I can see the status bar

Chapter 1004 D+1 day (4)
The so-called "intermediate coordination work" is mainly running errands.

Sun Li'en hasn't had much contact with this kind of work since the second year of Guipei.He came here suddenly today, not only did he not feel uncomfortable, but he even felt a little nostalgic.

The work of running errands will become very simple as long as you find out the tricks-just report to the responsible leader.

And now... the highest responsible leader on the scene is Sun Li'en himself, who is running errands.This saves the effort of repeated reporting, and the efficiency is higher.

"That's right, that's right, fall back!" After guiding the car to the place he had been eyeing for a long time, Dr. Jiang Yanming got out of the car.Hu Jia, whom he had not seen for two days, got off the car with him.

"Doctor Jiang, lean back a little bit." Sun Lien pushed Jiang Yanming away, and then hugged his girlfriend.Then the two moved out of the car together with six large cardboard boxes.

Jiang Yanming has a herniated lumbar disc, so it is not realistic or humane to ask him to bend over to carry heavy objects.But now that time is tight, it would be too wasteful for Dr. Jiang to waste time by the side.

"This is Director Zhong Jiguo, Director Zhong, and this is Director Jiang Yanming, the director of the ECMO team this time." Sun Lien pulled back Dr. Jiang Yanming who had just been pulled away, and then took him and stood aside to help Zhong Jiguo, who was moving the box to the trolley, met with him, "Director Zhong is the ECMO coordinator, and he was also a member of the ECMO team at the Children's Hospital. I don't know much about the workflow between your ECMO teams, but I heard that the design of the ECMO team is different between hospitals. So please check the process as soon as possible.”

After making a short and irresponsible introduction, Sun Lien trotted all the way to help Hu Jia carry the boxes.I have to say that Hu Jia's strength is really impressive.The box weighing tens of kilograms, Sun Lien originally wanted to move it down with Hu Jia alone.In the end, Hu Jia actually picked up the box with both hands, and still had enough strength to push Sun Lien away with his feet so that he would not get in the way.

The ECMO brought by the Fourth Hospital is portable.The machine itself weighs about ten kilograms dry.And also comes with a UPS uninterruptible power supply.It can maintain continuous operation for at least 90 minutes in the event of a power outage.

But also because it is portable, the use time of the consumable kit of this device is relatively short.The whole heparin coated kit can guarantee continuous use for 30 days.Continuous use of more than 30 days requires replacement of the pipeline, which is more troublesome than large-scale equipment.

Pushing the cart and jogging all the way, Sun Li'en and others quickly appeared in the green area of ​​North Fifth District, and saw the security uncle standing guard at the gate again.

"Please open it..." Sun Li'en paused and changed his words, "Well, you can use the card for me, and I will send it to you after I open the door."

"That can't be done." Uncle Security shook his head, and said in a voice with a strong Yunhe accent, "I only do this with my salary, and if you don't let me do it, why did the leader fire me? "

So yesterday's scene was repeated. The uncle stretched his arms, swiped open the door with his work ID, ran away from the door in three steps at a time, and watched Sun Li'en and others open the door to the green zone.

After pushing the cart into the green zone, Sun Lien greeted Director Lu who was preparing to hand over outside, and then led a group of people into the yellow zone, and began to put on protective clothing on his body.

"Anyway, I'm wearing protective clothing." Sun Li'en said to Director Lu while putting on the clothes, "It's a bit wasteful to change clothes after busy work, and we will help out in the red zone later."

"Then I can't ask for it." Director Lu nodded and said cheerfully, "Director Sun, you are such an outstanding talent, we can only think that we can't get enough."

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Putting Mr. Shen on ECMO is a very troublesome job.Although all critically ill patients are treated in the North Fifth District, the long-term use of ECMO requires patients to be located in the ICU or other highly monitored areas-this can avoid or reduce the possibility of patients being infected by other germs to a certain extent. sex.

As an invasive treatment, ECMO is, after all, directly connected to the patient's blood vessels with tubing and continues to operate.The pipes connected to the patient and the cut skin are an obvious route of infection invasion. In the ICU or other high-level monitoring and treatment centers, medical staff must strengthen disinfection and care to reduce the possibility of infection.

Therefore, before the ECMO connection, the medical staff of the fourth group first need to adjust the bed and ward.Bring together a group of critically ill patients who need intensive monitoring.

The mighty moving work lasted about two hours.Every patient must be handled with great care. The monitor can move with the bed, but the oxygen tube cannot.Therefore, it is necessary to install the gas cylinders in the ventilator in advance, then unplug the power supply, and quickly and steadily push the hospital bed into the adjusted room amidst the sharp alarm sound of the UPS.

The largest ward in North Fifth District was temporarily converted into an ICU unit.Eight beds can be put down here, and it is also the closest ward to the doctor's red zone office.

Moving a place for these patients who are receiving mechanical ventilation seems to be as simple as moving goods.But in fact... this transportation process is much more dangerous than it seems.

Since the transported patients were all critically ill, their bodies were already in severe hypoxemia.And to carry them, it is very likely to break the precarious balance of oxygen supply and consumption in their bodies.

And for those patients whose lungs have barely any reserves to increase oxygen exchange, once the balance is upset, the result is a rapid, malignant arrhythmia.From cardiac arrest to ventricular fibrillation, all sorts of unexpected things can happen.

In order to prevent such problems, Sun Lien decided to take charge of the handling process of each patient by himself.During the whole process of transportation, he kept the status bar turned on for monitoring. As long as he saw that the writing on the status bar on the patient’s head changed, he would immediately stop the transfer, let the patient be in a calm state, and then decide whether to rescue on the spot or start over transport.

The status bar can still come in handy, Sun Lien thought with some relief.After stopping twice in a row, Sun Lien and several other doctors finally completed the transfer of the last patient.

The transfer of seven patients took two hours, but none of the patients developed a malignant arrhythmia.Sun Lien breathed a sigh of relief, most of the difficult part has been solved.The next question is how to move the No.8 patient, Mr. Shen who needs ECMO treatment.

"In his current situation, I suggest that he go to VV-ECMO (venous-venous ECMO) first." For the past two hours, Dr. Jiang Yanming has been studying Mr. Shen's case and various examination data.After two more electrocardiograms, Dr. Jiang Yanming gave his own professional advice, "Looking at it now, the patient's circulatory system problem is not serious, and his own potential is still good."

"But after all, the age is here, and he has a history of type [-] diabetes." Although he knew that he should respect the professional opinions of other doctors, Sun Lien still asked a little worried, "Dr. Jiang, are you sure you can use VV-ECMO?" gone?"

"It is not necessarily a good thing to use VA-ECMO for patients whose hearts are still able to work." Dr. Jiang Yanming shook his head and said, "Although the VA (vein-artery) mode can directly replace the heart for circulation, the operation of the machine pump is very important. It will damage the red blood cells. No matter how sophisticated the machine made by humans is, the working principle lies here. It is impossible for it to not be damaged."

"Is this damage serious? Red blood cell damage can be solved by infusion of suspended red?" Sun Lien asked with a frown. In his opinion, the problem of red blood cell damage doesn't seem so difficult to solve.

"The damaged and dead red blood cells must have a place to go. Normal people's liver function is fine, just metabolize the damaged red blood cells. For them, the damage of VA is acceptable. But this patient's situation is different." Jiang Yanming explained, "Now he is in VA mode, and he will soon develop jaundice. If this continues, the jaundice will rise to a very dangerous level in a short time. What's more, VA mode also has a burden on the heart. For the elderly, it is very likely that heart failure will occur if the VA mode is hung for a week. It is not impossible to have left ventricular dilatation or even left ventricular thrombus.”

"Now that I am on VV, how long will it take to switch to VA if circulatory failure occurs later?" Sun Lien asked, "Will it be in time?"

"It's hard to say. We can only see how long he can last, whether our rescue measures can bring him back, and... the speed of my attack." Speaking of this, Dr. Jiang's eyes behind the goggles lit up, " I am confident I can complete the arterial cannulation within 3 minutes."

"Then you may have to work harder in the yellow zone. Wear protective clothing on duty." Sun Lien glanced at him, and then said, "It will take you 15 minutes to put on a protective clothing."

"If I have a positive pressure mask, I can be on duty in the red zone." Dr. Jiang insisted, "The positive pressure mask doesn't cause breathing difficulties, and I can stay in the red zone for a longer time."

"You're thinking too much." Sun Li'en signaled Jiang Yanming to start the tube immediately, "Anyway, I don't believe that if you don't eat or drink for a day, you can still stop shitting and peeing."

(End of this chapter)