When doctors have a simulated operating room

The patient was in a critical condition.

"Establish two intravenous channels, one for low-molecular-weight dextran, the other for a dose of norepinephrine, and then a set of dobutamine mixed with 500 ml of saline!"

Zhang Yi quickly gave instructions for the rescue work.

Low-molecular-weight dextran, also known as plasma substitute, can replenish the body's blood volume, promote circulation, and prevent the formation of blood clots.

Norepinephrine and dobutamine are both drugs that can raise blood pressure and increase vascular activity.

Originally, Zhang Yi wanted to add another set of antibiotics because he initially suspected that the man might have fulminant myocarditis.

But it was just a suspicion, and the specific cause was not yet known.

After thinking about it, Zhang Yi decided to play it safe first, correct the most important shock at the moment, pull the patient back from the brink of death, and then check and do the next treatment.

Why is it often said that doctors are a profession that is treading on thin ice?

Every step of judgment is related to the patient's life. If it is not done well, a life may be lost in their own hands, and many doctors will also be involved in lawsuits.

Some people may be right in one step and wrong in the next.

Some people are wrong in one step and then wrong in all the steps.

The ability to treat a patient is really not something that ordinary people can do.

But Zhang Yi still chose to believe in his own judgment.

At present, there are two preliminary suspected causes, one is fulminant myocarditis, and the other is acute myocardial infarction.

Because if it is fulminant myocarditis, there will be symptoms of gastrointestinal congestion, causing abdominal pain, nausea, and vomiting.

Although Zhang Yi did not see where the congestion point was just now, this cause cannot be ruled out.

Then there is acute myocardial infarction. The cause of myocardial infarction is not only coronary artery sclerosis, but also excessive fatigue leading to insufficient blood supply to the myocardium.

Especially now, office workers are all in their twenties, thirties, or even forties. There are a lot of people who stay up late to work overtime and don’t get enough sleep.

In addition to the most common precordial and back pain points of myocardial infarction, there are also rare pain points in the abdomen.

Before, Zhang Yi happened to meet an old man with myocardial infarction who also had pain points in the abdomen.

So these two causes are currently Zhang Yi’s main suspects.

Suspicion aside, it is still necessary to quickly complete the examination to confirm.

And now there is a tricky problem.

This young man seems to have come to the hospital alone.

There are no family members and no identity information. In case of rescue or surgery, the hospital cannot register.

"Did you see his friends or family members coming to the hospital with him just now?" Zhang Yi turned around and asked the foreigners.

As a result, several people shook their heads together: "No, he was the only one holding his stomach and half squatting on the chair, looking very painful. We asked him directly in British what happened and whether he needed help. Unexpectedly, he could speak a foreign language and communicate with us."

"He said he had a stomachache for more than three hours, and he felt a little chest tightness. He couldn't help it, so he asked for leave to come to the hospital."

"Yes, and he didn't seem to be as serious as he is now. He could talk to us in British just now. It's only been more than 20 minutes. Not only did his blood pressure drop, but I felt that he seemed a little..."

Twenty minutes ago, he could still communicate.

Twenty minutes later, not only did his blood pressure drop, but his consciousness seemed to begin to blur.

Zhang Yi quickly leaned over to the patient's ear and shouted: "Hello? Wake up? Can you hear me?"

Fortunately, the patient was still conscious. He frowned and slowly opened his eyes. After looking at Zhang Yi, he opened his mouth hard as if he wanted to speak, but he didn't say anything.

Zhang Yi asked again: "Do you know where you are now?"

The patient nodded gently: "... hospital... hospital..."

"Okay, okay, I'm glad you're awake. What's your name? Where are your family members? You're not in good condition now. Call your family members! Or give me your phone and I'll contact them for you."

Unexpectedly, the man wanted to get up immediately after hearing this.

He was in a state of shock in the last second, and he seemed to be able to bounce up immediately in the next second.

The nurse had just put a needle in his vein, but when he moved, the needle was crooked.

"Oh, don't move. I just put it in for you, and it fell off before the dressing was applied."

The patient half-supported his body and said a little unconsciously: "No... no... family members! I'm in pain... Okay, don't... no... don't scream..."

After saying that, he immediately fell back into bed as if he had lost his temper.

He really looked like he was dead, and he couldn't be woken up even if he was shouted!

This was a big surprise to everyone

People were shocked!

Zhang Yi hurriedly said: "Hurry up and give the injection to replenish fluids! First, give a norepinephrine! Then give a lidocaine!"

Adding lidocaine is to prevent the patient from having arrhythmia (ventricular fibrillation) in advance, and to give the medicine in advance just in case.

When the nurse saw that Zhang Yi was anxious, she picked up the needle again without saying a word and hit it in one shot.

After the norepinephrine and lidocaine were injected, the nurse quickly injected other drugs together.

On the monitor, the patient's various indicators are still not very good.

The blood pressure has been around 85 and just can't go up.

Because of the lack of heart power, the blood oxygen has never reached 95% even if oxygen is given all the time.

The foreigners watching on the side were also a little confused.

Although they couldn't hear what Zhang Yi said to the patient, they could see from the data that this young man seemed to have more than just abdominal pain.

If it was really abdominal pain, the condition would not have developed so quickly in just over 20 minutes.

And the blood pressure is so low, so low that it has to be measured by plasma.

That is definitely not a simple gastroenteritis, pancreatitis or cholecystitis.

Could it be myocarditis?

Sari walked to Zhang Yi and said what he was thinking.

"Do you suspect myocarditis?" Zhang Yi asked with his head tilted.

Sari nodded: "Well, fulminant myocarditis may cause gastrointestinal congestion, resulting in symptoms of pain, and the patient now also has signs of heart failure. Although the blood and qi analysis has not come out yet, I suspect it is myocarditis."

Zhang Yi glanced at him and nodded slightly: "I also have this suspicion, but it is just a suspicion. We have to wait for the blood test results to come out. I will do an electrocardiogram later."

After that, Zhang Yi quickly took advantage of the patient's unconsciousness to rummage through his bag, and there was indeed a mobile phone and a wallet inside.

There was an ID card and other documents in the wallet.

Fortunately, there was an ID card, so the hospital could at least register him.

"Xiao Li, take this ID card and get the patient admitted first."

"Okay!"

After giving the order, Zhang Yi lifted up the patient's clothes and quickly pulled out an electrocardiogram.

The result was amazing!

Widespread ST segment elevation!

Chest leads V3 and V4 were the highest, and limb lead II was the highest, all pointing to the apex.

It was indeed abdominal pain caused by cardiomyopathy!

The cause was definitely in the heart!