After being transferred from the intensive care unit to the general ward, Mr. Tan crossed the threshold of life and death.
Mr. Tan, 37, is a native of Guangxi Province and works in an electronics factory in Daling Town, Dongguan City. At 12:36 on December 8, because he had diarrhea all day, he took advantage of the noon factory break to come to the emergency department of Dongguan Hospital of Integrated Traditional Chinese and Western Medicine, wanting the doctor to prescribe some medicine.
At that time, his face was normal and there was nothing unusual. The front desk ** measured his blood pressure, triaged, and learned that he had diarrhea and asked him to find Dr. Gu Zhenchang. Gu Zhenchang asked for a detailed medical history, carefully conducted a physical examination, found that his heart rhythm was irregular, and recommended that the electrocardiogram be completed.
At 12:50, Mr. Tan entered the emergency room for an electrocardiogram examination. Suddenly, he felt palpitations, tightness in his chest, and sweating profusely. The medical staff at the scene asked him to lie down quickly, the doctor assessed the condition, and immediately carried out ECG monitoring, which showed that ventricular tachycardia.
*A normal heart rate range of 60 to 100 beats per minute is quietly awake, and ventricular tachycardia is defined as more than 100 beats per minute (usually no more than 160 beats per minute). Mr. Tan's heart rate exceeded 200 beats per minute, and his heart was beating wildly, which was very dangerous and prone to sudden death.
The onset of ventricular tachycardia must be terminated immediately**.
Doctors first try pharmacological cardioversion, giving verapamil 10 mg intravenously. However, the ECG monitoring before and after the medication could not capture a single signal of the sinus turn, and the heart was still beating wildly. Health care providers are concerned that if this continues, they may become hemodynamically unstable or turn into ventricular fibrillation.
Fears soon became reality. A few minutes later, Mr. Tan was still saying "nothing uncomfortable", and in an instant, he lost consciousness, looked upwards, and then his limbs twitched, and Tang Rixiang, director of the emergency department, considered that Mr. Tan had "A-S syndrome" and might immediately go into cardiac arrest.
"A-S syndrome" is a sudden onset of severe, fatal bradyarrhythmia or tachyarrhythmia, resulting in a sharp decrease in cardiac output and severe cerebral ischemic symptoms. The most common cause of "A-S syndrome" is cardiac arrest.
Tang Rixiang immediately made a decision to prepare for electrical cardioversion, two-way 120 joules synchronous electrical cardioversion. Charging, preparing for defibrillation, all flashing, discharging, the emergency team tacitly cooperated. One second after defibrillation, the patient becomes conscious, ventricular tachycardia, and the beating heart returns to normal.
After staying in the emergency department for nearly an hour, at 14:08, Mr. Tan was transferred to the intensive care department for close care.
Statistics show that the total number of cardiac arrests in China exceeds 1 million every year, but the survival rate of out-of-hospital cardiac arrest patients is only 115%。Tang Rixiang said that fortunately, Mr. Tan was in the emergency room when he became ill, and if he was outside the hospital, the hope of survival was very slim.
As a first-aid expert, Tang Rixiang reminds that when you encounter cardiac arrest outside, you can immediately call 120 emergency ** and take the following measures:
Chest compressions: After cardiac arrest, patients experience symptoms such as loss of consciousness, loss of aortic arteries and heart sounds, and apnea. At this time, the patient can be rescued by chest compression in time, and the patient's chest can be compressed vertically and quickly, so that the chest cage can contract rapidly, so that the pressure in the chest cavity increases, and the blood flow of the cardiac aorta and pulmonary artery can be promoted to achieve the purpose of timely rescue.
Rescue respiration: Chest compressions are performed at the same time as the patient. Artificial respiration can establish effective artificial circulation and gas exchange in the respiratory tract, so as to ensure the blood and oxygen of various organs of the patient's body.
In crowded places such as public places, schools, and enterprises, the installation of AEDs can provide timely treatment for cardiac arrest patients and improve the survival rate of patients. The use of the AED is very simple, you just need to follow the voice prompts.
First, turn on the AED and place the electrodes on the designated location on the patient's chest;Then, follow the voice prompts. The AED automatically analyzes the patient's heart rhythm and if a shock is required, the AED automatically delivers the shock and prompts the operator to continue CPR.
Text: Guangzhou** New Flower City Reporter: Wang Wanli Guangzhou** New Flower City Editor: Yang Hongquan.