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Wang Li Bing
Intensive Care Medicine Department
About me
Loudi Central Hospital, ICU, attending physician, has been engaged in ICU clinical work for many years, with rich clinical experience in the treatment of emergency patients.
Proficient in diseases
Proficient in using equipment such as continuous electrocardiogram monitoring, oxygen saturation detection, blood pressure monitoring, and disease monitoring.
Voices
Common causes of heart failure
Heart failure is a syndrome that occurs when various structural or functional cardiac diseases impair ventricular filling or ejection function. Once heart failure occurs, medical treatment should be sought promptly. Common causes of heart failure mainly include the following points. The first category is primary myocardial damage, which mainly includes coronary heart disease, myocardial infarction, myocarditis, cardiomyopathy, and diabetic cardiomyopathy, among others. The second major category is cardiac load, such as excessive pressure load, commonly seen in hypertension, aortic valve stenosis, pulmonary hypertension, etc.; and excessive volume load, mainly found in cardiac valve insufficiency and congenital heart disease, among others.
What is ventricular arrhythmia?
Ventricular arrhythmias mainly refer to disorders of the ventricular rhythm and are relatively common clinically, including premature ventricular contractions, ventricular tachycardia, ventricular flutter, and ventricular fibrillation. Premature ventricular contractions generally do not cause noticeable clinical symptoms, while ventricular flutter and ventricular fibrillation are very dangerous clinically and must be treated promptly with defibrillation. Therefore, ventricular arrhythmias must be treated promptly, actively treating the underlying disease, and managing the arrhythmia to prevent sudden death.
How to supplement potassium for hypokalemia
Hypokalemia generally has two common methods of potassium supplementation. The first is oral potassium supplementation, and the second is intravenous potassium supplementation. Oral potassium supplementation is the safest method, for example, taking potassium chloride sustained-release tablets orally, as well as potassium chloride injection solution orally, and eating more potassium-rich vegetables and fruits. The second method is intravenous potassium supplementation. For intravenous potassium supplementation, it is important to pay attention to the patient's urine output. If the patient's urine output is adequate, intravenous potassium supplementation can be appropriately performed, and the concentration of intravenous potassium supplementation should not exceed 0.3% to prevent arrhythmias caused by hyperkalemia. (Please use medications under the guidance of a doctor.)
How is hypokalemia diagnosed?
Hypokalemia refers to a blood potassium level below 3.5mmol/L. Clinically, it is mainly diagnosed through electrolyte tests and arterial blood gas analysis, which can confirm whether a patient has low potassium. After developing hypokalemia, patients may experience symptoms such as fatigue and limb weakness. At this point, treatment should include the oral administration of sustained-release potassium chloride tablets or intravenous infusion of potassium chloride, as well as advising the patient to consume potassium-rich vegetables and fruits to correct hypokalemia. Prolonged hypokalemia can lead to arrhythmia and even endanger the patient’s life. (Medications should be used under the guidance of a clinical doctor, according to the specific situation.)
Preferred examination method for upper gastrointestinal bleeding
Upper gastrointestinal bleeding is very common clinically. If the patient's respiratory and circulatory systems are stable, an esophagogastroduodenoscopy can be performed to further identify the bleeding site. Of course, it is also necessary to dynamically monitor blood tests and coagulation function, and pay attention to the patient's vomiting and rectal bleeding. The clinical treatment of upper gastrointestinal bleeding mainly involves transfusions to replenish blood volume and conservative medical treatment for hemostasis. If conservative medical treatment is not effective, surgical intervention can be considered.
What causes bronchial asthma?
Bronchial asthma is very common in clinical settings, mainly characterized by a reversible airflow limitation that can cause recurrent attacks of wheezing, chest tightness, and shortness of breath in patients. These attacks generally occur at night or in the early morning and can gradually ease after treatment. Bronchial asthma is mainly related to several factors, the first being environmental factors. Exposure to pollen and animal dander can trigger asthma attacks. Additionally, infections, diet, and medications are among the various factors that can provoke asthma attacks.
Treatment methods for hyperkalemia
In clinical practice, a blood potassium level greater than 5.5 millimoles per liter is referred to as hyperkalemia. Once hyperkalemia occurs, it must be actively managed: the first step is to stop using medications that increase blood potassium, such as sustained-release potassium chloride, potassium-sparing diuretics like spironolactone, and ACE inhibitors; the second step is to use calcium supplements to counteract the toxic effects of high potassium on the heart; the third step is to use hypertonic glucose with insulin and sodium bicarbonate to correct acidosis and promote the movement of potassium into the cells; the fourth step is to use the diuretic furosemide to help reduce blood potassium. If drug treatment is ineffective, bedside hemodialysis may be employed. (Use of the above medications should be under the guidance of a doctor.)
What are the symptoms of a pulmonary embolism warning sign?
Pulmonary embolism is also very common in clinical settings, mainly seen in patients who have been bedridden for a long time, undergone various major surgeries, suffered from long bone fractures, pregnancy, etc. In the early stages of pulmonary embolism, patients generally experience varying degrees of chest pain, hemoptysis, and difficulty breathing, among others. If pulmonary embolism is suspected and the patient's condition permits, a pulmonary artery CTA scan should be immediately carried out to further confirm the diagnosis of pulmonary embolism. If the pulmonary embolism has already caused circulatory disturbances, thrombolytic therapy should then be considered.
The most common symptoms of pulmonary embolism.
Pulmonary embolism is also relatively common in clinical practice, primarily caused by an embolus blocking the pulmonary artery system, leading to a group of clinical syndromes. The clinical manifestations of pulmonary embolism mainly include the following points: The first is that patients may experience unexplained difficulty breathing and shortness of breath, especially after activity. The second is that patients experience significant chest pain. The third may be accompanied by hemoptysis, but usually, the amount of blood expectorated is not large. The fourth is that patients may experience restlessness, panic, and even a sense of impending doom. Clinically, there sometimes appears the so-called triad, which includes simultaneous occurrence of difficulty breathing, chest pain, and hemoptysis, etc. Pulmonary embolism is primarily diagnosed clinically through pulmonary artery CT.
How to treat bronchial asthma?
After the onset of bronchial asthma, it is necessary to carry out active treatment. In clinical practice, the following categories of bronchodilator drugs are mainly used: The first is adrenergic receptor agonists, such as salbutamol and terbutaline; the second is anticholinergic drugs, mainly tiotropium bromide; the third category is xanthine drugs, which can include aminophylline or doxophylline. Additionally, glucocorticoids can be used for pharmacological treatment. If the patient still has recurrent attacks after systemic treatment, hospitalization is recommended for further management.