Chapter 1536 【1536】Doctors Should Consider Everything when Making Decisions

The pericardium is a membranous sac, divided into fibrous layer and serosa layer, and the serosa layer is divided into visceral layer and 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 a pericardial friction rub represents inflammation. Inflammation produces exudate, which flows into the pericardial cavity, and the resulting fluid accumulation is 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 it is rare and special to have a pericardial friction rub for a large amount of effusion clinically, and this old lady should not be. Because of auscultation, the patient's first heart sound and second heart sound were not far away.

It can be called luck that there is no large amount of effusion and the condition has not yet reached the level of cardiac tamponade.

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

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

It is dull pain. Although myocardial infarction is also dull pain, 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 the patient's myocardial infarction was small. The main problem is still a little acute heart failure.

The flight attendant brought the oxygen mask to the nurse. A nurse puts on an oxygen mask for a patient. The flight attendant took advantage of this time to whisper in Xie Wanying's ear.

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

The plane doesn't just land right away. Even a temporary forced landing must be coordinated with the airport first, and the consequences such as a collision will result in a plane crash and death.

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

"About an hour." The flight attendant replied.

So the plane is about to fly over the capital. The medical conditions around the capital are incomparable with those in the capital. What's more frightening is that everyone in the surrounding area knows that the doctors in the capital go to the capital to see a doctor. As a result, the medical technology in the surrounding areas is not as good as that of the hospitals in the capital.

"If I find a nearby airport to land temporarily, how long will it take? Will it take ten or twenty minutes?" Xie Wanying asked again.

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

Laymen don't know it. Doctors often have to count, regardless of whether they are physicians or surgeons. What kind of? Counting things are much older. It is a basic skill of clinicians to make daily ward rounds and prescribe medical orders to calculate patient drug doses. This item alone involves calculation. Doctors should try their best to calculate the specific dosage before the patient's condition changes. The more accurate the calculation, the better.

The on-site emergency doctor also needs to estimate the best transportation plan for the patient.

Can this patient wait for his condition? Can he wait for an hour to land safely at the Capital Airport before sending him to the hospital. If so, both patients and family members will definitely choose Capital University Hospital for treatment.

Xie Wanying needs to consider this for this patient because this patient is not a common type of heart disease, but a relatively rare hypothyroid heart disease here.