Liu Tangchun looked a little nervous as he watched the throat swab bottle being sent out of the clean room.
According to current regulations, if the unknown person is diagnosed with avian influenza, and the case in the second hospital is also diagnosed, Song'an Province will have to enter the province's second-level response mechanism, and the Fourth Central Hospital, which is the receiving hospital, will also
It was regarded as an epidemic site and was closed and thoroughly disinfected.
The main reason why the emergency room of the Second Hospital is closed but does not affect the overall situation is because the Fourth Central Hospital takes care of patients. But if even the emergency department of the Fourth Central Hospital is closed, those who need emergency services will
Where should patients go? The Fourth Central Hospital is responsible for more than 30% of the emergency work and tasks in the entire region. Once the emergency department is forced to close due to the epidemic, the extra 30% of emergency work will not be able to handle the emergency departments of other hospitals.
It can barely absorb the extra patients caused by the closure of the second hospital.
Faced with this situation, Comrade Liu was of course extremely nervous. If the emergency department was closed, who knew how much funding for the emergency department would be deducted in the next fiscal cycle?
The hospital staff entered the clean room wearing positive pressure protective suits and first put Xu Yourong into the protective suits they brought. Xu Yourong and Zhong Yu, who had direct contact with the patient, will be sent to the ward of the fever clinic
She will be quarantined and observed until infectious disease experts confirm that she does not have symptoms of avian influenza.
"Let you show off as a hero." Liu Tangchun crossed his arms and stared at Sun Lien, "How does it feel to be trapped in there?"
Sun Lien wore a mask and spread his hands towards Liu Tangchun, "Teacher Liu, you forced this treatment team on me. Now that something like this happens, I can't shrink back, right?"
"Are you being harsh?" Liu Tangchun raised his eyebrows and was about to curse, "Didn't the teacher teach you when you were in school? Protect yourself first before you can help others!"
"Am I wearing a mask?" Sun Lien chuckled twice, "Don't worry, it's not that mysterious."
An old man and a young man bickered across the door, and the hospital doctor next to him rolled his eyes. After the laboratory department sent the test results of Anonymous, the doctor relaxed a little. All five of Anonymous's infectious diseases tests were positive.
Negative, it seems that at least Xu Yourong does not need to worry about the impact of other infectious diseases and can only continue to observe the bird flu.
"Look, you are very lucky." Liu Tangchun showed Sun Lien the checklist and looked at it, which made Sun Lien feel a little more at ease. Then he asked, "How is the patient's condition?"
"To be honest, it's not very good." Sun Lien turned around and looked at the status bar. "After suctioning sputum, the blood oxygen concentration temporarily increased, and now it is only 91%. I suggest stopping imipenem cilastatin sodium and replacing it with
Let’s take peramivir injection.”
Liu Tangchun knew that Sun Lien wanted to ask for his consent. Xu Yourong was quarantined, and Sun Lien could only use his own prescription rights.
Liu Tangchun pondered for a moment and nodded in agreement with the suggestion. "Since imipenem has been used, let's forget about it."
"Didi, didi." The cardiopulmonary monitor shouted again. Sun Lien quickly ran to the bedside. "Anonymous" Wu Fenmei's blood oxygen saturation began to drop again. "Intubation!" Sun Lien immediately decided to rescue him.
direction, the patient is currently breathing pure oxygen, and the blood oxygen saturation drops again, indicating that the patient's own respiratory function is failing. Simply relying on oxygen inhalation and non-invasive positive pressure ventilator can no longer reverse the situation. Advanced ventilation must be opened immediately
channel, and maintain normal vital signs of the patient through a ventilator.
Usually in the emergency room, there are many doctors and nurses who can help with the rescue, but now there is only Sun Lien in the entire clean room. Liu Tangchun reacted very quickly, and was ready to put on protective clothing to help as soon as he heard Sun Lien's voice. But the hospital infection department led
How can the positive pressure protective clothing that comes here be so easy to put on? With the help of two people, it takes at least two or three minutes to be ready. Liu Tangchun cursed while putting it on, "All the funds you usually need are spent on dogs.
What are you doing with P4 level protective clothing? Showing off that you have it? The patient inside is definitely avian flu, but it’s not fucking smallpox!”
But Sun Lien could no longer hear Comrade Liu's cursing voice. He was working hard to insert a tube into Wu Fenmei's body. Her condition was very bad. As soon as the laryngoscope was removed, a steady stream of pink sputum came out of her throat.
The throat gushed out from deep inside. The narrow field of view provided by the laryngoscope was almost instantly covered by sputum. Sun Lien held the medium-sized throat tube and could only reach down from memory. Fortunately, the intubation was successful, otherwise
If he really had to perform pharyngeal incision and intubation, Sun Lien was really worried about his lack of experience.
"Director Liu, there is no need to come in." Sun Lien shouted towards the door, "The tube is inserted!"
"Shout earlier if you have the ability." Liu Tangchun opened the door and walked in. The positive pressure protective suit itself is like an inflated doll costume. Relying on the gas cylinder on the back, the internal pressure of the positive pressure protective suit is always slightly higher.
In this way, even if the protective clothing itself is damaged, the positive pressure can ensure that outside pathogens cannot enter the protective clothing within a short period of time.
Generally speaking, only the highest-level P4 biosafety laboratories will be equipped with this kind of equipment. This is not just because the protective clothing is very expensive. More importantly, if there is no external inflatable port, this protective clothing only relies on backpack air.
The bottles will not last long. Moreover, the Fourth Central Hospital itself has not designed a P4 level chemical disinfection spray room. It can be said that such protective equipment cannot fully play its role, but is extremely troublesome to use. No wonder
Liu Tangchun would be so dissatisfied with the hospital department.
"Do you think we bought this thing?" Bi Tianhua, the director of the college sense, jumped outside the door, "I shamelessly borrowed these sets of equipment from the college's biological laboratory!"
"Look at you like that." Liu Tangchun turned around and said disdainfully to Director Bi Tianhua outside the door, "You don't even know how to poach corners!"
Ignoring the threat of "I'm going to come in and kill you" from the director of the hospital's medical office, Liu Tangchun turned to look at "Anonymous" Wu Fenmei on the hospital bed and asked Sun Li'en, "How's it going?"
"It looks fine." Sun Lien glanced at the monitor, "The blood oxygen concentration is at 93%."
"We'll wait for people infected with the disease to come in later, so you can go and be quarantined." Liu Tangchun looked at the mask on Sun Lien's face and breathed a sigh of relief. N95-level masks are enough to protect against avian influenza. As long as they are carefully disinfected and quarantined for a while.
Just take it for a second. The current main mode of infection of avian influenza is through poultry to humans, and human-to-human transmission has not yet occurred. Compared with SARS, avian influenza is obviously more "mild". Although the mortality rate is as high as over 30%,
At least it's not that strong.
Liu Tangchun's kindness was rejected by Sun Lien. "Just think of it as training young people and let me continue to deal with it. If the person is transferred to other hospitals for treatment later, of course I have nothing to say, but since the person is in our hospital, and we
The hospital implements the first-diagnosis-responsibility system. Since Xu Yourong has been isolated, this patient should be handed over to me for further treatment."
This was the reason Sun Lien used to persuade Liu Tangchun, but for Sun Lien himself, there was actually only one reason for his insistence.
When bird flu develops into severe pneumonia, the patient's condition may be very extreme and changeable. And having a status bar means that he can detect the problem earlier than other doctors. Before other doctors wait for the laboratory results to come out, he can
Able to identify problems and intervene promptly.
And I am afraid that there is only one person in the world who can do this kind of thing, Sun Lien. Since this patient has touched your hands, then do your best to do it. At least don't leave yourself with regrets, thinking, "Ah, I was
It would be nice if she stayed and continued to treat her." This was Sun Lien's idea.
"You are just joining in the fun." Liu Tangchun glanced at Sun Lien, "You are not married, you have no children, and you are not a party member. This kind of thing is not your turn..."
Just when Liu Tangchun was about to reject Sun Lien's request, the cardiopulmonary monitor beeped for the third time. Sun Lien and Liu Tangchun looked behind them together. However, Liu Tangchun looked at the monitor, while Sun Lien first looked at the person lying on the bed.
Wu Fenmei.
"Wu Fenmei, female, 57 years old, h7n9 avian influenza infection, severe pneumonia, refractory hypoxemia, hypercoagulability."
What Liu Tangchun saw was the rapid drop in Wu Fenmei's blood pressure on the cardiopulmonary monitor. From 150/90 at the beginning, it dropped directly from a cliff to a dangerous level of 80/45.
"Director Liu!" Sun Lien shouted towards Liu Tangchun, "Look at her hands!"
Pieces of purpura appeared on Wu Fenmei's arm, and blood began to leak out from the area where the intravenous infusion needle was stuck. Although the amount of blood leakage was not too much, it was definitely not a small amount. Liu Tangchun lifted up the half-masked
On the quilt on Wu Fenmei's arm, it was discovered that the blood seeping from the needle had stained a large area of the bed sheet red.
"Skin purpura, bleeding tendency, blood pressure dropped rapidly..." Liu Tangchun took a breath of air, "This is DIC (disseminated intravascular coagulation)."
Liu Tangchun looked at Wu Fenmei as if he were looking at a dead person. Although he immediately asked the doctors on standby outside to send heparin, even Sun Lien knew that Wu Fenmei's condition was so critical that it was almost impossible to save her.
There may be many reasons for Wu Fenmei's disseminated intravascular coagulation. It may be circulatory system disorders caused by shock, systemic coagulation caused by severe pneumonia caused by avian influenza infection, or even long-term upper respiratory tract bleeding.
The coagulation reaction triggered. In short, the cause of this symptom is no longer important. If the DIC cannot be reversed as soon as possible, Wu Fenmei will soon die.
The method of dealing with DIC is also difficult because of the extreme duality of this symptom. Disseminated intravascular coagulation has two main symptoms, the first is coagulation, and the second is bleeding.
When these two extremely contradictory situations appear in patients at the same time, it is the doctor's turn to start having a headache.