"So you're back?" Liu Tangchun half leaned on his seat and looked at Sun Li'en in front of him with sympathy. He really felt sorry for his disciple. Something happened every day these days. I really don't know what this boy is.
Did he collide with some god?
Sun Lien had a grimace on his face, not knowing whether he should put on a pitiful expression or simply pretend not to care about Luo Luofan. He had decided that after these few days of work, he would go find a famous mountain and ancient temple to pay homage.
In order to wash away this inexplicable bad luck on my body.
"Okay, okay." Liu Tangchun waved his hand, "Go to sleep in the duty room." He suddenly thought for a moment and said, "Xiao Xu is on duty today. You go over and say hello to me. If necessary, change with me."
Just stay on duty. After all, Xiao Xu is a lesbian and a doctor with supernatural powers..." Liu Tangchun paused and continued, "Usually, these doctors with supernatural powers are held in their hands as treasures, but now it's better
, when you come to my place, you actually have to work the night shift on the front line..."
Neurosurgery doctors are required to have a steady hand and a steady mind. Starting from the university education stage, neurosurgery professors have been instilling this idea into students. Neurosurgeons should not only try to avoid doing physical work, but also ensure adequate physical exercise.
Rest time. After all, the surgical precision requirements in the field of neurosurgery are very high. If the hand shakes a little, the patient's life may have to be handed over on the stage. Insufficient rest and overuse of muscles will lead to poor hand movement accuracy. Therefore, this
This situation can even be considered taboo.
However, Xu Yourong didn't seem to care about this at all. Since joining Sun Lien's treatment team, Xu Yourong has worked two night shifts. Moreover, he is very active in the rescue process and has no awareness of "avoiding physical labor" at all. No wonder Liu Tangchun has been
I felt a little sorry. That's why I asked Sun Lien to share the pressure of duty. After all, Sun Lien was not a surgical doctor. Even if he was tired and his hands were shaking, he would not delay chest compressions.
Sun Lien wandered into the emergency room and said hello to Xu Yourong. A group of doctors on duty in the emergency room expressed their cordial "condolences" to Sun Lien. And everyone believed that the main reason why Sun Lien was so unlucky recently was because of his poor character.
Hu Jia is exhausted. If he wants to be transferred, it would be wise to treat everyone to a meal as soon as possible.
"You should go and have some rest first." Xu Yourong looked at his watch. It was now eight-thirty in the evening. "That's right. You can sleep for four hours and get up at two-thirty to take over for me. Then I'll get up and take over at six-thirty."
, prepare to make a handover with the day shift doctor."
The first half of the night is actually easier to get through than the second half of the night. But of course Sun Lien will not be dissatisfied with this arrangement. After all, the two people sleep for the same length of time. And after two o'clock in the morning, patients sent to the hospital generally also
slightly less.
After taking off his coat in the lounge, Sun Lien got under the quilt and began to urge himself to fall asleep. Xu Yourong, on the other hand, sat behind the duty desk outside and lowered his head to flip through the information that Dr. Pascal had read in the afternoon.
"Ding ding ding!" After reading the information for half an hour, the red phone in front of Xu Yourong suddenly rang. She took the phone with her left hand, closed the information in front of her with her right hand, and then took out a pen to write down, "Fourth Center
Hospital emergency room, what's going on?"
"Got it." Five seconds later, Xu Yourong hung up the phone and said to the nurse Zhong Yu on the side, "Forecast is a patient, unconscious, no obvious trauma, low fever, difficulty breathing. Arrive at the hospital in ten minutes."
Zhong Yu nodded and took out new protective clothing from the cabinet on the side. The patient previously admitted by the Second Hospital has been diagnosed with h7n9 avian influenza. Currently, according to the plan, the entire Ningyuan City is in level IV public health
In the emergency response mechanism, when all hospital emergency departments receive patients with high fever and respiratory symptoms, they should transfer the patients to fever clinics for isolation diagnosis. Once confirmed, the patients should be immediately transferred to designated hospitals for treatment.
The patient reported on the phone has difficulty breathing, but his body temperature is low, which means the patient's body temperature is lower than 38 degrees. According to regulations, he does not need to be sent to a fever clinic for treatment. However, according to regulations and for the safety of medical staff, fourth
The central hospital will still require doctors to take adequate protective measures when treating such patients.
Disposable transparent protective glasses and N95 level masks are necessary protective equipment. These protective equipment that obviously exceed the regulatory requirements are naturally sponsored by Dean Song. Mining and Billiton sponsor the Fourth Central Hospital every year
More than one-fifth of the funds are spent on these places.
"Send the patient directly to the clean room." The administrative level of the Infectious Disease Department of the Fourth Central Hospital is much higher than that of the Infectious Disease Department of other hospitals. And they continue to publicize it in their daily work.
The threat of transmission, coupled with the power to influence people's performance, has indeed made many front-line medical workers more cautious. After all, viruses are easier to survive in winter than under other conditions. In order to prevent cold, few people in winter
Opening windows for ventilation, this series of objective factors will indeed lead to a high incidence of infectious diseases. So Xu Yourong still arranged the room and route for isolation examination, although she did feel that since the patient's body temperature has not reached 38 degrees, the significance of this measure
It doesn't seem to be very big.
The preparations are proceeding in an orderly manner. By the time the patient is sent to the emergency room, other patients on the transfer channel have been evacuated to the positive pressure area of the emergency room. From the electromagnetic door of the emergency room to the clean room, 12 pictures on the channel
All beds are empty.
"The patient is female, about 50 years old, has no documents, and is unconscious. The blood oxygen saturation is 92%, the blood pressure is 110/155, the heart rate is 120, and the body temperature is 37.4c." The face of the pre-hospital first aid patient who rushed into the rescue room with a gurney.
Wearing an ordinary mask, probably due to violent breathing, half of the mask on the face of the pre-hospital first aid was blown off, exposing two nostrils. He didn't know what the meaning of this mask was. He lowered his head and pushed the car.
He came in and pointed to the policeman who followed behind him, "The patient was found fainted on the roadside with no obvious external injuries on his body. Passersby then called the police, and comrades from the police station rushed to the scene and made an emergency call."
"How long has it been since you noticed that you fainted?" Under the guidance of the nurse, the patient was pushed directly into the clean room. Xu Yourong put on blue latex gloves and used a small flashlight to check the patient's pupil reaction. "Have you found any family members?"
"Not yet." The police officer who followed him into the clean room looked young. He was probably a rookie who had just graduated from the police academy. He answered Xu Yourong's question nervously, "We received the call 20 minutes ago.
, that is, about eight o'clock...around eight forty." He simply took out a small notepad from his pocket, read the content on it and nodded firmly. "We received the call at eight forty.
, arrived at the scene five minutes later, and the man was already lying on the ground."
After Xu Yourong completed the basic examination, he turned around and said, "Please go with our nurse and call her first..." At this point, Xu Yourong suddenly didn't know what to say. After all, this patient didn't even have a name.
, I really don’t know what to do with this registration.
"I'll just take him there." Zhong Yu volunteered. She had been working in the emergency room for a long time. One look at Xu Yourong's look showed that she was in trouble. "I'm quite familiar with the registration process for patients without identity.
.”
In fact, we see a lot of patients who cannot obtain identity in the hospital every year. Some of these people have mental problems, some are homeless, and some are really desperate. For these patients, if they need emergency treatment, the hospital will
They will still be accepted and medical assistance will be provided within a certain range. This process is called the "unidentified patient treatment process."
It should be noted that this emergency service is limited to patients in need of emergency care. Unidentified patients whose condition is not urgent will be given priority to the rescue center of the Civil Affairs Bureau instead of the hospital emergency department. Medical staff will confirm the patients who are sent.
After an emergency, the patient will be reported to the medical office and registered for arrears, and the patient will be marked as "Anonymous" and "rescue" will be written on the bed card. If an emergency examination is required for the patient, the patient will also be identified as "Anonymous"
” mark is checked.
If the patient's identity cannot be verified in the end, the expenses incurred in this series of medical treatments will be paid uniformly every six months by the Disease Emergency Relief Fund.
Zhong Yu often dealt with patients like this when she was at the triage desk. Now in the emergency room, her ability to deal with such situations has not dropped at all. She took the little policeman out to register, while Xu Yourong continued to check.
Patient's physical signs.
Anonymous's tridentia is very obvious. Although she was still taking oxygen in the ambulance, her blood oxygen saturation is still only 92%, and the situation is not optimistic.
"Are you breathing pure oxygen now?" Xu Yourong and Xiao Guo checked the situation and frowned, "Call the imaging department to come and take a bed X-ray." In order to buy some time, Xu Yourong gave the order.
She ordered, while still doing other physical examinations. "Check a whole blood test, test twelve leads, do an electrocardiogram, check a general biochemistry, and add five infectious items..." She paused and clapped her hands hard.
Putting his hand on Anonymous's shoulder, "Wake up! Do you know where you are?"
Anonymous's eyelids moved, as if he had some reaction to the tap on the shoulder. But he still couldn't open his eyes.
The doctor from the imaging department rushed to the scene quickly. This time it was not Brother Luo, but another middle-aged imaging doctor named Huang. After learning the basic situation, he also put on a mask.
"Is it enough to take a chest X-ray?" Dr. Huang skillfully brought over the bedside
ah."
"Let's take a chest X-ray first." Senior doctors in the auxiliary department are indeed very sensitive to certain diseases, but Xu Yourong does not think that this anonymous person has problems such as cerebral hemorrhage. The patient's pupils on both sides react to light.
Good, and there is no dilation or asymmetry in the pupils, so at least the possibility of cerebral hemorrhage is unlikely now.
The results of the bed X-ray came out quickly. The X-ray confirmed that the patient had atelectasis on one lobe of the lung. At the same time, the X-ray showed infiltration of the middle lung lobe and leaf-like shadows in the lower lung.
"Lung cancer?" Xu Yourong frowned. Her knowledge of lung cancer was far inferior to that of other emergency doctors, let alone compared to Rachel. Rachel was an expert in oncology. After thinking for a while, she decided to call for breathing
Internal medicine doctors are here for consultation.
Wang Yin, the chief physician of the Department of Respiratory Medicine, took one look at the
What’s the saturation level? What’s the body temperature?”
"The body temperature is 37.4C, and the blood oxygen saturation is 92%." Xu Yourong replied, "The patient is already being given pure oxygen."
"Severe pneumonia is the most likely." Wang Yin handed back the X-ray. "I suggest you take anti-infective treatment first, and then do a sputum culture to confirm the type of infection."
Xu Yourong naturally had no objection to the specialist's advice. As soon as Wang Yin left, Xu Yourong, who had received the routine blood test report, noticed something unusual in the report. "White blood cells decreased, platelets decreased, and neutrophils decreased.
"
"Add cefepime hydrochloride, 1g, mixed with % normal saline for intravenous injection. Then prepare a bottle of imipenem cilastatin sodium, 1000mg, mixed with % normal saline for intravenous infusion..." She paused and emphasized, "
After imipenem is applied, pay attention to the injection speed."
Cefepime hydrochloride is a fourth-generation cephalosporin antibiotic that is very effective against neutropenic infections. And imipenem is a miracle drug with a clinical effectiveness rate of 93.0% in treating severe lower respiratory tract infections. Both drugs are
They are controlled antibiotics that are "used with caution" in clinical practice. In order to prolong the effectiveness of antibiotics as much as possible and reduce the chance of the emergence of drug-resistant bacteria, these two drugs are rarely prescribed to patients by doctors. However, Xu Yourong's behavior at this time was...
It's really a last resort reaction.
Anonymous's symptoms are very serious, but if we have to wait for the results of the sputum culture to come out, it may have been several days. Judging from her current oxygen saturation of 92%, if the development of the infection cannot be controlled as soon as possible, it will be possible to contain it.
As the pneumonia progresses, she may need to rely on a ventilator in a few hours.
Xu Yourong looked at the examination report in her hand. Although she had taken the correct response, she still felt a little uneasy. The combination of the severity of the patient's condition and the moderately high body temperature made her vaguely feel that something was not right.
.
Could it be that the patient's immunity was very poor, so he was unable to make an obvious immune response? Xu Yourong pondered for a moment and decided to add another bottle of gamma globulin injection to Jane Doe. This human blood preparation can be used together with antibiotics, which can be effective
Improve the effectiveness of antibiotics in treating serious bacterial infections.
After making arrangements, Xu Yourong breathed a sigh of relief. It was indeed a bit tiring to deal with emergency patients alone.