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
Subarachnoid hemorrhage should go to which department?
Subarachnoid hemorrhage is also relatively common in clinical settings. Its symptoms primarily include severe headaches, reflex vomiting, possible consciousness disturbances, and even seizures. Following the occurrence of subarachnoid hemorrhage, a cranial CT scan can be used for a definitive diagnosis. Patients typically seek treatment in neurology or neurosurgery departments. After admission to a neurology ward, DSA (Digital Subtraction Angiography) can be conducted to accurately locate the bleeding site, and interventional embolization treatments may be considered. If the patient has a large volume of subarachnoid hemorrhage, neurosurgery might be considered for the removal of intracranial hematomas or decompressive craniectomy, among other procedures.
Subarachnoid hemorrhage clinical manifestations
When a subarachnoid hemorrhage occurs, patients can experience varying degrees of headache, usually unbearable, accompanied by nausea and vomiting. Projectile vomiting indicates high intracranial pressure in the patient. Hours after the second subarachnoid hemorrhage, signs of meningeal irritation can appear, generally presenting positively, such as neck stiffness, headache, vomiting, etc. The third issue involves varying degrees of consciousness and mental disorders in patients, and some may even display symptoms of epilepsy. Therefore, with the appearance of the above clinical symptoms, patients should actively seek treatment from a neurologist for further management.
Pre-symptoms of subarachnoid hemorrhage
Before a subarachnoid hemorrhage, patients generally do not exhibit obvious symptoms. However, if a patient suddenly experiences severe headaches, nausea, vomiting, and other discomforts, subarachnoid hemorrhage should be suspected. The patient should promptly seek attention and complete a cranial CT scan. If the diagnosis of subarachnoid hemorrhage is confirmed, measures should be taken to dehydrate the patient and reduce intracranial pressure. If the patient has a significant amount of intracranial bleeding, surgical treatment should be considered to remove intracranial hematomas and other proactive managements, while dynamically observing changes in the patient's consciousness and pupils.
What medicine is used for chronic heart failure?
Chronic heart failure is also relatively common in clinical practice. The treatment of heart failure mainly includes preventing and delaying the onset of heart failure, alleviating the symptoms of clinical heart failure patients, improving the long-term prognosis of patients, and reducing mortality. These are the treatment principles for heart failure. After the occurrence of heart failure, its treatment mainly includes the treatment of the basic etiology, as well as the elimination of various precipitating factors, such as infections, etc. The pharmacological treatment mainly includes several aspects: first, the use of diuretics; second, the use of renin, angiotensin, and aldosterone system inhibitors; third, the use of receptor blockers; and fourth, the correct use of positive inotropic drugs, etc. Heart failure can alleviate the clinical symptoms of patients through pharmacological treatments.
Upper digestive tract bleeding vomit color
The color of vomit in upper gastrointestinal bleeding primarily relates to the amount of bleeding and the speed of bleeding. If the patient has minor bleeding, the gastric acid may process it, resulting in the vomiting of a coffee-ground-like substance, indicating a smaller amount of bleeding. If the patient has substantial bleeding at a rapid pace, surpassing the gastric acid processing, fresh blood may often be vomited, indicating significant bleeding and a poor prognosis. After upper gastrointestinal bleeding occurs, it is crucial to seek medical attention immediately. In clinical settings, patients are usually given proton pump inhibitors and somatostatin analog drugs to stop the bleeding, and it is vital to promptly conduct a thorough gastroscopy to ascertain the causes of gastrointestinal bleeding and so forth.
Which department should I go to for upper gastrointestinal bleeding?
The upper gastrointestinal system primarily refers to bleeding from the digestive system above the Treitz ligament. Therefore, if there is acute massive bleeding in the digestive tract, patients may present with symptoms such as vomiting blood and black stools. If the bleeding is significant and blood volume rapidly decreases, it can cause acute peripheral circulatory disorders, and may even be life-threatening. The causes of upper gastrointestinal bleeding include long-standing conditions like peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, and stomach cancer, among others. If upper gastrointestinal bleeding occurs, patients should actively seek medical attention at major hospitals' gastroenterology departments, undergo relevant examinations, and receive prompt treatment.
How to alleviate arrhythmia
Arrhythmia is very common in clinical settings, and its treatment mainly includes etiological treatment and symptomatic treatment. If a patient experiences occasional premature beats without significant hemodynamic effects, special treatment may not be necessary at this time. However, if a patient repeatedly experiences supraventricular tachycardia, atrial fibrillation, and other arrhythmias, cardiac electrophysiological examination and dynamic heart rate monitoring should be conducted. Antiarrhythmic drugs or even radiofrequency ablation may be administered for symptomatic treatment, as uncontrolled arrhythmias can easily lead to sudden death in patients.
Why does heart failure cause ascites?
Heart failure is relatively common in clinical settings, primarily divided into left heart failure, right heart failure, and global heart failure. The clinical manifestations of left heart failure are mainly reflected in symptoms of pulmonary congestion. It can present as varying degrees of dyspnea, cough, expectoration, palpitations, and fatigue. Right heart failure is mainly due to obstruction of the inferior vena cava flow, leading to increased venous pressure and capillary pressure. This causes plasma components to extravasate and ultimately leads to the formation of ascites. Global heart failure includes the symptoms of both left and right heart failure. Therefore, it is essential to seek medical attention promptly after heart failure occurs.
Pulmonary embolism should be treated in the department of respiratory medicine.
Pulmonary embolism is an emergency in clinical settings, with rapid progression and extreme danger, and is generally treated by the department of respiratory medicine. Pulmonary embolism primarily occurs due to dislodged blood clots that block the pulmonary artery and its branches, leading to pulmonary infarction. The clinical manifestations of pulmonary embolism mainly include severe breathing difficulties, chest pain, coughing up blood, and even circulatory disturbances. After a pulmonary embolism occurs, a pulmonary artery CT scan can be used to further confirm the diagnosis. Treatment options may include thrombolysis, and possibly anticoagulation therapy with low molecular weight heparin or warfarin. (Specific medications should be used under the guidance of a physician.)
What are the symptoms of upper gastrointestinal bleeding?
Upper gastrointestinal bleeding is relatively common in clinical practice. Its clinical manifestations mainly relate to the volume and rate of bleeding. Clinically, patients may experience vomiting blood and black stools. If a patient has a large amount of bleeding, they may develop hemorrhagic shock or hemorrhagic anemia, presenting symptoms such as dizziness, palpitations, and weakness. In such cases, patients should seek prompt treatment at a hospital, where they can receive blood transfusions, hemostasis, and volume repletion as active measures. If conditions permit, a gastroscopy can be performed to further clarify the diagnosis.