Chapter 1078: : Pain in which 1 analgesic is ineffective!

The Sackler family, known as the "pain medicine family", is not useless.
In order to make opioids the world's first medicine, make pain the standard of treatment.
To the extent that pain is more and more valued, the pain index and score have also developed rapidly.
The pain of aortic dissection is definitely the top four-degree pain in the classification, which is the fifth-level pain (five-level standard)!
This level of pain is although Chen Cang has not felt it, but according to the guidelines, the pain is persistent and severe, and it will be accompanied by changes in vital signs such as blood pressure, which is difficult for most people to tolerate.
Perhaps this description is not intuitive enough, for example, according to the twelfth grade of pain, level 1: mosquito bites, level 5: slap with the palm to leave red palm print level 6: pay attention to gastroenteritis and stomach pain caused by diet Level: Use a stick to make a black and purple mark.
Level 8: Various types of area-induced bleeding trauma Level 9: Pain in labor, of course, it is natural delivery.
Level 10: limbs with disfigured limbs, wounded and injured fingers, level 11: visceral pain, level twelve ... may be the top ten torture levels in the Qing Dynasty.
And acute aortic dissection paroxysmal pain is not specifically graded, because the plot situation is specifically analyzed, but it is definitely not under delivery.
After all, this is a pathological pain.
This pain will give people a sense of near-death, it is a feeling that death will come at any time.
Do you think this is the cruelest?
of course not!
Looking at Tian Zhengkai's pale complexion, the bean-sized sweat beads rolled down, and the severe pain was unbearable for this little giant with a height of more than two meters. Tian Zhengkai, who is an athlete himself, is still very strong. No worries.
In the past, Li Tian Zhengkai has always been the big brother of the team, a very humble person, very caring for the newcomers, and often teaches some skills.
So everyone respects him!
So, looking at him now, these teammates are very uncomfortable!
"Doctor, can you take painkillers?"
"Yes, that morphine!"
Chen Cang sighed and shook his head: "It's not forbidden to beat, it's useless to do it. The pain of aortic dissection, morphine doesn't work at all. And the effect of morphine can also affect the already unstable blood pressure.
After figuring it out, Chen Cang said to the old horse: "Get in the car first and take it to the hospital."
Several athletes quickly said: "Let's come, it's too heavy!"
Chen Cang and Lao Ma smiled, their exercise amount was not much.
Looked at each other, lifted the stretcher and walked out.
The assistant coach saw this and said, "You guys are here to continue the game, I will go to the hospital!"
Finally, he followed Chen Cang and walked away.
Has to say that this guy is really heavy, and the height is so high that the stretcher is incomplete.
Chen Cang once worried that the length of the ambulance was enough ...
Fortunately, the ambulance is long enough to not worry about this problem.
The assistant coach is not very young. He is the predecessor of Tian Zhengkai. He retired as the assistant coach of the Beijing team. Tian Zhengkai came here also partly because of his original intention.
Seeing him like this, the assistant coach was also worried.
Quickly asked: "Zheng Kai, how much telephone do you have at home?"
Tian Zhengkai's cell phone is still in the dressing room. If such a serious situation occurs, it is definitely necessary to contact the family.
Tian Zhengkai was a little exhausted at this time, the pain consumed his too much physical strength, and slowly said his phone again.
Here, Chen Cang and Xiao Ke quickly made an electrocardiogram.
The old horse is to contact the hospital, make relevant preparations, and complete the relevant examination as soon as possible.
What is the most dangerous aortic dissection?
Aortic rupture!
Once is broken, basically the probability of death is great.
Chen Cang's brain turned very fast, and Ma Yuehui also helped the monitor to monitor blood pressure regularly.
Because of this situation, once the patient's blood pressure is too high, the originally damaged aorta is likely to rupture suddenly due to excessive tension.
It is like water flowing in the leather tube. Suddenly the endothelium ruptures in the leather tube, and then the water instantly floods it, bulging the leather tube and thinning it!
And at this time, because a pseudo-aneurysm was formed, which hindered the flow of water, huge pressure may continue to expand here until ... "Bang" ... it burst
ECG results came out, no characteristic performance, almost normal!
Chen Cang glanced at the old horse: "Team leader, the electrocardiogram is normal!"
This seems to be good news, because myocardial infarction is ruled out.
However, after diagnosing such things and excluding one kind of killer, there will often be another.
The performance of aortic dissection and myocardial infarction are strikingly similar, and the electrocardiogram can be identified, and the use of painkillers for myocardial infarction can be effective, but the aortic dissection is not.
Now the patient can be diagnosed as an aortic dissection.
At this time, after Tian Zhengkai's wife answered the phone, the assistant coach quickly told the matter.
The sudden news surprised her!
Don't go to work, quickly go out and take a taxi.
Lao Ma's eyes have been staring at the blood pressure, fearing to increase.
Now blood pressure has become a fatal factor that threatens the lives of patients.
"Xiao Ke, add 100 mg of sodium nitroprusside to 500 ml of 5% glucose and instill at a rate of 20 μg / min!" Chen Cang said after a moment.
"Add 0.5 mg propranolol!"
Chen Cang broke the plan immediately.
Now that the patient's blood pressure is 100-110 is enough to maintain the blood supply needs of the heart, brain, kidney and other important organs, and the extra is very dangerous.
And must reduce the contractility of the heart, so as to stabilize the blood vessels, don't break it!
Sometimes, when medical explanation is not available ~ EbookFREE.me ~ can only use metaphysics!
Just like at this moment, the assistant coach was nervous and could only pray.
Is prayer useful?
Of course the assistant coach doesn't know, but ... he doesn't know what he can do!
Not only him, but Chen Cang and Lao Ma were also uneasy. Chen Cang had already put his hand on the instrument box. In case of a sudden drop in blood pressure, he would definitely have an operation.
Time just passed slowly in anxiety.
Finally, after 20 minutes, the car is good at the door of the emergency center!
Chen Cang took the lead to run down, and the old horse responded on the side. With the help of four or five people, it pushed the car steadily.
"Make an echocardiogram first!"
"Contact a cardiology consultation and prepare an aortic angiography as soon as possible!"
"Draw blood as soon as possible, complete the diagnosis, notify the blood distribution room, and prepare for blood supply!"
If the aortic dissection is really broken, the amount of bleeding is not a little bit, it must be prepared in advance!
What is the most important thing in medicine?
Be prepared!
Considering all possibilities.
After all, a little carelessness can be a life!

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