Shenzhen Business Daily • Reading Client Reporter Zhao Hongfei Correspondent Li Xiaoling Ren Wenyi
"Little sister, I'm flustered, I'm very stuffy, and my shoulder still hurts a little, you guys can help me take a look!"
Early in the morning of April 17, 71-year-old Grandma Yang walked into the Mingyue Community Health Service Center of the Eighth Affiliated Hospital of Sun Yat-sen University with difficulty. After receiving the consultation, the general practitioner of Mingyue Community Health was alert and accurately judged that Grandma Yang might have myocardial infarction. After calling 120, the social management center of the hospital coordinated online, and the cardiology experts of the hospital headquarters provided remote guidance, and opened a green channel for referral. It only took 50 minutes from Grandma Yang walking into the community health care to going to the operating table. The community health care at the doorstep has joined hands with the national chest pain center to seamlessly seize the speed of life.
Grandma Yang usually has high blood pressure, and she usually likes to make appointments with her good sisters to play soft ball in the small garden of the community. On the night of April 16, she felt unwell, her chest was tight, she took a heart-saving pill and lay down, and she didn't sleep well all night. However, Grandma Yang didn't take it seriously that night. Until the next morning, the symptoms of chest tightness and chest pain became more and more serious, and Grandma Yang came to Mingyue Community Health for help.
At 8:30 a.m. on April 17, Grandma Yang's simple words aroused the vigilance of the staff at the front of the community's health clinic, and the staff immediately helped Grandma Yang to the consultation room of general practitioner Li Haijie. After a quick physical examination, Dr. Li Haijie considered that it might be an acute myocardial infarction and helped Grandma Yang to the emergency room for an electrocardiogram examination. The results of the examination were astonishing: the ST segment of V1-V5 was significantly depressed, the heart rate was only 45 beats per minute, and the blood pressure was only 74/41mmHg! At this time, Grandma Yang's face was pale, her forehead was slightly sweating, and her life was in danger, and she could go into shock or cardiac arrest at any time. Dr. Li Haijie immediately reported to Zhai Fenfen, director of the Mingyue Community Health Center, and the nurse on the side immediately dialed 120.
"Mingyue Community Health has a case of myocardial infarction, what do you need to do?
"What are the symptoms?onset?Need to speed up rehydration"
In the Rapid Collaboration Group of the Chest Pain Centre of the Eighth Hospital of CUHK, Mingyue Community Health issued a request for help. The hospital's social management center quickly coordinated, and the on-duty doctors from the National Chest Pain Center, the Provincial Key Specialty, and the Cardiology Department of the Eighth Hospital of CUHK immediately gave advice. At the same time, Zhai Fenfen also called Liang Jianwen, deputy director of the vascular disease and structural heart disease specialist, who had just met.
At this time, a series of standardized rescue measures were carried out quickly: ECG monitoring, opening of intravenous channels, and the treatment of "a pack of drugs for myocardial infarction" was given to inhibit platelet aggregation, prevent the further development of thrombosis, and win valuable time for subsequent coronary reperfusion therapy.
The ambulance sped along Shennan Avenue all the way.
"120 arrives for direct conversation, and the cath lab pays attention to the empty time."
"120 is coming, send it to the emergency immediately".
"We waited in the emergency room......
At 8:58, the ambulance arrived at the North Gate Emergency Department of the Eighth Hospital of CUHK, and the transfer bed followed the red chest pain emergency channel guidance line, went straight to the emergency room, completed the preoperative examination, signed the informed consent form, and transferred to the cardiac catheterization laboratory.
At 9:20, coronary angiography showed that Grandma Yang had a dominant left coronary artery, a large left circumflex branch, and 100% occlusion in the middle section! Thrombosis, heart rate and blood pressure dropped, and she was in critical condition. Liang Jianwen skillfully performed interventional surgery for Grandma Yang, and it took only 15 minutes to successfully implant a stent.
After the operation, Grandma Yang's discomfort was significantly relieved, her blood pressure was stable, and she was transferred to the cardiac intensive care unit. A day later, she recovered well and was transferred to a general ward where she continued to receive professional treatment. "I didn't know anything when I came in, and thanks to the community health doctor and these specialists, I might not have been able to play softball again. It is reported that Grandma Yang will be transferred back to Community Health after being discharged from the hospital in the near future, and the family doctor will continue to follow up and return to visit to do a good job in chronic disease management.
Wang Peng, Vice Dean of the Eighth Hospital of CUHK, said that at the end of last year, Futian District accelerated the construction of a high-quality and efficient medical service system, and established three medical and health groups according to streets. The Eighth Hospital of CUHK will implement integrated management of 32 community health care facilities in the four sub-districts of Futian, Fubao, Huaqiangbei and Nanyuan, take the lead in implementing the integration of community health and community health in the hospital headquarters, increase two-way referral, and open a green channel for priority registration, reception, hospitalization and examination for community health patients, so as to promote the sinking of high-quality medical resources of Zhongshan Medical and greatly facilitate the medical treatment of residents.
The Mingyue Community Health Center that Grandma Yang walked into is one of the grassroots community health centers that were newly relocated to the Eighth Hospital of CUHK last year. Looking back on the whole rescue process, it only took 50 minutes for Grandma Yang to go to the operating table from walking into the community health care to going to the operating table. Zhai Fenfen is both happy and worried, "Usually, experts from the hospital headquarters will sit in the community health according to the needs of residents, and last Sunday, the cardiology department also held a special symposium with our community health care, introduced the superior technology, and carried out docking. Unexpectedly, this is used. She said frankly that after the occurrence of acute myocardial infarction, every minute is precious, and saving the myocardium needs to race against time, time is the myocardium, and time is life. From the discovery of the condition to the initiation of the first aid process, from on-site treatment to transfer and docking with the superior hospital, every link of Grandma Yang reflects the professionalism and rigorous attitude of the medical staff. In case of emergency, the general practitioner of the community health care department carried out first aid for myocardial infarction under the guidance of a specialist, and the operation was more standardized and the heart was more steady.
Liang Jianwen reminded that acute myocardial infarction is usually coronary atherosclerosis, plaque rupture, bleeding, the formation of thrombosis or continuous spasm of the artery, which makes the lumen of the coronary artery acutely completely occluded, resulting in myocardial ischemia and necrosis that receives arterial blood supply. Hyperlipidemia, hypertension, diabetes, and obesity are risk factors for the morbidity and mortality of coronary heart disease. Patients with high blood pressure are twice as likely to have myocardial infarction as normal. Patients with hyperlipidemia, hypertension, diabetes and obesity should be actively treated and managed for chronic diseases. When there is chest pain, chest tightness, palpitation and other discomforts, you should pay great attention to it, and you should immediately call 120 to the hospital for further examination and treatment.