I can see the status bar

Chapter 1009 D+2 day (1)
As of 25:26 pm on the 12th, a total of [-] provinces, municipalities, and autonomous regions across the country have launched a first-level response mechanism for major public health emergencies. This time, the emergency response mechanism has affected more than [-] billion people.

Yunhe's new coronavirus epidemic has long since ceased to be a gain or loss for one city or one province.And it has officially become an all-out war that affects the whole country, and may even affect the world.

And at the forefront of this war, in the trench named North Fifth District, Sun Li'en and several of his comrades were huddled in a corner and sleeping.

The yellow zone is brightly lit and there are several empty duty rooms.Although there are only stools in the duty room, the exhausted doctors don't care about them at all.Just spread something on the ground, and then everyone fell asleep.The only exceptions were Brun, who was undergoing an infusion, and Dr. Jiang Yanming, who had lumbar problems.Dr. Jiang was ordered by Sun Lien to sleep in the flat car beside Brunn next to the duty room in the yellow zone.And other doctors, including Hu Jia, basically found an office, found a pile of waste newspapers for a shop, and then fell asleep on the floor.

Sleeping on the floor is a stopgap solution.According to the actual situation, there is a high probability that doctors on the night shift will not be able to rest - from the yellow zone to the red zone, the fastest time to wear protective clothing is 10 minutes, and after entering and then coming out, a set of protective clothing will be scrapped .In a time when protective clothing is so tight, any waste is indistinguishable from a crime.

In addition to protective clothing, medical-grade N95 masks are also in short supply. 3M's 1860 masks, currently there are 1860 [-] masks in stock in the entire Yunhe City Infectious Diseases Hospital.

The North Fifth District needs to use more than 100 masks a day, and the entire Yunhe City Infectious Disease Hospital needs to use at least 1400 N95 masks.The entire hospital reserves a total of enough stock for one and a half days.

Although the whole city, the whole province and even the whole country are urgently transporting support materials to Yunhe, but...the reserves of such things are limited after all.Exactly how many masks can be transported to Yunhe City Infectious Disease Hospital every day, and when they will be transported... are all unknown.

Sun Li'en was lying on the ground, thinking about "is there any way to save masks", but... After thinking for a long time, he realized in frustration that it was impossible.

As a doctor, all he can do is to treat patients as much as possible.For other jobs, we can only rely on workers from all walks of life, 14 billion people.As a tiny screw in the state machine, doing one's own job well is to make a great contribution to the country.

After figuring this out, Sun Li'en felt a little better.At about 02:30 in the morning, he fell asleep in a trance.

It's dawn.

When he woke up in the morning, Sun Li'en felt that he had difficulty breathing.After opening his eyes, he realized that Hu Jia had fallen asleep next to him at some point, and held Sun Li'en's head in his arms.

It is indeed very comfortable to rest your head on your fiancée's lap.But the action of putting your hands on your chin affects your breathing a bit.Sun Lien struggled slightly, and then rescued his neck and upper respiratory tract from Hu Jia's hands.

The sky was still dark gray, and under the lights of the Infectious Disease Hospital, Sun Lien could vaguely see some raindrops falling.There are also some falling things in the middle, which seem to be snowflakes.

"Very good, at least the corridor can be cooler." Sun Lien looked at Xiaoxue outside the window, then slowly stood up from the ground, and stretched his muscles.

Tiredness is definitely tiring, and the fatigue caused by such a long period of slight hypoxia cannot be relieved by a single sleep.Putting newspaper on the floor as a mattress doesn't relieve it--it actually makes it worse.

After exercising, Sun Lien looked at Hu Jia who was still sleeping half leaning against the wall, thought for a while, took off his jacket, and put it lightly on her body.Then he wandered out of the office by himself.

Outside the office, the nurses and doctors on duty are staring at the monitors - the medical staff in the red zone are currently reaching the limit of their mental and physical strength.In order for them to save a little energy, the doctors in the yellow zone will replace them to monitor the patient's condition.And they sit on the chairs in the red zone office for a while or simply lie down for a while, so as to slow down the speed of physical exertion.

Director Lu taught them this trick.In Director Lu's words, "Working in the red zone requires not only taking care of patients, but more importantly, taking care of yourself. The night shift is very long, and many patients' vital signs will change. You won't last long staring at a patient's monitor endlessly. You have to rest, and rest."

Director Lu is an expert in intensive care medicine with more than 20 years of experience in intensive care medicine.When he was in charge, he went to the Tongxie for advanced training and learned from the hospital that established the first modern ICU bed in the country.

The opinions of such experts have been highly valued by the medical staff of the Comprehensive Diagnostic Center.And quickly implement it-of course, being unable to hold on physically is also an important reason for them to go to rest as soon as possible.

It was already [-]:[-] in the morning, and Sun Lien found a place to sit behind the nurse's station, and replaced one of the doctors with the word "tired" in black and bold letters above his head.He had only seen this doctor twice, and although the status bar told him that the name of this doctor was Shu Chang, Sun Lien didn't remember which department this Dr. Shu belonged to.

"Go and rest for a while." Although he can't remember which department he belongs to, this does not prevent Sun Li'en from being the supervisor, allowing him to rest early. "I'm watching over here."

Shu Chang glanced back at Sun Li'en, then nodded, "I'm looking at beds from 26 to [-], Director Sun, you've worked hard." Then he stood up and walked towards the office which is the rest room.

The patients in these ten beds were relatively mild, and Sun Lien felt sleepy after staring at them for a while.When he was about to change to a more comfortable position, the alarm on the side suddenly sounded.

"The blood pressure is down after grabbing the third bed." Deputy Director Ma Zhenjiang, who was watching the situation of the rescue bed, picked up the walkie-talkie and started calling for someone. Because he couldn't see the other party, his voice was very loud, "Duty room, grab someone Bed three's blood pressure has dropped, hurry over and see what's going on."

"Already on the way." A few seconds later, Yuan Ping'an's voice sounded on the intercom, and another ten seconds later, Yuan Ping'an's voice sounded again, "I'm already here."

"Director Sun." Deputy Director Ma Zhenjiang also knew that Sun Lien was here, "Do you want to see this patient?"

The patient who grabbed three beds was Uncle Peng with poor data before—the one with no fever but only 0.12*10^9 lymphocytes/L in peripheral blood.

"The blood oxygen saturation has also dropped, and the heart rate has also dropped." Sun Lien took the walkie-talkie from Deputy Director Ma Zhenjiang, and then shouted to Yuan Pingan, "You can't handle it by yourself, call for rescue!"

If it's just a drop in blood pressure, it may just be a problem with the patient's heart function or blood volume, which can be improved by using vasopressor drugs.However, a rapid drop in blood pressure, combined with a drop in blood oxygen saturation and heart rate is an extremely dangerous signal.This means that the patient's circulatory system may have completely collapsed.

Patients with pneumonia caused by the new coronavirus are basically walking on a steel rope in the abyss at any time.The patient's lungs had extensive lesions, and lung function was almost lost.With the help of pure oxygen and mechanical ventilation, Uncle Peng can only maintain his blood oxygen to about 94%, while his lung lesions are still expanding.

Now his blood pressure, saturation, and heart rate suddenly drop. Sun Lien, who has been in the emergency department, of course understands how dangerous the situation is - unlike other patients with circulatory system failure, Uncle Peng's lungs have almost no compensatory ability.He had sudden circulatory failure, the result of further progression of ARDS.

Uncle Peng's body is in a state of low blood oxygen for a long time. In order to supply enough blood to other organs, the heart will beat faster and work hard.But the oxygen supply to the heart itself is not enough, at least it should be at a level where the consumption is slightly greater than the supplement.

If this situation lasts for a shorter period of time, it may be able to resist.But half a month has passed since Uncle Peng got sick, and his heart can no longer withstand the damage caused by long-term hypoxia.

What's more, Uncle Peng also has hypothyroidism and stage IIb liver cancer.His physical burden was already heavier than that of other patients.

The situation was very dangerous, and Sun Lien made a decisive decision and asked Yuan Pingan to call for rescue.At the same time, Sun Li'en still had an ominous premonition—this time, Uncle Peng might be... difficult to be snatched back.

Although Yuan Ping'an was exhausted, but his mind was a little slow, not to the point of being stupid.He also immediately understood what was going on.After using the walkie-talkie to call for support, he immediately took the medicine from the rescue cart on the side and got down to start the rescue.

After raising the breathing rate of the ventilator to 24 breaths per minute, Yuan Pingan began to inject epinephrine into Uncle Peng's central vein.

Epinephrine is a powerful alpha and beta receptor agonist.It is very effective for rescuing patients in cardiac arrest.Although Uncle Peng's heart rate is still at 45 beats per minute, it is still dropping rapidly.At this speed, I'm afraid it will have to come to a complete stop in a dozen seconds.It is therefore imperative to intervene immediately.

Traditionally, epinephrine has been administered directly intracardiacly to patients in cardiac arrest.The method is to use a puncture needle with a slender and tough syringe to directly pass through the skin on the left side of the sternum 1 to 2 centimeters, vertically puncture four and five centimeters, and draw back blood to ensure that it penetrates into the heart instead of the myocardium.Then inject 0.5~1ml epinephrine into the heart.

However, this treatment method is more harmful to the heart, and at the same time, the heart compression needs to be stopped during the injection process, so it is basically not used at present.

However, central venous catheters avoid the need to stop cardiac compression and the disadvantages of greater damage to the heart.The central venous catheter is directly connected to the outside of the right ventricle, allowing the drug to enter the heart quickly and start acting.At the same time, it does not interfere with chest compressions and is an ideal channel for adrenaline infusion.

The rescue plan for Uncle Peng is of course not just adjusting the parameters of the ventilator, injecting epinephrine and chest compressions through the central vein.But this is the most urgent rescue project that needs to be executed the fastest.

The rescue team was in place within half a minute and quickly started the rescue of Uncle Peng.Meanwhile, Sun Lien and the other doctors stared at the monitor in front of them, holding their breath and waiting for a miracle to happen.

(End of this chapter)