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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
Subarachnoid hemorrhage examination methods
Subarachnoid hemorrhage is also relatively common in clinical practice. Patients may experience severe headaches, nausea, and projectile vomiting. The clinical signs generally include positive meningeal irritation signs, typically presenting with neck stiffness, Kernig's sign, and Brudzinski's sign all being positive. Clinically, the diagnosis can be confirmed mainly through cranial CT scans. If conditions permit, lumbar puncture can be performed to ascertain the nature of the cerebrospinal fluid and the intracranial pressure, etc. After a subarachnoid hemorrhage occurs, patients should be admitted to the neurology department for active treatment, and typically receive dehydration therapy to reduce intracranial pressure and neuroprotection among other symptomatic treatments.
The earliest clinical manifestations of hypokalemia
Hypokalemia is also relatively common in clinical settings. If the blood potassium level falls below 3.5 mmol, it indicates that the patient has hypokalemia. Clinically, this can affect related systems. For instance, patients may experience general weakness, nausea, vomiting, loss of appetite, and even disorientation. If the patient remains hypokalemic for an extended period, it can lead to arrhythmias, such as premature atrial and ventricular contractions. Once hypokalemia occurs, it must be actively managed by correcting the low potassium levels. Clinically, this can be done by administering potassium chloride sustained-release tablets via nasogastric feeding, as well as consuming potassium-rich vegetables and fruits.
How should aspirin be taken for cerebral infarction?
Aspirin should be taken for cerebral infarction. It can be used not only during the acute phase of cerebral infarction but also for secondary prevention treatment. If a patient suffers a cerebral infarction, thrombolytic interventional surgery can be conducted during the acute phase window. If the patient has missed the time for surgery, then choosing antiplatelet drugs like aspirin and clopidogrel, along with atorvastatin for lipid regulation and stabilizing plaques, is advisable. A follow-up CT should be done dynamically, and changes in the patient's consciousness and pupils should be monitored.
Upper gastrointestinal bleeding includes which areas?
In clinical practice, bleeding in the digestive system above the ligament of Treitz is referred to as upper gastrointestinal bleeding. It primarily includes the following areas: The first major category is esophageal diseases, such as esophagitis, esophageal trauma, and other causes of bleeding. The second category is duodenal diseases, such as peptic ulcers, acute erosive hemorrhagic gastritis, stomach cancer, etc. Another cause is liver cirrhosis leading to portal hypertension, which can cause rupture and bleeding in esophageal and gastric varices. The fourth category includes biliary system and pancreatic diseases involving the duodenum, such as pancreatic cancer, which can also lead to bleeding.
What tests are done for arrhythmia?
Arrhythmia is also relatively common in clinical practice, and its common detection method is mainly the electrocardiogram (ECG). ECG is a simple and non-invasive operation that helps to identify the type of arrhythmia. Another method is the 24-hour Holter monitor, which can record all heart rate changes occurring within 24 hours. If an arrhythmia occurs, it is crucial to seek medical attention promptly, visiting a cardiology department. Treatment may involve antiarrhythmic medications, and if possible, a complete electrophysiological examination can be performed.
What is a cerebral infarction?
Brain infarction is also relatively common in clinical practice, mainly seen in elderly people, generally accompanied by underlying diseases such as hypertension, hyperlipidemia, and diabetes. Brain infarction is primarily caused by the blockage of cerebral blood vessels, leading to necrosis of brain tissue due to ischemia and hypoxia. After a brain infarction occurs, patients should seek medical attention in a timely manner and be admitted to the department of neurology or neurosurgery for systematic drug treatment. If the infarction area is large or a brain herniation has formed, surgical intervention should be considered, such as decompressive craniectomy and lowering intracranial pressure.
Which department should I go to for a cerebral infarction?
Stroke is caused by blockage or narrowing of blood vessels within the skull, leading to ischemic necrosis of brain tissue and a range of symptoms. Typically, patients with strokes are seen in neurology departments. Of course, the location of the stroke varies, and each patient's clinical presentation is different. If a stroke occurs, a cranial CT scan can provide a clear diagnosis. Clinically, treatment primarily involves dehydration, lowering intracranial pressure, brain protection, and nutritional support. If the patient has a large area of cerebral infarction and high intracranial pressure, they can be seen in neurosurgery, where procedures such as craniotomy decompression may be used to reduce intracranial pressure.
What should be done if the area of cerebral infarction is large?
If a large cerebral infarction occurs, brain edema often peaks within two to three days, and the mortality rate is extremely high. If medical attention is sought within six hours of onset, thrombolytic therapy can be considered. If emergency thrombolysis is exceeded, then only conservative drug treatment is available. For example, mannitol dehydration to reduce intracranial pressure, nourish neurons, protect brain cells, provide nutritional support, etc. After a stroke, it is essential to monitor changes in the patient's consciousness and pupils, dynamically assess the patient’s Glasgow Coma Score, and be aware of various potential complications. Family members should be well-informed about the patient's condition, etc. (Specific medications should be administered under the guidance of a doctor.)
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.