Since 1981 Health School Chapter 633

  Deng Changle secretly groaned inwardly.

  Even if it is a top hospital like Dongshan Hospital, equipped with top medical teams and medicines, the most successful rescue record of the Burn Department of Dongshan Hospital is only 56% of the patients with II° and III° burn areas

  Good guy, the three patients of Yuezhong were Wang Zha as soon as they came up, how can they be saved?

   While Deng Changle was hesitating, director Yang Xingliang saw the arrival of foreign aid, quickly took off his gloves and opened the door:

   "Is it Director Deng? Ah, I'm looking forward to your arrival. Hurry up, the patient is in critical condition, and now he has no urine. Next, it will be up to you top experts."

   Without waiting for Deng Changle to refuse, Director Yang personally took the surgical gown, and prepared to let the Shanghai experts put it on, without giving them a chance to refuse.

   "No, Lao Yang, you have done a good job of debridement on this patient, there is no need to replace it, this..."

  Deng Changle didn't want to take over the patient at all, and wanted to turn around and return to Shanghai immediately, but unfortunately Yang Xingliang didn't give him a chance at all, and Zuo Liwei from the nearby Yuezhong Hospital also came to assist him.

   "Director Deng, don't be too polite. You see we have so many little doctors here, and everyone is waiting for you to teach us a lesson."

  The factory manager Qi Guomin, who is superstitious about the big city and the big hospital, is also constantly pleading:

   "Director Deng, you must act. Without you and all the experts, my worker master's life will be lost. I beg you, please."

   Now it's all right, I've completely chased the ducks up the tree.

  Deng Changle opened his mouth wide, unable to utter the words of refusal, so he stomped heavily:

   "Change clothes, let's go."

  It doesn't matter to the other doctors from Shanghai Hospital. Anyway, whether the patient is dead or alive has nothing to do with them. Practicing with such seriously injured patients is of great benefit to increasing clinical experience.

  Fifteen minutes later, the burn team of the First Affiliated Hospital of the Province was all withdrawn, and the medical team of Dongshan Hospital was replaced.

  Yang Xingliang changed his clothes and finished disinfecting. He gave up the red envelopes, and immediately led his subordinates to "escape" from Yuezhong as quickly as possible.

  He is a smart man. Judging from the attitude of Yuezhong Hospital and the condition of the patients, he knows that the three seriously injured are definitely hot potatoes.

   The one who can't be cured is the Yue Steel Factory, and the one who has been cured is the talented Chen Qi of the Yue TCM Hospital. It's not a good business for a red envelope, so it's best to leave early.

   Once the team of Haiyi No. 1 Hospital leaves, it will be a disaster for the doctors of Dongshan Hospital.

  They came here this time with 5 doctors and 3 nurses, and they brought some secret Chinese medicine ointment for burns with them. They were full of confidence at first, but now everyone looks serious.

  During the debridement, the three seriously injured people shouted that it was miserable.

  Chen Qi and Zhang Xing quietly hid behind the glass window to watch how the Shanghai experts debrided the wound. If it wasn't for the aseptic requirement, he would like to grab a handful of melon seeds and become a melon-eating crowd.

   "Hey, this debridement is really rough, I guess I'm in a hurry..."

   "Hey, the buttocks are all coke, and the soaking time of the normal saline is too short, how can this be uncovered?"

   "It's over, it's over, this patient is in extreme pain, his blood pressure has dropped drastically, and his heartbeat is about to stop."

  As soon as Chen Qi's cool voice fell, Chi Shanjun in the middle ward suffered cardiac and respiratory arrest due to severe pain and low blood volume, and a sharp decrease in circulating blood volume.

  Deng Changle saw that he "died" one just after taking over, and was so angry that his head was full of black lines:

   "Hurry up, the patient's heartbeat is gone, perform cardiopulmonary resuscitation immediately, and the epinephrine injection is ready..."

  Factory Director Qi also jumped up anxiously after seeing it:

   "Why did one die, why did only one die? Ahh~~~"

  Chen Qi pouted on the other side:

   "Idiot, there is no need for an international dual director like me, but with these Mongolian doctors, I have the nerve to shout."

   Fortunately, the patient's heartbeat and breathing recovered after intensive rescue.

  Zhang Xing quietly asked behind him:

   "Dean Chen, if we are the ones to rescue, what is the best way to do it now?"

   "Of course, the ventilator is the first to ensure that the patient's vital signs can be maintained. Secondly, a large amount of fluid should be administered immediately to replenish the patient's blood volume, otherwise the patient will die a second time."

  Ventilator, the Yuezhong People's Hospital really has it, but the doctors in Shanghai have to know how to use it.

  Chen Qi looked at the rescue in the window and said:

"Also, the injuries of Ding Xinjuan's mother and daughter are actually more serious than those of the three Yue Steel Workers. You must know that their mother and daughter are covered with a thick layer of ash from the bottom of the pot, and they are also dirtier. Therefore, when debridement I used Hibernation therapy was adopted to avoid stimulation to the patient.

If you look at these experts in Shanghai, they only know that the long debridement time will affect the prognosis, so they have ignored the severe pain caused by the patient, and said that the worker Chi Shanjun just died of pain, not at all. exaggerate.

The last fluid channel, they opened two channels, but did not open the large jugular vein, and I saw that there were no hemodynamic indicators such as central venous pressure, pulmonary artery wedge pressure, and cardiac output in the tools they carried. instrument.

   If there is no accident, the workers of the Yue Steel Factory will definitely overturn this time to rescue the workers, and the lives of these three workers may not be saved. "

   Zhang Xing became anxious when he heard it:

   "Dean Chen, since we have a solution, and you also have new technology, why don't we talk about it again and let the Yuezhong Hospital participate in the rescue, we can't just watch the workers die, right?"

  Chen Qi turned his head and glanced at his confidant lightly, thinking that this guy's thinking is definitely good, but it's a pity that he doesn't understand people's hearts too much. To put it bluntly, he is naive.

  If you want to send technology to your door, you have to be willing to accept it.

  But he didn't want to preach, the truth of life can only be experienced by himself, so he said indifferently:

   "Yes, I also want to participate in the rescue. After all, these workers are from the same hometown. Why don't you go and talk to Director Qi of Yue Steel Plant?"

   Zhang Xing did not doubt that he was there, and nodded heavily: "Okay, Dean, I will go and talk to Director Qi now."

  Chen Qi choked when he heard it, thinking that it's good to be young, and his head is strong enough!

  Qi Guomin is just outside the burn ward, comforting his family members:

   "Don't worry, we have invited the best experts from Shanghai Dongshan Hospital in the country, and we are doing our best to rescue them. No matter how much money is spent, our Yue Steel Factory will not frown."

   "Director Qi, Wenjie is the pillar of my family, you must save my family Wenjie!"

   "Director, whether my son lives or dies, I leave it to you!"

   "The factory director..."

   "Director Qi, Director Qi!"

  Qi Guomin was comforting again and again when he heard someone calling him from behind, he turned around, "Ah... so who, what's wrong?"

   "Director Qi, I am Zhang Xing, deputy director of the Burn Surgery Department of Yuezhong Hospital, and I want to tell you something."

   Qi Guomin is still confused, looking at the young doctor in front of him, he has not recovered:

   "What's the matter, tell me!"

   Zhang Xing straightened his expression and said seriously:

"Director Qi, the Burn Surgery Department of Yuezhong Hospital is currently equipped with the world's most advanced rescue machines and monitoring instruments, and we also have the best burn medicines, and our Director Chen also has a set of rehydration solutions and skin grafts developed by himself. plan.

At the beginning, we had rescued several patients with severe burns in Africa, so our team is relatively experienced. Now the treatment by Shanghai experts has loopholes. I think it is better to let President Chen and our team participate. Save the patient's life. "

   Zhang Xing thought that after he said these words, Director Qi should be convinced by him, and then sincerely invited Yuezhong Hospital to participate in the rescue.

  In the end, what he got back was a chuckle from Director Qi:

   "Hehe, Dean Chen taught you these words, right?"

   "No, it's me..."

   "Young man, it's good to be ambitious, but you can't be used as a gun. Can your Yuezhong Hospital compare with others' Dongshan Hospital? You must be self-aware!"

   After finishing speaking, Director Qi patted Zhang Xing on the shoulder, and walked away without giving Zhang Xing a chance to explain.

   "Director Qi, you can't do this, you..."

   On the other side, Chen Qi is still a melon-eating crowd, looking at some practices of the Burn Department of Shanghai Hospital with the eyes of later generations, no matter how you look at it, it is wrong.

  For example, the doctors in Shanghai Hospital did not perform aseptic operations, which is the most basic operating standard in the burn department.

   You must know that the Yuezhong People's Hospital uses a "sterile ward" for patients with extensive burns. This thing is very advanced, and it is to reduce the risk of microbial infection.

  But Dr. Shanghai's hand touched this and that, and even touched the patient's body surface after changing hands. Chen Qi frowned, thinking that such a good sterile ward was in vain.

   Just when Chen Qi was feeling bad, he saw the dejected Zhang Xing coming back from the corner of his eyes, and knew in his heart that this guy must have had a bad nose.

   "How is it? Did Yue Steel Works let us participate in the rescue?"

  Zhang Xing blushed with anger:

   "President Chen, this Director Qi is too much. He looks down on our Yuezhong Hospital and says that we can't compare with Shanghai experts. This is simply unreasonable."

  Chen Qi gave this subordinate a blank look, and secretly complained that a bookworm doesn't understand people's hearts.

  The reason why Qi Guomin spent a lot of money to invite experts from Shanghai, Shanghai and provincial capitals to come and treat the wounded was because of this attitude.

  It is similar to a performance, showing how much Qi Guomin attaches importance to him, and how he tries his best to do whatever it takes.

   This is for the 30,000 employees of the whole factory, for the families of the 38 burnt workers, and for the superior leaders to see.

   More precisely, it is related to his black hat.

  As long as the performance is in place, even if a few workers die in the end, Qi Guomin has done his best as the factory manager, and the punishment will be lighter at that time, and he may be able to work with illness and continue to be the factory manager.

  So the leaders of the Yue Steel Factory will not hand over the workers to the local hospital for emergency treatment.

  If it's gastroenteritis, it's okay to say, but Yuezhong Hospital has not made a blockbuster in the field of burns, so it's normal for people to have doubts.

"Okay, okay, don't complain, don't we still have two patients with extensive burns on hand, the Yue Steel Factory doesn't trust us, so let's compare with Dongshan Hospital to see who is more capable and can rescue them back patient."

   Still the same sentence, 60% of the burn area is a life-and-death line consensus in the medical community for 80 years.

  Now Yuezhong Hospital has concentrated 5 patients with burns exceeding 70%, and even 3 of them had burns exceeding 90%.

   It just so happened that the annual meeting of the "Chinese Society of Burn Surgery, Chinese Medical Association" will be held in Shanghai on November 20. What happened in Vietnam has aroused the great interest of the chairman Peng Yongyan.

  Peng Yongyan is the director of the Southwest Hospital of the Third Military Medical University in Shuangqing City. He wears a military uniform, and his major is the burn department.

  As a leader in the industry, he understands better than anyone else that it is not uncommon for patients with burn area reaching 90% clinically, but so far, why has there not been a single case of successful rescue in the world?

   It shows that this difficulty system is too high.

  Others may laugh at Yuezhong Chen Qi for not doing his job properly again, but Peng Yongyan does not see it that way.

   Chen Qi, a grass-roots doctor who graduated from a medical school, can toss out plastic surgery, hand surgery, and gastrointestinal surgery, and become a director of an international society. Can he be treated with common sense?

  So Peng Yongyan decided to go to Yuezhong to see the excitement before the annual meeting. Anyway, Shanghai is not far from Yuezhong.

   At this time, the Yuezhong Hospital has entered the night.

  Deng Changle's team completed the debridement work on the three seriously wounded.

  Then we will start to overcome the second difficulty - rehydration.

   Burn patients will lose a lot of water through the body surface in a high temperature environment.

  Secondly, burn patients are generally accompanied by skin damage, losing the protective barrier of the skin, and the body will lose more heat and water.

  A large amount of water is lost, and burn patients may suffer from hypovolemic shock, requiring fluid replacement therapy.

  In addition, rehydration is not simply hydration. In addition to losing water, burn patients will also lose a lot of electrolytes. Patients may experience acid-base balance and electrolyte disturbances, so electrolytes need to be supplemented.

  If an infection occurs in a burn patient, anti-infection treatment is also required.

  So debridement is easy, but rehydration is difficult.

   What to make up for? How much to make up? It's easier said than done.

  In the ward, Zeng Chu handed a piece of draft paper to Deng Changle:

   "Mr. Deng, this is our new rehydration plan. According to the course record, 4500ml of crystal gel liquid has been infused in the past 8 hours."

  Deng Changle was not happy when he heard that:

   "Why did you add such a small amount of fluid? How did you calculate it? Did you use the Chongqing formula? Nonsense, how can such a small amount of fluid be enough? I didn't see that the patient died twice because of insufficient blood volume."

   Zeng Chu nodded: "Okay, Mr. Deng, I will immediately recalculate according to our Shanghai formula."

  In the 1980s, there was no unified formula for rehydration for burns in China. Currently, there are three types of formulas in China: Chongqing formula, Shanghai formula, and Nanjing formula.

   Among them, the Chongqing formula, which is the rehydration mode developed by the team of Professor Peng Yongyan of Southwest Hospital, is currently the main rehydration formula in China.

  But how can the dignified Shanghai adopt the formula of a Southwest rural hospital?

  Of course they have to develop a set of so-called most advanced rehydration methods by themselves.

  So a number of hospitals in Shanghai, mainly Dongshan Hospital, jointly launched a "Shanghai formula", and began to compete with the "Chongqing formula".

   So what is the difference between the two before? Or is it different from the mainstream rehydration mode in later generations? How effective is the treatment? (end of this chapter)

Chapter end