Returning to ’90s, She Became Famous in Major Surgical Fields

  Chapter 1536 [1536] Doctors should consider comprehensively when making decisions

  The pericardium is a membranous sac, divided into a fibrous layer and a serosal layer, and the serosal layer is further divided into a visceral layer and a parietal layer. The visceral layer covers the surface of the heart, the parietal layer is attached to the fibrous layer, and there is a cavity in the middle called the pericardial cavity. Under normal circumstances, the parietal layer is very smooth, and now the pericardial friction rub indicates inflammation. Inflammation produces exudate that flows into the pericardial space, creating a collection of fluid called pericardial effusion.

When the pericardial effusion increases to a certain amount, the visceral layer and the parietal layer are separated, and there is no friction between each other, and the pericardial friction sound will disappear instead. This is why clinical cases with a large amount of effusion with pericardial friction are rare and special, and this old grandmother should not be. Because of auscultation, the patient's first heart sound and second heart sound were not far away.

   There is no large amount of effusion and the condition has not yet reached the level of cardiac tamponade, which can be called lucky.

  Xie Wanying put down the stethoscope, and then asked the patient the location and characteristics of the pain in her heart: "Is it the pain like being cut by a knife, or does it feel like being hit by a sandbag?"

  The old grandmother said, "It's like being hit in the chest by something heavy."

   is dull pain, although myocardial infarction is also dull pain, but this pain may come from the pressure pain caused by pericardial effusion. Xie Wanying analyzed and calculated in her brain through the examination data obtained at this stage, and believed that the possibility of myocardial infarction in the patient was small. The main problem is still a bit of acute heart failure.

  The flight attendant brought the oxygen mask to the nurse. The nurse puts the patient into an oxygen mask. The flight attendant took advantage of this time to mutter in Xie Wanying's ear.

   "The captain asked, do you need to make an emergency landing to a nearby airport? If you need it, please tell me quickly. We also need coordination from the airport to contact the nearby airport for landing."

  The plane does not land immediately when it wants to land. Even a temporary forced landing must be coordinated with the airport first, and the consequences of a collision, etc., will result in the death of the plane.

   "How long will it take to continue flying from the Capital Airport?" Xie Wanying asked.

   "About an hour." The flight attendant replied.

   That said, the plane is about to fly over the capital. The medical conditions around the capital are incomparable to those in the capital. And what's even more frightening is that everyone in the surrounding people knows that doctors in the capital go to the capital to see a doctor. As a result, the medical technology in the surrounding areas is somewhat inferior to that of the capital, and it is not as good as that of local hospitals far away from the capital.

   "How long will it take to land temporarily at a nearby airport? Does it take ten to twenty minutes?" Xie Wanying asked again.

   "Yes." The flight attendant was amazed at her quick calculation ability, as if she was more than a doctor.

   Laymen don’t know it. Doctors often have to count, whether physicians or surgeons. What kind of? Counting things are old. It is a basic skill for clinicians to prescribe a doctor's order to calculate the patient's drug dose every day. This alone already involves calculation. Doctors should try to calculate the specific dosage before the patient's changing condition. The more accurate the calculation, the better.

  On-site emergency doctors also need to estimate the best transportation plan for the patient.

   Can the patient's condition be waited for, and can he wait for an hour to land safely at the Capital Airport before being sent to the hospital? If it is possible, both patients and their families will definitely choose Capital Hospital for treatment.

  Xie Wanying needs to take this into consideration for this patient because this patient is not a common heart disease, but a relatively rare hypothyroid heart disease here.

   (end of this chapter)

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