Interventional Medicine of the First Hospital of Lanzhou University, the Second Hospital of Lanzhou University, and Xijing Hospital. He specializes in the integrated treatment of hypertension, coronary heart disease and cardiomyopathy, as well as the interventional treatment of cardiovascular diseases, congenital heart disease, arrhythmia, peripheral vascular diseases and tumor diseases. He has published many national and provincial medical papers.
Li Zengxi
Attending
Graduated from Gansu University of Traditional Chinese Medicine with a bachelor's degree. He has extensive clinical work experience and is good at the diagnosis and treatment of common cardiology diseases such as coronary heart disease, heart failure, myocardial infarction, arrhythmia, hypertension, and arteriovenous thromboembolism.
Li Shengpeng
Attending
He graduated from Lanzhou University with a bachelor's degree in clinical medicine. He has completed a three-year residency training in the First Hospital of Lanzhou University, and has rich clinical work experience, specializing in the diagnosis and treatment of common cardiology diseases such as coronary heart disease, heart failure, myocardial infarction, arrhythmia, and hypertension.