11.20, China Myocardial Infarction First Aid Day.
Acute myocardial infarction is an acute and dangerous event of coronary heart disease.
At this time, the myocardium suffered acute ischemic injury and necrosis occurred rapidly.
The myocardial electrical activity of ischemic necrosis is unstable, and the communication with normal myocardial tissue is abnormal, and malignant arrhythmias are prone to occur. The most serious one is ventricular fibrillation, ventricular fibrillation, and myocardial cells are independent and contract randomly. In this way, the heart cannot contract normally to supply blood, and it stops beating! Therefore, the most early death of myocardial infarction is caused by malignant arrhythmia.
When the ischemic necrotic myocardium loses its function, the ability of the heart to contract will be reduced, and the blood pumping will decrease, resulting in a drop in blood pressure and shock; in severe cases, the heart will lose its pumping function, which is "pump failure"!
The heart has stopped, or the pump has failed, what about the person? Are you ok?
Therefore, acute myocardial infarction is very dangerous, the rescue must be timely, and the method must be correct. A careless move can be fatal. However, acute myocardial infarction mostly occurs outside the hospital, and more than 70% of sudden cardiac death also occurs outside the hospital.
Therefore, it is so important to keep two "120" in mind when rescuing!
The first "120", call the "120" emergency number in time.
timely. The patient must call for help in time after the onset of the disease, and do not think about waiting and seeing again, because acute myocardial infarction has a rapid onset, rapid progress, and great danger.
Dial the emergency number "120" and call for an ambulance.
Some people say that how slow it is to call and wait for the doctor to come, hurry up and get to the hospital by yourself!
It's too dangerous.
Said two cases, both of which I encountered in the emergency room.
First. One day, a patient came into the emergency department, and when he entered the door, he said that he had chest tightness and discomfort. The nurse was about to measure his blood pressure, but the patient fell down. Rescue quickly. Fortunately, there is a rescue room next to it. It is fully equipped. Once the ECG is connected, it is ventricular fibrillation. Immediate cardiopulmonary resuscitation and electrical defibrillation are successful. The patient had an acute myocardial infarction.
Fortunately, this happened in the emergency room of the hospital. Wouldn't it be troublesome if it happened halfway? In addition, if you still walk around after a myocardial infarction, you may have ventricular fibrillation every minute, which is really dangerous.
As mentioned earlier, in the acute stage of myocardial infarction, the electrical activity of the heart is unstable. A little activity or a little emotional excitement may cause serious arrhythmia. During emergency treatment, the patient must be moved very carefully, and the patient can still be allowed to move around by himself? How dangerous!
It was also in the early 1990s, when our emergency department was still in charge of pre-hospital first aid. One day, a doctor in our department took an ambulance to rescue a patient who had a second heart attack. The distance from the patient's home to the hospital is about three or four kilometers. But when the ambulance pulled the patient and drove out one kilometer, the patient had ventricular fibrillation and his heart stopped! The doctor made a decisive decision. The ambulance stopped by the roadside. The medical staff performed cardiac compressions, defibrillation, and medication. Soon after the patient's heart resumed, he continued to be transferred to the hospital. The patient was also rescued successfully, and he came to the emergency department to express his gratitude after he recovered.
The "120" ambulance is equipped with professional doctors and nurses, various rescue monitoring equipment and medicines. It is a mobile CCU (Coronary Heart Disease Monitoring Unit), which can provide emergency treatment to patients at any time. The ambulance has priority on the road, which is more efficient than private vehicles. Cars and taxis are more convenient. Therefore, calling the "120" ambulance does not waste time. Doctors and nurses can check and dispose of them as soon as they arrive, and they can be transported to the hospital under supervision. The safety on the way is also greatly improved.
Therefore, once a patient develops a suspected acute myocardial infarction, the patient should immediately stop activities, rest in bed, keep quiet, and immediately call the "120" emergency number. Pay attention, clarify your condition and address, keep in touch, and someone will guide the ambulance to the intersection.
The second "120" is to grasp the 120-minute prime time for first aid.
Acute myocardial infarction is the sudden blockage of the coronary arteries of the heart and the interruption of blood supply, resulting in ischemic necrosis of the myocardium. The development of this ischemic necrosis is also a process. From 20 minutes of complete myocardial ischemia, necrosis can occur, and necrosis gradually expands from the central area of ischemia. The faster is 1 to 2 hours, and the slower is 5 to 6 hours. This part of the ischemic myocardium is completely necrotic. Of course, this is also related to the state of individual myocardial blood circulation. Therefore, early restoration of myocardial blood supply is very important.
The most direct and effective way to restore blood supply is emergency coronary angiography, finding the "criminal vessel", placing stents, and opening the blood vessels. If there are no conditions for emergency angiography and stent placement, drugs should be used to dissolve the thrombus blocked in the coronary arteries, so that the blood vessels can be partially opened and the myocardial blood supply can be restored. These practices, of course, the sooner the better. Opening up before myocardial necrosis can reduce myocardial necrosis, save those dying myocardium, prevent the expansion of myocardial infarction, protect heart function, and even save lives. The implementation of these rescues, preferably within 120 minutes after the onset of diagnosis.
Therefore, the "120 minutes" golden emergency time is given in medicine, which is based on the law of the incidence of myocardial infarction. At this time, don't hesitate to "put a stent" for acute myocardial infarction, and do it when it's time to do it. Because time is the heart muscle, it is life, and sometimes life and death are in this moment.