EKG spielerisch erklärt. Arteriosklerose, Vorhofflimmern, Kammerflimmern, Reanimation Medizin Pflege — Transcript

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1. 0:01We are moving on to a presentation from
2. 0:03the field of medicine. It is titled "
3. 0:06You Can't Mow a Racing Heart." That is
4. 0:10also the title of the book by the man
5. 0:11who is about to give this talk. He
6. 0:13comes from Marburg, my dear ladies and
7. 0:16panda bears. Let's give a huge round of
8. 0:18applause for Johannes von Borstel.
9. 0:25Thank you, my dear ladies and gentlemen
10. 0:31, tonight we are talking about the
11. 0:32crescendo of retrosternal rhythms. To
12. 0:35be more precise, it is about my
13. 0:36favorite organ. It is about our heart.
14. 0:40My name is Johannes and I am a doctoral
15. 0:42candidate at the Biomedical Research
16. 0:45Center in Marburg, and my main task
17. 0:47here is to research vascular
18. 0:49calcification, or as we call it,
19. 0:51atherosclerosis. I would like to start
20. 0:54with a few hard facts. Atherosclerosis
21. 0:57is a buildup of fat or plaque in the
22. 1:00vascular wall of a blood vessel. This
23. 1:03causes the blood vessel to narrow, and
24. 1:05the body parts supplied by that vessel
25. 1:08receive less or no blood at all. This
26. 1:11means a direct consequence would be, as
27. 1:13in this example, a heart attack, or
28. 1:15like in this example, a stroke. There
29. 1:19are also other conditions, such as
30. 1:21vascular dementia, which is essentially
31. 1:23age and vascular-related mental
32. 1:25incapacity. Um, now you might ask, why
33. 1:32is it so exciting for me to study this?
34. 1:34The main consequences of vascular
35. 1:37calcification—namely heart attacks
36. 1:40and strokes—are the number one and
37. 1:42two causes of death, even ahead of, for
38. 1:45example, HIV or diarrheal diseases, and
39. 1:48that is why it is so close to my heart
40. 1:51to work on this. Who comes into a
41. 1:54hospital with early atherosclerotic
42. 1:57degeneration? These are people who love
43. 1:59to eat. These are people who are lazy,
44. 2:02who love to smoke, and the typical
45. 2:05alcoholic. So, what do I do in the lab
46. 2:08to better understand this disease and
47. 2:11get to the bottom of it? For that, I
48. 2:15need several cuddly C57 Black 6 LDL
49. 2:17receptor knockout mice, because these
50. 2:20mice carry something in their bone
51. 2:22marrow that is very important to me,
52. 2:24namely monocytes. And from these
53. 2:28monocytes, I grow dendritic cells in a
54. 2:31cell culture. These are immune cells
55. 2:33that are significantly involved in the
56. 2:35growth of atherosclerotic plaques, in
57. 2:38other words, vascular calcifications.
58. 2:41So, in order to find these cells again
59. 2:43in the cell culture, I load them with
60. 2:46iron oxide. And you can look at the
61. 2:48whole thing under a microscope. There,
62. 2:50for example, you can see on the left
63. 2:52the iron oxide is black, in the middle
64. 2:54the iron oxide fluoresces green, and on
65. 2:56the right, you can see the iron oxide
66. 2:58is blue. So, for those who already find
67. 3:01that cool, I will take it one step
68. 3:02further. I performed a DAPI stain. This
69. 3:06means you can see, co-localized with
70. 3:08the red and green fluorescent iron
71. 3:10oxide particles, the blue fluorescent
72. 3:13DNA material in the cell nucleus, and
73. 3:15because they are so close together, I
74. 3:17assume that the loading worked. So,
75. 3:20what happens to these loaded cells?
76. 3:22They go into a syringe, and at this
77. 3:24point I have to say, I'm really sorry.
78. 3:27I'm really sorry, this syringe goes
79. 3:29into a mouse, and I'm really sorry. I
80. 3:31had pets as a child myself, including
81. 3:33mice and rats, and they are poor little
82. 3:35creatures. So, that's why I suggested
83. 3:37in our lab that we could use humans for
84. 3:40this. Uh, brain-dead ones, for example.
85. 3:43It didn't go over very well. So we
86. 3:46stuck with the mice. All right, so what
87. 3:49do we do now with this mouse that has
88. 3:51the loaded dendritic cells in its
89. 3:53circulatory system? I put it, under
90. 3:57anesthesia, mind you, into a
91. 3:59seven-tesla small animal MRI scanner,
92. 4:03and I hope to get images like this one
93. 4:06in the end. I take such recordings at
94. 4:10different times after the injection of
95. 4:12the cells and can then draw conclusions
96. 4:14about the migration behavior of the
97. 4:16dendritic cells in vascular
98. 4:17calcifications. And what is the great
99. 4:20thing about the procedure that my
100. 4:22research group in Marburg is trying to
101. 4:24establish with this work? Because it's
102. 4:26still relatively unpopular. Uh, there
103. 4:28are invasive techniques, which means,
104. 4:30well, slightly older techniques for
105. 4:32looking at the migration behavior of
106. 4:34cells. For that, you take a mouse,
107. 4:36inject the cells, put it down, cut it
108. 4:38into slices, and look at it under a
109. 4:40microscope. Unfortunately, the mouse is
110. 4:41dead then. In our procedure, we use MRI
111. 4:44to take digital cross-sections, which
112. 4:46means the process doesn't require the
113. 4:48animals to die from the measurement,
114. 4:49even if you have several appointments
115. 4:51in a row and scan the animals. And I
116. 4:54personally think that's uh, actually
117. 4:56pretty cool. That's why I think this
118. 4:58procedure is so wild. So, thank you.
119. 5:04What does all this have to do with the
120. 5:05heart? Vascular calcification causes
121. 5:08heart tissue to die, and you usually
122. 5:10don't see that well at all in yourself
123. 5:12at the beginning. I mean, you don't see
124. 5:15it at all. However, there is the
125. 5:17possibility for a doctor, for example,
126. 5:19to derive this line down here, the
127. 5:21so-called ECG, the electrical heart
128. 5:23activity. And based on this line, you
129. 5:26can see if there is something wrong
130. 5:27with the heart. Now, unfortunately, to
131. 5:29interpret an ECG, you usually have to
132. 5:31have completed a medical degree and be
133. 5:33a cardiologist. That's why I came up
134. 5:35with another method to bring my
135. 5:37favorite ECG images—first a
136. 5:39completely healthy one, then many
137. 5:41pathological ones—closer to you. But
138. 5:44the only thing you have to remember for
139. 5:46this is that my hands are the heart
140. 5:47atria, the upper part of the heart, and
141. 5:49my legs are the ventricles, and you
142. 5:51don't need a degree for that. Have fun.
143. 6:09Electrocardiography type one. Venus.
144. 6:15Ready. Go! Electro ablock. Ready, go.
145. 7:06Electrocardiography 3. Go! Next
146. 7:20Plankeit. 2 Oh, thank you. Oh, damn.
147. 8:13Sorry, that's exhausting. Of course,
148. 8:16after this asystole, the cardiac arrest
149. 8:18, we continue with resuscitation, which
150. 8:20you should definitely not confuse with
151. 8:22this. It's also a resuscitation. I know
152. 8:27, he's flat, right? No, it's about
153. 8:32chest compressions, which, according to
154. 8:34American Heart Association guidelines,
155. 8:36should be performed by laypeople in
156. 8:38Western industrialized nations without
157. 8:40rescue breaths. And there’s a reason
158. 8:42for that, because well, that’s not
159. 8:44what most people look like when they're
160. 8:45lying pulseless on the street in front
161. 8:47of you. There are people who look like
162. 8:49this. It gets worse. I’ll go one
163. 8:51better. Imagine they are lying in front
164. 8:53of you. So, no rescue breaths. What is
165. 9:00important for you in lay resuscitation
166. 9:02when finding the pressure point? If you
167. 9:04look in textbooks, you find the
168. 9:05well-known "between the nipples" method
169. 9:07. You simply look between the nipples.
170. 9:10We can try that. I see, I'm locating
171. 9:13the nipple here. That means the
172. 9:15pressure point would be roughly in the
173. 9:17area of the belly button. Unfortunately
174. 9:19, that’s not right. The "between the
175. 9:21nipples" method only works on people of
176. 9:22normal weight. Otherwise, if the
177. 9:25nipples are further down or in a place
178. 9:27you wouldn't expect, I advise you to
179. 9:29feel for the tip of the sternum. Two
180. 9:32fingers above that is the pressure
181. 9:34point where you should push. And do so
182. 9:36at a frequency of 100 to 120 beats per
183. 9:39minute. Even emergency doctors find it
184. 9:42difficult to maintain this rhythm or
185. 9:44frequency over a long period. And that
186. 9:47is why these three guys came up with a
187. 9:50brilliant mnemonic. Great mnemonic. I'm
188. 10:06a child of the 90s. I shamefully admit
189. 10:09I looked at my first record. Found this
190. 10:12resuscitation song. And I would like to
191. 10:24play my own resuscitation song on the
192. 10:27guitar. It plays in the background when
193. 10:30I myself, when I am resuscitating
194. 10:35someone. Best not to sing along. It
195. 10:38doesn't go over well. Thank you. Think
196. 11:07of the 100 to 120 beats per minute.
197. 11:12Thank you very much.