What is the main working principle of a pacemaker?
Sends 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 needs of clinical patients, pacemakers have different working modes. I will not elaborate on the overly subdivided model, but only talk about the two general categories. One type is the asynchronous mode, that is, the pacemaker directly sends out fixed pulses to stimulate the ventricles or new chambers of the heart regardless of how the patient's heart beats, which is referred to as the voo or aoo mode. What's the benefit of this model?
¡°During surgical operations, asynchronous mode of forced pacing is adopted to avoid electrosurgical interference with the pacemaker causing 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 surgery, he no longer uses electrosurgical surgery. Generally speaking, he no longer needs a fixed mode. Because this model has obvious flaws. how to say? Xie Wanying continued: "I just came to take a look and found that it doesn't look like ventricular fibrillation. If it is in a rhythm that is trying to induce ventricular fibrillation, I am afraid that the pacemaker has not been adjusted from the fixed mode back to other modes. After checking, I found that it is really like this. Quickly adjust the pacemaker back to other working modes. Therefore, her electrocardiogram is stable."
Once again, the simple explanation is: Xiaohui¡¯s condition has improved, and the new heart installed has finally returned to its normal working track. If the fixed mode is used again at this time, the pacemaker cannot sense the patient's heart's autonomic heart rate. Once the autonomic heart rate of a well-recovered heart exceeds the pacing frequency in the fixed mode of the pacemaker, the two will compete for frequency, eventually inducing ventricular dysplasia. Tachycardia or ventricular fibrillation are life-threatening to the patient.
When 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 only adjusted the pacemaker mode to resolve the alarm crisis.
Dr. Yao turned around and asked about Dr. Han: "Didn't you switch back to other modes when you came back?"
"It's adjusted." Dr. Han refused. He and his own people would never commit this kind of negligence.
There are many instruments and channels on 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 things like encountering ghosts. The most important thing is to make an accurate judgment and troubleshoot the problem when a danger is discovered. This is the responsibility of the doctor on duty.
Dr. Yao¡¯s accusation of the intern is actually completely unreasonable from beginning to end.
As she said herself, if she thought the interns were not suitable for these operations, she would have rushed into the ward as soon as possible to stop the interns from performing the operations. On the contrary, she was negligent in not arriving at the scene as soon as possible to carefully judge the patient's condition.
"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 picu people: "Go find your director."
The 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 meat pie.
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 he would suddenly become big news in the hospital. What's the big news? The two competing pillars, seemingly irreconcilable, actually joined forces to educate her.