The heart is not good, the doctor is required to do not do it first, and explain the situation directly with the doctor

On Friday, all routine case discussions. The goal of the discussion is whether the perioperative management scheme of various special patients has been appropriate for a week, and whether there is still room for optimization.

One of these cases, everyone feels that it must be paid attention to in the future.

Dr. Xue, who is responsible for the patient.

According to her, the preoperative visits were almost a big problem.

Patients are a 60 -year -old man who is ready to have a large gastric operation.

Due to the large surgery, she met meticulous in the visits, and everything was followed by standard steps.

During the visit, lung function must be evaluated. Because breathing is the top priority of perioperative management. Once there is a problem with the lung function, there will be a big deal.

Pre -surgery results show that there are some cable -like shadows in the lungs, and the overall situation is still possible. Therefore, Dr. Xue is still satisfied with this lung condition.

Checking the breathing function, the easiest and most traditional is the "screen gas experiment".

The so -called "screen gas experiment" is to evaluate lung function by observing the duration of the patient's screen gas. Normal people can generally take more than 30 seconds. If it is less than 20 seconds, the height is prompted to abnormal lung function.

However, just 20 seconds of breath, the patient suddenly covered his chest with his hands, but couldn't speak his mouth.

At this time, Dr. Xue, who was thinking of the patient's lung function, immediately noticed that it was wrong.

Quickly asked: What's wrong? What's wrong? At the same time, holding the patient's wrist with his hand, two fingers clasped the pulse area tightly.

In a few seconds, Dr. Xue's face became pale.

In her work experience, she has not encountered such a serious heart disease.

There is no big problem with ECG! How could this be? She asked herself repeatedly.

At this time, there is no time to think too much, let's talk about the symptoms first. So she instructed the patient to pant and call the nurse to take the rescue.

At this time, she was really afraid that there was a problem with the patient.

Fortunately, the patient's arrhythmia quickly returned to normal.

But here, she was keenly aware that the patient's arrhythmia was inseparable from the screen gas movement.

After doing all the preparations, she asked the patient to try the screen again. This time is under the dynamic ECG. Therefore, everyone is not as worried as before.

Sure enough, after a dozen seconds, the electrocardiogram appeared obvious arrhythmia, and then had premature beats.

Can't continue! Dr. Xue asked the patient to stop his screen immediately and breathe in his mouth.

There must be a big problem with the patient's heart! Dr. Xue, who had this judgment, immediately asked the surgeon to open a cardiac ultrasound, 24 -hour dynamic ECG, and coronary angiography to the patient. At the same time, the surgical plan was delayed the next day.

The next day, after all the results came out, it was confirmed that a blood vessels in the patient were blocked by nearly half. If you are not tired and have no lack of oxygen, this heart generally does not have any symptoms. The reason why there are symptoms in the screen gas experiment is because the screen gas movement leads to the result of lack of oxygen.

After clarifying the cause, the patient's myocardial oxygen supply and tolerance were systematically adjusted, and the operation was performed after a few days.

During the operation, the anesthesiology department attached great importance to and fine adjustments, and the operation was successfully completed.

After this incident, the anesthesiology department understands the unified understanding: if you have heart problems, you can do a screen gas experiment with caution. When performing a screen gas experiment, you must pay attention to the changes in the electrocardiogram or whether the patient is abnormal.

For patients, if the heart is not good, the doctor must inform the heart problem in time before doing the screen gas.

You can't think that the doctor is very godly and knows everything. Doctors also need to find the roots to find the cause for the reason.

If you take your life safety as a bet to test the doctor's level, is this behavior a bit?

[Reminder] Pay attention, there are a large number of professional science sciences here to reveal those things about surgical anesthesia ~

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