Chapter 1136: : Can this medicine be used?

Is the interlayer broken?
Thinking of this, everyone began to ooze cold sweat!
Part of the ascending aorta is in the pericardium. Once a rupture occurs here, arterial blood will soon fill the entire pericardium, forming a pericardial tamponade of the heart!
And this performance is precisely the most dangerous and also the cause of the highest mortality rate!
Therefore, after hearing Chen Cang say that the pericardium is stuffed, no matter whether it is Yu Yonggang, Li Baoshan, Xu Ziming and others, the heart can't help but feel cold!
How to do?
Even Yu Yonggang, who is the director of the emergency department, is still powerless in the face of such a patient!
Because even Xu Ziming of cardiac surgery, it is difficult to form a series of clear rescue ideas at this time!
Sometimes, many diseases come in a hurry, and come with the most serious complications and gestures, just like a torrential flood, and the patient is just a flat boat on the sea!
"Doctor Chen, do you want to remove the tamponade?"
Chen Cang took a deep breath. At this time, because the pericardium is full of blood, it is not clear what I saw!
You can only see a lot of blood filling the pericardium.
What is the state of the patient at this time?
Can it be lifted?
Should it be lifted?
Will it induce other risks?
No one can guarantee it!
Unless checked clearly!
But check now?
Where to check?
What check?
To be honest, any inspection now is tantamount to a death act!
However, without a clear diagnosis, how can we systematically and accurately judge the patient's condition?
How can we formulate a set of effective treatment plans?
For a time, the patient has entered an infinite loop!
The unclear diagnosis leads to a plan that cannot be formulated, and the plan cannot be formulated to cause the condition to continue to deteriorate. The continued deterioration of the condition leaves the patient with no time to do other tests and treatments.
Interlayer separation?
Or is the interlayer broken?
Whatever it is, it is a very dangerous thing.
Even, there may be a multi-dangerous factor mixed together.
Thinking of this, Chen Cang directly handed the pericardial puncture needle to Xu Ziming.
Staring at him and saying, "Director Xu, hold it, I will let you draw blood, you will draw blood!"
Xu Ziming looked solemn and nodded seriously!
Chen Cang went directly to the other side of the patient and brought a stethoscope. With one hand, the head of the stethoscope was placed at a different position in the precordial area. The other hand was placed on the patient's wrist!
He took a deep breath and calmed himself down at such a critical moment!
At this moment, in the room, the nurse said nervously:
"60 beats per minute!"
Everyone seemed at a loss.
Things are too sudden, and the disease is developing too fast!
Perhaps many people do not understand why most Marfan syndromes cannot survive in their thirties, just because they look like this now!
The condition is developing too fast, just like a tornado!
It's too late to rescue!
Chen Cang closed his eyes, and the people around him quickly calmed down.
Dare not to disturb Chen Cang.
At this moment, Chen Cang still heard the vague aortic valve auscultation area with diastolic murmur accompanied by systolic murmur through the pericardium!
After hearing this sound, Chen Cang was very happy!
This is a diagnostic sign!
The murmur is caused by dislocation, prolapse, and annulus expansion of the aortic valve due to dissection, aortic root dissection, and rupture of the intima, which protrudes into the lumen in a valve shape, causing vortex of blood flow.
And at this time, Chen Cang felt the surrounding signs of pulse pressure widening and edema pulse on his wrist!
Thinking of this, Chen Cang was very happy!
Ascending aortic vascular dissection is positive.
However, there was no serious rupture of the aortic blood vessel, but because of the injury of the ascending aorta, the blood leaked into the pericardial cavity through the wound!
Symptoms of pericardial tamponade occurred.
However, the aortic dissection is not completely ruptured, but the dissection hematoma is very serious.
Otherwise, it is impossible to produce such a series of pathological reactions ~ EbookFREE.me ~ Chen Cang's mind's four-dimensional map constantly through various imaging results to simulate the patient's chest at this time.
Through various kinds of diagnostic information, I gradually figured out the situation of the patient at a time.
Thinking of this, Chen Cang quickly said to Xu Ziming: "Puncture!"
"Can it be worn?" Lao Yu was worried.
Chen Cang nodded: "Yes! No problem!"
After talking, Chen Cang turned to the nurse and continued: "Intermittent propranolol intravenous injection combined with sodium nitroprusside combined to lower blood pressure!"
...
Chen Cang continuously issued various temporary medical orders.
Now is not the time to worry about who is the director.
Because Chen Cang knows, now he is the one who knows the patient's body best.
It is necessary to stabilize the patient's critical symptoms at this time and be ready to be sent to the operating room!
If surgery is performed here, the patient mortality rate is as high as 95%.
Emergency surgery is simply not enough to support such a large and cumbersome and precise operation!
For a time, everyone started to mobilize.
Medical orders are continuously executed.
Xu Ziming had already prepared for puncture.
Under the echocardiogram, the fluid in the pericardial cavity was slowly drawn.
After one minute, the puncture was completed.
250 ml of blood was drawn.
Various drugs have also been injected into patients.
"Can the blood pressure be lowered like this? The patient already has some low blood pressure?" At this time, the second group leader Hou asked.
Indeed, is propranolol combined with sodium nitroprusside too much?
Everyone is a little worried!
Although the patient's aortic dissection has appeared now, the patient has already shocked. If hypotension causes hypoperfusion, can I stick to the operating table?
This seems to have entered another contradiction.