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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 kind of stool is there with upper gastrointestinal bleeding?
In clinical terms, the upper gastrointestinal tract refers to the digestive system above the ligament of Treitz, primarily including the duodenum, stomach, and esophagus. If there is a minor amount of bleeding in the upper gastrointestinal tract, the color of the stool may not change significantly. However, if there is substantial bleeding, the blood can react with gastric acid and may form black, tar-like stools. If gastrointestinal bleeding is detected, it is essential to seek medical attention promptly. An endoscopic examination can be performed to establish a clear diagnosis and undertake aggressive treatment, which can potentially save the patient's life.
Upper gastrointestinal bleeding examination methods
Upper gastrointestinal bleeding is relatively common in clinical practice. The main diagnostic methods include gastroscopy, barium meal examination of the gastrointestinal tract, and DS imaging of the gastrointestinal tract, among others. If a patient experiences a large amount of bleeding at a rapid pace after upper gastrointestinal bleeding, it can lead to a drop in blood volume and hypovolemic shock, which can be life-threatening. In such cases, it is crucial to seek prompt medical treatment and use hemostatic drugs, and even endoscopic hemostasis or surgical intervention may be necessary to actively save the patient's life.
Subarachnoid hemorrhage headache causes
Subarachnoid hemorrhage commonly presents with clinical symptoms such as headache, reflex vomiting, and even consciousness disorders, seizures, etc. The main reasons for headaches caused by subarachnoid hemorrhage are, firstly, increased intracranial pressure, and secondly, impaired absorption of cerebrospinal fluid, leading to excessive accumulation in the subarachnoid space causing headaches. Additionally, blood entering the subarachnoid space can stimulate the meninges and toxic substances can also cause headaches. Therefore, patients should go to the hospital for a complete cranial CT examination and consult with the Department of Neurology or Neurosurgery.
How to treat hypokalemia?
After the occurrence of hypokalemia, there are generally two methods of potassium supplementation clinically. The first is oral potassium supplementation, which is relatively safe, and one can also eat fruits or vegetables rich in potassium. The second method is intravenous potassium supplementation. The first thing to note with intravenous supplementation is the patient's urination status. If the patient’s urination is normal, potassium chloride can be administered intravenously but must be diluted. In clinical practice, the concentration of intravenous potassium chloride generally does not exceed 0.3%, so we must pay attention to the concentration during potassium supplementation.
How is acute heart failure treated?
Acute heart failure presents with significant respiratory distress and symptoms of hypoxia. Immediate intervention is necessary to alleviate breathing difficulties. Clinically, the following measures are generally adopted: First, position the patient to sit up with legs dangling to decrease venous return to the heart. Second, administer high-flow oxygen through a nasal cannula, and if necessary, proceed with endotracheal intubation and ventilator support. Third, administer morphine subcutaneously or intravenously to reduce agitation and myocardial oxygen demand. Fourth, use rapid diuretics, such as furosemide. Fifth, utilize vasodilators such as nitroglycerin or nitroprusside. Sixth, use positive inotropic agents such as dopamine or dobutamine as appropriate. Seventh, employ digitalis drugs, but avoid use in acute myocardial infarction within the first 24 hours. Eighth, consider using an intra-aortic balloon pump or other cardiopulmonary support systems, etc., and after stabilization of acute heart failure, further treat the underlying cause, etc. (Use medications under the guidance of a doctor.)
The most common symptom of upper gastrointestinal bleeding
The most common symptoms of upper gastrointestinal bleeding mainly include: vomiting blood, black stools, or symptoms such as dizziness, palpitations, and fatigue, and even hypovolemic shock and hypovolemic anemia, etc. Therefore, when gastrointestinal bleeding occurs, if the patient has a large amount of bleeding and the bleeding is rapid, it is necessary to seek medical attention promptly, to administer fluid replenishment, volume expansion, and blood transfusion to replenish blood volume, along with symptomatic treatment such as medication and endoscopic hemostasis. If conservative treatment is ineffective, surgical treatment may be considered to avoid life-threatening risks.
Clinical manifestations of chronic heart failure
Chronic heart failure primarily includes left heart failure, right heart failure, and total heart failure. Left heart failure can present with varying degrees of respiratory difficulty, such as exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea, etc. Secondly, symptoms can include coughing and expectorating, coughing up pink frothy sputum, and patients may experience fatigue, dizziness, and palpitations, among others. Right heart failure mainly manifests as gastrointestinal symptoms, such as abdominal distension, poor appetite, nausea, vomiting, etc. Total heart failure encompasses the clinical manifestations of both right and left heart failure.
What causes upper gastrointestinal bleeding?
The most common causes of upper gastrointestinal bleeding. The first is hemorrhage due to peptic ulcers. The second is bleeding from ruptured esophageal and gastric varices. The third is acute erosive hemorrhagic gastritis. The fourth is bleeding caused by gastric cancer. The fifth is bleeding caused by Mallory-Weiss syndrome. After the occurrence of gastrointestinal bleeding, it is necessary to seek medical attention promptly, undergo treatments like hemostasis and blood transfusion in the hospital, and actively manage the symptoms. If necessary, a gastroscopy can be performed for endoscopic hemostasis. If not treated actively, emaciated individuals' lives may be at risk, so caution is necessary.
How to treat upper gastrointestinal bleeding?
After gastrointestinal bleeding, the patient should be kept in a recumbent position to rest and ensure that the airway is clear to avoid aspiration of blood due to vomiting. Close monitoring of the patient's vital signs, such as heart rate, blood pressure, and breathing, is necessary. It is important to actively replenish blood volume, correct hypovolemic shock, and administer medications for hemostasis. Endoscopic hemostasis with a gastroscope can also be used. If conservative drug treatment is not effective, surgical treatment may be considered. Emergency treatment is essential after gastrointestinal bleeding, as delays can be life-threatening.
What causes uremia?
Uremia is very common in clinical practice. It is mainly caused by abnormal kidney functions, leading to abnormalities in glomerular filtration, as well as in the reabsorption and secretion functions of the renal tubules, which results in a series of symptoms. Once uremia occurs, it can disrupt the internal environment of the body, cause electrolyte abnormalities, and even lead to life-threatening arrhythmias. Uremia is very dangerous in clinical practice and often requires regular hemodialysis treatment. Therefore, once uremia occurs, medical attention must be sought promptly.