Doctor: start with the heart

Chapter 4 Interventional Therapy
"Xiao Zhao?"

Wang Ming raised his head and looked at Zhao Xu with a serious expression. Li Haiyang, the anesthesiologist Yang Lin, and the equipment nurse Xu Yun all looked at Zhao Xu together by coincidence.

In their opinion, the director said that there was no better choice. At this time, Zhao Xu stood up and said that he had a solution, which made everyone think that Zhao Xu was the kind who was eager to perform, but overestimated his ability Irritable young doctor is up.

You know, in a hospital, sometimes position and qualifications represent strength and experience. In a department, the medical level and experience of a director are undoubtedly better than a resident doctor who has just joined the job!

Therefore, Zhao Xu stood up when Wang Ming had nothing to do, and said that he had a way. In the eyes of everyone, it was undoubtedly a bit of a sensationalist.

"Xiao Zhao, this is not a joke."

Wang Ming said to Zhao Xu very seriously, but there was also a glimmer of hope in his tone.

At this time, it's not the time to care about qualifications and titles, if there is a way, then don't care so much!
"Director, I suggest the patient to have a bedside echocardiography."

Naturally, Zhao Xu couldn't say it directly at the moment. He used Sean's visual-space conversion ability, which is the humanoid CT, and combined with the patient's condition, he had already calculated the reason why the patient's blood pressure dropped suddenly. The root is above the heart.

Therefore, the only thing to do now is to do an examination first, and use the results of the examination to confirm his inference. Otherwise, it is just a guess. As a top medical expert and the director of the emergency department, Wang Ming will definitely be more inclined to his own inference.

"Tell me?"

Seeing Zhao Xu's calmness, Wang Ming made up his mind a lot. Since young people are capable and thoughtful, as the director of the emergency department, Wang Ming will naturally support and train young people.

In recent years, Wang Ming, as the director of the emergency department, has felt powerless. On the one hand, it is because of the increasingly heavy workload of the emergency department; In terms of reserves, compared to other departments, it is much weaker.

Otherwise, as an undergraduate, how could Zhao Xu stay in the emergency department of the first attached hospital? This also shows that the emergency department is quite short of people now.

"Director, please look, the patient now has a low T wave. I think it is very likely that the abdominal bleeding formed a thrombus. The thrombus reached the heart vessel along with the blood circulation and formed a blockage, causing myocardial ischemia. It causes a drop in blood pressure."

Zhao Xu quickly explained his speculation.

If it were the previous Zhao Xu, it would naturally be impossible to think of the myocardial ischemia caused by the blockage of the blood vessels in the patient's heart by a simple change in the electrocardiogram, combined with the patient's symptoms, which manifested as a sudden drop in blood pressure.

This requires not only solid professional knowledge, but also a special way of thinking and ability, that is, Sean's visual-spatial conversion ability. With this ability, he can perform 3D modeling in his mind according to the patient's condition.

"Huh~"

"Don't tell me that I haven't discovered it yet. The T wave is indeed somewhat flat."

Hearing Zhao Xu's words, Wang Ming couldn't help but look up at the ECG on the life monitor carefully. After looking at it, he found that there was indeed a low T wave as Zhao Xu said.

"Xiao Li, tell the ultrasound room to come over and take a bedside heart photo."

Wang Ming is also a vigorous and resolute person. Now that he found the problem, he didn't waste any time, so he immediately asked Li Haiyang to contact the doctor in the ultrasound room for an examination.

"Okay, Director."

Li Haiyang nodded, but he glanced sideways at Zhao Xu.

Xiao Zhao, he hadn't seen this level before, what's going on today, he exploded suddenly?
The operating room is the battlefield, and the doctors in the B-ultrasound room came very quickly. After a while, the Doppler ultrasound image of the patient's heart appeared on the electronic screen.

"Director Wang, it can now be confirmed that the patient has severe myocardial ischemia, which is preliminarily estimated to be caused by blockage of blood vessels in the heart."

Song Xinying, the doctor on duty in the B-ultrasound room, looked at the images on the electronic screen, and said to Wang Ming while continuing to operate.

As soon as Song Xinying said this, everyone in the operating room looked at Zhao Xu.

The result of this test was exactly the same as what Zhao Xu said!
This guy is simply a humanoid X-ray machine!
Li Haiyang looked at Zhao Xu with a weird face, and couldn't help but complain in his heart.

"I see."

"Xiao Zhao, your deduction is very correct!"

Wang Ming let go of the doubts in his heart, looked at Zhao Xu with admiration and said.

"Xiao Yang, please come over to Director Xu from the Department of Cardiac Surgery to prepare for interventional surgery."

Wang Ming said to the anesthesiologist Yang Lin again.

Now that the cause of the disease has been determined, the next step is to determine the location of the embolus under X-ray fluoroscopy conditions, and then perform catheter intervention to remove the embolus and restore the smooth flow of blood vessels in the heart.

Such a professional operation naturally requires a specialist in cardiology to do it.

Director Xu Hui of the Department of Cardiology has been good friends with Wang Ming for many years. It would be great if Xu Hui was invited to come.

"Director Xu from outside the heart will come for a while, Xiao Zhao, Xiao Li, please cooperate with me to do an extracorporeal circulation to reduce the burden of the patient's heart blood supply."

After Wang Ming explained to Yang Lin, he spoke slowly to Zhao Xu and Li Haiyang.

Interventional surgery is not something that can be done in a short time, or that people can do it when they come. Now that the patient's heart muscle is in a state of ischemia, it is necessary to do extracorporeal circulation first to reduce the burden of blood supply to the patient's heart, and then Under X-ray fluoroscopy, the position of the patient's embolus is determined, and a catheter is used to intervene in the heart blood vessels to remove the embolus and completely solve the problem.

"Ah."

Both Zhao Xu and Li Haiyang nodded together.

"Xiao Zhao, how did you think that the patient's problem was caused by an embolus blocking the blood vessels in his heart?"

While doing extracorporeal circulation with the two of them, Wang Ming asked Zhao Xu with some doubts. On the one hand, it was a comparison. On the other hand, Wang Ming also wanted to know what Zhao Xu's way of thinking was.

In Wang Ming's opinion, Zhao Xu's medical knowledge reserve and professional quality skills must not be compared with him as the director, or even the attending doctor Li Haiyang standing next to him. After all, he has accumulated years of practice.

But Zhao Xu's way of thinking made Wang Ming very interested. Otherwise, Zhao Xu would have discovered something that neither he nor Li Haiyang had thought of or discovered. This had to be said to have surprised Wang Ming very much.

In clinical practice, technology and knowledge are very important, but clinical thinking that wins by surprise is sometimes more important. Modern medicine almost always has very detailed norms and procedures for the treatment of various diseases. As long as you know the cause, you can Can prescribe the right medicine to treat according to the norms and procedures.

But the human body is complex, and the same symptom can sometimes be caused by many different causes. Therefore, determining the cause based on symptoms and signs is arguably the most important thing in clinical practice.

Therefore, having flexible clinical thinking is the most important thing to be a good doctor.

(End of this chapter)