What is the main working principle of a pacemaker?
Send out pulses to stimulate the myocardium, causing it to contract and relax.
When should the pacemaker send out pulses to save the patient's life? According to the different clinical needs of the patient, the pacemaker has different working modes. The overly subdivided modes will not be described in detail, but only the two general categories will be discussed. 1.
It is classified as asynchronous mode, that is, the pacemaker directly sends out fixed pulses to stimulate the ventricle or new chamber of the heart regardless of how the patient's heart beats. It is referred to as VOO or AOO mode. What is the advantage of this mode?
"During surgical operations, asynchronous mode of forced pacing is adopted to avoid electrosurgical interference with the pacemaker and triggering ventricular fibrillation in the patient," Xie Wanying said.
Simply put, the electrosurgical operation will interfere with the sensor signal system of the pacemaker, so a fixed mode without the operation of the sensor signal system must be used during surgery.
After the patient returns from the operation, he no longer uses electrosurgical surgery. Generally speaking, he does not use the fixed mode. This mode has obvious flaws. How should I put it? Xie Wanying continued: "I just came to take a look and found that it didn't look like a room."
If it is a rhythm that is going to induce ventricular fibrillation, I am afraid that the pacemaker has not been adjusted from the fixed mode to other modes. After checking, I found that this was the case and quickly adjusted the pacemaker to other working modes. Therefore, her electrocardiogram stabilized.
Already."
Once again, the simple explanation is: Xiaohui's condition has improved, and the new heart installed has finally returned to the normal working track. If the fixed mode is used again at this time, the pacemaker will not be able to sense the patient's heart's self-pacing heart rate, and the pacemaker will return to normal.
Once the heart's autonomous heart rate exceeds the pacing frequency in the fixed mode of the pacemaker, the two will compete for frequency, eventually inducing ventricular tachycardia or ventricular fibrillation, endangering the patient's life.
After everyone heard this, they finally figured out the whole story. Xie did not and did not need to perform intrachest heart compressions on the patient. He just adjusted the pacemaker mode to resolve the alarm crisis.
Dr. Yao turned around and said to Dr. Han: "Didn't you switch back to other modes when you came back?"
"It's adjusted." Dr. Han refused. This kind of negligence would never be committed by him or his own people.
There are many instruments and channels in the patient's body. It's hard to say whether he accidentally pressed the pacemaker button at some point and something went wrong. In clinical practice, we often encounter this kind of thing that seems like encountering a ghost. The most important thing is to detect the danger.
It is the duty of the doctor on duty to make accurate judgments and troubleshoot problems.
Dr. Yao's accusation against the intern is actually completely unreasonable from beginning to end.
As she said herself, if she thought that the interns were not suitable for these operations, she would have rushed into the ward immediately to stop the interns from performing the operations. On the contrary, she was negligent in not going to the scene to carefully judge the patient's condition at the first time.
"You said she did something wrong and you didn't stop her?" Cao Zhao faced Dr. Yao, the small whirlpool in his dark eyes was bottomless.
"I, I am -" Dr. Yao couldn't find an excuse and kept sweating. He couldn't say that his skills were inferior to those of a medical student.
Mu Yongxian said to the people in the PICU: "Go and find your director."
Big bosses never need to argue with others when talking. After the other party has finished arguing, they suddenly reach out and slap the person into a piece of meat.
The students at the scene were taught a lesson. To teach others a lesson, you have to use the boss mode.
Dr. Yao would never have imagined that one day she would suddenly become big news in the hospital. What big news? Two competing pillars, seemingly irreconcilable, would join forces to educate her.