In the process of transporting the patient, the patient's heart rate continues to increase, the blood oxygen saturation gradually decreases, and in the state of high-flow oxygen inhalation, it can only be maintained at about 92%, and the patient's chest tightness and chest pain continue to worsen, and he becomes more and more irritable. The scruffy middle-aged man was lying on a flat car, constantly trying to tear the leads and venous access on his body, and his mouth kept on and out, and after I made careful identification, I found that it did not seem to be in English.

Medical diagnostics is not my category, based on what kind of symptoms and signs, combined with what kind of test or imaging results to diagnose or rule out a disease, about this should be the process, but different doctors have their own set of diagnosis and treatment habits, this is the practice of medicine for many years of habits and experience summary, some are similar, some are different, some tend to be conservative, conservative but not biased and wrong, some prefer to be bold and careful, do not like to stick to traditional thinking, each has its own advantages and disadvantages, there is no right or wrong.

When faced with such a middle-aged man who is critically ill but already has signs of heart failure, what will our doctors do? Continue to insist on taking the greatest risk and opening the blocked blood vessels as quickly as possible, but they may face the end of both people and money, or will they give up surgery, avoid huge surgical risks, and stabilize the heart function first, but this is also impossible to predict the outcome of a life.

How to choose? Who is the choice? Doctor? Patient? Or is it the patient's family? At the stake in your life, after the doctor tells you about the pros and cons of N treatment options, most patients and their families will ask the doctor: Which one is more likely to live? Doctor, what do you think? Too many people don't understand that life and death are not multiple-choice questions at any time, either/or. No matter how professional and first-class the doctors are, they can only rely on their professional ability and level to race against death, but you must know that not every time they will win......

The family members have not arrived for a long time, and the personnel and equipment in the operating room have been prepared, and everything is ready to go. The head nurse in the operating room didn't embarrass Steve and me, and gave us radiation-proof lead suits and allowed us both to follow the stage. Without the informed consent of the family, did this cardiologist dare to go under the knife? I stood in the corner of the operating room, staring at the surgeon's every move.

The doctor turned on the camera, picked up the extension phone in the lens, and called the man's immediate family and emergency contacts, but no one answered the phone. The doctor in turn seeks the patient's own opinion.

“I am your attending doctor，no，I illl ask you some you conscious no? (I'm your attending doctor, I'm going to ask you a few questions now, are you conscious now?)"

"Yes......" replied the man on the operating table with difficulty.

In the presence of the camera, the doctor quickly explained his current condition to the patient, informed him of his surgical and non-surgical options, and concisely informed him of the need for coronary angiography, as well as the risks and complications of the operation. The patient's chest pain could not be relieved, and he did not seem to be able to fully understand the doctor's words, but in the end he still chose to trust the doctor's judgment and agreed to the operation.

After the patient signed and confirmed, the doctors and nurses in the operating room quickly stood up, sterilized the tools, put the surgical instruments in place, the surgical computer display screen was adjusted to the most comfortable position, the doctor quickly disinfected his hands, put on the sterile surgical gown with the assistance of the nurse, and turned around to tie the strap, I seemed to see the shadow of Director He. The patient's clothing is removed, and the bare right forearm is exposed, abducted on the operating table. The doctor used an iodophor sponge brush to disinfect the patient, and the anesthesia began as a lidocaine ampoule was snapped open by the operating nurse with a crisp sound.

Coronary angiography through the radial artery puncture of the right hand is recommended by the guidelines, and it is not uncommon for it to be done in China. After the effect of local anesthesia is achieved, under the guidance of B-ultrasound, the doctor quickly performs radial artery puncture, which hits the nail on the head smoothly, and then quickly sends the sheath and guidewire, and at the moment of contrast agent injection, the heart blood vessels are rapidly developed like splashed ink landscape paintings, and all this is displayed on the display screen above the operating table.

"Mom, it's so bad!" "The moment I saw the results of the imaging, I came out of a Chinese sentence out of place.

The doctors and nurses on the stage were naturally not affected, but Steve, who was next to him, was startled by me and looked at me with a puzzled expression, thinking in his heart: What bird text?!

“I…… I mean it's too serious......" I shrugged in embarrassment, and my face suddenly became a little hot, uh...... Too excited...... Too excited......

I turned to the side so that I could see the imaging results on the monitor more clearly, and the blood vessel that caused the myocardial infarction had been completely blocked, and in addition, the previously placed stent had also undergone another narrowing, and almost none of the major blood vessels were spared. Oh, my God...... What kind of person, what kind of experience, can have such a heart that will end at any time at this age......

I was still there to study the vascular situation, and the doctor in charge of the surgery communicated with the patient on the stage again, roughly telling him the results of the imaging, they are now planning to aspirate the thrombus, dilate the blood vessels, and place a stent, the patient on the stage is in pain but still sober to listen to the doctor's information, suddenly his eyes are rolled up, his whole body convulses, and the monitor followed him to call the police, ventricular fibrillation!

I almost didn't have time to be surprised, and I immediately reflexively began to look for defibrillators all over the world, but fortunately Steve grabbed me in time, "hat are you doing!" Oh...... This is in Dublin, this is not their own home...... After being reminded by him, I came back in a trance.

But people are also extremely professional, the patient is connected to the automatic external defibrillation equipment, the doctor gives medical orders, the nurse repeats it aloud, immediately 150 joules charge, "clear!" After charging, the nurse reminds everyone to leave the patient, and then discharges. The 300 joules of direct current passed through the patient's body in an instant, and the man on the stage, who had just been awake, twitched from the overelectricity, and at this moment, his consciousness was already a little blurred.

Ventricular fibrillation is a precursor to cardiac arrest, and it is a wandering before the ghost door is closed. The atmosphere in the operating room was highly tense, the air was condensed, everyone's hearts should be mentioned, Steve's eyes widened on the side, I felt his pupils slowly getting bigger, I subconsciously clenched my fists, and the doctors and nurses in the stands were anxiously rescuing, administering medicine, defibrillation, observing, administering, defibrillating, observing, administering, defibrillating, observing......

Eventually, my heart stopped.

But stopping the beating does not mean the end, the heart stops, the defibrillator has no effect, and the doctor immediately began chest compressions to try to break the ride.

“”

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