"Does the patient have high blood pressure, heart disease, high blood sugar, and high blood lipids?" Zhao Heng asked while opening the patient's eyelids.
Tao Le had already activated her cell phone. At this time, she activated the flashlight function and matched his movement of turning his eyelids to shine on the patient's pupils.
Zhao Heng looked up at Tao Le and expressed his approval for her quick response.
"My father suffered from high blood pressure when he was 50 years old. It has been 20 years now. His heart and blood sugar are fine, but his blood lipids are a bit high. I have taken daily antihypertensive medicine this morning. Just after the plane was bumpy, suddenly... ..”
High blood pressure may cause cerebral hemorrhage. Hyperlipidemia may lead to the formation of blood clots and cerebral obstruction. Neither of these two diseases is a good thing. Zhao Heng sighed.
For this acute illness, a cranial imaging examination, commonly known as brain CT or MRI, must be performed. At the same time, multiple indicators such as complete blood count and creatinine must be tested to determine the cause. Based on the results, intravenous antihypertensive or thrombolysis and other treatments may be given. Depending on the situation, craniotomy may be required.
But on this plane, no examination or treatment can be done.
"The pupil of the patient's left eye was constricted and the light reflex became weak, but the right eye was normal." Tao Le said about the results of the light reflex.
This result is neither too good nor too bad.
"Have you brought the blood pressure monitor?" Zhao Heng asked.
"The blood pressure is about 180/130, the heart rate is 110, and the blood oxygen saturation is poor. It is recommended to inject oxygen immediately to improve oxygenation." Tao Le couldn't help but interrupt.
She read the data directly on the golden finger interface just to save time.
However, no one paid attention to her.
The flight attendant handed the blood pressure monitor to Zhao Heng, who took the measurement seriously.
The results came out quickly. 180/130, heart rate 112. There was little difference from what she had just said.
Seeing this result, everyone turned their attention to Tao Le.
Tao Le didn't explain anything. Her expression was as usual, neither resentful because she had been ignored just now, nor complacent because the result was the same.
There was a hint of appreciation in Zhao Heng's eyes.
"I agree with your suggestion, give me oxygen," he said.
A patient's heartbeat is too fast, often because the oxygen content in the blood is not high, and the heart needs to beat harder to increase oxygen acquisition. Oxygen administration can quickly improve this symptom.
To be honest, this is the only medical support patients can get on airplanes now.
Tao Le placed the oxygen mask on the patient's face and adjusted the flow rate. Zhao Heng took a look and found that Tao Le had set 3L per minute, which was just right.
The higher the oxygen concentration, the better. If the concentration is low, the effect will not be achieved; if it is high, it may cause metabolic acidosis without any monitoring equipment, which is counterproductive.
This female student must have performed very well during her internship. The reaction is quick, the hands and feet are nimble, the basic skills are solid, and you can even surprise yourself.
The patient's breathing becomes evener. On the interface in front of Tao Le, the patient's blood oxygen saturation has increased to 92%, and the heart rate has dropped to 95.
Zhao Heng stood up and explained the condition to the patient's son.
"Combined with various symptoms, it is now highly suspected that your father has a cerebral hemorrhage or acute cerebral obstruction."
Most people understand what these two medical terms mean.
Although there were speculations, the patient's son also panicked when he heard that it was indeed such a serious disease.
"Director, can you save him? My father's safety is very important. He came to Yun City just to discuss a project worth more than 2 billion yuan. Nothing can happen to him!"
Zhao Heng sighed: "Doctors are not omnipotent and can only do their best. But if your father can still remain conscious when he gets to the hospital, then there is no doubt that there is hope for recovery in the future."
He turned to the flight attendant: "Report to air traffic control. There are critically ill patients here. They suspect cerebral hemorrhage or cerebral infarction. Please provide all convenience and support and prepare an ambulance."
The flight attendant hurriedly reported to the captain to contact regional air traffic control.
The plane has been flying for nearly an hour now, and there are continuous mountainous areas below. The nearest airport that can land is Yun City, which is also the original destination of the flight.
After a while, the flight attendant came back with good news: "Air traffic control has opened a green channel for us, directed the surrounding aircraft to avoid it, and allowed us to land first."
"The plane is speeding up now, but it will take at least forty minutes. The airport emergency center is ready, and the ambulance will be on hand as soon as possible."
Zhao Heng and Tao Le looked at each other. Forty minutes is not too long, but it’s not short either!
The positive factor is that the patient has not vomited or comatose so far, and the situation is still under control.
But there is never any reason for a disease like cerebral hemorrhage.
In Zhao Heng's view, there is nothing left to do except wait.
"Xiao Tao, what do you think of this patient?" he asked Tao Le gently.
"I judge that it is bleeding in the thalamus on one side. The amount of bleeding is not large for the time being, but if it is not treated in time, it is difficult to tell." Tao Le replied.
"Oh?" Zhao Heng became interested: "How do you judge that it is the thalamus, rather than the brainstem and other parts?"
"The director is taking an exam for me." Tao Le said, "Only thalamic hemorrhage can cause the patient's mouth to become distorted, numb or hemiplegic."
"Don't forget cerebral obstruction." Zhao Heng reminded. Unless a CT scan is performed, he cannot accurately determine which type it belongs to.
Cerebral hemorrhage can be clearly seen on CT, but cerebral obstruction cannot be seen at the time. It takes 24 to 48 hours before low-density images can be detected on CT.
"It's not cerebral obstruction." Tao Le's voice was low, but filled with unquestionable certainty.
"I don't want it to be a cerebral obstruction. But the fact is, we can't distinguish between these two situations now."
Tao Le's heart moved. She found a reason to persuade the other party: "I have checked the patient's pulse. It is a strong pulse, few and slightly slippery. This is what the pulse looks like in cerebral hemorrhage caused by high blood pressure."
"Cerebral obstruction is caused by blood clots blocking the blood vessels in the brain, resulting in poor blood flow. The pulse should be thin, stringy, frequent, or astringent."
These words moved Zhao Heng: "You didn't graduate in clinical medicine? How can you understand Chinese medicine?"
As the director of cardiovascular surgery, he agrees with the efficacy of traditional Chinese medicine in treating cardiovascular and cerebrovascular diseases. In fact, Chinese patent medicines are usually prescribed to patients to dredge their blood vessels and regulate their bodies.
Zhao Heng knows several well-known traditional Chinese medicine doctors in the industry. They can indeed tell the difference between cerebral hemorrhage and cerebral infarction by taking the pulse, but they are all old doctors who have been practicing medicine for many years and have so much experience.
The little girl in front of me might not be able to distinguish such subtle pulse patterns even if she learned Chinese medicine from her mother's womb.
“Although my major is clinical Western medicine, I also have traditional Chinese medicine inheritance,” Tao Le said. She felt a little depressed because her mentor didn't know her at all yet, so it really couldn't be justified to say that her medical skills were passed down from him.
Fortunately, Zhao Heng did not ask further questions. He was inclined to trust her, a thought that was rare in his many years of medical practice.
Soon they stopped chatting as the patient tilted his head to one side and fell unconscious without warning.
