I really don't want to be a doctor

Chapter 155 Rescue after death 30 minutes
Upon hearing this, Zhu Zhu rushed out of the doctor's office and ran into No. 1 emergency room.

Jing Xiaoran, Teacher Cao and Senior Sister Li from the same group followed closely behind, and doctors from other groups who had nothing to do also rushed over.

"The patient said that he had chest pain, nausea, and vomiting. I just told you to go to you, and his breathing became short of breath, and his blood pressure on the monitor suddenly dropped."

Walking into No. 1 emergency room, the bedside nurse quickly reported the patient's condition to Zhu Zhu, while another nurse had already pushed the ambulance over.

Zhu Zhu immediately checked the patient's status.

At this time, the patient had no self-consciousness. The blood pressure above the intensive care unit was 76/54mmHg, and he was in shock. The blood oxygen saturation was 89%. The heart rate began to slow down from the initial 110 beats/min.

Zhu Zhu has already started cardiopulmonary resuscitation, and at the same time ordered: "Prepare for endotracheal intubation, add a bag of liquid, administer dopamine, Cordone, and magnesium sulfate, and then check the electrocardiogram and take blood gas!"

Sister Li pushed the electrocardiogram, and Teacher Cao took the equipment for bronchial intubation from the nurse.

"Have you gone into cardiogenic shock again?"

In this critical emergency, as an intern, Jing Xiaoran couldn't help at all, and there were doctors and nurses from other groups around to help.

"Student, can you make blood gas? Help me make a blood gas."

Nurse Guan Xin also ran over to help, collected blood gas from the patient's radial artery, and handed the test tube to Jing Xiaoran, "I'm a little busy now, thank you."

"Oh, good."

Jing Xiaoran immediately took the test tube and ran to the blood gas analyzer.

It is very simple to do blood gas analysis, as long as the air is prevented from entering the test tube and affecting the results of blood gas analysis.

"Squad leader, is this a patient in your group?"

Hong Sheng came to Jing Xiaoran's side at this time, and did not go to No. 1 emergency room to join in the fun.

"Well, our group admitted a patient with myocardial infarction in the morning." Jing Xiaoran began to put the blood in the test tube into the blood gas analyzer.

"This intensive care unit is going on every day. It's really scary. It's the third time this kind of big rescue is done today, let alone other small rescues. It's really too many to count." Hong Sheng shook his head and sighed, "This The intensive care unit is really tiring."

Jing Xiaoran nodded, "The ICU of the Cardiology Department is busier than the ICU. There are many patients here, and they are all emergencies. I heard from Mr. Zhu that the ICU of the Cardiology Department can admit up to [-] patients on a night shift..."

"Thirty in one night?" Hong Sheng's eyes widened.

There are only two doctors on the night shift, and [-] doctors are admitted in one night, all of whom are emergency patients.

"No matter which department I do in the future, I will not work in the intensive care unit of the cardiology department." Hong Sheng curled his lips.

During the conversation between the two, Jing Xiaoran had already finished the blood gas analysis, and the results were also released.

"It's just mild acidosis." Jing Xiaoran looked at the result and sent it to the No. 1 emergency room.

At this time, in the No. 1 emergency room, the patient had already been intubated, and all kinds of emergency medicines were used.

Jing Xiaoran looked up at the bedside ECG monitor, which showed escape rhythm.

Yibo heart rate is a self-protecting rhythm of the heart, including junctional escape beat and ventricular escape rhythm.The appearance of Yibo rhythm often indicates that the patient is in critical condition. If not treated in time and effectively, cardiac arrest may occur.

"Zhu Zhu, go and communicate with the patient." Teacher Cao took over from Zhu Zhu and continued to perform chest compressions, "We can just stay here."

"Yes." Zhu Zhu nodded, took off the gloves, and immediately walked out of the emergency room.

The monitor was still "tick ticking", and everyone in the rescue room was silent, without the sense of urgency to rescue them before.

"Squad leader, what's the matter?"

Hong Sheng asked softly from the side.

"The patient should be gone."

Jing Xiaoran looked at the various indicators on the monitor. Ventricular escape rhythm had already appeared, and the heart rate was about 30 beats per minute; the blood oxygen saturation fluctuated between 50-60%, and the blood pressure was 62/40mmHg.

Because of the presence of a ventilator, there is also a breathing rate on the monitor.

"No, it's gone?" Hong Sheng was taken aback, "Then why continue to rescue?"

"When breathing and heartbeat stop, and after 30 minutes of rescue, if no vital signs can be monitored, and the bedside electrocardiogram shows a straight line and no electrophysiological activity, clinical death will be declared at this time." Jing Xiaoran said.

Hong Sheng asked, "Is there any point in doing this?"

"It's meaningless on the surface, but it's actually worth saving, at least it's a kind of care and comfort for the family of the deceased." Jing Xiaoran said, "In addition, when the breathing and heartbeat stop, the body's life activities have stopped, but The weak metabolic activity in the body tissue is still going on. In 4 to 5 minutes or a little longer after stopping, there is still a small amount of oxygen in the body, and the lowest living condition can be maintained. If artificial respiration is used, heart compression, heart start There is still a possibility of life recovery.”

"Ah? Is there such a possibility?" Hong Sheng asked in surprise.

"Well, clinically, there have been reports in the literature that patients were successfully resuscitated after 1 hour or 2 hours of continuous CPR after cardiac arrest, and there is even a medical miracle of complete recovery after 3 hours of continuous CPR." Jing Xiaoran said.

"But I think everyone is doing this, will it be a waste of medical resources?"

Jing Xiaoran smiled, "At the current stage where the relationship between doctors and patients is tense, if a patient is sent to the emergency department, the doctor immediately tells the family that the patient has died. I believe the family will not accept it. We will spend 30 minutes Time allows the family members to slowly accept this cruel fact. If you insist on not resuscitating, the family members may beg you on their knees, or say that you are irresponsible, and if you do not even rescue them, you will say that there is no cure, and they will seize you and make a fuss. A hospital visit is also common."

Hong Sheng nodded slightly, as if he understood a little bit.

At this moment, Jing Xiaoran turned his head to look at the patient lying on the bed, feeling a little strange in his heart.

This is a patient with myocardial infarction, even if it is cardiogenic shock, it shouldn't be gone so quickly, it didn't take a few minutes before and after.

"Ms. Cao, what is the cause of the patient's death?"

Jing Xiaoran looked at Teacher Cao who was undergoing cardiopulmonary resuscitation and asked.

"The high probability is heart pump failure." Teacher Cao said, "We will discuss the case later."

"Is the pump failing?" Jing Xiaoran frowned slightly.

After thinking for a moment, he asked aloud, "Mr. Cao, could the patient have a ruptured heart?"

During myocardial infarction, the myocardium softens, and the heart may rupture under the impact of blood flow, which is one of the important complications of myocardial infarction.Rupture of the right ventricle is the most common, followed by left ventricle and right atrium, and rupture of large blood vessels in the left atrium and pericardium is rare.

The heart is broken, for a more easy-to-understand term.Where there is myocardial infarction, the myocardium will be necrotic, so it cannot beat; but where there is no myocardial infarction, it will still beat with the heart.

When one side of the heart beats and the other doesn't, a shearing force is created where the two sides meet, and this shearing force can rupture the heart.

(End of this chapter)