With the release of the "new ten", hospitals have become the first "breakwater" to face the wave of infection.
Recently, the reporter approached the ICU department of Qingdao University Hospital, and directly hit the ICU in their fight with the virus, and the race against death.
23 elderly 21 people new crown infection
Some people blood oxygen saturation fell to 80% to emergency
ICU as a first-line department, the wave of infections come, admitted after being subdiagnosed with serious illnesses. Shan Liang, director of the City South Ward of the Critical Care Medicine Department at Qingdao University Hospital, has clearly felt the impact of the new crown.
Patients admitted to the hospital have become seriously ill due to the symptoms of the new crown, and there are more and more "white lungs" in the CT images of the patients' chests. More and more patients are being sent in, and the medical staff is experiencing the plight of constant attrition
Single Liang is discussing the patient's condition with his family, and the old man's lungs have become "white lungs" due to the infection of the new crown. "White lungs"
In a ward of ICU in the city's southern hospital district, where there are 23 integrated beds, 23 elderly people, the oldest age of 92 years old, were admitted. Among them, there are 21 elderly people infected with the new coronavirus.
They already have serious underlying diseases, or hypertension, coronary heart disease, ketosis, heart bypass, or serious vascular disease, coupled with the infection of the new coronary, lung oxygen function is poor, and some patients' blood oxygen saturation even fell to 80% into a coma, and their families were sent directly to the hospital for emergency treatment.
January 8, China's new coronavirus infection formally implemented the "B B tube". The overall program on the implementation of the new coronavirus infection "B B tube" proposed to increase investment in the construction of medical resources, focusing on the preparation of hospital beds and intensive care beds, with a full complement of high-flow respiratory therapy, ventilators, ECMO and other intensive care equipment, and to improve the conditions of oxygen supply.
In order to better cope with the "climax" of critical illnesses, QNUH has set up a critical care team to strengthen the treatment of patients with acute and critical illnesses. A specific time each day to organize difficult case discussions of patients with severe pneumonia, and the emergency ICU, neurosurgery ICU, cardiac surgery ICU, respiratory ICU and other specialized ICU for the treatment of critically ill patients, to fully guarantee the patient's medical treatment.
Single Liang, as the director of ICU City South Ward, was busy on the front line with his team for nearly a month, whether he was sick or not. From morning to night, he almost constantly shuttled between various beds, always highly nervous to observe the changes in the patient's condition, Qingdao University Hospital, head nurse of the Department of Intensive Care Medicine Gao Si-long, together with the single bright timely adjustment of medication and respiratory parameters, and so on.
At the beginning of the peak of social infection, most of the medical staff of the department was also infected, as a leader, the two of them every day is a "war" state, every health care workers in the post has become a "super warrior", they face a sudden surge of patients, the other side has to face the "super warrior", and the other side has to face a sudden surge of patients, the other side has to face a sudden surge of patients, the other side has to face a sudden surge of patients. The first is that the first time the company has been in the market for a long time, the second is that the company has been in the market for a long time, the third is that the company has been in the market for a long time.
After a busy morning, the medical staff had a simple meal
Gao Sailong is clearly a "veteran" in dealing with the critically ill patients with new coronary artery disease.
When the epidemic broke out in 2020, he became one of the third batch of medical staff from the Qingdao University Hospital to assist Hubei, and was stationed in the intensive care unit of the Tongji Hospital affiliated with the Tongji Medical College of Huazhong University of Science and Technology in Wuhan. After that, he was stationed in the hospital's isolation ward and Qingdao's emergency backup and sentinel hospital for many times.
"This time when all the infection, some of our colleagues are actually considered ordinary type of pneumonia patients, but still insisting, it is our persistence, most of the critically ill patients to get timely and proper treatment." Gao Silong said.
"High-flow oxygen, pick up a balloon mask ......"
Always ready to "snatch" with the Grim Reaper
The numbers on the ECG monitor have a life-and-death significance, and calmness is a form of safety.
Single Liang and the team are most afraid to hear the "ding ding ding" sound on the monitor, once it rings, it means the rescue began.
Doctors and nurses will be the first to respond to changes in the condition of the elderly
An elderly patient with extreme hypoxia, breathing on his own has been difficult to maintain the amount of oxygen in the body, Shan Liang immediately put on a mask and gloves, and the presence of health care workers together, the laryngeal tube into the patient's trachea, and then fixed the position of the laryngeal tube.
In the space of a few dozen seconds, the patient's face reddened due to oxygen deprivation, his chest rose high, and a violent wheezing sound came from his throat. The moment the tube was connected to the ventilator, the patient lay on his back in the hospital bed, his face finally regained its calm.
"Invasive endotracheal intubation is to extinguish his voluntary breathing, completely through the device ventilation oxygen, new crown combined patients sent to the most important symptom is respiratory difficulties, many lungs have turned white, come up we have to give enough oxygen in his body." Shan Liang told reporters.
The patient, Mr. Hou, is 80 years old and has serious diabetes himself. "As a result of diabetes, his blood sugar has risen extraordinarily high leading to acidosis and ketone bodies in his urine, and we are currently focusing on correcting his ketosis."
Single Liang explained that the patient was given CRT to correct his ketosis as he had a high fever of 39 degrees Celsius. After an overnight infusion, his temperature had dropped to just over 36 degrees Celsius.
"There are some diabetic patients, the first manifestation is not necessarily a prominent manifestation of pneumonia, but also may be the manifestation of comorbidities, such as impaired consciousness, severe electrolyte disorders, metabolic acidosis and other manifestations. There is also a part of the patient because of infection-induced heart failure aggravation, induced a serious myocardial ischemic event, or even myocardial infarction." Shan Liang said.
The patient, Mr. Lin, 78 years old, had inflammation in his lungs due to a previous heart bypass. After the infection of the new coronary to, due to severe hypoxia, lung function is even worse, after which Mr. Lin's symptoms became more and more serious, and eventually into the ICU.
"Push 5 mg midazolam again," "airway pressure is too high," standing in front of the hospital bed, Shanliang as a "the sea god needle".
The patient's family at the door of the ICU, anxiously asking about the old man's condition
In his case, such emergencies often occur, oxygen saturation drop, respiratory failure, cardiac arrest tracheal intubation, connecting the ventilator, cardiopulmonary resuscitation, and every kind of crisis has the means to deal with.
In just a few minutes, a person can go from life to death, or be pulled back from the brink of death by battle-hardened ICU medical staff.
"Ward more than 80 years old accounted for more than one-third of the elderly, for the elderly all signs may change at any time, must be careful and careful." Shan Liang said.
Patients from uncooperative to cooperative
"Prone position" ventilation can effectively improve blood oxygen
In order to meet the patients with serious illnesses, Qingdao University Hospital prepared a lot of intensive care beds, when a patient is transferred out of the immediate after a new intensive care patients are admitted, the various intensive care wards are always maintained at full capacity. The hospital has been operating at full capacity.
"Now look at the ICU, the patients are still relatively calm and orderly, are relying on each medical staff to hold out." In the meantime, Shan Liang is working with his colleagues to perform "prone position ventilation" for an 84-year-old patient.
The head of the bed was slightly raised, and the patient was lying prone on the bed with a U-shaped pillow in front of his chest. "Let's try to lie down for a while, prone ventilation is very important, it can promote airway secretion drainage, improve the patient's oxygenation, reduce the mediastinum and the heart on the lungs of the compression." Shan Liang said.
There are times when patients are uncooperative due to physical difficulties. Some patients feel that it is hard for them to sit and gasp for air, and lying on their backs will be even more difficult. This time Gao Sailong, head nurse, will patiently persuade the old man to sit on the edge of the bed, lying on the bedside of the bed padded bedding. After a few hours, his oxygen saturation went from 88 percent to 97 percent and his breathing improved significantly.
Medical staff in the old man in the "prone position ventilation", the old man's blood oxygen has been significantly improved
Gao Sailong introduction, prone position ventilation is also known as "lying" treatment, the use of turnover beds, turn over the device or artificial bare hands for Turning over, so that the patient in the prone position under the state of respiratory or mechanical ventilation, can effectively improve the patient's blood oxygen saturation, but also can effectively improve the ratio of pulmonary ventilation / blood flow, so that the dorsal side of the atrophic alveolar reopening, the lungs and tracheal secretions in the role of gravity can be good drainage, and can reduce the heart and the mediastinum of the sagging lungs area of the compression.
"Yang had a lot of people with respiratory difficulties after the new crown lying on the popularity of the new crown, some patients are able to improve blood oxygen through this position, improve blood oxygen saturation." Gao Sai Long said.
After the arrival of the new crown, Qingdao University Hospital is also stepping up training to ensure that more health care workers have the ability to treat critical illnesses. According to the requirements of the higher level documents, Qingdao University Hospital will carry out the new coronavirus infection diagnosis and treatment program training. The training content for the new coronavirus infection diagnosis and treatment program, new coronavirus infection diagnosis and treatment program interpretation.
"Critically ill patients are not waiting for people, we can only try to overcome the difficulties, and then hold out a little more, although the guard is tough, but every saved a patient, health care workers, despite the fatigue, but also gratified, which is both the responsibility of the medical profession, but also the mission of the medical profession." Shan Liang told reporters.
●According to the peninsula all media reporter Qi Juan Mao Zi Quan