From December 7, the implementation of comprehensive and precise prevention and control of the "new ten", the cunning new crown virus in the experience of a short period of groping, testing, already has the foundation of the epidemic in Haizhu, Guangzhou, finally in about a week to appear in a larger range of the social surface of the spread. People began to experience various symptoms such as high fever, generalized body aches and pains, chills, and then violent coughing and the appearance of blood in sputum. Despite three years of arm wrestling with the new coronavirus, the vast majority of people in the early stages of infection were still frightened and at a loss for words, and had to turn to hospitals and doctors for help.
The coldest time of the year in Yangcheng, the city's emergency system, represented by the emergency department of the First Affiliated Hospital of Jilin University, was the busiest, tightest, and most difficult time for emergency rescue.
From mid-December, the public generally feedback 120 phone is difficult to call, 120 out of the car to go through a long waiting list. The whole emergency system in Guangzhou is in a busy time with more than 3 times of the standard capacity," he said. "Engaged in emergency work for so many years, really is the first time to feel the Guangzhou has so many super-elderly elderly, this wave of epidemic so that some of the elderly people appear viral-like pneumonia affecting symptoms." Liu Hui, deputy director of the emergency department of the First Affiliated Hospital of Jilin University, told Nandu reporters. And engaged in emergency work for 26 years, the head nurse of the ward Zhu Liyun is bluntly said, December 2022, is the darkest moment of his years in emergency medicine.
And now, the city's surveillance system found that the tide of new coronavirus infections began to lay down and quietly fall back when it first broke through the mountains and walls, imposing, and leveling all obstacles. Two kilometers away from the JIU Hospital, Tianhe City, Zhengjia shopping district began to bustle with people. The emergency medical personnel still dare not relax, a moment to reload and continue to fight.
"Experts predict the tail end of the epidemic will continue until after the Spring Festival, and the dominant strains from outside the country after the full liberalization of the epidemic are still watching, so it's far from time to slacken off."
December 15
The emergency department was flooded with elderly patients all at once
Younger people infected with omikujon generally have mild symptoms, but the strain is remarkably unkind to the elderly, especially the super-elderly.
What struck Hui Liu was that on Dec. 15, a cold winter rain was falling in the sky. The emergency department at once crowded into dozens of gray-haired elderly. "Usually in their 90s, accompanied by family members either in wheelchairs or lying on traveling beds, sighing and struggling to breathe, each breath seemingly difficult and unusual."
Omicron's attack on the younger group is mainly focused on the upper respiratory tract, not yet enough to affect the breathing, oxygen and that humans depend on. But the older age group is different; a check of blood oxygen saturation is basically in the 70s or 80s, far from the safe threshold of 93 or more.
And then a chest scan through the emergency room's own CT, either a typical viral-like pneumonia or simply a large white lung. Therapeutic medications definitely need to be administered in a timely manner, but the most, most critical oxygen therapy needs to be administered even more promptly.
The emergency department of the First Affiliated Hospital of Jilin University has 17 beds for observation, and the rapid flow can ensure that more than 30 people are hospitalized for emergency treatment. But this is set up in accordance with the routine process, and the new wave of coronavirus infection brought about by the impact of emergency care, is clearly ultra-regular. Every elderly person needs oxygen, occupying a set of oxygen therapy equipment, and close to a hundred of the 300 or so emergency visits a day.
The observation area, designed for 17 beds, was so crowded with flat beds and wheelchairs that it was hard to find a place to stand. At its peak, the observation area was filled with about 60 elderly people. The kindly old people who could still move consciously pressed their positions inward. They know that if they can make room for one more person, they will have more hope of saving a life.
Fixed oxygen supply tubes were given to the 17 beds on the elderly, so mobile oxygen cylinders, pillow oxygen bags have become a life-saving "life-sustaining equipment". "These elderly and their families also let our medical staff is very touched and heartbreaking, they quietly sucked oxygen, infusion. When the observation bed or flat bed has a serious illness of the elderly unfortunately passed away, waiting for the bed of the elderly will silently wait for the medical staff to quickly deal with, and then without fear of lying in that bed, calmly accept the doctors and nurses to provide treatment. All are the oldest old people who have seen nearly a hundred years of wind and rain, and have a more transcendent understanding of life and death since."
The emergency ward was silent and solemn at the time, with hundreds of people crammed into the narrow space, most of whom were still suffering from the discomfort of oxygen deprivation, but the ward rarely even heard the sound of ouch or other long and short sighs.
Saving lives in a crowded space
The whole hospital began to dredge up the emergency
The tide of infections in the city of Yangcheng continued to climb, and the number of 120 calls has long exceeded the 10,000 mark. The Emergency Department of the First Affiliated Hospital of Jilin University can only "snail shells in the dojo", only own 17 observation beds, crowded with flat beds can also be retained 50 to 60 people in the observation area is obviously unbearable. Every day there are two to three hundred people pouring into the emergency room, the most day crowded into the nearly 340 people, every day to be in the emergency room resuscitation of as many as 50 to 60 people.
The manpower problem was the first to hit, and the emergency department's own surgical and pediatric teams were the first to be mobilized. Pregnant nurse Liu Qiyao also rushed to the forefront of the rescue with an oxygen pack. The old director Jiang Yabin also rushed to the forefront to participate in emergency rescue, consultation, and even personally involved in rescue operations.
The entire department of more than 100 medical care, in addition to a maternity leave doctor, all swooped in the front line, infected after the sun, no symptoms insisted on drying, the symptoms are obvious, survive the acute phase of fever continue to do. "This kind of infectious attrition of medical staff is the most helpless, just started, it is one or two, then four, six. The hyper-transmissibility of the Omicron strain is even more open and unchecked in a crowded emergency department."
Hospital emergency department in a **** have Liu Hui, Zhang Rong, Zhou Youfen, Zhou Yijuan four female doctors, all Yang over; young nurse Wu Shangxi, has been in the emergency line, a day without rest, colleagues thought he did not have Yang, can enter the "final round". The fact is that this young man has long been Yang over, fever, dizziness and other symptoms are not less. December 28, the department's busiest time, the old nurse Chen Yide in the night shift before finding the head nurse Zhu Liyun, reported that he began to fever, antigen positive. "I thought he was going to take a leave of absence, but he said he had just taken fever-reducing medication, he could walk and move, I'm a boy, I can carry through, I can hold on to this night shift."
The emergency department doctors and nurses use flesh to build a rescue barrier, still being subjected to emergency tide of one wave after another beat. Liu Hui told Nandu reporter, "particularly impressive is the day of December 26, the morning a **** completed 21 cases of emergency rescue, 18 people were transported, after the whole hospital triage. By noon, there was an immediate influx of more than 20 senior citizens, all needing oxygen or even ventilator support."
When space, beds, and ventilators were tight, one senior citizen also had a sudden cardiac death. There is really no space, stay in the observation area patients spontaneously and each closer together, to make a space of less than two square meters, Dr. Zhou Youfen is kneeling, lying on the ground for the elderly heart compression and a variety of drug infusion treatment.
Can't avoid the topic of death
The old director took up the work of the death report
The new Coronavirus infection mainly attacked the respiratory system, can be called the system is involved in the blood oxygen saturation plummeted, the oxygen-carrying blood perfusion to the body's ability to various organs is greatly reduced. So where the organ blood supply oxygen supply is not enough, which organ will begin to appear failure, life-threatening.
When tens of thousands of patients with emergency needs flooded into the emergency room every day through the 120, self-driving car, the denominator of the near-infinity, the lower the probability of death have evolved into a cold death data and remains.
In the emergency department of the First Affiliated Hospital of Jilin University is also the same, when the medical staff exhausted all kinds of power to save lives but to no avail. It's too late to wipe the sweat off their foreheads, not to mention helplessness, strangling, removing the medical gloves from both hands and pressing them down heavily on the decontamination bottles to vent the indignation in their chests. A new pair of gloves and rushed to the next critical care.
It is said that there is no winter that can't be overcome, but the lives of these elderly people who died because of severe respiratory distress, because of systemic organ failure, drew a stop sign in this winter.
Jiang Yabin, the old director of the emergency department, and Liu Hui, deputy director of the emergency room is so busy, every serious illness will be personally involved in the scene to direct the rescue. When modern medical technology is not enough, the practice of medicine for many years, accustomed to life and death of Jiang Yabin and took over the complicated but can not have the slightest error or omission of the work of the funeral system, so that front-line doctors and nurses can fully save the patient. "Each declaration through the system, even the most skillful skilled hands need to spend more than an hour." The old director knew the information, condition, and cause of death of every deceased person very well, and he was present to participate in every resuscitation process. He could only input the last text information of each deceased person silently with an iron face, complete the report and send it.
No spring will go by without it
The tide of emergencies is coming back down, and the light is already on the horizon
The crowding of patients in an emergency department with limited staff, resuscitation equipment, resources, and space is certainly not conducive to saving lives. The entire hospital must be mobilized for diversion and triage.
Hospital President Xu Aning, party secretary closed Sicheng in the emergency tide of the first time the hospital began to carry out the total coordination, Zheng Xiaofei, vice president of the emergency every day to the scene of the office, the establishment of critical care patients coordinated admission group. All the clinical departments have started to support the emergency department to ensure that the emergency department should receive as much as possible, to ensure that every patient can get better treatment. Expansion of the emergency department also rapidly advanced up, remodeling the site, expanding the existing site and mobile boarding house, increased the number of consulting rooms and beds, and make every effort to increase the allocation of respiratory machines, suction machines, infusion pumps, monitors.
The effect of the help from other clinical departments on the emergency tide is also immediate, the ICU of the hospital center, with the support of Director Yin Haiyan, has opened up a direct channel from the emergency department to the ICU. whenever there is a bed vacant in the ICU, the most critical patients in the emergency detention area will be transferred to the ICU which has a more advanced life-supporting unit to continue the treatment.
With the addition of cross-disciplinary admissions from other sister specialties, the pressure on the emergency department is easing step by step.
The average age of the elderly in the holding area is declining, with most now in their 60s and 70s. The 300-plus daily emergency room visits are coming down, the dispatch orders from the 120 emergency command system are flowing smoothly, and Director Jiang Yabin rarely sits in front of the death-reporting system with a grimace on his face to report the cold data.
The wave of emergencies is slowly receding.
On Jan. 1, 2023, the Guangzhou Municipal Health Commission announced that the city's current outbreak of new crown infections had peaked. The neighboring Tianhe Gangding and Tianhe City shopping districts began to be crowded with cars and people again.
Spring 2023 is near!
Writing: Nandu reporter Wang Daobin correspondent Liu Lifang Zhang Cancheng
Video, photography: Nandu reporter Zhao Ming