Chapter 1788： IABP
"What do you think at home?" Su Yun squats and fiddles with the patient's chest tube.
He emptied the fresh blood drained from the chest tube, and while timing, he bent a chest tube to observe the speed of drainage.
The chest tube is unobstructed and there is not much drainage. This can be confirmed.
What Su Yun does not seem to be necessary, but Zheng Ren knows that he is excluding some small details that may arise.
Many seemingly serious illnesses are actually a result of a little bit of accumulation.
"Old Zhao, the second line?" Su Yun asked while he was playing with the chest tube.
"Professor Zhang..." Zhao Yunlong said.
Su Yun is also very helpless.
It’s not about Professor Zhang. The level of each person is different. The ability and the idea of taking risks are different.
Some people are radical and some are conservative.
Each has its own advantages and each has its own shortcomings.
As for Professor Zhang, if you go to school, it will be a good teacher. But in this extremely complicated situation, he may not be a good emergency first aid candidate.
"What about people?" Zheng Ren asked.
“It’s coming soon.” Zhao Yunlong said: “Zheng... Boss, you will give me a look, I will remind the patient’s family.”
"Go." Zheng Rendao: "Is the catheter room ready for IABP?"
"Ready, Director Zhang Lin is coming over from home." Zhao Yunlong said.
Zheng Ren nodded, did not continue to speak, but turned on the computer and began to see the patient's medical record.
Zhao Yunlong’s narrative is too brief. He only said the most important points, and the rest did not have time to elaborate.
For the patient's situation, Zheng Ren still wants to take a closer look at it.
The patient is 52 years old and has a history of familial hypertension. His father died of cerebral hemorrhage. There have been no symptoms before, as Zhao Yunlong said, the first two days because of chest tightness and shortness of breath before coming to the hospital.
In the medical record, the patient complained of no history of dizziness.
On this point, Zheng Ren expressed doubts. If there is dizziness, it is most reasonable with concealed onset.
The patient's medical history is like this, and it does not represent everything. It can only be used as a reference, especially for patients with complicated conditions.
On admission, the head CT was abnormal, and the head MRI was done after one day.
Zheng Ren can feel that the family members of the patient do not sign and agree to the IABP. It may be early in the morning that there are signs that both family and economic factors are possible.
The test list and various inspection reports, like Zheng Ren, look the same.
He has a certain understanding and understanding of the patient's condition. Su Yun looked around at the medical record, looked back at the patient's condition, and his neck was quickly twisted.
"Boss, the smoke sickness shown on the nuclear magnetic field is very heavy." Su Yun sees Zheng Ren inserting the nuclear magnetic film into the reader, commenting.
"Well, I think about it..." Zheng Rengang said here, the sound of the monitor alarm is loud.
The sound of the drip sounds through the room.
Zheng Ren and Su Yun "Teng" suddenly stood up, Zheng Ren's chair turned to the ground, making a "squeaky" sound.
"Prepare IABP!" Zheng Ren whispered.
Su Yun stunned, and he subconsciously wanted to refuse. No patient's family signed, directly do IABP, is this want to die?
However, he heard from the voice of Zheng Ren that he could not refuse.
Take care of him! Su Yun’s heart is horizontal, and there is a boss in the sky. It’s a great choice to go to work at the Massachusetts General Hospital.
“The IABP machine and machine are ready for helium!”
"The IABP catheter and puncture bag are ready!"
"0.9% Nal500ml + heparin 5000U, ready!"
“Pressure bag, keep pressure 300mmHg?”
Su Yun asked.
"Yes." Zheng Ren opened the quilt on the patient, then opened the IABP puncture bag and prepared the iodophor.
"Lidocaine." Zheng Ren said with a gloved voice.
Su Yun has opened the machine, pushed it to the side of the bed, directly unscrewed a plastic bottle of lidocaine, and put the syringe into a sterile bag.
Zheng Ren picked up the syringe and probed the needle into the opening of the plastic bottle to extract the lidocaine.
Do not dilute, grab an iodophor in the right hand, disinfect the patient's femoral artery, and then local anesthesia.
The puncture is successful and the balloon catheter is delivered into the patient's femoral artery. Zheng Ren's movements were very fast. Su Yun had just placed the electrode pads on the patient's chest, and the two sets of ECG monitoring systems were running at the same time.
At this time, Zheng Ren has finished the operation and sent the IABP tube to the descending aorta.
Open the anti-pulse pump, Zheng Ren handed the sensor to monitor the aortic pressure to Su Yun.
Su Yun connects the sensor to the host.
The irrigation system is connected to the sensor and the central chamber is connected to the pressure conduit.
The work that Zheng Ren needs to do is basically completed, and Su Yun is busy flying up.
Connected to the helium gas pipeline, Su Yun looked several times to determine that the working pressure of helium gas meets the requirements.
"Sew it." Su Yun said with certainty.
Zheng Ren nodded and began to fix the helium pipeline.
And Su Yun debugs various parameters on the host.
This point Su Yun is more professional than himself, Zheng Ren knows. Let him do it is the most worry-free way.
I don't have to participate at all.
As the IABP system began to work, Zheng Ren took a sigh of relief and the patient was fine for a short time.
The machine feeds the patient's ECG or blood pressure signal to the counterpulsation control device to synchronize the balloon pump with the patient's heart beat.
Immediately before the contraction of the heart, that is, when the aorta is open, the balloon is deflated, reducing the end-to-end pressure in the aorta and reducing the work of the left ventricle. Reduce post-load and reduce myocardial oxygen consumption.
A moment before the diastole, the balloon is inflated, increasing the diastolic coronary perfusion pressure and increasing myocardial oxygen supply.
This can reduce the left and right anterior and posterior loads and reduce the heart load. The balloon is quickly exhausted immediately before the heart contracts and the aortic valve is opened, so that the instantaneous decompression in the aorta is reduced at the same time, and the cardiac output is increased.
For perioperative support and stable hemodynamic status, IABP has unparalleled significance.
With the launch of IABP, the mad call ECG monitoring began to calm down.
"Boss, the patient's family did not sign it." Su Yun debugged the various parameters of the machine, see Zheng Ren to pack up the IABP, but helplessly said.
"No time." Zheng Rendao, "When the family members of the patient sign the word, everyone is dead."
"How old Zhao did not come back?" Su Yun snorted, his eyes staring at the monitor.
The emergency first aid was successful, but the various values and indicators were still not ideal. The patient is still in a state of sudden death. As for when it is not possible, it is time to watch.
"Boss..." Su Yun said with a frown. "I don't think it's right. The patient is too sick and heavier than he thought."
Zheng Ren also noticed this, and the heart is calculating what to do next.
He emptied the fresh blood drained from the chest tube, and while timing, he bent a chest tube to observe the speed of drainage.
The chest tube is unobstructed and there is not much drainage. This can be confirmed.
What Su Yun does not seem to be necessary, but Zheng Ren knows that he is excluding some small details that may arise.
Many seemingly serious illnesses are actually a result of a little bit of accumulation.
"Old Zhao, the second line?" Su Yun asked while he was playing with the chest tube.
"Professor Zhang..." Zhao Yunlong said.
Su Yun is also very helpless.
It’s not about Professor Zhang. The level of each person is different. The ability and the idea of taking risks are different.
Some people are radical and some are conservative.
Each has its own advantages and each has its own shortcomings.
As for Professor Zhang, if you go to school, it will be a good teacher. But in this extremely complicated situation, he may not be a good emergency first aid candidate.
"What about people?" Zheng Ren asked.
“It’s coming soon.” Zhao Yunlong said: “Zheng... Boss, you will give me a look, I will remind the patient’s family.”
"Go." Zheng Rendao: "Is the catheter room ready for IABP?"
"Ready, Director Zhang Lin is coming over from home." Zhao Yunlong said.
Zheng Ren nodded, did not continue to speak, but turned on the computer and began to see the patient's medical record.
Zhao Yunlong’s narrative is too brief. He only said the most important points, and the rest did not have time to elaborate.
For the patient's situation, Zheng Ren still wants to take a closer look at it.
The patient is 52 years old and has a history of familial hypertension. His father died of cerebral hemorrhage. There have been no symptoms before, as Zhao Yunlong said, the first two days because of chest tightness and shortness of breath before coming to the hospital.
In the medical record, the patient complained of no history of dizziness.
On this point, Zheng Ren expressed doubts. If there is dizziness, it is most reasonable with concealed onset.
The patient's medical history is like this, and it does not represent everything. It can only be used as a reference, especially for patients with complicated conditions.
On admission, the head CT was abnormal, and the head MRI was done after one day.
Zheng Ren can feel that the family members of the patient do not sign and agree to the IABP. It may be early in the morning that there are signs that both family and economic factors are possible.
The test list and various inspection reports, like Zheng Ren, look the same.
He has a certain understanding and understanding of the patient's condition. Su Yun looked around at the medical record, looked back at the patient's condition, and his neck was quickly twisted.
"Boss, the smoke sickness shown on the nuclear magnetic field is very heavy." Su Yun sees Zheng Ren inserting the nuclear magnetic film into the reader, commenting.
"Well, I think about it..." Zheng Rengang said here, the sound of the monitor alarm is loud.
The sound of the drip sounds through the room.
Zheng Ren and Su Yun "Teng" suddenly stood up, Zheng Ren's chair turned to the ground, making a "squeaky" sound.
"Prepare IABP!" Zheng Ren whispered.
Su Yun stunned, and he subconsciously wanted to refuse. No patient's family signed, directly do IABP, is this want to die?
However, he heard from the voice of Zheng Ren that he could not refuse.
Take care of him! Su Yun’s heart is horizontal, and there is a boss in the sky. It’s a great choice to go to work at the Massachusetts General Hospital.
“The IABP machine and machine are ready for helium!”
"The IABP catheter and puncture bag are ready!"
"0.9% Nal500ml + heparin 5000U, ready!"
“Pressure bag, keep pressure 300mmHg?”
Su Yun asked.
"Yes." Zheng Ren opened the quilt on the patient, then opened the IABP puncture bag and prepared the iodophor.
"Lidocaine." Zheng Ren said with a gloved voice.
Su Yun has opened the machine, pushed it to the side of the bed, directly unscrewed a plastic bottle of lidocaine, and put the syringe into a sterile bag.
Zheng Ren picked up the syringe and probed the needle into the opening of the plastic bottle to extract the lidocaine.
Do not dilute, grab an iodophor in the right hand, disinfect the patient's femoral artery, and then local anesthesia.
The puncture is successful and the balloon catheter is delivered into the patient's femoral artery. Zheng Ren's movements were very fast. Su Yun had just placed the electrode pads on the patient's chest, and the two sets of ECG monitoring systems were running at the same time.
At this time, Zheng Ren has finished the operation and sent the IABP tube to the descending aorta.
Open the anti-pulse pump, Zheng Ren handed the sensor to monitor the aortic pressure to Su Yun.
Su Yun connects the sensor to the host.
The irrigation system is connected to the sensor and the central chamber is connected to the pressure conduit.
The work that Zheng Ren needs to do is basically completed, and Su Yun is busy flying up.
Connected to the helium gas pipeline, Su Yun looked several times to determine that the working pressure of helium gas meets the requirements.
"Sew it." Su Yun said with certainty.
Zheng Ren nodded and began to fix the helium pipeline.
And Su Yun debugs various parameters on the host.
This point Su Yun is more professional than himself, Zheng Ren knows. Let him do it is the most worry-free way.
I don't have to participate at all.
As the IABP system began to work, Zheng Ren took a sigh of relief and the patient was fine for a short time.
The machine feeds the patient's ECG or blood pressure signal to the counterpulsation control device to synchronize the balloon pump with the patient's heart beat.
Immediately before the contraction of the heart, that is, when the aorta is open, the balloon is deflated, reducing the end-to-end pressure in the aorta and reducing the work of the left ventricle. Reduce post-load and reduce myocardial oxygen consumption.
A moment before the diastole, the balloon is inflated, increasing the diastolic coronary perfusion pressure and increasing myocardial oxygen supply.
This can reduce the left and right anterior and posterior loads and reduce the heart load. The balloon is quickly exhausted immediately before the heart contracts and the aortic valve is opened, so that the instantaneous decompression in the aorta is reduced at the same time, and the cardiac output is increased.
For perioperative support and stable hemodynamic status, IABP has unparalleled significance.
With the launch of IABP, the mad call ECG monitoring began to calm down.
"Boss, the patient's family did not sign it." Su Yun debugged the various parameters of the machine, see Zheng Ren to pack up the IABP, but helplessly said.
"No time." Zheng Rendao, "When the family members of the patient sign the word, everyone is dead."
"How old Zhao did not come back?" Su Yun snorted, his eyes staring at the monitor.
The emergency first aid was successful, but the various values and indicators were still not ideal. The patient is still in a state of sudden death. As for when it is not possible, it is time to watch.
"Boss..." Su Yun said with a frown. "I don't think it's right. The patient is too sick and heavier than he thought."
Zheng Ren also noticed this, and the heart is calculating what to do next.
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