Subscribe
63
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
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.
How to administer oxygen for respiratory failure.
First, we should evaluate whether the patient has type I or type II respiratory failure based on arterial blood gas analysis. Type I respiratory failure is primarily characterized by low oxygen tension, indicating a state of hypoxia, with normal carbon dioxide tension, in which case high-flow oxygen therapy can be administered. In type II respiratory failure, both the oxygen tension is low and the carbon dioxide tension is high. In this case, only low-flow oxygen therapy should be given, or non-invasive ventilation, or endotracheal intubation connected to mechanical ventilation may be employed.
Clinical manifestations of heart failure
Heart failure is divided into left heart failure, right heart failure, and total heart failure. Left heart failure mainly manifests as exertional dyspnea or nocturnal paroxysmal dyspnea. It is often accompanied by palpitations, orthopnea, coughing, coughing up pink frothy sputum, accompanied by palpitations, fatigue, etc. Right heart failure primarily presents with symptoms of the digestive system, such as abdominal distension, nausea, vomiting, edema, oliguria, etc. Once heart failure occurs, active treatment must be administered. In clinical practice, treatments mainly include cardiotonics, diuretics, vasodilators, and other symptomatic treatments.
Clinical manifestations of chronic heart failure
Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Clinically, left heart failure is the most common. The clinical manifestations of left heart failure primarily involve pulmonary congestion and reduced cardiac output, which can present as varying degrees of dyspnea, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Patients may experience coughing, expectoration, pink frothy sputum, fatigue, tiredness, dizziness, palpitations, and more. Right heart failure primarily manifests as gastrointestinal and liver congestion, causing abdominal distension, poor appetite, nausea, vomiting, and more. Total heart failure naturally includes the clinical manifestations of both left and right heart failure.
Treatment of severe pancreatitis
Severe pancreatitis must be managed with comprehensive measures and aggressive rescue treatment. For medical treatment, the first step is to enhance monitoring of vital signs such as heartbeat, respiration, and blood pressure. The second step involves actively replenishing fluids and electrolytes to maintain effective blood volume. Severe cases often experience shock, and it may be appropriate to administer albumin, plasma, etc. The third step for patients with severe pancreatitis, who typically have high metabolic demands, is to enhance nutritional support, possibly using parenteral nutrition. The fourth step involves routine use of antibiotics for severe pancreatitis to prevent infections related to pancreatic necrosis. The fifth step involves using somatostatin analogs like octreotide to suppress the secretion of pancreatic enzymes and pancreatic juice as part of conservative medical treatment. If pancreatic necrosis is complicated with infection, or if a pancreatic abscess forms, surgical treatment can be considered.
The most common cause of upper gastrointestinal bleeding
Upper gastrointestinal (GI) bleeding is very common in clinical settings, and the main causes of upper GI bleeding include the following: First, gastric and duodenal ulcers, esophageal diseases. Second, esophageal and gastric fundal varices rupture caused by portal hypertension. Third, diseases of organs or tissues adjacent to the upper digestive tract, such as biliary bleeding or pancreatic diseases involving the duodenum, such as pancreatic cancer, as well as aortic aneurysms breaking into the esophagus, stomach, or duodenum. Fourth, systemic diseases, such as allergic purpura, hemophilia, etc., can all lead to upper GI bleeding. After such bleeding occurs, it is essential to seek medical attention promptly.