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Full help Bailey Azalea Management District People's Hospital (hereinafter referred to as "Bailey Azalea People's Hospital") to establish five specialties + an emergency center and an intensive care unit (hereinafter referred to as "5 + 2" task) is the Zengcheng District, the city's largest city. " task) is one of the key tasks of the healthcare system in Zengcheng District. Bailey Azalea People's Hospital is a second-class general hospital, with emergency department, internal medicine, surgery, intensive care, general surgery, orthopedics, obstetrics and gynecology, traditional Chinese medicine, pediatrics and other clinical departments. At present, the hospital mainly exists in the backbone of the business talent, lack of medical equipment and diagnostic and treatment technology is relatively backward and so on.
In August this year, the Zengcheng District health system sent the ninth batch of **** 6 medical personnel, in a "group" way, to the Bailey Azalea People's Hospital to carry out a period of 1-6 months of help, to complete the "5 + 2 The task of "5+2". As of November 22, except for Zeng Jianqiu of Zengcheng District Chinese Medicine Hospital, who is still helping in the local area, the remaining 5 people have returned to Zengcheng. The following are the bits and pieces they experienced during their help at the Paradise People's Hospital.
Establishment of obstetrics and pediatrics cooperation system to carry out the first case of labor analgesia surgery
District Maternal and Child Health Hospital Liu Chunlan to help Bailey Azalea People's Hospital Obstetrics and Gynecology
"In the stage of the life of this stage of life, to be a member of the '5 + 2' medical support group, can be for the Hundred Miles Azalea People's Hospital's healthcare work to do a little something, feel very proud, very gratified. One day Baili people, lifetime Azalea love."
The first day of the obstetrics department of the Bailey Dujuan People's Hospital, before the official shift, Liu Chunlan immediately "on" the operating room, a fetal intrauterine hypoxia emergency pregnant women for rescue.
It turned out that the patient for a 41 + weeks gestation primigravida, the night before repeated fetal monitoring score is not good, fetal monitoring baseline from the night of 140 / min, fell to the next morning 100-108 / min. Liu Chunlan and the department after discussion, decided to immediately emergency surgery, the operation found that the umbilical cord around the neck for two weeks, amniotic fluid is too little, the fetus was born with mild asphyxia, the A score of one minute 4, then immediately contacted the pediatric director Qiao Zhongxiang, who is helping together. After cleaning the airway, oxygen, fetal score of 8 points in 5 minutes, 10 minutes rating 10 points, the newborn turned to safety. From this case, Liu Chunlan and other helping experts to establish a system of cooperation in obstetrics and pediatrics, to better protect the safety of newborns.
The third day of the help, Liu Chunlan, Qiao Zhongxiang and help experts Yao Bo Liang **** with the cooperation, to carry out the first case of labor analgesia in the Bailey Duzhuan People's Hospital, successfully for a first-time mothers to carry out a smooth operation, the successful output of a 4.2 kg of healthy babies. What makes Liu Chunlan more gratified is that the doctor who delivered the baby that day was formally from the Zengcheng District Maternal and Child Health Hospital for further training back to the doctor, and the doctor in charge of anesthesia, but also from the District People's Hospital for further training back to the doctor. "The significance of blood creation is far greater than a simple blood transfusion." Liu Chunlan said.
Two months of helping time, Liu Chunlan has carried out a number of standardized teaching room and business training, from the station to the content of the training bit by bit. At the same time she also hand in hand in the operation to teach, and update the diagnosis and treatment routine of common obstetrics and gynecology and first aid process, to carry out the whole hospital . Postpartum hemorrhage drills to better protect the safety of mothers and babies.
Formation of emergency center to enhance the hospital's emergency capacity
Licheng Street Community Health Service Center Chen Yubin to help the Bailey Dujuan People's Hospital Emergency Center
"The gap between the East and the West is large, this gap is not a day can be leveled off, to all **** with the efforts of the whole population, a batch of help workers continue to pay in order to achieve. " --Chen Yubin
"Poor" is Chen Yubin's biggest feeling about the local healthcare in Bailey Dujuan. "Poor" is the local medical resources are quite barren, the entire management area of the Bailey Dujuan only a public secondary health care institutions, hospitals are renting a hotel business room remodeling, other supporting rooms are temporary. The "white" is the talent and technical force and the necessary medical equipment blank.
According to the "5+2" help content, Chen Yubin is responsible for the emergency center construction. At that time, the hospital did not set up the emergency department, no equipment, more talent, emergency center construction basically from scratch.
How to squeeze out a suitable site to build a first aid center in the tight business room, this is the first problem encountered by Chen Yubin. In the process of promoting the construction of the site, Chen Yubin found that the facilities of the renovation are delayed. An inquiry, it turned out to be a very tight hospital finances, there is no extra money for renovation. At this point, Chen Yubin self-financing, leading the newly formed section of the personnel from the whitewash, office equipment, living equipment, ward facilities, wall system, signs and other aspects of the construction of the initial construction of a simple version of the emergency center.
The hospital drew 16 elite medical personnel to form the Emergency Department, but only one director of the licensed physician's license, others have two licensed physician's license, the rest of the personnel are trainee doctors. As a result of the hospital treatment is not timely, personnel mobility is large, talent and technical reserves difficult.
In order to change this situation, Chen Yubin believes that poverty alleviation must first help the will. The first lesson of his training is life planning, so that we all realize that rather than just muddle through, it is better to learn the skills. In the hospital's strong support, "5 + 2" team members at least two times a month to carry out more than the hospital training, every day after the department shift are carried out a small class training and practice, the whole department staff gradually mastered the emergency rescue techniques. Previously, 120 out of the car is basically a porter, slowly can be general pre-hospital emergency, have the courage to take the patient back to the hospital to deal with, save a lot of lives.
Emergency Department set up only an old defibrillator, cardiac monitoring, electrocardiography and gastric lavage machine and other rescue equipment, the hospital does not have the funds to purchase equipment. In order to solve this problem, the temporary party branch to help many times with the Zengcheng District Health Bureau leadership report, in the District Health Bureau leadership and Zengcheng District related hospitals, donated more than 3 million worth of medical equipment and more than 13 million funds, basically solved the problem of equipment.
All efforts to enhance the level of departmental diagnosis and treatment
District Maternal and Child Health Hospital Qiao Zhongxiang to help the pediatrics department of the Bailey Azalea People's Hospital
"It is recommended to choose some younger intermediate titles above the rotation, continued to help for a period of time, to enhance the business level of the medical workers in the area of support, thereby enhancing the comprehensive strength of hospitals and consolidating the effect of support. " --Qiao Zhongxiang
The department staffing is incomplete, the medical staff specialty is not clear, the entire medical team does not have a high, middle and low seniority ratio, the team is too young, the overall education is not high, the configuration of the medical equipment is incomplete, the test and inspection supporting incomplete ... ...After a detailed understanding of the situation of the Bailey Dujuan People's Hospital, Qiao Zhongxiang felt that the hospital's overall medical level has a lot of room for improvement.
Specifically to help the pediatrics, he is even more difficult. The hospital did not set up a pediatric specialty, only internal pediatrics (adult internal medicine and pediatrics), and emergency department, infectious diseases, ICU, 120, pre-screening and triage departments in the same department. During the help period, Qiao Zhongxiang applied for adjusting the internal pediatrics and traditional Chinese medicine on the same floor according to the actual situation, and **** using the same nursing team.
Technical support, Qiao Zhongxiang is responsible for daily morning teaching room, four major weekly room, four small lectures in the department every week. At the same time in two phases of training in neonatal advanced life support, the training object including obstetricians and gynecologists, nurses, anesthesiologists, pediatricians, etc., hand-to-hand operation teaching, so that everyone hands, everyone passes the test, and print the questionnaire examination, photographic archives.
After completing two months of help, Qiao Zhongxiang obviously feel that the department has a great improvement, departmental management than before there is a significant improvement, such as the refinement of the departmental staff files, departmental structure chart posted on the wall, began to establish the department of two types of disease clinical pathway, etc.; departmental diagnostic and treatment level has been improved, the doctors on the diagnosis and treatment of common and frequent diseases is gradually standardization of the difficult and serious diseases can be initially proposed their own diagnostic and treatment ideas. The first step is to make sure that you have a good idea of what you want to do.
Speaking of the most impressive people or things during the help, Qiao Zhongxiang immediately recalled the first week of help, in cooperation with other departments, the successful completion of a cesarean section of a newborn, a painless delivery of a huge child (weight 4. 2kg) supervision.
Achieve a number of new breakthroughs in anesthesia technology in Paradise
Yao Bo-liang of the District People's Hospital to help the Department of Anesthesiology of the Paradise People's Hospital
"Helping hospitals with relatively backward medical equipment, the level of medical technology and the concept of management, Zengcheng Healthcare System medical assistance team has brought a great challenge. However, the helping team will definitely try to overcome the difficulties and spare no effort in teaching the helping departments." -- Yao Bo Liang
On August 26, the Department of Orthopedics of Paradox People's Hospital received a 40-year-old male patient diagnosed with necrosis of the right femoral head, who was proposed to undergo total hip arthroplasty. At that time, the anesthesia choice of lumbar hard joint anesthesia, the estimated operating time of about 4 hours, must be performed in the internal jugular vein tube to ensure the infusion of fluids and medication, this is the department's first case of internal jugular venous catheterization. The surgery was performed by Wu Zhichang, a member of the medical support group, and Dr. Yao Bo Liang, an anesthesiologist, was responsible for anesthesia guidance. The surgery was completed successfully, and the patient's vital signs were stable.
On August 27, a pregnant woman in the hospital went into labor at full term and learned that the Department of Anesthesiology had analgesia for labor. After an evaluation by the expert director Liu Chunlan, she strongly recommended analgesia for labor and the pregnant woman looked forward to this technology, so she completed the first analgesia for labor and delivery of a 4.2 kilogram baby girl. The hospital does not have a special pulse electronic pump for labor analgesia, Yao Bo Liang can only use the ward's ordinary infusion pump continuous epidural medication, he needs to have been in the delivery room to observe, adjust the speed of drug delivery, the process is quite difficult.
On September 17, there was a male patient with acute appendicitis in the hospital who was to undergo laparoscopic appendectomy. Considering the short time of the operation, Yao Bo Liang and the local anesthesiologist for the patient laryngeal mask general anesthesia, which is the first case of laryngeal mask general anesthesia in the people's hospital of the Bailey Dujuan Management Area. Laryngeal mask general anesthesia without laryngoscope, easy to use, to avoid tracheal mucosa damage; compared with intubation general anesthesia, laryngeal mask general anesthesia induction and awakening process hemodynamics is more stable. One and a half hours after the successful completion of the operation, the patient quickly awake, quiet.
For Yao Bo Liang, the above procedures are a very common technique in the anesthesiology department of the District People's Hospital where he works, but it is a zero breakthrough for the Bailey Dujuan People's Hospital. In addition, he also helped the surgical anesthesiology department to improve the rules and regulations, every Tuesday and Thursday for business study, professional skills training, etc., to improve work efficiency.
Implementation of the first ERAS rapid rehabilitation total hip arthroplasty
District Xintang Hospital Wu Zhichang to help the orthopedic department of the Bailey Azalea People's Hospital
"The cause of helping is still on the road, there are still a lot of things that we need to continue to work hard to do, so that the local health care environment from the transfusion of blood to blood, from the granting of fish to the granting of fish. If there is a need, I am always ready to join the country's poverty alleviation cause again." -- Wu Zhichang
On August 24, shortly after arriving at the People's Hospital of Bailey Dujuan Management Area, Wu Zhichang received a middle-aged male patient who came to the hospital for treatment of double hip pain. After Wu Zhichang check, diagnosed as a result of long-term drinking alcohol caused by bilateral necrosis of the head of the femur, need to carry out total hip replacement.
The patient was worried and said to Wu Zhichang, "I'm afraid to do the surgery, and to do this surgery is not to the city's major hospitals to do, I do not have so much money to do the surgery!" Understanding his worries and difficulties, Wu Zhichang patiently explained: "If you don't have the surgery, your condition will worsen day by day, and you may not be able to walk because of the pain one day. Now this surgery is very mature, you can stay here in the hospital I personally do for you, the cost is also much lower, the right side of the femoral head necrosis is more serious, you can first do the right side of the total hip arthroplasty." The patient listened to the words of Wu Zhichang was overjoyed, and learned that he is from Guangzhou over the doctor will be at ease to stay in the local surgery.
Two days later, Wu Zhichang and the orthopedic team at Bailey Duzhuan People's Hospital performed the surgery for the patient, the first case of total hip replacement using ERAS orthopedic postoperative rapid rehabilitation management in the hospital. The patient was able to get out of bed in three days after the operation, greatly reducing the occurrence of postoperative complications and accelerating the patient's recovery.
In addition to carrying out new technologies, Wu Zhichang also established the Orthopaedic Union WeChat group of Zengcheng and Bailey Dujuan Management District People's Hospital to enhance the understanding and affinity, and use off-duty time to strengthen theoretical knowledge learning and exchange of business issues through WeChat group. In daily work, also make full use of the morning handover time for rules and regulations learning, so that the system not only hangs on the wall, but also let every orthopaedic medical staff engraved in the heart, monitoring the implementation of the in place; grasp the inspection wards, surgery, and other every favorable opportunity for the medical staff for hand-to-hand teaching, teaching medical personnel how to analyze cases, find out the "knots The medical staff were taught how to analyze cases, find out the "crux" and formulate measures; they were also given lectures and training on the newly developed technologies, which were gradually consolidated and promoted. According to incomplete statistics, during the period of help, Wu Zhichang to carry out systems, processes, business training **** about 20 times, teaching room more than 20 times, surgical demonstration 20 times, to enhance the overall service capacity of orthopaedic department of the Bailey Azalea People's Hospital and specialty characteristics of the construction of the foundation has been laid.
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