At the same time, the clinic and ward of respiratory medicine department of Zitong County People's Hospital is a different scene.
65438+1October 5-6, the paper interviewed the township and county medical institutions in Zitong County, and found that after the peak of infection, life began to recover, but the treatment pressure was concentrated in the county people's hospital, and the medical staff were still trying their best to deal with it.
After the mode of "one bed in the whole hospital" was started, the hospital strengthened the professional training for front-line support personnel. The pictures in this article are all paper media reporter Xu Huitu.
On October 5th, 65438/KLOC-0, the paper met with Yang Lin, director of the Department of Respiratory Medicine of Zitong County People's Hospital. She is attending the training of medical staff. When introducing the use of the ventilator and special precautions, she stopped from time to time, panting and coughing. She was infected before, and was once treated with an oxygen mask because the department was short of staff.
In order to alleviate the shortage of staff and beds, Zitong County People's Hospital started the management mode of "one bed in the whole hospital": at the peak of COVID-19 epidemic, all the spare beds in all departments in the whole hospital can be used to treat "positive" infected people. At present, the hospital is strengthening the training of medical staff, focusing on cultivating the ability of treatment and first aid for ordinary and critically ill patients.
Under the hierarchical treatment system, Zitong County Hospital undertook the heaviest treatment task pressure in the county during the first wave of COVID-19 infection peak, while township hospitals and village clinics undertook the reception and treatment of patients in the region and the transfer and diversion of critically ill patients to the next level hospital according to their respective positioning, and successfully passed the first wave of infection peak.
In the first half of this month, this article interviewed Baoshi Township Health Center and Baoqing Village Clinic in Zitong County. The patients infected with COVID-19 were only sporadic. Township hospitals and village clinic hospitals are mobilizing equipment or preparing medicines, and doctors who have been "positive" or overworked are also recovering and adjusting. "I don't know if there will be a rebound during the Spring Festival, and all parties should be prepared," said a grassroots doctor.
The village doctors in the celebration village "treat the symptoms" according to the instructions.
On the afternoon of October 6th, 65438/KLOC-0, a medical doctor from Baoshi Village in Zitong County once again came to the villager Yang's house to take her blood pressure.
Fan told this newspaper that the resident population of Celebration Village is 1.460, including 334 elderly people, including 27 people with hypertension 1.27 and more than 40 people with diabetes.
As a village doctor, one of Fan's main tasks is to take blood pressure for the elderly in the village. Whose blood pressure is high or low, remind them to see a doctor and take medicine in time. This is an important service he can provide for the villagers with simple medical equipment. In the past two or three years, he has another important task, which is to do nucleic acid testing for villagers.
Fan participated in 36 nucleic acid tests last year, including the first two years, and never detected a "positive". COVID-19 seems far away to them. Until a month ago, all of a sudden, many people around said they were "Yang".
On February 7, 2022,65438, the "Ten Articles of New China" for epidemic prevention began to be released, which Fan and many grassroots medical workers called "liberalization".
After "letting go", Fan couldn't tell how many people were infected with COVID-19 and how many people just caught a cold. According to the guidance of experts and scholars and superior medical institutions on general symptoms, "symptomatic treatment".
In the past 10 years as a rural doctor, Fan spent most of his time dealing with diseases such as "headache and brain fever". For the villagers who came to consult, he judged according to the condition. If the symptoms are complicated, patients should go to township hospitals or county hospitals for treatment. If the symptoms are not serious, give the medicine directly.
Because of the limited conditions in the village, Fan directly recommended the hospital for adults and children with complex infections. Especially for children, he asked parents to take them directly to the county hospital. Because children can't express themselves, they should go to a professional hospital with good conditions. Every village in Zitong county has a cement road, which is 20 kilometers from Qingcun to the county people's hospital, about half an hour's drive.
Township hospitals at the peak: 12 medical staff, only 1 person was not infected.
The celebration village in Baoshi Township is located in a ravine, and a road built along the ravine connects the residents of the village, which is more than 10 miles from the head to the end of the village. Most of the villagers are independent houses, and the distance between households ranges from tens of meters to hundreds of meters. In this environment, it is not difficult for residents to avoid mutual infection.
On October 6th, 65438/KLOC-0, villager Yang said that many neighbors were "positive" at that time, but her family was an exception and no one was infected. Her family opened a grocery store on the roadside, which gave her more opportunities to contact outsiders. She believes that the lack of "Yang" may be related to her careful protection. She wears a mask when she goes out and always keeps a proper distance from outsiders. Washing clothes is sterilized.
Last month, two young drivers stopped by the roadside to buy things, rolled down the window and told her that all the people who came back from Chongqing were "Yang". She hurriedly told the other party not to get off the bus. She got things ready, put them in one place with the QR code of the receipt, and then walked away. The young man went to get things and pay.
Although most of her neighbors are infected, she hasn't heard of anyone who is particularly serious. She said that last month, an 86-year-old five-guarantee household in the village passed away, but he already suffered from hypertension, diabetes, bronchitis and other diseases. I'm not sure whether the old man's death is related to COVID-19. Every winter, heart and lung diseases always take the lives of some old people.
Except for the old man Yang, I never heard any other bad news. Neighbors usually rest for a few days after being infected, and they didn't go to the township health center, although it was only two or three kilometers.
On the afternoon of October 6th, 65438/KLOC-0, when this newspaper came to Baoshi Township Health Center, only 73-year-old Cao was infusion, accompanied by his wife. The only ambulance in the hospital is parked in the yard, and there is no task.
Cao said that she developed infection symptoms around February 30th of 10. These days, she has a bad cough and a little pain in her chest. So, his wife took her to the hospital on a motorcycle. On June 5, 65438, she started infusion and went home every day after infusion, without hospitalization.
There is antibiotic penicillin in Cao's infusion, which is usually the main means for grassroots doctors to deal with pneumonia and other diseases. Antibiotics are usually used to treat bacterial infections, but not viral infections.
When Cao gave an infusion, her husband was sitting by the bed with a mask in his pocket. He is confident that he is healthy and will not be infected. Even if he is infected, he feels that he can carry it like other villagers.
65438+1October 6, the medical staff of Baoshi Township Health Center introduced that during the peak period of infection, the health center gave 20 or 30 people infusion every day. Doctors in another nearby town health center said that the peak period of infection was from 65438+February to 20, 2022, and only 1 of their 12 medical staff were not infected. He thought that the infection rate in the whole town had exceeded 80%, but the medical run did not appear at their level.
At present, the shortage of medicine supply has eased. A doctor in a township health center said that if you place an order for 50 boxes of medicine, you may only send 20 boxes, at least the medicine will not be broken. When the dosage should be prescribed for three days or a week, the doctor can only prescribe the first aid medicine for two days, and then ask the patient to come back two days later.
Zitong county hospital: it undertakes the main treatment pressure of counties and towns.
Under normal circumstances, it is only half an hour's drive from Baoshi Township Health Center to Zitong County People's Hospital. The main tasks of local township hospitals are pre-hospital first aid, routine disease diagnosis and treatment and public health and epidemic prevention. Complex cases will be transferred to county-level medical institutions or directly to Mianyang Central Hospital, the best hospital in Mianyang.
The fever clinic of Zitong County People's Hospital after the peak of the epidemic.
A doctor from a township health center in Zitong County told the newspaper that most township health centers do not have the conditions to do CT scanning and use ventilators, but the referral channels from township health centers to county hospitals and then to municipal hospitals are smooth.
At the peak of infection, Zitong County People's Hospital bears the main treatment pressure from counties and towns.
On October 5th, 65438/KLOC-0, when this newspaper saw Yang Lin, director of respiratory medicine department of Zitong County People's Hospital, she was attending ventilator training for medical staff in a conference room of the hospital.
Yang Lin paused, wheezed and coughed from time to time when introducing the use of ventilator and special precautions. The staff of the hospital explained that there were too many patients in the respiratory department during the peak period of infection. Yang Lin is a second-wave infected inpatient with pneumonia symptoms. Last week, he had been infusion, and he was wearing oxygen when he was admitted to the hospital. He hasn't fully recovered.
The staff of the hospital said that when the department was busiest, some patients found that the doctor was hanging oxygen as soon as they entered the door, and they felt more serious than themselves. They persuaded "You are like this, go back to rest." In fact, the hospital also requires infected medical staff to rest normally.
Yang Lin said that at that time, doctors and nurses in the department were infected one after another, but the number of patients was increasing. There are only five doctors in the whole department, and one person has to support several people. Therefore, at first, the uninfected ones will be pushed up, and the infected ones will go home to rest. After all of them are "yang", push them up if the symptoms are mild, then push them up if they recover quickly and have fewer symptoms, and rest if the symptoms are severe.
Some doctors and nurses "fall down" when they are busy. Yang Lin said that after two female doctors in the department were "Yang", they still worked night shifts for three consecutive days, and fatigue and infection once made them collapse. As the head of the department, she can only take the lead and insist on oxygen.
Yang Lin said that she applied to the hospital to support a doctor. Although the leader disagreed, she finally supported a doctor.
In order to alleviate the shortage of human resources during the peak period of infection, Zitong County People's Hospital re-deployed the staff, and all the personnel with medical qualifications returned to the front-line departments and specialties, completely breaking the barriers between departments, and any department should treat patients as long as there are extra beds.
Now, the hospital strengthens the training of medical staff, focusing on cultivating the treatment and first aid ability of ordinary and critically ill patients.
"One bed in the whole hospital" mode: mobilizing beds and medical strength in the whole hospital
"Although the beds are tight, I still have the ability to be admitted." Liu Dan, director of the administrative office of Zitong County People's Hospital, said that at the peak of this wave of infection, more and more infected people need hospitalization. As the largest and most authoritative public hospital in the county, according to the requirements of the local party Committee and government, it is necessary to maintain the capacity of admission.
In order to mobilize medical resources, the hospital started the management mode of "one bed in the whole hospital". Now all departments treat infected patients, and the whole hospital of respiratory medicine makes rounds, consultations and formulates treatment plans, but severe patients still need to be transferred back to respiratory medicine for "specialist treatment". This means that through the temporary reform measures, all departments of the hospital, regardless of specialty, have participated in the treatment of infection in COVID-19.
Zitong county people's hospital emergency room.
This has alleviated the problem of medical staff's tension to some extent. Liu Dan told the newspaper that there are 700 people in the hospital now, which is the historical record of the hospital. Before the peak of infection, the number of hospitalized people was only over 500 at the most.
Liu Dan said that at the beginning of last month, the hospital had a certain anticipation of the upcoming infection peak, ordered 165 beds in advance, coordinated more than 100 oxygen cylinders, and the security department repaired some of them and several idle ventilators. Now there are 28 ventilators in the hospital, and three ventilators urgently coordinated by Mianyang Health and Health Commission will be in place on the evening of 6th. Now there are twenty or thirty critically ill patients in the hospital, and the ventilator is insufficient.
However, the purchase of new equipment and antiviral drugs remains a thorny issue. Liu Dan said that the hospital ordered the 15 ventilator from April 38 to early February last year, and it has not arrived yet. There is also a shortage of antiviral drugs for COVID-19. Recently, two boxes of nimativir/ritonavir combination drugs and 20 bottles of afudin tablets arrived, which can only be used to treat critically ill patients first.
On the one hand, hospitals focus on treatment. On the other hand, as the peak of infection passed, the number of fever clinics decreased significantly.
After the peak, Zitong County People's Hospital information desk.
On October 5th, 65438/KLOC-0, the newspaper saw at the gate of Zitong County People's Hospital that people came in and out of the hospital by twos and threes, and there were almost no people in the square. An ambulance left the door without sounding the alarm. There is only one doctor on duty in the fever clinic, and no patient sees a doctor.
But recently, some patients have symptoms such as cough and chest pain after yang, and more people go to the hospital for emergency CT.
A doctor from Zitong County People's Hospital told the newspaper that there were many fever clinics during the peak period of infection. Now in the recovery stage, there are many people who suspect "sequela", so they went to the emergency department for ct scanning, but only a small part of them were really diagnosed with lung infection or pneumonia. After discovering these patients, they will be admitted to the "specialist treatment" of respiratory medicine.
At present, whether a large number of people will bring a new wave of infection during the Spring Festival is another issue that medical staff pay close attention to.