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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
What are the precursors of pulmonary embolism?
Pulmonary embolism is also relatively common in clinical practice. Its precursors may include varying degrees of respiratory difficulty, chest tightness, and shortness of breath, among others. If such symptoms occur, medical attention should be sought promptly, primarily to rule out the possibility of acute myocardial infarction. Pulmonary artery CTA can further confirm whether there is a pulmonary embolism. In cases of extensive pulmonary embolism, there is a high risk of sudden death, and aggressive thrombolytic and anticoagulation treatments should be administered. If the patient's chest tightness and shortness of breath are relieved after the aforementioned treatments, hospitalization for observation and treatment is still necessary.
Pulmonary embolism belongs to which department?
Pulmonary embolism mainly refers to the detachment of thrombi in the blood, leading to the obstruction of the main trunk of the pulmonary artery and its branches, causing a series of syndromes. Pulmonary embolism is an emergency in clinical practice. If the patient's circulation becomes unstable after the embolism, thrombolytic therapy should be considered. If the patient's respiratory circulation remains stable after the embolism, anticoagulation therapy can be considered. In clinical practice, pulmonary embolism is primarily diagnosed through pulmonary artery CTA examination to further clarify the diagnosis, and patients generally consult the respiratory medicine department.
The most common cause of upper gastrointestinal bleeding.
Upper gastrointestinal bleeding is also relatively common in clinical practice, and its common causes mainly include the following points: The first is bleeding from gastric and duodenal ulcers; the second is liver cirrhosis leading to portal hypertension, which causes rupture and bleeding of gastric varices; the third is acute erosive gastritis leading to acute ulcer bleeding; the fourth category includes gastric cancer and various systemic diseases, such as bleeding caused by hematologic diseases. Therefore, if upper gastrointestinal bleeding occurs and the patient has a large amount of bleeding or rapid bleeding, they must seek medical attention immediately.
The basic mechanisms of heart failure
Heart failure is not an independent disease; it can be caused by various factors, such as myocardial infarction, cardiomyopathy, and various myocarditis, which lead to changes in the heart structure and subsequent cardiac dysfunction. Heart failure is mainly due to a disturbance in the heart's contractile function or diastolic function, which prevents the heart from adequately ejecting the returning blood volume. This results in pulmonary congestion, systemic circulation congestion, and a series of syndromes caused by insufficient arterial perfusion.
Is the heart rate fast or slow in heart failure?
Heart failure is also relatively common in clinical practice, primarily due to dysfunction in the heart's contractile or relaxation capabilities. This leads to ineffective expulsion of venous blood returning to the heart, resulting in venous congestion and a series of symptoms. Patients typically experience varying degrees of breathing difficulty, coughing, expectoration, coughing up pink frothy sputum, as well as gastrointestinal symptoms. Following the onset of heart failure, a patient's heart rate generally increases as a compensatory response to promote increased cardiac output. If a patient enters the terminal stage of heart failure, a decrease in heart rate may occur, and can even lead to death.
Why is calcium used for hyperkalemia?
Hyperkalemia can increase the excitability of myocardial cells, leading to various malignant arrhythmias and even sudden death. Immediate treatment is necessary after hyperkalemia occurs. Clinically, it can be treated by hemodialysis or conservatively with medication. Why use calcium preparations for hyperkalemia? Because after using calcium preparations, the excitability of myocardial cells can be stabilized, effectively maintaining stable heart rates in patients and preventing sudden death due to malignant arrhythmias.
Is acute heart failure dangerous?
Acute heart failure is very dangerous in clinical practice. It is mainly caused by a sudden decrease in cardiac output, leading to insufficient perfusion in tissues and organs and acute blood stasis syndrome. The main clinical symptoms include severe respiratory distress, often accompanied by restlessness, profuse sweating, frequent coughing with pink frothy sputum, and in severe cases, sudden cardiac and respiratory arrest can occur. After the occurrence of acute heart failure, effective measures should be taken to alleviate symptoms such as respiratory distress. The most effective methods in clinical practice include strengthening the heart, promoting diuresis, and dilating blood vessels.
Upper gastrointestinal bleeding gastroscopy time
Upper gastrointestinal bleeding is also relatively common in clinical practice. The most common causes are bleeding from peptic ulcers, rupture of esophageal and gastric varices, bleeding caused by gastric cancer, and various emergency bleedings. Once gastrointestinal bleeding occurs, medical attention should be sought promptly. If the patient experiences hemorrhagic shock or hemorrhagic anemia, it is necessary to provide blood transfusions and hemostasis, and replenish blood volume as active treatments. Additionally, for upper gastrointestinal bleeding, it is generally advisable to complete a gastroscopic examination within 24 to 48 hours, which can help clarify the cause of the patient’s gastrointestinal bleeding.
How is hyperkalemia treated?
Hyperkalemia must be handled immediately after it occurs, otherwise it can cause malignant arrhythmias and even endanger life. The first step is to stop potassium supplements, such as potassium chloride sustained-release tablets; the second step is to stop potassium-sparing diuretics, such as spironolactone and other drugs. We can administer calcium intravenously to antagonize the toxic effects of high potassium on the heart. Additionally, we can use high glucose with insulin and intravenously drip sodium bicarbonate, which can promote the movement of potassium into cells. We can also use diuretics to excrete potassium through urine. If the treatment effect is poor after medication, we can use bedside hemodialysis to reduce blood potassium.
What to eat when there is upper gastrointestinal bleeding?
Upper gastrointestinal bleeding is relatively common in clinical practice. Its main causes include bleeding from gastroduodenal ulcers, rupture of esophagogastric varices, and bleeding caused by gastric cancer, among others. When upper gastrointestinal bleeding occurs, it is crucial to seek medical attention promptly. After systematic treatment, if the symptoms of bleeding are controlled, the patient can then consume small amounts of clear broth and thin porridge, and gradually transition back to a normal diet. However, the patient should avoid spicy and irritating foods to prevent the recurrence of gastrointestinal bleeding.