When an emergency specialist needs first aid.

　 　 　 This is a silent storm.

　　On the operating table, Miao Ting’s eyes were half open and there was no light. His clothes were cut open and electrode pads were attached to his body. The ECG monitor sends out a rapid alarm sound, indicating that the patient is experiencing fatal arrhythmia, and a violent curve on the screen keeps rolling forward.

　　Cardiac ventricular fibrillation is coming.

　　In the emergency room of the First People’s Hospital of Chengdu (hereinafter referred to as the first hospital), it is not uncommon for patients to have ventricular fibrillation, which will make medical staff enter the most tense state every time. It often appears before people die, caused by circulatory failure, almost as dangerous as "a straight line"

　　Next, every minute of the rescue is divided into 60 seconds. The actions of doctors and nurses are like pressing the fast-forward button, relaying chest compressions, establishing venous access, putting on a simple ventilator, and preparing a defibrillator … They can’t bear to look up, while operating, reporting various physiological indexes and issuing instructions.

　　Miao Ting couldn’t hear this. His heart stopped, his breathing stopped, his consciousness was completely lost, and he looked extraordinarily calm, and he didn’t respond to the rescue. But under the skin and bones, his heart is experiencing a stormy storm.

　　In medicine, the phenomenon that ventricular fibrillation occurs at least twice within 24 hours is called "electrical storm". This is one of the last symptoms that doctors want to see when accepting patients with acute myocardial infarction (hereinafter referred to as acute myocardial infarction). Miao Ting went into fibrillation four times in 20 minutes.

　　If you think of an acute myocardial infarction as a person hanging from a branch on the edge of a cliff, then when the "electric storm" comes, the branch will split open. One of the most authoritative cardiology organizations in the world, the European Society of Cardiology (ESC) defines "electrical storm" as "the most serious malignant arrhythmia caused by extremely unstable ventricular electrical activity".

　　The storm also stirred the emergency department of a hospital. After the rescue began, 11 doctors and nurses were surrounded in the 15-square-meter rescue room. Someone keeps hearing the news and can only stand by and watch.

　　The patient in front of us is both their "old director" and their "instructor". Miao Ting was the director of the emergency department of a hospital for 10 years, and then transferred to the Chengdu Emergency Command Center (hereinafter referred to as the Emergency Center) to be in charge of first aid training. At the moment, almost every medical staff who participated in the rescue or just stood by and waited anxiously in the emergency department had received his first aid skills training.

　　Now, it’s time for the exam.

　　one

　　February 27th was a Sunday. After several days of continuous rain, the temperature in Chengdu dropped to 12 degrees Celsius. Apart from this sudden "cold spring", that day was nothing special.

　　Near noon, Miao Ting put on a woolen coat and prepared to go out. Every weekend, he and his wife visit their mother in the old city. My wife remembers that he was in good spirits that day and drove down easily for more than half an hour.

　　Miao Ting always looks energetic when he does things, and his friends like to sum up his character with "boldness". He is 65 years old and has just retired from the training department of the emergency center for two years. He was a member of the Standing Committee of the First Aid and Resuscitation Branch of China Cardiovascular Anesthesia Society and the Standing Committee of Sichuan Emergency Medicine Committee, and he was an expert in the field of first aid, especially in the field of sudden cardiac death.

　　Miao Ting, who retired three years later, is still busy. Public security, railways, airports, and his most familiar medical system often invite him to give lectures. He is always happy to go to appointments to teach basic or advanced life support skills. In the first 57 days of 2021, he did at least 18 first aid trainings.

　　The day before the accident, he was still giving an AHA (American Heart Association)-certified ACLS (Advanced Cardiac Life Support) training course to the medical support team of the Universiade. On the same day, he uploaded 9 photos of class in the circle of friends, with the text "Continue training".

　　On the 27th, he seldom had a rest. At 1 o’clock in the afternoon, the old mother prepared her son’s favorite handmade buns, pork and cabbage stuffing. Miao Ting ate three as usual. In the meantime, the family talked a lot, and there was no topic worthy of emotional excitement.

　　After chatting, my mother and wife cleaned up the dishes, and Miao Ting lay on the sofa watching TV, and soon began to snore-a habit he developed in the emergency department of the hospital. He always worked the night shift and took a nap.

　　My wife went to sleep after she was busy. I don’t know how long it took. In confusion, she felt some noise around her. Open your eyes, she saw Miao Ting frowning, pale, clutching his chest with one hand, moving back and forth on that three-person sofa, looking restless.

　　She became alert. At home, Miao Ting asked all family members to master first aid skills. "Even my 10-year-old grandson knows the principle of cardiopulmonary resuscitation.". For decades, every time Miao Ting successfully rescued a patient, she had to be an audience, watching him dance and retell the whole process, and she knew the characteristics of those patients.

　　Miao Ting likes to socialize, and his friends are mostly colleagues in the medical circle. She has lost count of how many cases she has heard from them. "Chest pain", "facial change" and "sweating" are the most common words.

　　She reached out to touch her wife’s forehead, which was "tidal" and did not sweat as often as acute myocardial infarction.

　　"What’s the matter with you?" She’s a little worried.

　　"I have chest pain and woke up with pain." Miao Ting replied, clutching his chest hand didn’t put down.

　　This is an extremely dangerous signal. The wife recalled that after hearing her husband’s answer, the familiar and frightening disease flashed through her mind: acute myocardial infarction.

　　In the eyes of many people, Miao Ting can be called a healthy person. I haven’t had any serious illness, but I can maintain my vigorous energy. Minor ailments rarely come to him, and sometimes he won’t catch a cold once a year.

　　But his wife knows that he has been "walking on thin ice" all these years. He has high blood pressure, hyperlipidemia, frequent smoking and drinking, and his weight has gradually increased in recent years, which has become an obese figure-all of these are high-risk factors for acute myocardial infarction.

　　Three days ago, Miao Ting had a brief experience of chest pain, accompanied by a momentary toothache. After several tens of seconds, the pain disappeared. That night, he also attended a friend’s party on time and drank half a catty of liquor.

　　"Call 120?" When his wife asks Miao Ting, it’s like asking for a doctor’s advice.

　　"No, look again." Miao Ting gave a hand.

　　After a minute or two, Miao Ting’s symptoms were still not relieved, and he kept moving back and forth between the two ends of the sofa. The wife can’t sit still, and the common sense learned from her husband tells her that hesitation is "killing life" at this time.

　　"I can’t listen to him. He couldn’t make normal decisions at that time." The wife recalled the situation at that time.

　　She should act immediately and dial 120, instead of being influenced by a patient’s opinion.

　　2

　　The wife dialed the emergency number with Miao Ting’s mobile phone and handed it to her husband.

　　"I have chest pain and need an ambulance." At this time, Miao Ting can still express himself normally.

　　The dispatcher of the emergency center is familiar with this voice and number. On weekdays, Miao Ting often presides over emergency drills and sometimes conducts spot checks. He will use his phone to "raid" the emergency center to check the quality of ambulance visits.

　　After putting down the phone, the wife told other family members present to keep an eye on Miao Ting. She hurried downstairs, rushed to the intersection in advance, and guided the ambulance to the downstairs of the unit to save time as much as possible.

　　Shortly after going out, she received a call from 120. It wasn’t Miao Ting on the other end of the phone. The other party wondered, "Isn’t it a drill or a spot check? What about Teacher Miao? "

　　"He is really ill, so hurry up."

　　In the field of first aid, patient treatment is divided into "pre-hospital" and "in-hospital" two links. China Cardiovascular Report 2018 released by the National Cardiovascular Center shows that there are 544,000 cases of sudden cardiac death in China every year. In another data, more than 70% of these sudden deaths occurred in the "pre-hospital" stage.

　　In the case, someone, like Miao Ting, found the chest pain tolerable and kept delaying the call to 120. Some people believe that driving to the hospital is faster than an ambulance, and as a result, they encounter traffic jams or get sick on the way.

　　Although he knows this better than most people, as a patient, Miao Ting is still making mistakes as dangerous as them.

　　It took only seven minutes for the ambulance to reach the gate of the community. After the doctors and nurses went upstairs, they first put an oxygen bag on Miao Ting, and then detected the electrocardiogram on the spot, initially judging that it was an acute myocardial infarction.

　　"Not typical enough." Miao Ting shook his head. "Look again."

　　Doctors and nurses are his "junior", and some of them are at a loss. They can only gently persuade him, "Uncle Miao, go to the hospital, you are very dangerous." He lay on the sofa without moving, just waving his hand.

　　"Go to the hospital right away!" The wife has a firm attitude.

　　Throughout the process, she was decisive and calm enough. She said that she had to do this. No one knew that her palms were sweaty and her heart beat significantly faster. "I can feel it."

　　Miao Ting seemed to be intimidated by his wife and didn’t resist. Just like the usual exercise, several emergency personnel carried the stretcher and sent him to the ambulance in the fastest and most stable way.

　　Before getting on the bus, the doctor took out "a pack of medicine for chest pain" (aspirin, tegrello and clopidogrel, all anticoagulant and platelet aggregation inhibitory drugs) and asked him to chew it up and take it as soon as possible. In addition, patients with acute myocardial infarction are often accompanied by vomiting symptoms. After chewing, patients can try to avoid spitting out the whole medicine.

　　Panic, a pill fell to the ground, his wife forgot so much, picked it up and stuffed it into Miao Ting’s mouth with dirt.

　　The ambulance sounded the siren, and the vehicles on the road gave way one after another, and the red light was unstoppable.

　　In the ambulance, Miao Ting became more agitated and "tossed and turned" on the stretcher. The nasal oxygen tube was repeatedly thrown off and put on. The nurse pressed his shoulder and his wife pressed his leg, trying to control his body.

　　The sweat on his forehead increased obviously and fell off one by one. After a while, he touched his throat and said, "It’s like a fire" and it "burned" all the way to his stomach.

　　"Huaxi Hospital! Tianfu Avenue! South Railway Station … "Along the way, the nurses were synchronizing the ambulance position with him, reassuring him that" it will arrive soon ".

　　Fifteen minutes later, the ambulance arrived at the emergency door of a hospital. The pre-hospital rescue is over, and the process is almost perfect, but the patient’s dangerous condition has not been alleviated. The coronary artery is being blocked a little bit, and every second, the heart may be damaged by ischemia.

　　In the treatment of acute myocardial infarction, there is a classic "DtoB" time, which refers to the time from the patient entering the hospital gate to dilating the blocked blood vessel with a balloon. In China, the prime time for DtoB is 90 minutes. After this time, the benefits of patients will decline exponentially until they die.

　　In this rescue, the next stage began to time.

　　three

　　When receiving the call from the ambulance, Li Jiawen, an emergency doctor in a hospital, had just settled a dizzy patient and was communicating with the patient’s family.

　　"A patient with acute myocardial infarction will be admitted to the hospital in 10 minutes. Please be prepared." Explain on the other end of the phone. Then added, "The patient is Mr. Miao Ting."

　　Li Jiawen was already nervous, but she was "relieved" when she heard that it was Teacher Miao Ting. Like the people in the emergency center, she also felt that "Teacher Miao came to exercise again".

　　She worked as an emergency doctor for 8 years. When she joined the company, Miao Ting had been transferred from the position of emergency director, but she was no stranger to Miao Ting. Every year, the hospital conducts rescue training and invites Miao Ting to give lectures. Sometimes the city holds first aid competitions, and Miao Ting often takes part in scoring as a judge.

　　"Teacher Miao’s training is very interesting, and it will be particularly passionate and useful in combination with the cases he has encountered before." In Li Jiawen’s impression, Miao Ting devoted himself to first aid training and was "very strict". I learned a lot from him about the operating rules I mastered and the handling methods of some urgent cases.

　　She and several colleagues are pushing the rescue bed to prepare for the "patient". The ambulance quickly drove into the rescue channel, and the door opened. Li Jiawen saw Miao Ting lying on a stretcher, one hand on his chest, sweating profusely. There are also family members around, and the expression is tense. This is obviously not a performance.

　　Too late to be surprised, the doctor in the ambulance pushed the stretcher out of the car and called them to transfer the patient to the rescue bed.

　　On the way to the intensive care room, Li Jiawen even felt a little trance. An expert who teaches people how to rescue myocardial infarction every day is now rescued because of myocardial infarction. "This is too unreal." She picked up Miao Ting’s electrocardiogram, and her doubts disappeared. The curve above suggested that the patient had typical myocardial infarction characteristics.

　　In daily life, there are many factors that induce acute myocardial infarction, such as heavy drinking, excessive fatigue, strenuous exercise, emotional excitement and sudden drop in temperature. No one can accurately tell the cause of Miao Ting’s sudden acute myocardial infarction. Perhaps it was the wine game three days ago, or the sudden cold in spring and the fatigue for several days, or it may be related to these factors. But there is no doubt that compared with others, his living habits are more likely to make a heart attack come to you.

　　"I should not be a myocardial infarction. I may be an aortic dissection (another serious cardiovascular disease)." Miao Ting was lying in bed, obviously short of breath when he spoke, but he still tried to make suggestions. Even in Li Jiawen’s view, this judgment was a bit strange-in Miao Ting’s class, students loved to listen to him talk about how to read ECG. He is the proposer of ECG in the annual first aid competition in the city.

　　Doctors rushed in, and Liu Tong, a cardiologist, happened to be in the second-line class in the inpatient department. He and Miao Ting have been friends for many years and "ran to the rescue room".

　　After seeing Miao Ting, he found that the other person’s reaction and dialogue were "more than half a beat slower than when he was awake", and the whole person also seemed very upset. When the nurse wants to draw his blood, he just cuts his hands and needs someone to press it. Miao Ting told Liu Tong that he couldn’t be a myocardial infarction and "can’t put a shelf (coronary stent)".

　　At this time, Miao Ting’s second electrocardiogram came out, and it was more clear that the patient had a problem with the right coronary artery. "If he can still misjudge this picture when he is awake, he can basically change careers." The doctor took his blood pressure again. If it is aortic dissection, the blood pressure on both arms will generally have a pressure difference of at least 20 mm Hg, but he didn’t.

　　"He was the kind of’ troublesome patient’ at that time. He didn’t listen to the doctor’s advice and had his own views on the condition, which interfered with normal medical procedures." Liu Tong said with a smile that he can understand Miao Ting’s reaction. "He is sensitive to the stimulation of the medical environment, like a person’s self-protection mechanism in dangerous situations."

　　Liu Tong judged that Miao Ting should have suffered from cerebral ischemia at that time, which led to confusion and decreased judgment. When this symptom occurs, the patient’s heart function is obviously weak-the contraction and relaxation of the heart depend on the myocardium. Coronary artery is a blood vessel that supplies blood to the myocardium. After occlusion, the blood supply to the myocardium is insufficient, and the ability of heart to relax and contract is affected, so it is impossible to send enough blood to the brain.

　　Rescue bed, Miao Ting is still opinionated. The doctor couldn’t help it, and "for the 1% possibility", he promised him to take a CT on the way to the catheter room and "look at the aorta".

　　"When he was a patient, his doubts about doctors and his resistance to treatment were no different from those of ordinary people." Liu Tong said that he had experienced this feeling. As a cardiologist, he underwent interventional surgery all the year round, was irradiated by radiation, and his body showed serious symptoms. The hematologist told him that he might be suffering from eosinophilic leukemia. "I first suspected, and then I felt that the sky was falling. That kind of great despair is hard for even doctors to hold back."

　　But when facing the patient as a doctor, professional rationality once again dominated him.

　　"He (Miao Ting) wants to talk to me about the conditions, no problem, I want to maintain a soft way of communication, but my principle is to trust my professional judgment and not be influenced by a patient with cerebral hypoxia."

　　The doctors and patients finally reached a consensus, but Miao Ting was still fidgety and kept repeating his opinions. The nurse opened the door of the emergency room and prepared to push him to the CT room.

　　"My diagnosis should be …" Suddenly, Miao Ting’s eyes turned up and fainted.

　　four

　　The rescue immediately entered another stage.

　　Syncope in patients with acute myocardial infarction is a very urgent situation, which is clinically called "Adams-Stokes syndrome", that is, cardiogenic cerebral ischemia syndrome. At the time of attack, the heart function has been seriously insufficient, and the human circulatory system has almost stagnated.

　　The alarm of ECG monitor sounded almost at the same time, and the number of heart rate turned into flashing red, representing "first-class alarm".

　　"Ventricular fibrillation!" A doctor shouted.

　　The nurse slammed the curtain between the rescue beds, and the family members left and cleared the room routinely. Everyone is like a programmed machine, which suddenly starts and executes quickly step by step.

　　Someone was holding a needle and looking for blood vessels in Miao Ting’s hand. Someone smeared conductive paste on his chest to prepare for electric defibrillation. The patient didn’t breathe spontaneously and had no time to intubate. Someone put a simple respirator over his mouth and kept holding the balloon of the respirator with one hand.

　　Others patted him on the shoulder, "Old Miao, Old Miao" to confirm his consciousness, but he didn’t respond at all.

　　"Defibrillator ready!"

　　Everyone stepped back two steps. A doctor stepped forward and pressed the electrode plate in front of Miao’s chest. Discharge, 200 joules of energy instantly penetrated his skin and muscles and reached his heart. His body bounced up and down from the bed.

　　When ventricular fibrillation occurs, the patient’s ventricular muscle is ischemic and the cell electrical activity is disordered, and the ventricle will tremble as quickly and weakly as a spasm, so that the heart cannot pump blood. Under the strong direct current pulse, the electrical activity of myocardial cells is completely eliminated, waiting to return to normal, just like restarting after a computer crash.

　　In the next few seconds, the rescue site suddenly became very quiet, and almost everyone held their breath and stared at the changes on the monitor screen.

　　The violent fluctuation of ventricular fibrillation disappeared, but the ECG on the monitor turned into a straight line, and the original rapid alarm sound became an annoying and uninterrupted buzzer.

　　The heart, the most diligent organ of the human body, usually starts to work from the sixth week of embryonic development. For nearly 40 years, Miao Ting has been committed to ensuring that the patient’s heart will not stop. Now, his heart has stopped.

　　It was at this moment that the blood in his blood vessels stopped flowing and every organ began to suffer from ischemia and hypoxia, including the brain. Every moment, there are tissues and cells that wither and then die.

　　Almost no reaction time is needed, and doctors have rushed to give Miao Ting chest compressions. Every time the chest should be pressed down by 5 cm, and then fully rebound. Just like squeezing a balloon, the heart can perform some functions of contraction and relaxation under the external physical compression, although it does not act autonomously.

　　"It is this part of the external force that brings about the relaxation and contraction function. Under the deployment of human advanced nerves, it will give priority to blood supply to important organs such as the brain, heart and kidney to avoid damage to these organs to the greatest extent." Liu Tong said that if a person has a sudden cardiac arrest, he should be given cardiopulmonary resuscitation at the first time. "The golden rescue time for cardiac arrest is only 4 minutes. If it takes more than 4 minutes, brain cells will be irreversibly damaged. If it takes more than 10 minutes, people will basically not come back."

　　He once treated a patient who had an acute myocardial infarction like Miao Ting. After being sent to the hospital, the blood vessel opening operation went smoothly, and the heart resumed its spontaneous beating. However, because cardiopulmonary resuscitation was not done in time in the early stage, the respiratory center in the brain was damaged, and the patient lost his spontaneous breathing and was "suffocated alive".

　　Fortunately, Miao Ting is lying in the rescue bed now. The doctor pressed the relay, and the high-quality cardiopulmonary resuscitation was almost uninterrupted. At the bedside, the machine replacing manpower has been debugged, the cardiopulmonary resuscitator similar to "pile driver" can be used at any time, and the parameters of non-invasive ventilator have been set, waiting for intubation and airway opening.

　　Defibrillation at the first time when ventricular fibrillation occurs, reducing the patient’s sympathetic excitability with drugs, timely cardiopulmonary resuscitation when cardiac arrest occurs, paying attention to the patient’s acidosis after putting on a ventilator and opening blood vessels …

　　Miao Ting, who is in shock, can’t know that these processes and movements are just like his lessons. For Li Jiawen, a doctor who is burying his head in the rescue, all movements are derived from the "muscle memory" formed by repeated training.

　　But there are still more difficulties than expected. Li Jiawen is responsible for tracheal intubation, because chest compressions will squeeze the airway at the same time, so intubation must be as fast as possible.

　　"5, 10, 15 …" Li Jiawen just started intubation, next to the doctor timing.

　　She found that Miao Ting’s trachea was a "difficult airway", and it was difficult for the catheter to enter without the aid of equipment.

　　"Stop! Stop! " The on-site commander shouted. Li Jiawen withdrew and CPR immediately resumed. After her blood pressure stabilized, she tried again, but it didn’t work.

　　At this time, the alarm sound of ECG monitor suddenly sounded. Ventricular fibrillation is coming again.

　　five

　　After defibrillation again, Miao Ting’s electrocardiogram had new changes.

　　Liu Tong recognized this waveform in front of him, and the ST segment (a band of ECG) suddenly rose like a tombstone, so the medical profession called this waveform "tombstone-like" ECG.

　　In patients with acute myocardial infarction with this ECG waveform, the myocardium has usually been seriously damaged.

　　Before everyone reacted, symptoms of ischemia and hypoxia began to spread to Miao Ting’s whole body. His blood oxygen content dropped to about 80%, which was seriously lower than the normal value of more than 95%, and the skin on his fingers and face began to turn purple.

　　"Can Teacher Miao come back?" A nurse whispered.

　　No one answered. At this time, doctors from the emergency department, cardiology department, intensive care department and anesthesiology department have been present, and the rescue team even prepared ECMO (extracorporeal membrane oxygenation) to deal with the worst possible situation-the patient’s cardiopulmonary failure and establish cardiopulmonary bypass.

　　They continued to try conventional means. A shot of adrenaline was injected into Miao Ting at the maximum dose. This "cardiotonic needle" had an effect, and the monitor showed that Miao Ting had recovered his spontaneous heartbeat.

　　Just jumped a dozen times, the third ventricular fibrillation came again.

　　This time, it was an "electric storm". After defibrillation, Miao Ting’s heart stopped again. This made Liu Tong feel desperate. After defibrillation for three times, the patient gave almost no response. What’s more, in his clinical experience, "even if everything is done perfectly, there are still 15%-20% patients with’ electric storm’ who can’t get out of the emergency room."

　　On the same day, Qin Fang, deputy director of the Department of Cardiology, was also at the rescue site. She was Miao Ting’s old partner for many years. She took a photo of Miao Ting with her mobile phone and sent it to the family group. "Old Miao may be dying.". She saw another colleague standing beside her, staring at the rescue bed, her hands clenched and shaking.

　　A doctor came forward to shine a flashlight on his eyes to see if his pupils were contracting-the rescue has been going on for more than ten minutes, and they are confirming whether to give up.

　　The patient’s pupils contracted. This is one of the most advanced nerve reflexes in the human body, and the rescue continues.

　　Li Jiawen again ready to intubation, she bent down, have seen an anesthesiologist is present, suddenly stopped.

　　"Teacher, you come." She looked at her colleagues, or teammates.

　　The anesthesiologist stepped forward, assisted by electronic laryngoscope, as he did every day, and successfully intubated once.

　　Miao Ting’s oxygen saturation gradually improved. From the onset of Asperger’s syndrome, the rescue has been going on for almost 20 minutes, which is a long time in the rescue of cardiac arrest. After that, even if the patient is rescued, the prognosis of the patient may not be optimistic.

　　At this moment, Miao Ting had a fourth ventricular fibrillation. After emergency defibrillation, Liu Tong saw that Miao Ting recovered his heartbeat, though it was weak, but it was beating spontaneously.

　　Then, a doctor saw Miao Ting’s eyelids beating slightly. Then everyone saw it, and his hands and feet moved. Suddenly, he began to vomit with a "ouch", and the doctor quickly helped his head to the side to prevent accidental inhalation.

　　This is not a "neat" ending, but no one cares about it anymore.

　　"yeah!" Li Jiawen and his colleagues looked at each other and couldn’t help shouting.

　　six

　　Outside the rescue room, Miao Ting’s wife stood there, "her mind was blank". In the meantime, nurses kept coming out, holding a bunch of papers for her to sign. She almost agreed without hesitation.

　　"I believe the doctor, as long as it is beneficial to him, just go to the hospital." Half a month later, when she recalled the storm, her tone remained firm.

　　After more than 30 years of medical treatment, Qin Fang has seen too much life and death, and "has been very open." However, those patients who "had the opportunity to pull back, but failed to stay for some non-medical reasons" will make her worry every time.

　　She met some family members of patients with acute myocardial infarction, and had to wait for all family members to come to the scene to discuss before signing the agreement. As a result, the patient had been "delayed". There are also family members who ignore the doctor’s urgent urging and tell the patient that they can’t afford to wait. They still have to make a phone call and find an "authoritative doctor" before agreeing to the operation. The result is tragedy.

　　"Miao Ting’s case, at the level of family members, may not be delayed for a minute. The whole rescue is completely led by the hospital." In her view, the trust of family members in the hospital is one of the key factors for the success of the rescue.

　　After coming out of the intensive care unit, Miao Ting was pushed to the catheter room, and Liu Tong performed interventional surgery for him to install stents in arterial blood vessels.

　　"His entire right coronary artery is blocked by half." Liu Tong lamented.

　　At 8: 30 pm, the operation was over. After work, Liu Tong put on casual clothes and made a circle of friends on his way home. "I finally got this disobedient’ old boy’ back."

　　After the operation, the doctor gave Miao Ting a sedative, and he was in a coma for three days in the intensive care unit. Two days ago, he had a high fever, and the doctor pulled out foreign bodies from his alveoli, which were cabbage and meat stuffing.

　　After leaving the hospital, Miao Ting’s memory of the onset was blank. Apart from this, his health is almost fine. It’s just the pain in his chest, the bruises on his arms, and the blood stasis left by interventional surgery that still reminds him that he experienced a life-and-death test that day.

　　For Miao Ting families, the aftermath of this storm has not subsided.

　　Once upon a time, Miao Ting was the first to get up in the family every morning. Now, his wife always checks if he still has breath before he wakes up. Walking on the road, his wife should also help him, even if his mobility has not decreased. Even when talking, his wife will touch his forehead from time to time to check if he is sweating.

　　He sent a banner to the hospital, emergency department and cardiology department that saved him, and wrote: Saving his life is unforgettable. He is most grateful to his wife.

　　"Her disposal is almost textbook-style." Miao Ting answered the call and decided to dial 120 after discovering his family’s chest pain, and chose a hospital with the ability to treat it. Let the patient lie flat as far as possible and don’t move at will, which will increase the burden on the heart. When other family members take care of the patients, guide the ambulance to save time as much as possible. After arriving at the hospital, I completely trusted the doctor and didn’t hesitate.

　　Miao Ting once learned a data at a meeting of medical institutions in Chengdu. Only about 17% of the patients with chest pain in Chengdu went to the hospital by calling 120, and most of them went to the hospital by themselves.

　　"This should not be the level of’ medical education’ that a large city should have." Miao Ting touched his chest with a heavy tone.

　　In fact, according to the China Cardiovascular Disease Report 2018 released by the National Cardiovascular Center, there are 544,000 cases of sudden cardiac death in China every year, and the success rate of out-of-hospital rescue is less than 1%, which is far lower than 2%-15% or even 30% in developed countries. Correspondingly, the penetration rate of cardiopulmonary resuscitation skills in China is also 1%, and that in developed countries is 60%.

　　Miao Ting used to smoke more than one pack of cigarettes a day, but now it’s reduced to less than two, and he dare not drink any more wine. He wants to continue to promote first aid technology, and the latest case is this personal experience.

　　"I am testing my training with my life." He typed this line on the courseware. (Reporter Yang Hai)