I can see health

Chapter 86 Massive pericardial effusion
When Lu Chen woke up, it was already two o'clock in the afternoon.

The hunger in his stomach made him decide to go out for food.

After washing up a bit, Lu Chen carried his little black bag and went out.

It was past lunch time, and the hospital cafeteria was closed.

He had to go to a small restaurant near the hospital to deal with it.

In the alley of the hospital.

Passers-by are in a hurry, and everyone seems to be in a hurry, whether it is a patient or a medical staff wearing a white coat.

Jinghua Second Hospital, one of the top hospitals in the province, carries a large part of medical care, and most of the patients in the surrounding counties and cities will flock here.

Lu Chen walked in the hospital, feeling a little emotional for no reason.

During this period of time, while treating patients, he also received gratitude from patients or their families.

After digitizing the value of gratitude, he can feel more and more that the relationship between doctors and patients is so tense now.

Every bit of gratitude is hard-earned.

He increasingly felt the difficulties of the doctor's profession.

The future has a long way to go.

……

In the small restaurant at the entrance of the hospital, Lu Chen ordered a rice bowl with fish-flavored shredded pork.

The store is not big, but the taste of this dish is quite good, or maybe Lu Chen was hungry, so he ate with relish.

Just half a day off.

After eating, Lu Chen decided to take a stroll around here.

After coming to Beijing for so long, he really didn't get a good feel for the customs of Beijing.

After two hours of shopping, Lu Chen wandered around the hospital for a few miles.

Strolling on the street, walking hard, enjoying a moment of peace away from the hospital.

When he was about to go back to the dormitory, Lu Chen suddenly received a call from Sun Guoguo.

"Junior Brother Lu, do you have time tonight? Our teacher treats you, and all the students in the Second Academy will come out for dinner together."

Lu Chen has no reason to refuse such a large group activity.

"I have time, sister, what time is it at night? Where is it?"

"My two junior sisters and I will go by car after get off work, why don't you come and meet us in the department?"

"it is good."

After hanging up the phone, Lu Chen checked the time.

It's almost five o'clock, half an hour before get off work.

Go to the department now, the time should be about the same.

Lu Chen then walked in the direction of Jinghua Second Hospital.

……

Jinghua No. [-] Hospital, eight districts in the heart.

"Dr. Ding, Director Lin Cui just admitted a patient in the outpatient clinic."

Liu Mei walked into the doctor's office.

Ding Deli glanced at Liu Mei, "Let Dr. Yin accept her, she just came to the department and needs to practice."

Liu Mei handed Zhang's hospital certificate to Yin Xinhua, the attending doctor who just came to the eighth district of Xinxin.

"Which bed is it?"

"Bed 41." Liu Mei said.

"Okay, thank you."

Yin Xinhua took the hospital certificate and looked at the admission and diagnosis line.

Admission diagnosis: the cause of dyspnea is to be investigated.

"Doctor Yin, the patient's condition is not good, why don't you go and see the patient first." Liu Mei said.

"Well, I'll go right away."

Yin Xinhua nodded, and then called He Sirong to go with her to see the patient.

in the ward.

A man about 50 years old, sitting in a wheelchair.

His lips were pale, his breathing was a little short, his head was tilted to one side of the wheelchair, and his mental state was very poor.

"Recently, after my dad's activities, he developed chest tightness and shortness of breath. He received an injection in the clinic for three days, but it didn't help, and the condition was getting worse. He came to the hospital today."

The family members of the patient are describing the course of the patient's illness.

"Doctor He, measure the patient's blood pressure and then do an electrocardiogram." Yin Xinhua immediately ordered.

Meet an emergency patient.

The most important thing is to judge two things.

The first is circulation, that is, blood pressure and other conditions.

The second is breathing.

As long as circulation and breathing are acceptable, the patient's life is not in danger for the time being.

"Senior Sister Yin, the patient's blood pressure is 96/60mmHg." Together with his family members, He Sirong moved the patient to the hospital bed. "The pulse is a little weak, but you can feel it."

"it is good."

Yin Xinhua nodded, picked up the stethoscope and auscultated the patient.

Boom... Boom... Boom...
"The heart sound is very low." Yin Xinhua frowned, "I didn't hear any obvious noise."

She auscultated the lungs again.

The breathing of the lungs is slightly rough, but there are no obvious dry and wet rales.

Cardiac percussion, the dullness of the heart expands.

At this time, He Sirong also finished the electrocardiogram.

"Sister, the electrocardiogram shows low voltage in the limb leads and chest leads. The QRS amplitude of the chest leads is lower than 1mv, and the limb leads are lower than 0.5mv."

"Low voltage in the lead?" A diagnosis immediately popped up in Yin Xinhua's mind - pericardial effusion!
There is a layer of "skin" on the surface of the human heart, which is called the pericardium in medical terms.

The pericardium is a double-layered capsular structure consisting of a serosa layer and a fibrous layer.

The serosa layer is divided into parietal layer and visceral layer. The parietal pericardium is composed of serosa parietal layer and fibrous layer. The visceral pericardium is the visceral serosa layer.

There is 15-50ml of serosal fluid in the normal pericardial cavity, which acts as a lubricant.

but.

If the serosal fluid increases beyond the capacity of the heart, the serosal fluid will press against the heart, preventing the heart from stretching, resulting in a decrease in the amount of blood flowing back into the heart.

Then, the amount of blood ejected from the heart to the whole body will decrease, resulting in insufficient blood supply and oxygen supply to various tissues and organs of the human body.

Patients experience symptoms such as dyspnea.

Judging from the patient's signs and auxiliary examinations, all support the diagnosis of pericardial effusion at present.

And looking at the patient's symptoms, the amount of pericardial effusion is still quite a lot.

"Senior sister, is this...pericardial effusion?"

The patient's symptoms and auxiliary examinations were very typical, and He Sirong also thought of the diagnosis of pericardial effusion.

"Well, however, we can't control the cause of the pericardial effusion for the time being." Yin Xinhua said in a deep voice, "Looking at his condition, the amount of pericardial effusion should be quite a lot. A pericardial puncture should be performed as soon as possible to relieve the compression symptoms of the heart."

A large amount of pericardial effusion, if the fluid is not punctured in time to relieve the compression symptoms, it is very likely to cause cardiogenic shock or even sudden death!
"Sister, how about I call the Ultrasound Department, do an emergency bedside ultrasound, and then go directly to the bedside puncture?" He Sirong said.

"No, directly contact the CCU on the fourth floor and push the patient to them." Yin Xinhua said, "They have complete rescue equipment."

"Okay." He Sirong immediately ran out of the ward and called the CCU on the fourth floor.

……

……

It was already 10:[-] pm when Lu Chen came to the eighth district of Xinner.

"Junior brother, you are really punctual. After the shift is over, we are ready to go." Sun Guoguo was writing the shift record.

The dinner this time was a gathering of all the students of Teacher Li Yao in Jinghua No. [-] Hospital.

Lu Chen was looking forward to it.

At present, apart from his two classmates, Jiang Qingyan and Ke Yue, he only knows Senior Sister Sun Guoguo, and he doesn't know any other senior brothers and sisters.

"How about this, Junior Brother Lu, you and the first two Junior Sisters go to the first floor and wait, the car to pick us up has already arrived." Sun Guoguo said suddenly, "Don't make him wait, I'll come down right away."

Lu Chen nodded: "Alright then, Jiang Qingyan and I will go down first."

……

Lu Chen, Jiang Qingyan, and Ke Yue took a step ahead.

Walking up the elevator, the elevator door slowly closed.

"Hey, the elevator, wait a minute!"

Suddenly, He Sirong and his family pushed the hospital bed together and hurried towards the elevator entrance.

Lu Chen immediately pressed the button to open the door.

Fortunately, there were few people in the elevator, only Lu Chen and the three of them.

The hospital bed can be steadily pushed into the elevator.

　Thank you Chen Gugu is not Gugu, BB Bubble for your tip.

　　
　
(End of this chapter)