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خاطرات یك پزشك عمومی - نوارقلب
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دوشنبه 2 مرداد 1391

نوارقلب

دوشنبه 2 مرداد 1391

نوع مطلب :
نویسنده :شكوفه نصر

خانم مسن بادیابت امددرمانگاه فشارخون بالا داشت وعلایم گاستروانتریت فشارش دراول بار 14 روی 95 بود برایش سرم نوشتم وداروی تزریقی درسرم بعدازنیم ساعت همسرش امدوگفت لرز دارد واستفراغ می كند بیمار دل دردش بهترشده بود ولی لرز شدیدداشت ودوباراستفراغ داشت مشكوك بود به پرستارگفتم فشارش رابگیر كه ایكاش نمی گفتم بدون هیچ گونه گوشی یالمس نبض فشار بیماررابه من اعلام كرد مانده بودم چه بگویم ولی این برای اولین بار بود كه می دیدم كسی ازروی تكان خوردن عقربه های دستگاه فشار بیمار رامی خواندانهم 85 به رویش نیاوردم گفتم یك نوارقلب دراولین فرصت ازش بگیر گفت چرا اخه باید برود روی تخت دیگر گفتم اشكال ندارد برود دوباره گفت اخه سرمش به این دستش است دستگاه ای كی جی دران سمت گفتم خانم فلانی این نوارقلب رادراولین فرصت بگیر اگر سرمش هم نرفت اشكال ندارد تو فقط نوارقلب بگیر خلاصه بااكراه نوارقلب گرفت حدسم درست بود یك silent mi درحال شكل گرفتن بود st elevation شدید كمپلكس qrs دروضعیت wide بود خلاصه ذره ذره داشت به مراحل خطرناك می رسید متاسفانه شبكه بهداشت تشخیص داده بود درمانگاه ما نیاز به امبولانس نداردجون ضروری نیست پذیرش زنگ زد 115 بعداز دوبارپیگیر امدند وقتی امد گفت شما كه یك امبولانس دارید گفتم ظاهرش است داخلش هیچ گونه تجهیزاتی نیست وتازه خراب است گفت چرا مزاحم ماشدید اخر باماشینش می رفت گفتم بیمارراببینید بعدبا بی ادبی فراوان رفته بالای سر بیمار خلاصه یك عالمه متلك به من وپرستارانداخته كه این حالش خوبه دردقفسه سینه نداره گفتم اقا نوارقلبش مشخصه ایشون دیابت دارند معلومه كه باید silent mi باشد .دوباره می گه باپایش برود توامبولانس می گم بابا این حالش خرابه گفت یعنی شما می گید برانكارد بیاریم می خواستم بگم پ نه پ خودم كولش می كنم خلاصه مریض رابردند وبعدگفتند زود یك امبولانس بگیرید كه دفعه بعد مزاحم 115 نشویم نمی دانم چرااینقدر برایشان مشكل بود بیماردرلحظه بردن فشارش 185 روی 10 بود به پرستارگفتم وگفتم 185 خیلی بالا بود ایشان هم گفت ا حتمادوباره رفته بالا خلاصه تنهاكسی كه تشكر كرد عرس و وشوهر بیماربودند وگفتند ممنون همین برایم كافی بود ومهم همین است كه جان بیماری رانجات دادم خداراشكر




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