Chapter 167 A special medical skill, the turnaround of 6-bed patients

Author: Jiangbian Yuweng

Chapter 167 A special medical skill, the turnaround of 6-bed patients

"Just wait for me in the office around 3:30 tomorrow afternoon."

It seems that Director Liu will work the evening shift tomorrow.

"Do you have WeChat? I'll add the work group within the group later. If there are temporary shifts or other matters within the group, they will be notified in the group."

Doctors in almost every department are divided into several medical teams.

For example, there is a group for extraskeletal surgery and orthopedic trauma. The doctors in this group basically study diseases in the field of bone trauma. Then there is a group for bone and joints, a group for microsurgery, a group for extra-hand surgery, a group for extra-ankle surgery, and a group for spinal surgery.

Group.

Zhou Can has just entered the critical care department and doesn’t know much about the grouping of this department.

The Department of Critical Care Medicine is generally divided into three groups.

It mainly includes three fields: respiratory, multiple organ dysfunction, cardiovascular and cerebrovascular and neurological.

To put it bluntly, it is the three major systems of internal and external circulation and nerves.

As long as there are no problems with these three major systems, a person's life is guaranteed.

External circulation mainly refers to breathing, including the entire respiratory system, blood oxygen exchange, synthesis, etc.

Internal circulation mainly refers to blood transportation, supply of blood and oxygen in the body, and nutrient supply and excretion.

Needless to say, nerves are the entire nervous system with the brainstem as the center.

After analyzing the three major systems of a person's life support, looking at the work of an anesthesiologist, it seems that it is not so mysterious.

If you want to make the patient lose the feeling of pain, just cut off the nerve signals.

General anesthesia and spinal anesthesia are the most commonly used methods by anesthesiologists. As for local anesthesia, this is rarely a big problem for them.

Considering the cost of surgery, the department will usually do this together with the surgeon.

"Dr. Hu, after you get off work later, remember to bring Dr. Zhou into the work group of our group."

After Director Liu finished explaining, he left without waiting for Zhou Can to say anything else.

When Director Liu left, Dr. Hu obviously relaxed a lot.

"From now on, it will be your young people's world! The waves in the Yangtze River rush against the waves behind, and each generation becomes stronger than the other." Dr. Hu's expression was very complicated.

Seeing Zhou Can make great achievements, it would be a lie to say that he is not sad.

Now, Zhou Can has gained Director Liu's appreciation and can be said to have strong wings.

Dr. Hu can only accept the reality.

Try to maintain a good relationship with Zhou Can as a colleague and no longer treat him as an ordinary trainee.

At this time, the alarm on bed 6 went off.

The alarm sound of each machine is actually different.

Zhou Can has been working here for a day. When he heard the sound, he knew there was something wrong with his blood pressure.

When I ran over and took a look, my blood pressure was indeed dropping vertically.

I'm afraid I have to give away another person in bed No. 6. When will this curse be broken?

Dr. Hu has long been accustomed to all kinds of big scenes, so he doesn't panic.

After checking, he said decisively, "It's ventricular fibrillation, it must be ventricular fibrillation. Defibrillate immediately."

Ventricular fibrillation is a rapid and weak contraction of the ventricular muscle or an uncoordinated rapid tremor.

This will cause the heart to stop pumping blood and all heart sounds and pulses to disappear.

Blood perfusion to the heart, brain and other organs and surrounding tissues stops.

The human heart is like a water pump. It pumps blood through constant beating and transports it to all major organs and tissues in the body through arteries and blood vessels.

When ventricular fibrillation occurs, it is equivalent to a problem with the water pump and the blood pumping is weak.

Irreversible damage will occur within three minutes of cerebral ischemia. Brain cells begin to die one after another.

Ventricular fibrillation is very dangerous.

At this time, the most common rescue method is defibrillation with a defibrillator.

"Xiao Zhou, I taught you defibrillation yesterday, can you do it?"

"meeting!"

Zhou Can took the prepared defibrillator and said nothing nonsense.

Deliver an electric defibrillation shock to the patient's chest.

After receiving an electric shock, the patient's body suddenly bounced up.

This is a normal reaction.

[First-aid wisdom, experience value +1.]

Zhou Can was a little confused B.

I have never acquired this medical skill before! Why did an emergency doctor’s intelligent medical skill suddenly appear?

He was in a hurry to save the patient, so he couldn't delve into it carefully.

The first time I defibrillated the patient, the effect was not very good.

"Come again!"

Dr. Hu stood aside and gave calm instructions.

Zhou Can performed electric shock defibrillation on the patient again.

[First-aid wisdom, experience value +1.]

The patient's heart rate and blood pressure gradually returned to normal, and his life was temporarily saved.

He and Dr. Hu both breathed a sigh of relief.

Just now I watched the patient's blood pressure drop in a straight line, which was really scary.

Some patients living in the ICU ward have to go through hell many times a day.

Doctors and nurses worked together to pull them back each time, and then continued various life support and treatments until all means were exhausted to help them successfully avert danger and transfer them out of the ICU.

Or eventually send the person away.

There are also some special circumstances where patients may be transferred out.

For example, family members do not agree to treatment. Or patients with malignant tumors or other terminal illnesses know that they cannot be cured.

In principle, such patients would be transferred away.

Some private hospitals or small hospitals may consider the operating costs of ICU. When there are not enough patients, it is also a common practice to keep patients for a few more days.

For regular doctors like Tuya, when rescuing patients in the ICU, if the material cost exceeds 200 yuan, they must ask family members to sign for approval.

Moreover, the operating costs of ICU are very high, and they basically lose money.

Let’s give two examples of charges to explain that the cost of ICU treatment for a day is at least 2,000 to 3,000 yuan, and the most is tens of thousands. Why is it said that it will be a loss?

Performing a thoracentesis or abdominal puncture on a patient costs about 90 yuan per session.

Performing a thoracentesis requires at least two medical attendants.

A senior attending doctor, plus a nurse to help.

If the puncture goes well, it will definitely take half an hour. This is due to the attending physician's excellent operating skills, skillful techniques, and proper cooperation from the nurses. The patient's condition should be relatively normal.

Otherwise, various difficulties will occur during puncture. At this time, B-ultrasound must be used for positioning to complete the puncture.

It took two or three people to work for at least half an hour, and they also needed equipment like B-ultrasound, which is neither cheap nor particularly expensive, and consumables. The final charge was 90 yuan.

Do you think the hospital is losing money?

As another example, I believe many people are familiar with chest compressions.

This is the cardiopulmonary resuscitation method that is often mentioned.

I believe everyone who has done chest compressions knows how tiring the seemingly simple chest compressions are. If the rescuer is an adult, the depth of each chest compression is about 5cm, and more than 100 compressions are required per minute.

It is best to reach about 120 times.

This kind of high-intensity compression, one or two people take turns, is fine for a short time. If it takes a long time, don't even think about it.

But the family members were unwilling to give up, and the doctors and nurses had to continue rescuing her even with tears in their eyes, gritted teeth, and exhaustion.

Generally, this rescue process will last several hours.

Four or five hours is common.

Family members generally hope for a miracle of life and for doctors to rescue their loved ones. Therefore, family members will not give up without resuscitation for a few hours.
To be continued...