“The patient had a history of heart disease,
Heart rate is only 30 beats per minute,
Take it to the emergency room! “
…
In the middle of the night on October 20, there were few people in the streets of Dalian. On the side of No. 826 Southwest Road, Shahekou District, the neon characters of “Emergency Center” were shining brightly. The “race” is unfolding…
△Every moment in the emergency room is racing against time.
Here there is the helplessness of lack of skill, the ecstasy of survival, and the trust of life.
From October 19th to 21st, the reporter visited the emergency medical center of Dalian Central Hospital four times, witnessed the thrilling scenes in this 24-hour green channel of life, and raced against time to rescue patients, and listened to the medical staff about what happened in the emergency room. The warmth and sadness, the contradiction between illness and survival are expressed to the extreme…
△The on-site medical staff cooperated tacitly and treated the patients in an orderly manner.
● 24 beds in the rescue area
How to treat emergency patients after they are sent to the hospital? How busy are emergency medical staff at night? … At 20:30 on October 20, the reporter brought these questions to the Emergency Medicine Center of Dalian Central Hospital to find out.
As soon as you enter the rescue area of the emergency medical center, you will be greeted by the display screen of the central monitoring station. The emergency patients on the 24 rescue beds are connected to the network, and the vital signs such as heartbeat, pulse oxygen and respiratory rate of all patients are displayed in real time. This advanced equipment has changed the In the past, only the history of a single bed could be monitored.
△ Every rescue that goes all out is related to the happiness of a family.
Dudu, Dudu… The 13th bed issued a yellow warning, “abnormal blood pressure, low pressure 110, high pressure 150.” Seeing the yellow light flashing on the monitoring screen, Yu Xinpeng, a male nurse at the nurse station, quickly called the doctor to check the 13th bed. The patient was An elderly man, the doctor said that he came to the emergency room because of heart discomfort.
At the bedside of the remaining patients, medical staff were busy. The 5th bed is a patient with hematuria to be investigated. The doctor has just finished catheterizing the patient’s urine and instructed the accompanying family members to drink more water and observe at any time;
A car accident patient was lying on the emergency bed No. 1, all stitches on his face. “The 120 ambulance came in by the siren, and after emergency rescue, it was out of danger.” The head nurse on duty said Leng Chuang.
Although he has been engaged in nursing work for 12 years, his nerves are still highly tense when he goes to work every day. “Every day when he arrives at the unit, it is really like going to war on the battlefield. Emergencies happen at any time. When the patient’s family members shout, they rush over to have a look. What’s the matter?”
After the triage nurses assess the condition and check vital signs of the emergency patients, they will be sent to the emergency department, the general surgery area or the rescue area for treatment according to their condition. Afterwards, the professional doctors begin to calm down and choose treatment as appropriate. Program.
△ Director Ji Ying (left) discusses the patient’s diagnosis and treatment plan with the doctor.
● The story behind the pennant
The stories of emergency rooms racing against death to treat patients at the speed of life and death are staged almost every day. Director Ji Ying, who has worked in the emergency medicine center for 18 years, told reporters a little story that happened this year:
Some time ago, an elderly man went to the emergency center due to diarrhea and suffered from shock, low blood pressure, and lack of energy (still able to speak). Expressed disagreement, “It’s not for economic reasons. If you are admitted to the intensive care unit, you will be worried that the elderly will not be able to see their family members, and the family will be even more worried if they can’t see the elderly.”
During the observation and diagnosis and treatment of the elderly in the rescue area, they were carefully treated by medical staff. Every doctor on duty repeatedly suggested that “the elderly’s condition still needs to be admitted to the intensive care unit, and more refined treatment can be obtained.”
“Severe diarrhea in the elderly can lead to severe infection, even shock and organ damage. At that time, the elderly did not eat well and consumed a lot. Diarrhea may disrupt the balance of the body’s internal environment, and even damage the liver and kidney functions at the same time. “
△ The picture is an information sheet.
After the medical staff repeatedly and fully informed the condition, the family finally agreed to send the old man to the intensive care unit. After more than a day, he was completely cured. After the recovery, the patient’s family sent a pennant to the medical staff in the emergency center.
The sick old man’s daughter took Director Ji Ying’s hand and said, “My old father was able to recover and be discharged from the ICU very quickly. Neighbors said it was a miracle.”
● Life is hanging on the “Golden Hour”
After 21:00, the rescue area of more than 200 square meters began to get busy. There were a total of 20 medical staff on duty that night, including the stroke center, chest pain center, neurology, internal medicine, cardiology, gynecology, surgery, orthopedics… At night, the general outpatient service of the hospital There is no admission, so the more patients at night, the more patients, and the emergency room has become the department with the most complex diseases and the most heavy rescue tasks in the hospital.
The reporter’s attention was attracted by the special bed for intravenous thrombolysis for stroke, which was parked at the door. “This bed can measure body weight, and it will be more scientific and accurate for medical staff to calculate the dosage based on body weight during rescue.”
△ Medical staff operate the special bed for stroke intravenous thrombolysis.
Faced with the reporter’s doubts, emergency doctor Liu Yushi emphasized that the advanced emergency equipment is crucial to rescuing patients. He pointed to an automatic cardiopulmonary resuscitation machine, which was newly purchased by the hospital last year. There are 3 units in the room, which are the most frequently used “artifacts” for first aid. Traditional manual cardiopulmonary resuscitation mainly relies on doctors and nurses taking turns to perform chest compressions. After the automatic cardiopulmonary resuscitation machine is activated in the rescue area of the emergency department, high-quality cardiopulmonary resuscitation has significantly improved the rescue success rate of sudden death patients.
In addition, the reporter also discovered several other “life-saving artifacts” in the emergency medical center, a defibrillator to terminate ventricular fibrillation, a life-saving “artifact” ventilator for patients with respiratory failure, acute exacerbation of chronic lung disease, and heart failure, and pneumatic Clinical Sample Transmitter…
In addition to advanced first aid equipment, there are CT examinations, clinical examinations, surgical treatment and other clinics next to the rescue area, less than 20 meters away, which greatly facilitates patients and saves emergency treatment time.
The true meaning of the phrase “time is life” is most fully reflected in the emergency department. In the stroke center, time is the brain; in the chest pain center, time is the heart muscle; in trauma surgery, patients with severe trauma who need emergency surgery can save their lives during the golden hour; when life is on the line, time is especially precious!
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Dalian Central Hospital
Ji Ying, director of the emergency department
“For acute cerebral infarction within 6 hours of onset, no matter what kind of treatment method is used, time is the most critical.” Ji Ying, director of the emergency department, said that autumn and winter are the season of high incidence of cardiovascular and cerebrovascular diseases, with high morbidity and mortality. High, high recurrence rate, many complications…
60 minutes is the golden treatment time for these acute cerebral infarction patients after they arrive at the clinic. During this time, a large number of dying brain cells can be rescued. But over time, 1.9 million neurons in brain cells are damaged every minute or so. After 6 hours of onset, the chances of functional recovery of necrotic brain cells may be very low. “
● “Saving the wounded and helping the wounded, giving priority to life”
Critically ill patients have more stringent time requirements. To this end, Dalian Central Hospital has formulated a detailed plan of “payment after treatment” and the supporting design of related admissions and payment processes, which has effectively promoted the improvement of emergency efficiency. This people-oriented and patient-first treatment measures fully reflect The hospital’s value orientation of saving the dying and helping the wounded and giving priority to life.
According to Ji Ying, Dalian Central Hospital has established a green channel for rapid diagnosis and treatment for patients with acute cerebral infarction. In the green channel, patients do not have to wait in line, register or pay fees. Nurses give priority to triage, perform electrocardiogram examination, and then invite doctors with diagnostic capabilities to make a diagnosis.
If the patient is clearly diagnosed with acute cerebral infarction, under the premise of obtaining the informed consent of the family members, the standby intravenous thrombolytic drug in the rescue area is administered immediately, and then the patient is directly sent to the interventional catheterization room to open up the blocked cerebral arteries as soon as possible. For hospitalization procedures or paying a deposit, it is the first treatment and then the fee.
“It can be said more clearly that such patients do not have to pay from entering the door to the operating table. They are always managed by medical staff and have special personnel in charge. This is the green channel of ‘payment after diagnosis and treatment’, and after entering this channel, The laboratory department and the radiology department have signs, and the medical staff will see this as if they saw a passport, and will give the patient the results of the test as soon as possible, in case the patient’s family members can’t find the way or raise medical expenses to delay the treatment time.” Ji Ying said.
Statistics from Dalian Central Hospital directly prove the importance of rescuing patients at the prime time. From January to September this year , 650 patients with acute cerebral infarction were treated with intravenous thrombolysis in the emergency department of Dalian Central Hospital , and the thrombolysis rate within the time window was 78 %. % ; 457 patients with acute myocardial infarction were treated with coronary intervention , and the proportion of surgery was 94.6% .
● It is happiness to be able to eat lunch
During the four visits to the emergency department by the reporter, I often saw the nurses standing for four or five hours at a time, constantly busy, and sometimes they just leaned against the wall to rest for a while when they were too tired.
“For us, being able to eat lunch is a feeling of happiness, because it’s normal.” Nurse Du Hui said that she didn’t feel hard, “Everyone is used to this kind of work, if you really sit down, you won’t be able to. I know what to do.”
“The emergency department is indeed a test for the physical strength and energy of medical staff. You have to be highly concentrated, especially many diseases are particularly prone to onset from three to five in the morning, when people are the most tired and sleepy, but the patient comes. , you have to keep a clear head, so it is stressful for us.” The head nurse said coldly that it was not easy.
△ Director Ji Ying (middle) and head nurse Leng Chuang (left) communicated with our reporter about the work of the emergency department.
Ji Ying, director of the emergency department, said that she once jokingly said that the medical staff who can stay in the emergency department are all strong, able to endure hardships, and they also love this position very much. “The leaders of the hospital have given us a lot of support, and the medical staff have received a lot of psychological encouragement.”
The medical staff in the emergency department have even developed an unwritten habit of not walking around when they have nothing to do after get off work, and seldom go out to socialize. Why? First, he was worried that Corey would need to return to work in a timely manner due to urgent matters. Second, he was afraid that he would not have enough rest and lack of energy, which would affect his work the next day, especially during the epidemic.
● “What do you fear most in the emergency department?”
At 23:00, the night was getting darker and darker. There were 4 people with myocardial infarction, 3 people with cardiac insufficiency, 4 people with cerebral hemorrhage, and 1 person with cerebral infarction. Depressed, all the family members accompanying the clinic showed anxious expressions. A woman suddenly stuck her head in, “Can you hurry up, doctor? My husband is drunk and is throwing up badly now…” In the sound of vomiting coming from the corridor , Dr. Liu Yushi finished the prescription for the patient in front of him, and then said to the woman who spoke just now, “I’ll be fine right away, I’ll check your situation first.”
Most of the patients and their family members who come to the emergency department are anxious, and their condition is likely to be aggravated by emotions. “We must deal with it calmly, communicate patiently, and make correct judgments in a timely manner based on the situation.”
“What is the most afraid of working in the emergency department?” “The most afraid of family members not understanding.” Dr. Liu Yushi expressed the pain and tears in his heart.
The emergency department is a high-incidence area of doctor-patient disputes. Because emergency medical staff work intensively, patients and their families are also prone to irritability. In the final analysis, it is often a lack of trust and understanding. If patients can empathize, dissatisfaction with medical care in certain scenarios can be reduced. In the face of the disease, medical staff and patients are actually “comrades-in-arms” walking side by side.
“The simplest example is myocardial infarction and cerebral infarction. When the blood vessel is blocked, the blood vessel needs to be dredged. Whether it is an acute myocardial infarction stent or cerebral infarction, there is a time window for thrombolytic intervention. If you miss this golden time, you cannot do it. Because the treatment effect is not good, it also increases the risk of treatment.” Ji Ying said that some family members of some patients asked around their friends at the most critical time. They didn’t believe the doctor and kept asking on the phone. In the past, the patient’s family had to make a decision as soon as possible.
“Actually, as a medical worker, the happiest moment is when facing a patient, when the patient is in critical condition or even life-threatening, and then after our treatment, the condition is stable. .”
“The emergency department guards the health of citizens 24 hours a day, and every critically ill patient needs our full-scale treatment.” The head nurse Leng Chuang, who was standing on the side, said.
At about 4 am on the 21st, only two or three taxis were waiting at the entrance of the Central Hospital. The emergency department was still brightly lit and busy until the end of the night shift.
The busy emergency medicine center of the central hospital receives more than 400 emergency patients almost every day , and in the past 24 hours , medical staff received a total of 432 patients. That night, an emergency team consisting of 8 doctors and 12 nurses in the emergency department treated 223 patients, of which 28 critically ill patients have passed the critical period smoothly, and these patients are still recovering.
Wind Watch Observation Post
Making unannounced and unannounced visits, reflecting public opinion, and fully exercising the right to investigate, supervise, and review are the duties of a behavior supervisor. As the behavior supervisor of Dalian Health and Health Commission, and concurrently the social supervisor of Dalian Central Hospital, from now on, our reporter will go deep into Dalian Central Hospital to conduct experiential interviews to understand the people in an all-round, multi-perspective and three-dimensional manner. The real experience of medical treatment, the relationship between doctors and patients, and the selfless work and selfless dedication of the medical staff who are fighting on the front line day and night.
Zhang Ximing, chief reporter of 39 Degree Video of Peninsula Morning News
Zhou Lei, Chief Photojournalist, 39 Degree Video, Peninsula Morning News