I Can See Health

Chapter 86: massive pericardial effusion

   Chapter 86 Massive pericardial effusion

   When Lu Chen woke up, it was already two in the afternoon.

   A feeling of hunger came from his stomach, which made him decide to go out for food.

   After washing up for a while, Lu Chen went out with his little black bag on his back.

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

   He had to go to a small restaurant near the hospital for a meal.

   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 in a white coat.

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

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

   During this time, while treating the patient, he also received thanks from the patient or the patient's family.

   After digitizing the gratitude value, he can feel more and more that the doctor-patient relationship is so tense now.

   Every bit of gratitude is hard-won.

   He felt more and more the difficulties in the medical profession.

   There is a long way to go in the future.

  …

  In the small restaurant in front of the hospital, Lu Chen ordered a fish-flavored shredded pork rice bowl.

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

   There is exactly half a day off.

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

   After coming to Jinghua for so long, he really didn't get a good feel for Jinghua's customs.

   After walking for two hours, Lu Chen walked around the hospital for a few miles.

   Strolling down the street with hard steps, enjoying a moment of tranquility away from the hospital.

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

   "Junior Brother Lu, do you have time tonight? Our teacher treats you as a guest. All the students in the Second Academy will come out to eat together."

   This kind of large-scale collective activity, Lu Chen has no reason to refuse.

   "If you have time, Senior Sister, what time is it in the evening? Where is it?"

   "My two junior sisters and I are ready to go by car after get off work, why don't you come to the department to join us?"

"it is good."

   hung up the phone, Lu Chen checked the time.

   It’s almost five o’clock, and there’s still half an hour left before get off work.

   Now go to the department, the time should be about the same.

  Lu Chen walked in the direction of Jinghua Second Hospital.

  …

   Jinghua Second Hospital, eight districts in the heart.

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

  Liu Mei walked into the doctor's office.

  Ding Deli glanced at Liu Mei, "Let Dr. Yin accept it, she has just come to the department, she has to practice her hands."

  Liu Mei handed Zhang's hospital certificate to Yin Xinhua, the attending doctor who had just come to the eighth district of his heart.

   "In which bed?"

   "41 beds." Liu Mei said.

   "Ok, thank you."

   Yin Xinhua took over the hospitalization certificate and looked at the line of admission diagnosis.

   Admission diagnosis: The cause of dyspnea remains to be investigated.

   "Doctor Yin, the patient's condition is a little bad, why don't you go see the patient first." Liu Mei said.

   "Well, I'll go right away."

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

   in the ward.

  A man of about fifty years old in a wheelchair.

   His lips were white, his breathing was slightly rapid, his head was tilted to the side of the wheelchair, and his mental state was very poor.

   "Recently, after my dad's activities, he had chest tightness and shortness of breath. He had to take a dangling injection in the clinic for three days.

  The patient's family members describe the patient's disease process.

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

   Encountered emergency patients.

   The most important thing is to judge two things.

  The first one is circulation, that is, blood pressure and so on.

   The second is breathing.

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

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

"it is good."

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

  dong dong... dong dong....

   "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 is no obvious wet and dry rales.

   Heart percussion, enlargement of the dullness circle of the heart.

   At this time, He Sirong also finished the electrocardiogram.

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

   "Lead low voltage?" A diagnosis immediately popped into 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 sac structure composed of two parts, the serosa layer and the fibrous layer.

  The serosal layer is divided into the parietal layer and the visceral layer. The parietal pericardium is composed of the serosal layer, the parietal layer and the fibrous layer. The visceral pericardium is the serosal visceral layer, and the space between the parietal and visceral pericardium is the pericardial cavity.

   There is 15~50ml of serous fluid in the normal pericardial cavity, which plays a lubricating role.

but.

  If the amount of serosal fluid exceeds the capacity of the heart, the serosal fluid will compress the heart, making the heart unable to stretch, resulting in a decrease in the amount of blood returning to the heart.

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

   The patient will have symptoms such as difficulty breathing.

   From the patient's physical signs and auxiliary examinations, all of them currently support the diagnosis of pericardial effusion.

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

   "Sister, is this... pericardial effusion?"

   The symptoms and auxiliary examinations of this patient are very typical, and He Sirong also thought of the diagnosis of pericardial effusion.

   "Well, however, the cause of pericardial effusion cannot be controlled for the time being." Yin Xinhua said solemnly, "Looking at his state, the amount of pericardial effusion should be quite large, and pericardiocentesis should be done 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!

   "Senior sister, then I will call the ultrasound department to do an emergency bedside ultrasound, and then go directly to the bedside puncture?" He Sirong said.

   "No, contact the CCU on the 4th floor directly and push the patient to them." Yin Xinhua said, "They have complete rescue equipment there."

   "Okay." He Sirong immediately ran out of the ward and called the CCU on the 4th floor.

  …

  …

   When Lu Chen came to the eighth district in his heart, it was already 5:20 in the afternoon.

   "Junior Brother, you came on time. We'll be ready to go after the shift is over." Sun Guoguo was writing the shift record.

   This time the gathering was a gathering of all the teachers and students of Li Yao in the Jinghua Second Academy.

  Lu Chen is looking forward to it.

   At present, apart from his two classmates, Jiang Qingyan and Ke Yue, and he knows Senior Sister Sun Guoguo, but does not know any other Senior Brothers and Senior Sisters.

   "Let's do it, Junior Brother Lu, you and the first two junior sisters go to the first floor and wait. The car to pick us up has arrived." Sun Guoguo suddenly said, "Don't make him wait, I'll get down immediately."

  Lu Chen nodded: "Alright then, I'll go down with Jiang Qingyan and the others first."

  …

  Lu Chen, Jiang Qingyan and Ke Yue took the lead.

   stepped into the elevator, the elevator door slowly closed.

   "Hey, 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 door button.

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

  The hospital bed can be steadily pushed into the elevator.

   Thank you Chen Gugu for not being Gugu, BB Bubble for the reward.

  

  

   (end of this chapter)

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