Days are a very strange thing. Sometimes, every second in a day seems to be as long as a year. And sometimes, half a month is just a blink of an eye.
And Sun Lien's experience these days is like taking a second look.
Since the duty hours were adjusted to be consistent with Zhou Jun's, Sun Lien suddenly had a lot more free time. No joke, the third-line doctors suddenly enjoyed the duty frequency of the first-line doctors. From working six days a week to three days a week
, there are simply no people who can adapt to this change instantly.
However, adjusting the duty order does not mean that Sun Lien can completely herd sheep. He goes to the hospital with Zhou Jun every Monday, Wednesday and Friday, and has to go to the laboratory to soak in the laboratory on Tuesday, Thursday and Saturday. Originally, he still had one day off a week.
Day, it's so good now, I don't even have time to take a breath.
Of course, Sun Lien was a little dissatisfied with this arrangement. No one would like the life of working every day, seven days a week. But Sun Lien could not directly express his dissatisfaction in any case. The reason was very simple. The same was true for Zhou Jun.
That's what it does.
Sun Lien himself has not yet done a project proposal report, and no one has come to tell him what project he should research. As an associate professor in charge of teaching in Liu Tangchun's laboratory, Zhou Jun is usually responsible for developing projects. But Sun Lien will only enroll next year, and now the entire laboratory
There really was no project that could be assigned to him.
After much thought, Zhou Jun decided to first let Sun Lien participate in a project that was almost completed. At least let Sun Lien start to get involved in scientific research projects and gradually build up some experience. Then he would transfer to other projects. Sun Lien
You won't be bumping around like a headless fly.
"So you are mainly engaged in research on cardiopulmonary resuscitation now?" In the dormitory, Dr. Cao and Sun Lien were sitting in the living room, with several bottles of beer on the table in front of them. The photo in Sun Lien's circle of friends has been posted for half the time.
Month, the impact cannot be explained in a few words. Dr. Cao really couldn't bear it. Everyone in the entire laboratory knew that he usually had to kneel down to reply when he provoked his girlfriend. Therefore, Dr. Cao decided to invite Sun Lien to drink
After a meal, he coerced and coerced him into deleting the photos. However, this purpose seemed to have been forgotten by him long ago, and he began to become curious about the projects Sun Lien participated in.
"I'm actually just a handyman." Sun Lien took a sip of beer. Tomorrow is Sunday and he doesn't have to go to the hospital for duty. So there is no psychological pressure when he drinks. "Brother Xu's research data has basically been collected. I am now
The main job is to regularly call and follow up with the families of the patients who are used as research data."
Brother Xu, whose name is Xu Shengyong, is a student of Liu Tangchun. As a graduate student in the field of cardiopulmonary resuscitation in emergency medicine, his research project is very direct "Analysis of the Effects and Influencing Factors of Cardiopulmonary Resuscitation in the Emergency Department".
Cardiac arrest (CA) is the most critical clinical situation. When the heart's ejection function suddenly stops and the mechanical activity of the heart completely disappears, the blood supply to the whole body will be immediately interrupted. The blood supply to the brain will be interrupted for about 10 seconds.
Loss of consciousness. It is generally believed that if the heart stops beating for more than five minutes, the brain will suffer irreversible damage. If the heart stops beating for more than fifteen minutes, more than 95% of the brain tissue will be damaged. Therefore, in clinical medicine, there is no
This disease state is more serious than cardiac arrest, and it is also the last common clinical path for many critically ill patients. Cardiopulmonary resuscitation (cpr) is the most important and the only emergency medical method to rescue patients with cardiac arrest.
And cardiac arrest is not simply "the heart does not beat." According to the electrocardiogram analysis, there are four types of cardiac arrest, namely ventricular fibrillation (VF), pulseless ventricular tachycardia (VT),
Pulseless electrical activity (pea) and cardiac arrest (asy). VF and VT can be treated by defibrillation, so these two types of cardiac arrest are also called defibrillable heart rates. pea and asy are non-defibrillable cardiac arrests.
Defibrillation heart rate. Therefore, unlike what most people think, not all cardiopulmonary resuscitation treatments will use a defibrillator.
However, modern CPR technology has been developed for almost half a century, but the overall mortality rate of patients with cardiac arrest has not been fundamentally improved. According to a multi-center study report in North America, they included 20,520 cases of out-of-hospital cardiac arrest (ohca).
) patients, the discharge survival rate in various centers ranged from 3.0% to 16.3%. Across all centers, a total of only 954 (4.6%) patients were able to survive to discharge.
Yes, in North America, where CPR first aid knowledge is widely promoted, less than 5% of patients who suffer cardiac arrest outside the hospital can eventually be discharged alive. And domestic statistics and prognosis are even less optimistic than in the United States.
In 2003, the Shanghai Emergency Center treated a total of 4,166 OHCA patients, and a total of 143 patients had pre-hospital return of spontaneous circulation (ROSC), but only one patient (0.02%) was discharged alive.
The kind of scenes in movies and TV shows where people perform chest compressions and artificial respiration when the heart stops beating, and finally put an electrode pad on the person's chest in a handsome way, and the person can be saved by electrifying it. In fact, it is really rare. It is caused by myocardial infarction.
Ventricular fibrillation (VF) is relatively easy to deal with. The "chest pain centers" hanging in major emergency centers are actually specially designed to deal with patients with acute myocardial infarction.
The data that Sun Lien came into contact with during this period was actually very shocking. He had been working in the emergency department for more than two months and almost three months. Although some of the patients he had come into contact with had passed away, in general, they were all still alive.
It’s a pretty good result. Therefore, when he saw the data of 0.02%, Sun Lien’s first reaction was “Is this data wrong?”
But the data doesn’t lie. Xu Shengyong’s data was collected from the Emergency Department of the Fourth Central Hospital. During the four and a half years of research, there were a total of 730,000 emergency room visits, and more than 13,000 people were observed. Rescue patients
Fourteen thousand people, the rescue rate was 1.9%; among them, there were 1,936 cases of cardiac arrest, accounting for 2.6‰ of the patients and 13.6% of the rescue patients. In the study, a total of 597 people were included in the study, with an average age of 5.95
±17.9 years old, the oldest patient is 103 years old, and the youngest patient is 18 years old.
During the rescue operations at the Fourth Central Hospital, 36.7% of the patients were able to achieve spontaneous recovery of circulation after cardiopulmonary resuscitation, but only 3.2% were able to survive and be discharged. The most valuable effect of CPR is that those who survived the hospital discharged with good neurological function.
It only accounts for 2.7% of all studied cases.
Only 16 of the 597 patients survived and were discharged from hospital with good neurological function. This is the performance of the Fourth Central Hospital, the largest emergency center in the region, and a large emergency pilot unit in the past four years. As for those who were not included in the study, except for ten
Several patients younger than 18 years old were excluded because they did not comply with the ethical review. Most of the patients were voluntarily discharged after their families refused resuscitation or suffered cardiac arrest. It can be speculated that their outcomes were basically death. In other words,
In the past four years, about 1,900 people were sent to the Fourth Central Hospital for rescue due to cardiac arrest. 16 of them were able to complete activities such as eating, dressing, and going to the toilet without the help of others and were discharged. Although the other three survived, they still
With severe neurological damage.
Is cpr really necessary? Sun Lien looked at the data in his hand and fell into confusion again. He had done cpr, and Zheng Guoyou was pressed by Sun Lien. The old man probably belongs to one of the very lucky 2.7%.
He showed few neurological sequelae.
After Wu Fenmei, who contracted bird flu, stabilized, she was transferred to the Second Hospital for centralized treatment. What was the specific situation? Sun Lien didn't know that when Wu Fenmei was transferred, Sun Lien was still playing with his mobile phone in the isolation room. But at least, Sun Lien
It is certain that before he fainted, Wu Fenmei restored sinus rhythm. She was also lucky, at least luckier than the 63.3% of cardiac arrest patients. For a long time, a large dose of epinephrine, and multiple electric defibrillations, this
Under all circumstances, it can return to the state of sinus rhythm. Sun Lien didn't feel that he was doing very well at first, but under these data, he had to re-examine the advantages brought by the status bar.
Is it possible that if there is a reminder of the number of times, the patient's spontaneous circulation can be restored?
Not long after this drinking session, Sun Lien opened a total of seven bottles of beer, and Brother Cao couldn't hold it anymore. Four of them were drunk by Sun Lien himself.
"How dare you go out and drink with others when you only have three bottles of beer?" This is really the first time that Sun Lien has seen someone unable to hold back even one bottle of beer. Brother Cao felt like vomiting after drinking three bottles of beer in fifty minutes.
The condition even made Sun Lien wonder whether his roommate had taken antibiotics before drinking beer. The disulfiram-like reaction will prevent the body from metabolizing alcohol, causing alcohol to accumulate in the body, and this reaction may be fatal.
However, through the double confirmation of the status bar and the inquiry, Sun Lien determined that Dr. Cao was simply a drunkard. This made him feel relieved.
After carrying Dr. Cao into the room, Sun Lien walked to the balcony. He looked at the moon in the sky, and the white air coming out of his mouth blocked the soft moonlight like clouds.
Doctors are human, too, and when straightforward research data seems to mock the futility of everything they do, frustration and self-doubt are inevitable.
The moonlight seemed to be getting stronger, and the cold north wind suddenly woke up the thinly-clad Sun Lien.
No, how could it be in vain? Without those ten minutes of chest compressions, Zheng Guoyou would have become a martyr long ago. Without eleven times of electric defibrillation, Wu Fenmei would definitely have died on her birthday. All the hard work was not in vain.
Even based on research data, 3.2% of patients survived due to cardiopulmonary resuscitation.
Without the doctors' desperate efforts to rescue them, these nineteen people would not have survived.
This is the job of emergency doctors. Not everyone will be saved, but those who are saved will survive because of the doctors' full treatment.