The conference room began to get restless and everyone started chatting.

Zhou Yewu listened to the sound in the conference room behind him, and from time to time he turned around and took a sneak peek.

"Why should I go in earlier and finish the matter? Wouldn't I have to train any skills later?" Zhou Yewu smiled bitterly.

His smile is a little distorted now.

And all this is thanks to Xu Lu...

Xu Lu seemed a little embarrassed: "But I don't want to go in, please accompany me out for a walk."

"What's the thing? Go out for a walk?" Zhou Yewu looked at Xu Lu in amazement.

This is still in class.

He just slipped away so blatantly? He asked the people inside to wait for a few hours in vain? Zhou Yewu thought about it and found it a bit exciting.

But this is purely a thief heart and no courage.

Zhou Yewu said, "Stop messing with me, the head of the medical department is sitting inside. If he doesn't go back early, when he complains to the hospital, we will be in trouble."

Xu Lu seemed not satisfied, and still wanted to go out.

"Then I'll go alone." After she said that, she was about to get up and walk out.

"No." Zhou Yewu subconsciously grabbed Xu Lu's hand.

The two men grabbed their hands together in an instant.

Xu Lu was stunned.

Zhou Yewu was also slightly stunned.

...

"How about doing this, I'll take a walk with you again?" Zhou Yewu said softly.

Xu Lu's attitude also changed, and she said softly: "Okay."

The two of them yelled forward and walked into the conference room.

Everyone either lowered their heads and played with their phones or chatted, so they didn't notice that they came in together.

It was not until the head of the medical department cleared his throat and coughed that the conference room, which was originally a little playful, calmed down again.

Zhou Yewu looked at the guide on his phone.

I wrote down the treatment of glucocorticoids for the treatment of new G.

"For patients with progressive deterioration of oxygenation indicators, rapid imaging progress, and over-activated inflammation in the body, the use of glucocorticoids in the short term should be noted that large doses of glucocorticoids may delay the removal of the virus due to immunosuppression."

Hormones are such a double-edged sword, and as a doctor, you must be good at using them.

Zhou Yewu has little experience in the application of hormones.

"Then when it comes to severe and critical patients, they should actively prevent and treat complications, treat underlying diseases, prevent secondary infections, and provide timely organ function support, such as respiratory support, nasal catheter or mask oxygen inhalation. Pao2/fio2 is less than 300 mmhg.

Generally, after receiving nasal catheter or mask in clinical practice, the patient should observe closely for a short time. If respiratory distress and hypoxemia do not improve, transnasal high-flow oxygen therapy or non-invasive ventilation should be used. Zhou Yewu has seen a lot of this in the respiratory department.

"Pao2/fio2 is less than 200     mmhg                                                                                                                                                                                                                                                 �

"If the condition does not improve after a short period of treatment, especially after receiving prone treatment, hypoxemia still does not improve, or the number of respiratory frequency, excessive tidal volume or excessive inhalation efforts, it is often suggested that hfnc or niv treatment is not effective, and invasive mechanical ventilation should be performed in a timely manner."

When it comes to this innovative step, there is no choice.

Inventiveness is literally the same, which can cause trauma to the human body.

Zhou Yewu was silent for a while and continued: "If invasive mechanical ventilation is generally the case, pao2/fio2 is lower than 150 mmhg, and invasive mechanical ventilation can only be considered. However, given that the clinical manifestations of hypoxemia in patients with severe novel coronavirus pneumonia are not typical, whether pao2/fio2 meets the standards should not be simply used as an indication for tracheal intubation and invasive mechanical ventilation, but should be evaluated in real time in combination with the patient's clinical manifestations and organ function."

It is worth noting that delaying tracheal intubation may bring greater harm!

Early appropriate invasive mechanical ventilation treatment is an important treatment method for critically ill patients. Implement pulmonary protective mechanical ventilation strategies. For patients with moderate to severe acute respiratory distress syndrome, or invasive mechanical ventilation, if fio2 is higher than 50%, lung reextraction treatment can be used, and based on the reactivity of the lung reextraction, whether to repeatedly implement the lung reextraction technique.

It should be noted that some patients with new g pneumonia have poor lung retease, and excessive peep should be avoided to cause barometric injuries! Sometimes the patient is damaged during treatment, which is also encountered many times during Zhou Yewu’s internship!

Do bad things with kindness...

As for airway management to strengthen airway humidity, active heating humidifiers are generally used to use loop heating wires to ensure the humidity effect if conditions permit. It is recommended to use closed sputum suction. If necessary, bronchoscope suction and actively carry out airway clearing treatment, such as vibrating sputum excretion, high-frequency thoracic oscillation, posture drainage, etc. When oxygenation and hemodynamic stability, passive and active activities should be carried out as soon as possible to promote sputum drainage and pulmonary rehabilitation.

"Actually, the most common thing you use now is ecmo." Zhou Yewu said smoothly in English.

"Ecmo is extracorporeal membrane-pulmonary oxygenation, which is mainly used to provide continuous external breathing and circulation to patients with severe cardiopulmonary failure to maintain the patient's life. Its core part is the membrane lung, that is, artificial lungs, as well as blood pumps, artificial hearts, which can provide long-term cardiopulmonary support to patients with severe cardiopulmonary failure, winning valuable time for the rescue of critical illnesses."

Zhou Yewu has never seen the application of ecmo, and he is still very interested when it comes to this thing.

Anyway, critically ill patients who meet the ecmo indications and have no contraindications should start ecmo treatment as soon as possible, delaying the timing and leading to poor prognosis of the patient.

Zhou Yewu was lyrics and became more and more bored.

If you really want to finish the guide, you don’t know if you will be the year of the monkey and the month of the horse.

"I won't talk anymore, I won't talk anymore, it won't be close to the actual medical situation at all." Zhou Yewu thought to himself.

Then Zhou Ling seemed to have woken up at this time in the audience.

She looked at Zhou Yewu on the stage and listened to him talking about these things, and she became more and more sleepy when she heard them.

My eyes were blurred and I seemed to want to sleep again.

Xu Lu absent-mindedly lowered her head and played with her mobile phone.

Zhou Yewu thought that no one would listen anyway, and if the patient really found that the fever and nucleic acid test were positive, wouldn’t it be fine to send it directly to Tianfeng People’s Hospital?

Why do you have to make the whole nation so hard and spend a lot of effort!

Zhou Yewu brewed his emotions and said in a deep voice: "To sum up, all patients who find abnormal fever will be sent to Tianfeng Human Doctor. Sometimes, everyone may not remember the diagnosis and treatment of those diagnoses and treatments!"

There was applause from the audience.

The meeting ends!

A doctor said, "It's very good, and the content is detailed."

Another doctor said: "It's very good and easy to understand."
Chapter completed!