Detailed Treatment Process
Male, 67 years old Because of intestinal bleeding and emergency visit, tranexamic acid was used for hemostasis during the emergency On the morning of the 19th chest pain began to appear, below are some medical record materials Blood routine report Department: Emergency Internal Medicine Sample type: Whole blood Clinical diagnosis: Chest pain Report time: November 19 21:50 1. White blood cell count 16.04 (3.50-9.50 * 10⁹/L) 2. Neutrophil ratio 80.60% (40.00-75.00%) 3. Lymphocyte ratio 14.10% (20.00-50.00%) 4. Monocyte ratio 3.20% (3.00-10.00%) 5. Eosinophil ratio 1.90% (0.40-8.00%) 6. Basophil ratio 0.20% (0.00-1.00%) 7. Neutrophils 12.93 (1.80-6.30 * 10⁹/L) 8. Lymphocytes 2.26 (1.10-3.20 * 10⁹/L) 9. Monocytes 0.51 (0.10-0.60 * 10⁹/L) 10. Eosinophils 0.30 (0.02-0.52 * 10⁹/L) 11. Basophils 0.03 (0.00-0.06 * 10⁹/L) 12. Red blood cell count 2.23 (4.30-5.80 * 10¹² /L) 13. Hemoglobin 65 (130-175g/L) 14. Hematocrit 0.208 (0.400-0.500L/L) 15. Mean red blood cell volume 93.3 (82.0-100.0fl) 16. Mean RBC-HGB content 29.1 (27.0-34.0pg) 17. Mean RBC-HGB concentration 313 (315-365g/L) 18. RBC mean distribution width 0.14 (0.110-0.145) 19. Platelet count 363 (125-350 * 10⁹/L) 20. Platelet hematocrit 0.40 (0.100-0.350) 21. PLT volume distribution width 12.3 (9.0-18.1fl) 22. Mean platelet volume 11.0 (6.5-11.5fl) 23. Large platelet ratio 34% (13-43%) 24. Quick C-reactive protein 28 (0-10mg/L) 25. Serum amyloid A 72 (0-10mg/L)
Electrocardiogram (November 19 21:17) report text is physician handwriting, difficult to read, possibly 1. Abnormal Q wave with ST segment elevation 2. ST segment changes (I, aVL, II, III flat/inverted)
Department: Emergency Internal Medicine Sample type: Plasma Clinical diagnosis: Upper gastrointestinal bleeding Report time: November 20 00:46 1. Total bilirubin 6 (3-28μmol/L) 2. Alanine aminotransferase 27 (0-50U/L) 3. Aspartate aminotransferase 33 (0-50U/L) 4. AST/ALT 1.22 5. γ-Glutamyl transferase 25 (0-52U/L) 6. Lactate dehydrogenase 380 (313-618U/L) 7. Creatine kinase 221 (24-195U/L) 8. Creatine kinase isoenzyme 53 (0-25U/L) 9. Troponin T 0.224 (0-0.014ng/mL)
Chest pain continued until after nine o'clock in the evening, at this time the family could not stand it anymore and contacted the writer. After the writer reviewed the patient's real-time video and electrocardiogram report and other medical record materials, nitroglycerin was suggested. The doctor said that nitroglycerin has serious side effects and the family must sign. After the family signed, the doctor prescribed 1 tablet of nitroglycerin. The family asked whether several more tablets could be prescribed. The doctor said the pharmacy stock only had 10 tablets and needed to keep them for other patients. After the patient took 1 tablet, the chest pain quickly subsided.