After 100 Days Of Sign-In, The First Operation Shocked The World

So,

Why does "right heart failure" cause edema of both lower limbs?

The main reason is that the pressure of the systemic circulation, that is, the pressure of the venous system, is increased, causing the water to not fully circulate through the heart throughout the body, causing blood to pool on the legs, causing edema of the lower extremities.

soon,

The elderly patient was pushed into the rescue room~.

The patient's son was blocked by the door.

"Quickly, connect..."

Actually, without Lin Feng's order, the nurse will quickly use the ECG monitor, ventilator...

Connect quickly.

Lin Feng commanded: "Hurry up and push the electrocardiograph... and the bedside ultrasound..."

at this time,

The data of the ECG monitor began to come out.

The physical sign data of the patient’s elderly are as follows:

· Blood pressure: 198/130, very high (if you fall down at this time, you must pay attention to cardiac arrest)

· Blood oxygen: 94%, it should be heart failure that caused the blood to flow back to the lungs, leading to pulmonary edema, and the lungs’ air exchange and itching function decreased...

·Heart rate: 140...... (If the heart rate drops down at this time, it is likely that a cardiac arrest will occur)

·Respiration: 48...Heart rate and breathing are very high, obviously the heart is still doing crazy work...

at this time,

The medicine has come.

First medicine, sacubatril, valsartan, beta-blocker... etc., let's talk about lowering blood pressure...

While the nurse was spraying medicine, Lin Feng listened to heart and lung sounds.

·Lungs, with strong rales, apparently pulmonary edema (blood backflow to the lungs)

soon,

The electrocardiogram was pushed over.

Take the electrodes and stick them on the elderly.

1 minute later,

The result is out!

·Ventricular hypertrophy...

·No myocardial ischemia, etc...

Needless to say, this is definitely "heart failure".

"Doctor Lin..."

At this time, another nurse also pushed the B-ultrasound machine over.

Lin Feng switched on, adjusted the data, took the probe, and applied the couplant.

He didn't aim at the heart of the patient's elder for the first time, but at the aorta which is almost below the clavicle fossa of the old man's quasi-neck.

Test the "ejection function"!

When the heart pumps blood, blood is ejected from the aorta, which is called ejection function.

Then there is a concept called "ejection fraction".

The ejection fraction is a volume ratio index that reflects the ejection function of the ventricle from the perspective of volume. If the ejection function is reduced, it indicates heart failure.

Lin Feng took the probe to measure,

really!

·Ejection score: 38%! !

In general, the left ventricular ejection fraction is ≥50%; the right ventricular ejection fraction is ≥40%. If it is less than this value, it is cardiac insufficiency.

Then the B-ultrasound probe was aimed at the heart, and it turned out that the ventricles were enlarged and thickened, and there was a lot of fluid in the lungs...

All inspections are complete.

The current situation of the elderly is relatively serious.

·Heart failure + pulmonary edema + insufficient itchiness + hypertension + coronary atherosclerosis...

Both are more troublesome diseases.

...

It was rescued for about 2 hours,

The patient's condition finally settled down.

Coughing, nausea, ascites, etc. appeared in the middle...

Fortunately, the patient did not have the cardiac arrest he was worried about.

...

"Hoo~~~~"

Lin Feng sat on the chair, took a long breath, and finally rested.

"This night shift is really tiring!!!"

Lin Feng feels that the night shift god is not so cute anymore.

(God of the night shift:?? Little brother, do you want to be a little tired??)

finally,

The god of the night shift felt that Lin Feng was too handsome to make him so tired, so this night shift was passed ‘safely’...

...

One day off during the day...

Then the next day,

Lin Feng continues to work.

The first 8 patients all had abdominal pain and fever...

The ninth patient is quite special.

ophthalmology.

Lin Feng hasn't had an eye disease for a long time.

...

"Doctor Lin, look at my eyes... there is something here..."

The patient, about 30 years old, was wearing construction clothes, but he was cleanly washed and his manners were a little formal.

He stretched his head and stared at Lin Feng.

Pointing to the rubbed red right eye.

"There seems to be something in my eyes, it may be iron filings..."

Lin Feng's eyes were very good, and he immediately saw the cornea next to the patient's dark pupils. There was a brown spot, about 1mm in size.

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"Corneal foreign body"!

"Tell me what happened..."

"That's it. I am a soldering iron worker on the construction site. Half an hour ago, I did not wear goggles when soldering the iron. Then I felt a pain in my eyes, maybe it was splashed by iron filings... At that time I couldn't open my eyes with pain. When I opened my eyes, the worker told me that there was a black spot. I looked in the mirror and there was a black spot. I rubbed it with my hand for a long time and didn't get the iron filings out..."

Lin Feng nodded.

According to the patient's description, it should be iron filings.

When soldering iron, it will shoot high-temperature sparks, that is, iron filings, and then splash into the eyes.

. ....... .......

The patient’s disease is obviously a "corneal foreign body."

This disease is a common disease in ophthalmology. Generally, patients who have a foreign body in the cornea and cannot rub it off will go to the ophthalmology department of the hospital.

This disease is easy to treat.

As long as "corneal foreign body removal" combined with "antibiotic instillation", the recovery effect is usually better.

However, Lin Feng has no corresponding tools.

"You go to the ophthalmology department..."

"No, no, no...Dr. Lin, I think you can treat me, you are a good doctor..."

".................."

Faced with such flattery, Lin Feng had no choice but to agree.

"You wait outside first, I will ask the girl (nurse) to borrow some tools from the ophthalmology department..."

"Thank you Doctor Lin..."

...

20 minutes later,

Nurse Xiao Ai came back with eye tools.

Lin Feng expertly instilled anesthetics on the patient's right eye, removed corneal foreign bodies, and then used anti-infective eye drops for the patient...

Lin Feng is satisfied: "Okay, it's okay..."

Patient thanks: "Thank you Dr. Lin!"

After thanking, I left the clinic happily...

Lin Feng thought it was over,

result,

After half an hour, the patient came back!

Lin Feng: "???"

The patient rubbed his right eye: "Dr. Lin, it's not right, I still feel a lot of pain..."

Lin Feng was stunned.

"It still hurts? Impossible, right?"

.again.

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