After the epidemic, I believe everyone will have a deeper understanding of the word “health”.
Sudden illnesses and outbreaks can overwhelm countless families.
And the medical staff have been busy on the front line, and they face the most unspeakable human suffering, life and death, every day.
For example, the second episode of the doctor’s observation documentary “My White Coat” tells a thrilling story again.
Severe abdominal pain for more than 2 hours
Can’t find the specific pain site
At 9 pm on March 4th, a 42-year-old male patient was sent to the emergency department of Shenzhen People’s Hospital.
“It has been in pain for more than 2 hours, and since 6 o’clock, the pain started after eating a lot of soybeans for dinner…”
At the time of the epidemic, both the man and his wife who accompanied him to the doctor wore masks.
The man’s eyebrows were twisted together, and his face was pale, fidgeting, and even speaking in a hoarse voice.
Dr. Jiang Xiren palpated his stomach, but no matter where it was, the man said it was painful.
“Probably pancreatitis,” Dr. Jiang speculated based on experience.
Gui Pei doctor Cai Wanna continued to ask, “Is it a tingling pain or a dull pain?” The patient mentioned a tingling pain in the right chest.
When Cai Wanna reported to Dr. Jiang, she thought that “the first thing to consider is whether it is a heart problem”.
Dr. Jiang looked at the examination report again, D-mer 4.74, “very high”.
D-dimer, the residue of blood that is broken down after clotting. This indicator is high, indicating that there may be a large number of blood clots or blood clots in the body.
Common causes include deep vein thrombosis, disseminated intravascular coagulation, pulmonary embolism, acute myocardial infarction, cerebral infarction, etc., and further examination is required to clarify.
Dr. Jiang changed the subject and made a sharper judgment:
“This person wants to rule out (aortic) dissection.”
Aortic dissection
A disease that could kill at any time
The aorta, the largest artery that comes directly from our heart, is responsible for sending blood throughout the body.
And aortic dissection, simply put, the intima of the aorta has “pierced a hole”, but the media is still intact, so a “dissection” is formed, and blood keeps going to the dissection Li Chong, propped up the blood vessel wall.
When the vascular membrane swells to its limit, it acts like a piece of paper. At that time, even if you sneezed or urinated forcefully, it would be broken, and the person would be finished.
Therefore, this disease is also known as the “cyclone killer”, If not treated in time, it may be life-threatening!
In our country, this disease is mainly caused by high blood pressureCaused by stress, high incidence in winter and spring every year. Especially men in their 50s who don’t take medicine and have uncontrolled high blood pressure are most likely to get this disease. In addition, many men’s habit of smoking and drinking is also a major risk factor.
Patients often experience severe and persistent pain, mainly in the chest, back, or stomach. These are exactly the same as for men!
Dr. Jiang hurriedly told the patient: “From now on, don’t eat or drink water, this is very important!”
At this time, the doctor who was measuring the blood pressure suddenly found that the blood pressure of the two feet was different, the left side was 160, the right side was 90 (mmHg), and the result was the same both times.
Large differences in blood pressure between the extremities are one of the symptoms of aortic dissection, because the dissection affects the arteries on both sides of the body to varying degrees.
“Probably a mezzanine.”
Dr. Jiang made a decisive decision, gave up the plain CT scan, and urgently sent the patient to undergo an enhanced CT with a clearer visualization.
The doctor read the film in the CT room, it was aortic dissection! So he quickly called a cardiac surgeon for emergency consultation.
“What should I do?”
“Just listen to us!”
Cai Wanna told the man to relax now and not move, not to force the bowels, otherwise the blood vessels may rupture. But he was in a hurry.
“Intubation! Intubation! Critically ill! Critically ill!”
Dr. Jiang asked Cai Wanna to quickly sign the catheterization consent form and the critical illness notice to the family members.
At this time, the man’s wife could not be found. It turned out that she was on the phone outside.
After finding her, the cardiac surgeon has arrived, and he communicates with the family:
“We tried our best to save him, but he was very ill, with dissection combined with intestinal ischemia, and the mortality rate for this (case) is 63%. The risk of surgery is very high, and it may not be saved. Come here.”
The man’s wife collapsed, took off the mask and cried:
“What should I do?”
The doctor told her to put on a mask quickly, protect herself, and immediately call other relatives to confirm.
After a while, seeing that she had not finished calling, Dr. Jiang answered the phone and said to her son in a very fast voice: “(Your father) has a very dangerous disease, If it can’t be delayed, I must be hospitalized, and there is absolutely no hope if I don’t have surgery.”
“Are you going to have surgery right away?” “Yes, get ready right away!”
After the family agreed, Dr. Jiang quickly contacted to arrange the operation.
“Get a painkiller first. If he can’t move, he must be sedated.”
At this time, my eldest sister was still asking why my husband was still in pain after taking painkillers.
In order to make the family less flustered, Dr. Jiang told her calmly: “Just follow our arrangement.”
Seeing her bewildered to go through the hospitalization procedures, he took the initiative to help with the medical records.
After 10 hours of surgery, the man finally saved his life.
“No one dares to say with any certainty
You can only do your best and do your best”
“There is a fifty percent hope that our whole family will support his rescue.
Before the hospital bed, this middle-aged man who had just walked on the edge of the gate of hell and was recovering also shed tears silently.
Many people may not be able to empathize with them until they are seriously ill. That feeling of helplessness, just wanting to cry, and “the brain is blank” couldn’t be more real.
They also appreciate their prompt medical attention. It is very wise to call 120 to send to the hospital immediately after having stomach pain for two hours.
Here, I also give you a reminder:
People with high blood pressure in the family, especially middle-aged men, don’t think they’ll be fine if they don’t have symptoms. Always take medicines as prescribed by your doctor, and do not smoke or drink alcohol.
Otherwise, dangerous complications such as aortic dissection may one day be fatal!
If you experience severe tearing or knife-like pain that persists in your chest, back, or stomach, be sure to bring it to the hospital. During the process, be careful not to force or move, as it is dangerous if the aorta ruptures.
Although aortic dissection is so dangerous, doctors will do their best to treat if there is a silver lining.
Afterwards, Dr. Jiang sighed: “When a doctor is most afraid of others saying, ‘You can give me an explanation, and you can give me the bottom line’.
As this patient said today, ‘You tell me if I still have a cure, and there is still a good chance’. But who dares to say how certain it is for this disease? No one dared to say. Just do your best and do your best. “
During this process, I had to admire the doctor’s keen observation and accurate judgment, decisively carrying out various examinations, and racing against time to treat patients, so that the patients whose lives were on the line were out of danger.
Cai Wanna followed along and said that what she admired most about Teacher Jiang was his quick and accurate judgment.
“I think that’s the most valuable ability of an emergency physician.”
*The content of this article is for the popularization of health knowledge and cannot be used as a specific diagnosis and treatment suggestion, nor can it replace the face-to-face consultation of a licensed physician, and is for reference only.
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