Chapter 1027: You give me the injection
Qin Guoliang first gave an emergency treatment plan, asking the patient to take nitroglycerin sublingually to expand the coronary arteries, so as to relieve pain and relieve symptoms. After the patient took it sublingually, the symptoms were temporarily relieved, but not long after, the heart rate continued to increase, and the blood pressure continued to increase. Still declining, breathing sharply, and blood oxygen indicators continue to decrease.
Qin Guoliang looked at the index on the ECG monitor and became a little nervous. The patient had symptoms of heart failure so quickly.
Qin Guoliang gave a series of treatment plans.
Change the patient's position and help the patient maintain an upright sitting position. Adopting such a position can help reduce the amount of blood returned to the heart and reduce the burden on the heart.
Introduce high-flow oxygen inhalation immediately to avoid the patient's symptoms of physical hypoxia.
Inject a sedative to reduce the load on the heart.
Let the nurse prepare cardiotonic drugs, mainly drugs that rapidly increase cardiac myocardial contractility such as cedilan, to improve myocardial contractility, treat heart failure, and use diuretics to reduce the load on the heart and reduce the burden on the heart. Use vasodilator drugs to further reduce the amount of blood returned to the heart and reduce the load on the heart.
Use aminophylline to relieve airway spasm, improve ventilation quality, improve cardiopulmonary exchange, increase oxygen supply, and relieve symptoms of acute heart failure.
Quickly establish intravenous access.
It should be said that Qin Guoliang's treatment plan was timely, but it had little effect on this patient. Instead of improving, various physiological indicators continued to decrease, and symptoms of cardiac arrest soon appeared.
All medical staff are prepared for the worst.
Qin Guoliang was performing CPR while shouting for the nurse to prepare a manual defibrillator.
Xu Chunliang also rushed over after hearing about the situation here. After quickly understanding the patient's condition, he said to Li Jiakuan: "Uncle Li, do you still remember the last time we met?"
Li Jiakuan nodded, why didn't he remember that on the train to Nanjiang, because Luan Yuchuan of Equator Capital fell ill, medical workers were urgently requested for assistance. It was he, Xu Donglai, and Xu Chunliang who came to the rescue. Of course, the one who played a key role was Xu Chunliang.
At that time, Luan Yuchuan's condition was much more serious than this patient's. Luan Yuchuan had lost his breathing and heartbeat, his lips were black, the nails on both hands were cyanotic, his pupils were dilated, his reaction to light disappeared, and he was about to die. It was Xu Chunliang who used acupuncture to save Luan Yuchuan. He was pulled back from the door of hell.
Although Li Jiakuan has not officially accepted Mr. Xu Changshan as his disciple, Mr. Xu has actually regarded him and Liu Shanmin as his disciples. Whenever they ask for advice, he will teach them without reservation.
Li Jiakuan also consulted Xu Chunliang privately about Luan Yuchuan's case. Xu Chunliang did not hide his secrets and told him the complete treatment plan in detail.
Xu Chunliang said: "It's better you do it!" He took out his needle bag and handed it to Li Jiakuan.
Li Jiakuan was stunned for a moment, but when he saw Xu Chunliang's trusting eyes, he instantly felt confident. Traditional Chinese medicine sometimes does have some metaphysical elements. A breakthrough in level can be achieved in just a thought. The same disease, the same acupuncture method, why do others Whether it can cure you or not, one of the key factors is confidence.
In fact, Li Jiakuan was beside the patient when he became ill. Li Jiakuan hesitated again and again but did not dare to take action himself and asked Tang Mingliang to call in an expert. He also did not directly say to call in Xu Chunliang. After all, he had promised Xu Chunliang that the rescue of Luan Yuchuan would be for him. Confidentiality.
Li Jiakuan silently recalled the scene when Xu Chunliang rescued Luan Yuchuan. He closed his eyes and nodded vigorously, finally making up his mind. This was the best opportunity to combine theory with practice, and it was also a time to test his responsibility.
The patient's right foot was raised, and a filiform needle was inserted directly into the Yongquan point on the sole of the foot. Yongquan point is located on the sole of the foot, also known as Di Chong. It belongs to the Kidney Meridian of Foot Shaoyin. The water from the kidney meridian in the human body gushes out of the body surface through this point. .
The purpose of acupuncture at Yongquan point is to produce strong pain to wake the patient up from severe coma.
Li Jiakuan reviewed the acupuncture techniques used by Xu Chunliang countless times after the train emergency, and now he can be said to have a clear understanding of it.
Following Xu Chunliang's original method, he punctured the patient's skin to elicit the first needle sensation and then continued the acupuncture. He successively broke through the plantar aponeurosis and short curvature of the patient's foot, passed through the metatarsal space, and then penetrated the intermuscular fascia and foot in turn. The skin on the back penetrated the Neiting point of the Stomach Meridian of Foot Yangming. The bright needle tip penetrated the skin on the back of the foot and penetrated the entire sole of the foot.
This acupuncture process requires accurate acupoint identification, and the blood vessels and nerves of the feet must be avoided, and the filiform needles penetrate the soles of the feet.
Li Jiakuan acupunctured the Yongquan points on both feet of the patient one after another, and then selected Neiguan, also known as Yinwei point, which belongs to the pericardial meridian of Jueyin of Hand.
Use a long needle to quickly penetrate the skin through the fat layer. When breaking through the intermuscular fascia, the long needle will produce an obvious sense of resistance. The first needle sensation is stimulated by piercing the intermuscular fascia, continues through the flexor digitorum superficialis, and reaches between the flexor digitorum superficialis and flexor digitorum profundus muscles. The needle tip penetrates the median nerve to stimulate the second needle sensation. Li Jiakuan did not have Xu Chunliang's ability to insert needles into both hands at the same time, so he chose to do it in sequence. Even so, his technique of inserting needles impressed everyone.
Liu Shanmin watched attentively. He didn't expect that Li Jiakuan had made such rapid progress in acupuncture. Could it be that Mr. Xu loved him so much that he opened a small stove alone? Little did he know that Li Jiakuan got the scriptures from Xu Chunliang.
Li Jiakuan gradually relaxed. He controlled the filiform needle with both hands to twist, lift and insert the patient's Neiguan point.
The patient's hands and feet began to move, and his blood pressure stopped its downward trend and slowly increased.
Qin Guoliang was dumbfounded. He could not figure out that after taking so many first aid measures, the patient's condition did not improve and his blood pressure did not rise. However, after a few injections by Li Jiakuan, the patient began to show a stable trend.
Liu Shanmin saw the clue. The fundamental reason why Li Jiakuan's acupuncture was effective was the Neiguan point. The surface water of the pericardium meridian was injected into the body through the Neiguan point. The internal space is injected into the internal meridians of the pericardial meridian from the surface, but the vaporized gas of the water in the pericardial meridian cannot be discharged from the external space of the Neiguan point, just like a one-way checkpoint valve.
Li Jiakuan used the lifting and inserting method to repeatedly acupuncture the Neiguan point, which is equivalent to helping the patient open and close the valve to discharge the qi, thereby improving circulation.
The treatment has reached the most critical moment. Li Jiakuan needs to use filiform needles to bridge the gap between the Yin and Yang meridians.
After pricking the inner gate for three minutes, he continued to insert the needle. The needle tip broke through the extensor digitorum communis and the intermuscular fascia, and penetrated the outer gate. At this time, Li Jiakuan was completely immersed in his own world. He forgot about the onlookers and forgot about the onlookers. After losing his environment, only himself and the patient were left between heaven and earth. He wanted to use this needle to build a bridge of life for the patient.
Waiguan point is the Shaoyang triple burner meridian, which leads to the Yangwei channel and is the point where the eight meridians meet. In normal people, the meridians flow and yin and yang run alternately. The patient has cardiac arrest, blood stasis blocks the heart pulse, lacks the drive of the heart, stagnation of yin and yang, and the inability to convert between each other, which leads to the occurrence of the disease.
This key needle builds a new bridge between the Yin and Yang channels. The Yin energy sinks and the Yang energy rises. The power of the Yin and Yang cycle reappears in the meridians. The Yin and Yang meet and the Yang becomes gloomy and stagnant for a long time. The meridians began to flow again.
In an exchange between Li Jiakuan and Xu Chunliang, Xu Chunliang told him that in the event of cardiac arrest, the meridians are like static water channels, and the heart ratio is like a water wheel in the water canal. If you want the water wheel to turn again, you must let the water in the water canal flow first. Only the flow of water can drive the waterwheel to rotate again.
The automatic external defibrillator has not yet come into use, but the patient has already restored his spontaneous heartbeat under Li Jiakuan's acupuncture.
A strand of long hair on the side of Li Jiakuan's forehead fell down, and his bald forehead was covered with sweat. He looked quite funny, but no one laughed. In their eyes, Li Jiakuan's body was covered with a halo of holiness, and he might not be an angel. It's what everyone imagines. Angels may also be bald.
Li Jiakuan successfully completed the rescue. Seeing the gradually recovering physiological indicators, Li Jiakuan felt as if he was stupid. He came to Xu Chunliang in despair: "Chunliang, I succeeded."
Xu Chunliang nodded.
Li Jiakuan excitedly grabbed Xu Chunliang's hand: "I succeeded!"
Xu Chunliang said: "Success, you saved this patient."
Qin Guoliang frowned, auscultated the patient again, and said in a deep voice: "The condition is not that simple. Further examination is needed to confirm the condition. I suggest that he be sent to Juzhou City for a comprehensive examination as soon as possible." After speaking, he said to Li Jiakuan: "Director Li What do you think?"
While Li Jiakuan was rescuing the patient just now, Xu Chunliang had already diagnosed the patient's pulse and looked at the patient's medical history: palpitations, asthma, and coughing up blood, which were even worse when he moved. Every time I eat, my heart will be agitated, and I will be worried every time I eat. In order to avoid my heartbeat, I will stop eating, and a meal will often be delayed for two to three hours.
Xu Chunliang wrote his own opinions on the medical record and quietly handed it to Li Jiakuan.
Li Jiakuan took a look and said: "Looking at the symptoms, the yin and yang of the heart are both deficient, and the yang deficiency is more severe. After long-term illness, the qi in the spleen and stomach is severely damaged, and the child steals the mother's qi, so the heart palpitations worsen during meals. Gradually, the five internal organs lose support. , the congenital kidney qi is depleted, so the waist is trapped like a fold, the kidneys are not able to accept qi and cause asthma, the true yang is not solid and causes excessive sweating, syncope and pulse failure. Deficiency will cause blood stasis, and blood stasis blocks the heart pulse, so chest tightness and tingling For pain, it is advisable to warm the kidneys and restore yang, unblock the meridians and remove blood stasis, and nourish the fluid to save the heart."
Qin Guoliang sneered secretly. He believed that Li Jiakuan's success in rescuing the patient just now had a certain amount of luck. The correct treatment method is to send the patient to a municipal general hospital as soon as possible. It is best to do a coronary angiography to determine the stenosis site and perform interventional treatment. .
He did not completely deny the role of traditional Chinese medicine, but I am afraid that traditional Chinese medicine cannot cure this kind of patient. Moreover, according to his auscultation just now, this patient should have rheumatic heart disease and organic mitral valve disease. Ordinary hospitals may not be able to cure it. Dare to perform interventional treatment for her.
Let me say it again, something happened in the last ten days, which will affect the update. I will try my best to keep updating.
(End of this chapter)