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 a pulse to save the patient's life? According to the different needs of clinical patients, pacemakers have different working modes. I will not go into detail about the overly detailed modes, but only talk about the two general categories. One is the asynchronous mode, that is, the pacemaker directly sends out a fixed pulse to stimulate the ventricle or atrium of the heart regardless of how the patient's heart beats, referred to as VOO or AOO mode. What is the advantage of this mode?
"During surgical operations, asynchronous forced pacing is adopted to avoid the electric knife interfering with the pacemaker and causing ventricular fibrillation in the patient," said Xie Wanying.
Simply put, when the electrosurgical unit is operating, it will interfere with the pacemaker's sensing signal system, so a fixed mode without the sensing signal system operating must be used during surgery.
After the patient came back from surgery, the electrosurgical unit was no longer used. Generally speaking, the fixed mode was no longer used. Because this mode has obvious defects. How should I put it? Xie Wanying continued, "I just came to take a look and found that it did not look like ventricular fibrillation. If it was the rhythm that would induce ventricular fibrillation, I was afraid that the pacemaker was not switched back from the fixed mode to other modes. After checking, I found that this was the case, so I quickly switched the pacemaker back to other working modes. So, her electrocardiogram has stabilized again."
To explain it simply again: Xiaohui's condition has improved, and the new heart has finally returned to normal working track. If the fixed mode is used again at this time, the pacemaker cannot sense the patient's heart's spontaneous heart rate. Once the recovered heart's spontaneous heart rate exceeds the pacemaker's fixed mode pacing frequency, the two will produce a competitive frequency, eventually inducing ventricular tachycardia or ventricular fibrillation and endangering the patient's life.
After hearing this, everyone finally understood the whole story. Xie did not and did not need to perform chest compressions on the patient, but simply adjusted the pacemaker mode to resolve the alarm crisis.
Doctor Yao turned back and said to Doctor Han: "Didn't you switch back to another mode after you came back?"
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"It has been adjusted." Doctor Han denied it. He and his people would never make such a mistake.
There are many instruments and tubes on the patient, and it is hard to say whether the pacemaker button will go wrong if someone accidentally presses it. Clinical doctors often encounter such ghost-like things. The most important thing is to make accurate judgments and troubleshoot problems when a dangerous situation is discovered. This is the responsibility of the doctor on duty.
Dr. Yao's accusations against the intern were actually totally unreasonable from beginning to end.
As she said, if she thought the intern was not suitable for these operations, she should have rushed into the ward to stop the intern from doing them. Instead, she was negligent in not going to the scene to carefully judge the patient's condition.
"You said she did something wrong, and you didn't stop her?" Cao Zhao turned to Dr. Yao, the whirlpool in his dark eyes deep and unfathomable.
"I, I am..." Doctor Yao couldn't find an excuse and sweat kept falling. He couldn't say that his skills were not as good as a medical student.
Mu Yongxian said to the PICU staff, "Go find your director."
The big guys never need to argue with others when they talk. After the other party has finished arguing, they suddenly reach out and slap the person, smashing him into a meat patty.
The students at the scene learned a lesson that if you want to teach someone a lesson, you have to use the boss mode.
Dr. Yao would never have thought that one day she would become big news in the hospital. What big news? Two major rivals, two seemingly irreconcilable guys, actually teamed up to teach her a lesson.
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