Author of Guangming Daily: reporter Su Yan, correspondent Du Lina of Zheng Jinming
On February 13, 207 medical staff from Jiangsu People's hospital went to Wuhan for the war epidemic. Hou Yumeng photo
The Wuhan medical team assisted by Jiangsu Provincial People's hospital is undergoing tracheotomy. Li Xue photo
[the forefront of the showdown]
Novel coronavirus pneumonia novel coronavirus pneumonia was successfully transferred to the Wuhan Pulmonary Hospital in March 19th at 14:00, and the last one was treated with the new crown pneumonia ECMO. The Jiangsu Province People's Hospital, which was taken over by the Jiangsu Province People's Hospital, was taken over by the Hubei Wuhan medical team.
"ECMO patients are in the most critical condition. Any negligence in the moving process may be fatal. Fortunately, the" most difficult transfer "is successfully completed. Over the past 35 days, our medical team has admitted 78 patients, 42 of whom have been cured and discharged, 8 of whom have been transferred from heavy to ordinary, and 26 of whom have been transferred from heavy to light. " Liu Yun, the leader of the seventh group of Jiangsu medical aid team and vice president of Jiangsu People's Hospital, told reporters.
"I would like to take this opportunity to thank all members of the medical team of Jiangsu People's hospital! You are our Savior! " The daughter of the patient, who was still in isolation, sent a thank-you message to the team.
Since novel coronavirus pneumonia was seen in Wuhan, Huangshi, from critical wards to shelter hospitals, Jiangsu Province People's Hospital has sent 270 white warriors to the forefront of Hubei's anti epidemic efforts in 7 batches. The number almost occupied 1/10 of the Jiangsu medical team, and the number of medical care specialists in the Department of serious diseases has reached 80% of the total number of the hospital. A serious medical team moved to Hubei.
With the fighting spirit of "fighting day and night, rushing up, and being the main force", the "Provincial People's medical corps" creatively summed up "ten key points of ward round", "three modernizations", "five ones" and other "Jiangsu programs" in practice, contributing an indispensable Jiangsu force in the war "epidemic".
1. "The" seven member medical team "took the lead in exploring and summarizing the" ten key points of ward round "
On February 2, Wuhan is in a hurry! Hubei is in a hurry!
"Seven comrades are seven flags flying high!" After receiving the notice of emergency rescue to Hubei, seven comrades, including Zhou Jing, the first group leader of Wuhan medical team of Jiangsu Provincial People's Hospital, Zhou Jing, the deputy head nurse of the Department of critical medicine, Liu Shaohua, the chief physician of the Department of critical medicine, and 111 Jiangsu team members in the province, started the rescue work of critical patients in Tongji Hospital Affiliated to Huazhong University of science and technology.
On February 4, they entered the ward as the first medical team members, working for 8 to 10 hours. Two days and two nights of fighting, the 32 bed intensive care unit quickly filled up. A 70 year old critically ill patient in the ward was in urgent condition and needed deep vein catheterization, but there was no ultrasound guidance. The medical staff wore multi-layer gloves, thick protective clothing, and goggles were all foggy, so it was very difficult to operate. In a hurry, Zhou said calmly, "let me try." With many years of rescue experience, she fumbled with her fingers to find the puncture site, quickly aimed at the upper part of the patient's clavicle, completed the catheterization, and opened a life channel for the patient. "It's a success!" The rescue greatly inspired the confidence of the team members.
In order to improve novel coronavirus pneumonia, the "seven medical team" has explored and summarized ten key points of "ward rounds" for new crown pneumonia patients in practice. Liu Shaohua summed it up as follows: first, listen to the patient's main complaint; second, test vital signs; third, know the patient's breathing condition; fourth, see whether there is panic; fifth, know the patient's nutrition intake; sixth, check all the test results of the patient, such as blood routine test, liver and kidney function, electrolyte, blood coagulation function, etc.; seventh nuclear disease human nucleic acid test results; eight pairs of patients' CT test results before and after; Ninth, see whether the patient has missed Ten is the double control of doctors inside and outside the cabin to ensure that the patients can be treated safely.
2. "Break the hand of death and pull the patient back hard"
The process of treating novel coronavirus pneumonia critically ill patients is to continue to fight hard battle. The medical team of Jiangsu People's hospital is one of the first teams to carry out comprehensive medical technology in Wuhan, such as endotracheal intubation, tracheotomy, deep vein catheterization, arterial indwelling monitoring, bronchoscopy, lung lavage, etc. In the face of a series of treatment problems, they relied on excellent psychological quality and mature medical technology to "break the hand of death and drag the patient back" in the "storm eye" of the epidemic.
On the sixth day of her first visit to Wuhan, Qiao Li, chief physician of Emergency Medicine Department of Jiangsu People's Hospital, took only one minute to place a deep vein catheter for a severe patient and opened the "life channel" in time; on February 27, she completed tracheotomy for a 70 year old patient in five minutes; on the evening of March 8, she successfully completed tracheotomy for an 83 year old patient Open. On the evening of March 3, another battle of life protection was launched in two wards separated by one wall in the critical ward of the first hospital in Wuhan. A novel coronavirus pneumonia in a novel coronavirus pneumonia in 70 year old male patient was found to be alive in two lung. A 71 year old woman with new crown pneumonia had a sudden decrease in urine volume and a sharp deterioration in renal function. It is necessary to simultaneously carry out extracorporeal membrane oxygenation and continuous renal replacement therapy. At 8:30 that night, Chen Xufeng, a member of the medical team and chief physician of the emergency medicine department of Jiangsu People's Hospital, led the "ECMO sentry group" to tackle the problem and successfully puncture a male patient. At the same time, Xu Xueqiang, deputy chief physician of kidney Department of Jiangsu Provincial People's Hospital, led two nursing backbones to establish a temporary vascular access for blood purification and carry out hemodialysis for a female patient.
In the ICU, such breathtaking moments are on every day. Within 35 days after the reconstruction system took over the ICU of Wuhan first hospital, the medical team of Jiangsu People's hospital carried out extracorporeal membrane oxygenation treatment in 2 people, tracheotomy in 6 people, tracheoscopy in 20 people, tracheal intubation in 14 people, noninvasive ventilation in 6 people, high flow in 26 people, positive pressure ventilation in prone position in 10 people, and continuous renal replacement therapy in 4 people.
3. "15" commandos "gnawed the" hard bone "of critical illness"
"In order to chew down the" hard bone "of critical illness, we set up 15" commandos " Qi Xu, head of the medical team and chief physician of respiratory and critical care medicine department of Jiangsu People's Hospital, said that depending on the diversified disciplines of the team, the team has established a precise treatment mode that includes tracheotomy, continuous renal replacement therapy (CRRT), fiberbronchoscope diagnosis and treatment, etc., to achieve the combination of horizontal and vertical treatment of patients by large forces. "It is convenient for us to deal with all kinds of possible emergencies and win time for personalized treatment of critical patients.
The effect of "1 + 1 & gt; 2" was achieved by establishing "commandos". On February 26, grandma Huang, a patient in Wuhan first hospital, suffered from two diffuse lung diseases, and her life was in an emergency. The endotracheal intubation group and the deep vein intubation group immediately gave the patients endotracheal intubation to connect the ventilator and the deep vein intubation to open the venous access. The soaring heart rate of the patient originally due to dyspnea slowly dropped to the normal level. After intubation, in order to improve the ventilation and oxygenation index of blood flow at the lung bottom of the patient, the sputum suction group used closed sputum suction tube for sputum suction, humidification and atomization treatment as required, and carried out the original "sandwich turn over method" according to the patient's condition, giving prone position ventilation. The rehabilitation training group carried out precise body position drainage to help patients introduce sputum into the main bronchus. Then, the sputum suction group was treated with concussion sputum discharge, and the fiberbronchoscope diagnosis and treatment group was examined and washed when necessary, and finally the sputum was effectively discharged. Through the precise diagnosis and treatment path, the elderly took only 18 days from tracheal intubation to tracheotomy, to the withdrawal of sedatives, and finally to the successful offline.
In the medical team, the strength of the full-time rehabilitation training team led by the nursing team leader Song Jin and the national rehabilitation specialist nurse Ji Jie, with the participation of seven head nurses, should not be underestimated. Jiangsu Province People's Hospital has a novel coronavirus pneumonia team headed by Li Jianan, and Professor Tang Jinhai, a hospital Secretary of the CPC Committee, stressed in many times the video consultation with the front that we must bring into play the discipline advantages of rehabilitation medicine and integrate it into the rehabilitation treatment and nursing of patients with new crown pneumonia.
Novel coronavirus pneumonia is a professional guideline for the rehabilitation of respiratory diseases. Ji Jie said that up to now, the discharged patients have received effective rehabilitation training guidance. "Through the combination of precision treatment and professional rehabilitation, some critical patients have achieved gratifying changes from lying to sitting to standing. It can be said that sitting up is hope and standing up is rebirth. "
4. "2020 is difficult at the beginning, but we are full of warmth and strength"
Qiao Li, chief physician of Emergency Medicine Department of Jiangsu People's Hospital, likes to communicate with patients. Many critical patients can't speak, so she holds the patient's hand and waits for the patient's response. "We have a patient with an endotracheal intubation whose mind is clear. I said to him, 'Lao Chen, hold my hand'. He gave me a strong hand. I have a wish in my heart to do everything possible to save him. " Jori said.
In the novel coronavirus pneumonia treatment process, the medical team members uphold the provincial people's medical "people-oriented" purpose, inject humanistic care everywhere, care for patients.
Zhang Qian, chief physician of geriatric intensive care department, pays special attention to several critical patients every day when she works in the intensive care unit of Wuhan first hospital. One patient had been worried about his wife who lived in the light illness area on the same floor. "Before I went to work, I recorded her wife's video on my mobile phone. As soon as I took over the shift in the evening, I showed it to her, and her heart was stable."
From February 12, the members of the national (Jiangsu) emergency medical rescue team of Jiangsu People's Hospital "moved" with the light patients of Wuhan living room shelter hospital, known as the "favorite square dance" by netizens. They also led the patients to carry out breathing exercise training outdoors, and the psychological consultants LED the group psychological counseling activities. The nutrition specialists recorded the nutrition guidance video Guide healthy diet of patients
On March 2, in addition to receiving the love gifts with chocolate, sachet and health education leaflet prepared by the hospital, the discharged patients of Wuhan living room shelter hospital received the certificate of honor for excellent volunteers to commend their enthusiasm and help.
Sincere humanistic care deeply touched every patient. A discharged patient from the intensive care unit of Wuhan No.1 Hospital said: "I checked it with my mobile phone specially. It's 870km away from Jiangsu Provincial People's medicine. After I leave hospital, I must go to Jiangsu and provincial people's medicine to see you!"
According to the unified arrangement of the national health and Health Commission, on March 23, Jiangsu Provincial People's Hospital assisted in the construction of the ICU medical team of Wuhan first hospital and the national (Jiangsu) emergency medical rescue team of Jiangsu Provincial People's Hospital transferred 209 medical and nursing personnel to two critical areas of Wuhan Jinyintan hospital, taking over 80% of the critical patients of the hospital; on March 26, seven medical teams transferred to Wuhan Pulmonary Hospital To participate in the treatment of a 20 bed intensive care unit in the hospital.